Johns Hopkins Health Alerts | Diabetes |

Is Stress Reduction the Missing Step in Your Diabetes Plan

Controlling stress may help improve your blood glucose control. Biofeedback, yoga, or another stress-reduction technique may help.

If you’re a chronic worrier or blow your cool too easily, take heed: All that fretting and fussing may be bad for your blood glucose levels. Psychological stress as well as anxiety can distract you from following a healthy glucose-control regimen and can produce changes in your body chemistry that make diabetes more difficult to manage.

The most important way that emotional stress affects blood glucose control is by interfering with the healthy behaviors required to control diabetes. For example, stress can wilt willpower, leading you to overeat, splurge on junk food, or drink too much alcohol.

Stress can also sap the energy needed for daily exercise. You may even neglect blood glucose monitoring or skip your medication doses. Also, when you feel stress, your body produces a flood of hormones. These chemical messengers signal the liver to release a supply of glucose into the bloodstream to provide muscle cells with a quick source of energy during the crisis. People without diabetes adjust by producing extra insulin to bring down the elevated blood glucose levels. However, someone with diabetes may make too little insulin, or none at all, to blunt this rise in blood glucose.

Whatever the cause of stress, several studies suggest that people with diabetes struggle with blood glucose control when they feel stressed or anxious. The following stress-reduction techniques may help:

• Stress-reduction technique 1: Meditation. Quiet contemplation is one of the oldest forms of relaxation therapy. Research shows that regular meditation can lower blood pressure.
• Stress-reduction technique 2: Yoga. This ancient discipline combines meditation with physical movement and breathing control. Although better-quality research is needed to confirm its benefits, some studies have found that practicing yoga can cause up to a 33% drop in fasting blood glucose levels.
• Stress-reduction technique 3: Progressive muscle relaxation (PMR). Mental stress causes muscles to become tense and uncomfortable. During a PMR session, you contract individual muscles in turn for five or 10 seconds, and then relax them. Many studies have found that PMR relieves anxiety.
• Stress-reduction technique 4: Biofeedback. In biofeedback training, a doctor or psychologist attaches sensors to your skin to measure various body processes associated with stress, such as muscle tension. A small 2005 study found that people with type 2 diabetes lowered their average HbA1c levels from 7.4% to 6.8% after three months of biofeedback training.
• Stress-reduction technique 5: Combination therapy. Combining relaxation techniques may be the best bet. One recent study compared two groups of type 2 patients enrolled in a five-week diabetes-education course. As part of the program, one of the groups received stress-management training, which included instruction in relaxation techniques and psychotherapy. After a year, 32% of the patients in the stress-management group (compared with 12% of those in the other group) lowered their HbA1c levels by 1 percentage point, a change that can significantly reduce the risk of diabetes complications.

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Johns Hopkins Health Alerts | Diabetes |

Is Stress Reduction the Missing Step in Your Diabetes Plan