Type 2 diabetes mellitus has emerged as a global epidemic, with increasing numbers of diagnosed individuals every year. Multiple factors contribute to the onset and progression of Type 2 Diabetes Mellitus, and stress is recognized as having a significant influence.

As researchers and clinicians delve deeper into the physiological and psychological impacts of stress, a growing body of evidence suggests that effective stress management strategies can play a critical role in preventing and reversing Type 2 Diabetes Mellitus. This article delves into the connection between stress and diabetes and explores the potential of stress management in reversing this chronic condition. [1]

The Stress-Diabetes Link

Our body's stress response is inherently adaptive. In prehistoric times, stressors such as predators triggered the 'fight or flight' response, releasing hormones like cortisol and adrenaline. These hormones increase blood sugar levels (glucose levels), providing the body with the necessary energy to either fight or flee.

However, modern-day stressors like work pressure, financial worries, and interpersonal conflicts are more chronic in nature. In response to these continuous stressors, the body keeps pumping out glucose into the bloodstream. For individuals susceptible to diabetes, this can pose a problem. [2] This increased vulnerability makes the risks of chronic stress higher including developing diabetes.

Chronic stress affects the body in various ways

Blood Sugar Level Rise: Chronic stress exerts a profound influence on blood sugar levels, complicating the management and potential onset of diabetes. When the body is under stress, it responds by releasing stress hormones, notably cortisol and adrenaline. These hormones trigger a cascade of physiological reactions designed to prepare the body for the 'fight or flight' scenario. Among these reactions is the release of stored glucose from the liver into the bloodstream, providing an immediate energy source to respond to the threat, whether it is perceived or real.

However, when stress becomes chronic, this evolutionary protective mechanism can have detrimental effects. The constant release of stress hormones means that there's a consistent surge in blood sugar levels; glucose levels remain elevated when they should naturally return to a healthy level. Over time, this can lead to insulin resistance, where the body's cells don't respond as effectively to insulin, the hormone responsible for transporting glucose from the blood into cells. When insulin is less effective in moving glucose into the cells for energy, it gets stored as fat elsewhere in the body, especially in the liver. This sustained elevation in blood glucose can both precipitate - cause -  and exacerbate - worsen -  diabetes in susceptible individuals. [3]

Chronic stress often leads to behavioral responses such as poor dietary choices and reduced physical activity, which can further disrupt blood sugar regulation. Hence, the interplay between chronic stress and elevated blood sugar levels underscores the need for integrated strategies that address both physical and psychological factors in diabetes management. [4] Food additives in highly processed, ultra-refined foods and beverages contribute to the cycle of poor food choices. This situation is unfair and it is important to be aware of the issues it brings with it.

Insulin Resistance: Chronic stress is a potent contributor to insulin resistance, a condition where the body's cells fail to respond effectively to the hormone insulin. Insulin's primary role is to facilitate the uptake of glucose from the bloodstream into the cells, providing energy. However, chronic stress disrupts this delicate balance. [5]

When the body is persistently stressed, it releases a continuous stream of stress hormones, particularly cortisol. This hormone prompts the liver to release more glucose into the bloodstream to equip the body with immediate energy, preparing it for a 'fight or flight' response. Concurrently, the constant surge of cortisol can cause cells to become less responsive or resistant to insulin's effects. [6]

As a result, the body needs more insulin to achieve the same glucose-lowering effect. This can strain the pancreatic beta cells, responsible for insulin production, potentially leading to their burnout over time. Furthermore, individuals under chronic stress often adopt behaviors, such as poor diet and sedentary lifestyles, that exacerbate insulin resistance. This can become a vicious cycle that reinforces the very things that cause the disease to start, and then worsen over time, unless effective lifestyle changes are made and sustained.

Unhealthy Coping Mechanisms: Chronic stress, when left unaddressed, often drives individuals towards unhealthy coping mechanisms. These mechanisms are typically quick fixes that provide temporary relief, but in the long run, they can exacerbate the stress and lead to a host of other health issues.

Under the weight of persistent stress, many turn to comfort foods, especially those high in sugar, salt, and unhealthy fats. This kind of emotional eating can lead to weight gain, further metabolic disturbances, and increased risk of chronic diseases. Alcohol and nicotine are also common crutches. While they may offer a transient sense of relaxation, they can lead to dependence, addiction, and an array of health complications over time. [7]

Furthermore, chronic stress may push some towards the misuse of drugs or medications, seeking an escape from their constant state of tension. This not only masks the underlying issue but poses significant health risks and can potentially lead to substance use disorders.

In addition, some people may retreat from social interactions, leading to isolation and exacerbating feelings of loneliness and depression. This avoidance behavior can spiral into more significant mental health challenges. [8]

Stress Management Strategies to Reverse Type 2 Diabetes Mellitus

Mindfulness Meditation and Deep Breathing: These practices help in grounding individuals, bringing them to the present moment. Mindfulness has been shown to reduce cortisol levels and help manage blood sugar. Deep breathing exercises can activate the body's relaxation response, counteracting the 'fight or flight' response. [9]

Regular Physical Activity: Regular physical activity improves glucose uptake, reduces insulin resistance, and enhances cellular response to insulin, promoting better blood sugar regulation and improving insulin sensitivity. [10]

Adequate Sleep: Chronic sleep deprivation can exacerbate stress and also directly interfere with glucose metabolism. Ensuring 7-9 hours of restorative sleep can significantly aid in managing stress and diabetes. [11] Avoid swing shift work and working a night shift as it can wreak havoc on metabolism and blood sugar control.

Time Management: Planning and organizing tasks can help reduce the feeling of being overwhelmed. Setting realistic goals and breaking them down into manageable steps can be particularly effective. [12]

Hobbies and Creative Outlets: Engaging in activities like painting, reading, or gardening can offer a welcome distraction, reducing feelings of stress. [13]

Social Connections: Sharing worries and concerns with friends or joining a support group can offer a sense of belonging and reduce feelings of isolation. Social connections have a protective effect on health. [14] Loneliness is a root cause of chronic illness. Feelings of community and social connections are essential and should be a priority.

Professional Counseling: In some cases, seeking help from therapists or counselors can provide individuals with coping mechanisms and strategies to manage their stress better. [15]

Limit Stimulants: Reducing or eliminating the consumption of caffeine and certain medications can help decrease stress. It's essential to consult with a healthcare provider before making any medication changes. [16]

Relaxation Techniques: Progressive muscle relaxation, guided imagery, and biofeedback can help reduce stress and its physiological effects. [17]

Setting Boundaries: Learning to say 'no' and understanding one's limits in both personal and professional spheres can be vital in preventing burnout and excessive stress. [18] The word “No” is a complete sentence. You don’t have to give reasons. It is OK to say no. 

It's imperative to understand that while stress management can significantly assist in the reversal and management of Type 2 Diabetes Mellitus, it is just one piece of the puzzle. Dietary changes, medication (when prescribed), regular health check-ups, and other lifestyle modifications play equally crucial roles.

However, as our understanding of Type 2 Diabetes Mellitus evolves, it's becoming clear that addressing the psychological elements, like chronic stress, is just as vital as managing the physiological factors. Adopting a holistic approach that encompasses both the mind and body offers the best chance of effectively preventing, managing, and potentially reversing Type 2 diabetes.