Stress and Diabetes

Find a way to help your community, country and the world in a way that will allow you to feel good about yourself and your diabetes control at the same time. This is not the first article I have written about stress and diabetes, but we continue to receive questions about how to cope with the extra stress that living with diabetes can add to our everyday lives. Although individual differences and other factors influence the way we experience stress, there are certain common events that all of us experience as stressful events including death and dying, health-care issues, crime and justice issues, financial or economic issues and family related issues.

Several studies have shown that 50 major life events can be ranked according to the degree of stress they tend to cause and the extent to which that stress carries a risk of illness or psychiatric disorders. The greater the number of life events we experience, the higher the risk of developing a problematic degree of stress. Think stress only effects those of us with diabetes? Just look at number 5. The first 5 will be of interest to anyone with a chronic disease.

1. Death of a spouse
2. Death of a close family friend
3. Major illness or injury
4. Detention in jail or other institution
5. Major injury or illness in a close family member

Let's talk a bit about stress and how we as people with diabetes can lower it in our lives. There is scientific evidence that stress may cause blood glucose levels to either rise or fall. Some people with diabetes are more sensitive to stress and the way it affects them. This is because it is a chronic disease that brings stress with it as a 24/7 condition. There are those of us who feel at times, some of the time, a majority of the time, or most of the time, that diabetes is our ruler. In other words, we spend some of our time living against diabetes rather than with it. It is easy for someone who doesn't have diabetes to tell you to learn to live with your diabetes and therefore lower your level of stress, but that person doesn't know the "truth" no matter how many diabetic people they treat. Dear readers, that is why there is this web site. You know we have diabetes and that we live what we write. Therefore, I want to share with you that emotional stress can cause your blood glucose levels to rise and fall in 2 ways. Stress releases stress hormones that can cause these fluctuations, but also the actual cause of the stress can interrupt our daily routine and make caring for our diabetes more difficult and "stressful". Think you are exempt from this? I wish, but we'd all live with stress even if we locked ourselves in a room with all the books we always wanted to read and had a chef to cook our meals.

Please go back and read our other articles on stress as they examine that chemical reaction in your body. Here we will just say that under stress our bodies start a chain reaction that will change your blood glucose levels, make your heart beat faster and raise your blood pressure. Remember that "fight or flight" reaction we spoke of in past articles? This is where it occurs. The next problem is that in our society, many times external stresses are such that we can neither fight or flee. After all, no one is going to punch out their boss, throw a cake at a husband who is asleep on the sofa while the children are fighting, or kick a child who is demanding while dinner is cooking, or run over a dog who made on your perfect lawn just before the garden club arrives. Our problem, as diabetics, is that once that blood glucose levels goes up, it may stay up for a long while. If you add all of our everyday stress with the stress of coping with diabetes, then you have an idea of why we are at risk for seeking help to cope with stress, depression, anxiety, etc.

Let's look at how your personality and diabetes may conflict. Let' say you are a spontaneous person and you're told that you must monitor your blood glucose levels frequently. Or let's say you're a person who is compulsive by nature. You can imagine what a blood glucose level, which is "too high", can do to you, and that's just 2 personality types. Add to that the fact that supplies are very expensive and that pricking a finger in public and giving yourself insulin, whether by pump or injection, can be difficult for some people, and you can see little stresses can build up to big stressors.

OK, so I talked about the bad part of stress. Now let's look at the positive part of this universal feeling. Stress is a signal that something in your life is not so good. It is your job to figure out how to "modify" what is bugging you so that the stress is manageable. It may mean that you learn to confront a superior at work, positively, or invent that "What'sit?' that will change the production line and make you rich. It can also be the impetus to begin looking for another job. At home it may be the reason for seeing a therapist if it is a marriage problem, or someone just for you if it is your problem. Do remember that some times we 'share' some of our diabetes with others in the family, and that can cause them to become stressed. I know I have never done this consciously, but everyone in my family has had to treat hypoglycemic events. They all read my actions and I know they are under various levels of stress when we are together, even when I am fine.

In our families there are issues that can add to our everyday stress. These include:

• Marriage problems
• Money worries
• A new job
• Buying a new home
• A new baby
• Worries about children
• And finally an impending separation or divorce and /or marriage

What are the first line interventions?

1. Talk. That's easy to say and hard to do for some of us. Talking, not whining, and having some one listen can be good, but it is only the beginning. Any therapist will tell you that education does not make people better. A small change in behavior makes people feel more empowered to control their stress, and that's good.
2. Join a support group. Here they have to listen, and if there are members who can listen and not preach, you will learn a great deal about yourself and others. Giving makes people feel better, and giving your support will help with your ability to cope.
3. Get a hobby. That sounds easy, but for some of us that is also hard. Our lives are already too full. Well, if that's true, pick a hobby that is relaxing for you. I read. No sweat here, but in my everyday life, I don't get to read novels and biographies, and so I put away time to do just that.
4. Exercise. You know what we think about exercise from reading this web site. You know how it helps control your diabetes. You know the chemical reactions that occur in your brain and muscles. Exercise starts our day, seven days a week. We do all kinds, but we do them.
5. Meditate: I wish I did this more often, but when I walk, I go away in my head to that peaceful place we have found in meditation. If you have not learned to meditate, find someone who can teach you, or learn relaxation techniques. This one I do and it really works. Just learning to release a tightened muscle is a joy when every muscle in your body is tight and you feel like a wound spring. Both techniques can lower your levels of stress and help you control diabetes. Do look at our articles on Yoga. That is another way to find some peace.
6. Learn to say "No." This one is hard, but necessary whether you are on too many boards, have taken on too much work, or if you are the one who takes care of everything at home. Others need to help. You can help them do it and win in the end.
7. When all else fails, do go see a doctor-a therapist, who can help. Ask your primary doctor for psychiatrists who work with people who have chronic diseases. Check a few out and then go.

1. Smoke: Why do something that has the potential to kill you? That stress is out there, and you can learn how to modify it and live with it.
2. Drink alcohol to excess: Why do something that has the potential to kill you? That stress is out there and you can learn to modify it or live with it.
3. Eat fatty foods: Why do something that has the potential to make you very sick? That stress is out there and you can learn to modify it or live with it.
4. Withdraw from others: Why do something to make the stress worse? That stress is out there and you can learn to modify it or live with it.

BSP