Can stress cause Type 2 Diabetes to progress?

Most people know that chronic stress is hard on our bodies. But, many do not realize that Type 2 Diabetes can progress quicker when people cope with either physical or psychological stress over a long time.   In fact, most patients are never told about the strong link between chronic stress, inflammation and diabetes.

In many cases, the anti-inflammatory effects of diet and exercise are the prime mechanism behind most lifestyle interventions for Type 2 Diabetes.  Multiple large-scale studies have also demonstrated a strong link between chronic stress and Type 2 Diabetes.   The link is so strong, physiologists commonly measure Allostatic Load (or chronic stress exposure) as a routine part of metabolic research.

But, how exactly does stress impact diabetes?

Inflammation is part of our body’s most basic architecture.  Both our brain and body regulate inflammation because of its’ powerful effects on the body.  Too much inflammation, and we fail to achieve health.   Too little, and there is no reliable way to defend and repair our bodies after injury or illness.

Stress hormones (the main class being glucocorticoids) help us respond to stress, and are well-known for turning down our inflammatory response.  Glucocorticoids specifically shut off inflammation to conserve energy, so more blood sugar is available to run away from that tiger or fight that infection.  Therefore, all stress hormones cause your liver and muscles to “dump” sugar into your blood – and lots of it at that.

In order to sustain higher blood sugars, stress hormones also change our glucose metabolism.  For example, the stress hormone cortisol increases insulin resistance in  skeletal muscle cells.   Therefore, muscles exposed to stress are less likely to use blood sugar and instead use their own glucose and protein stores to do the work of moving.  If exposed to cortisol for a long time, skeletal muscles will start to shrink as they consume their own protein energy stores.

So, inflammation results in higher blood sugars precisely because our body must use glucocorticoids to manage the resulting stress response.   Inflammation is, therefore, a stress-linked pathway.  And, it’s one reason why people with Type 2 Diabetes find it difficult to exercise.  Their muscles are already depleted, after months (or even years) of being deprived of glucose stores.   At the point of diagnosis for diabetes, most muscle cells will have lost insulin receptors on their cell membranes.

Thankfully, insulin resistance is highly reversible.  After only a couple of moderate-to-vigorous exercise sessions, both cardiovascular and resistance exercise dramatically increases the insulin sensitivity of our muscle cells.  Because exercise itself is stressful, it yields the capacity to shut off stress once we stop exercising, and it moderates our inflammatory response.

Great. Now, what should I do?

Conventional approaches for diabetes treatment typically ignore the role of inflammation in Diabetes progression.  There are also many varied factors that cause diabetes, so there is not one single cause of diabetes.  However, all treatments – insulin, oral medications, diet and exercise – have important impacts on metabolic pathways which in turn reduce inflammation and stress levels within the body.  Failing to measure changes in chronic stress and inflammation can sometimes “paralyze” diabetes treatment, making the disease highly resistant to traditional treatment approaches.

At Consortia Care, we assess and treat inflammatory disease while drawing from the latest research into the links between chronic stress, inflammation and metabolic disease.  We do this because the evidence is compelling, and we see dramatic changes in diabetes control using this approach.

Published by Adam Henley

Adam is a Registered Nurse with experience in chronic disease management, symptom measurement, hematology/oncology, primary care behavioural health and geriatrics. He combines counselling, nutrition & exercise with traditional home nursing care. Adam cares to live health together with clients in a manner consistent with Parse’s Theory of Human Becoming. At the heart of his care, Adam offers evidence-based strategies to transform health together.

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