Acute Stress Impact on Blood Sugar

During an acute stressful episode continuous glucose monitoring (CGM) data has shown a blood sugar rise similar to the consumption of a meal directly following an acute stressful episode. These effects can linger for 6-8 hours following a stressful episode causing any meals eaten in that period to spike blood sugars higher than normal.

Note: high adrenaline sports and exciting life events can also cause physiologic stress responses; in young children happy occasions, like birthday parties, can even have this impact on blood sugars.

It is important to note that hypolgycemic episodes are also acute stressful events and trigger a similar adrenal response leading to elevated blood sugars for several hours following the low.

Chronic Stress Impact on Blood Sugar

Stress Response System

Chronic stress (stressors lasting several days or more) typically begin and may periodically lead to adrenal responses, but the primary hormone of chronic stress response is cortisol. Cortisol affects the breakdown of carbohydrates, lipids, and proteins to provide energy. Cortisol is part of the regulation of immune and inflammatory activities in the body, affecting body salt and water balance and an increase in glucose as an energy source. Because of the carbohydrate metabolism, the presence of cortisol makes weight management particularly difficult and frustrating. Cortisol also causes a persistent low level of insulin resistance that can cause blood sugars to remain elevated for days and even months at a time.(5)

Chronic Stress

Chronic stress also may depress sex hormones in both men and women. This can lead to increases in visceral fat deposits which have been shown to increase insulin resistance.

Physiologic Causes of Stress Response

Some will turn off or reduce basal insulin delivery when a low is expected.  This reduces the risk of hypoglycemia and lessens the duration and severity of the low.  The algorithm automatically resumes basal insulin delivery when glucose levels return to a safe level.  The Medtronic 670G, Tandem with Basal IQ, and do-it-yourself HCL systems such as Loop, Open APS and Android APS offer this feature.

Physical Manifestations of Stress
And, of course, there are the physical ways stress makes itself known. Here are some of the more common ones: