Stress and Chronic Illness: the Case of Diabetes

Abstract

Globally, Type 2 Diabetes Mellitus (T2DM) is one of the most prevalent chronic illnesses. Managing T2DM is a major challenge now affecting the lives of around 200 million people. Even when medication, diet, and physical activity regimens are maintained, blood sugar levels might not be effectively controlled because stress triggers the release of sugar into the blood. This makes the management of stress an important adjunct to the treatment of T2DM. Stress includes both life stress, the major issues that people face in their lives, such as job loss, divorce, or death of a loved one, and daily hassles, smaller everyday problems, such as deadlines for work, traffic hold-ups, or family disagreements. The stress levels created by these events are exacerbated by the stress created by the demands of managing diabetes. In this paper, we first examine the evidence for the relationship between stress and poor blood sugar control in people with T2DM. Then, we consider research that has examined the impact of various stress management strategies on blood sugar level. Finally, we discuss some promising psychological techniques for managing stress that could be helpful for people with diabetes or pre-diabetes. We note the double benefit of physical activity, which directly assists in the metabolism of sugar from the blood and indirectly reduces acute stress and chronic stress reactivity, thus providing a buffer against the effects of stress for people with T2DM.

Understanding Stress Among Adults Diagnosed with Type 2 Diabetes at a Younger Age

“…This indication that higher HbA1c measures are related to greater levels of diabetes-related distress is consistent with previous research. Several studies reported that life challenges associated with diabetes may cause additional stress for individuals with T2DM, resulting in a negative impact on psychological well-being and metabolic control [3,10]. Karlsen and colleagues, for example, found adults with both type 1 diabetes and T2DM experienced difficulty managing their diabetes during the winter months when diets included more enriched foods (e.g.…”

“…There are, however, significant psychosocial challenges associated with diabetes which are often unaddressed and warrant discussion. As the literature attests, diagnosis of T2DM can lead to emotional distress regarding lifestyle changes, adjustments with relationships, and social networks [3]. Upon receiving a T2DM diagnosis, younger adult patients (under 65 years old) were more likely to experience anxiety as a result of their diagnosis [4].…”

“…Everyday life stressors such as work deadlines and family disagreements can exacerbate diabetes management challenges [3]. It has been suggested that diabetes-related stress affects the ability to self-manage diabetes, thus negatively impacting metabolic control and psychological well-being [3,9,10].…”

The Effectiveness of Mindfulness Based Stress Reduction Intervention on Emotion Regulation Problems and Blood Sugar Control in Patients With Diabetes Type II

“…Previous studies have investigated the relationship between stress and weak blood sugar control in those with diabetes. They have also investigated the effect of different stress management strategies on blood sugar levels (T. Morris, Moore, & F. Morris, 2011).…”

Emotional reactivity to daily stress, spousal emotional support, and fasting blood glucose among patients with type 2 diabetes

“…Evidence suggests that life stress can adversely affect blood glucose control in patients with type 2 diabetes (Morris et al, 2011), perhaps by depleting the psychological resources needed for effective diabetes self-management (Hagger et al, 2009) or by triggering the release of hormones that contribute to elevated blood glucose (Surwit and Schneider, 1993). Yet the association between stress and blood glucose control exhibits considerable individual variability (Riazi et al, 2004), and this variability may be due, in part, to individual differences in the degree to which stress arouses emotional distress (Soo and Lam, 2009).…”