Type 1 Diabetes Hyperglycemia Can Stress Cause High Blood Sugar? By Angelica Bottaro Angelica Bottaro Facebook LinkedIn Angelica Bottaro is a writer with expertise in many facets of health including chronic disease, Lyme disease, nutrition as medicine, and supplementation. Learn about our editorial process Updated on April 20, 2022 Learn more</a>." data-inline-tooltip="true"> Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Danielle Weiss, MD Medically reviewed by Danielle Weiss, MD LinkedIn Dr. Danielle Weiss is double board-certified in internal medicine and endocrinology. She is the founder of the Center for Hormonal Health and Well-Being in San Diego, California. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How Stress Affects the Body Stress In People with Type 1 Diabetes Stress in People with Type 2 Diabetes Other Ways Stress Causes High Blood Sugar What to Do if You Have a Blood Sugar Spike Frequently Asked Questions Both emotional and physical stress can be detrimental to the body in many ways. One of the effects it could have on health is a spike in blood sugar levels. When the body experiences high levels of chronic stress, it releases more cortisol, the primary stress hormone. A higher serum cortisol level causes the body to decrease insulin secretion. Insulin helps bring sugar into cells from the bloodstream, where it's used for energy. Without the proper release of insulin, more sugar remains in the bloodstream and blood sugar levels become imbalanced. Stress can affect blood sugar both directly and indirectly. Its effects can also vary depending on the type of diabetes a person has. Chronic stress can lead to prolonged high levels of cortisol and ultimately a lowered insulin secretion in the long run. This makes stress both dangerous for those with diabetes and a possible risk factor for its development. FG Trade / Getty Images How Stress Affects the Body When the body is under stress, it releases cortisol. Cortisol is synthesized from cholesterol and then released from the adrenal glands. The hypothalamus-pituitary-adrenal axis, which is a unit in the brain comprised of the hypothalamus, the pituitary gland, and the adrenal glands, is what regulates the production of cortisol and how much of it is released during periods of physical and emotional stress. When the body sends signals of stress—both emotional and physical—it releases cortisol to help the body respond to a perceived threat, control blood pressure, and reduce inflammation. It is the hormone that is used for the fight-or-flight response so if there is any immediate danger, the body will be ready to face it or run from it. Cortisol can also encourage the liver to release glucose and fatty acids to help give the body the energy it needs to deal with stress. From an evolutionary standpoint, the release of cortisol to deal with stress was important for survival. However, times have changed and those types of threats to life are now, for the most part, nonexistent. This means that cortisol is released and not used by the body in ways that it's meant to be used in some situations. Types of Stress Stress can be broken up into two categories; emotional or mental stress and physical stress. Emotional or psychological stress tends to originate internally. This type of stress can occur for many reasons. Some reasons, such as nervousness for a job interview or becoming angry in traffic, can lead to an emotional stress response, as can losing a loved one or going through a traumatic event. Physical stress, on the other hand, comes from external sources such as strenuous exercise, prolonged physical activitiy, or physical traumas and injuries. Both types of stress, when experienced long-term, can lead to various negative health effects and diseases such as cardiovascular events, cancer, immune system suppression, and diabetes. Stress In People with Type 1 Diabetes Stress can affect those with type 1 diabetes by both increasing and decreasing blood sugar. In the case where it lowers blood sugar levels, chronic stress can lead to a syndrome known as adrenal fatigue. Adrenal fatigue is where prolonged exposure to stress drains the adrenal glands, leading to a low cortisol state. In those with type 1 diabetes, the underproduction of hormones such as cortisol can cause an imbalance in hormones that are meant to regulate blood sugar levels. Research has also looked at whether stress can cause diabetes. Many studies have postulated that chronic stress especially can contribute to the onset of type 1 diabetes in those who are already susceptible to developing it. Hypoglycemia (Low blood sugar) Hunger Irritability Trouble concentrating Fatigue Sweating Confusion Fast heartbeat Shaking Headache Hyperglycemia (High blood sugar) Extreme thirst Dry mouth Weakness Headache Frequent urination Blurry vision Nausea Confusion Shortness of breath Stress in People with Type 2 Diabetes For people with type 2 diabetes, high levels of stress can lead to an increase in blood sugar levels. When there is a high level of cortisol in the body, it causes body tissues to be less sensitive to insulin. Therefore, more blood sugar is available in the bloodstream. When this happens, blood sugar levels become imbalanced and can reach dangerously high levels, especially if it is left untreated. How Stress Is Connected to Diabetes Other Ways Stress Causes High Blood Sugar There are other ways that stress can lead to spikes in blood sugar. During periods of stress, people may participate in behaviors that could lead to high blood sugar such as emotional overeating of refined carbohydrates or foods that are high in added sugars. People may also fail to exercise or take their medications when they’re supposed to. Since stress has the ability to change healthy habits, these factors can all lead to elevated blood sugar levels. Stress can also affect sleep because stress and sleep are both controlled by the hypothalamus-pituitary-adrenal axis. When a person is under high stress and the axis is encouraging the extra production of cortisol, changes in the axis occur. This leads to problems with getting quality sleep as well as changes in sleeping patterns. When a person isn’t getting enough sleep, it can cause glucose intolerance, which describes metabolic conditions that cause high blood sugar levels. Symptoms of High Blood Sugar In Persons Without Diabetes What to Do if You Have a Blood Sugar Spike For those with diabetes, having a blood sugar spike can be dangerous because too much sugar in the blood passes into the urine. This triggers the body to filter out the fluid, which could lead to dehydration or a diabetic coma. In the event that blood sugar levels spike because of stressors that cannot be managed, it’s vital to make managing your blood glucose a priority. You can do this by focusing on things you can control, such as your diet and exercise, checking your blood sugar regularly, and taking your medications as instructed by your physician. How to Manage Your Stress Levels Some forms of stress cannot be managed, especially if they are not frequent in nature such as a one-time traumatic event or an accidental injury. Other types of stress, such as taking care of family, work stressors, or any other day-to-day stressful situations, will likely be there permanently or semipermanently. These types of stressful events are the ones that need to be managed as best you can. To do this, you can proactively plan ahead. This means being prepared for the regular stressors of life and managing your time, reading self-help books, or minimizing the source of stress as much as possible. Calming exercises such as yoga and meditation have also been proven to reduce stress levels. You will also want to avoid indulging in unhealthy behaviors such as overeating. It may seem comforting at the time, but it will not help to relieve the stress you are experiencing. Setting realistic and manageable goals is also a big stress reducer for those with diabetes. Instead of focusing on a large and vague goal such as losing weight, setting a goal of walking for at least a half-hour every day on specific days of the week will be much more achievable. A Word From Verywell Stress is a normal part of life and no one can avoid it all the time. This is why it’s vital to protect yourself from the repercussions of stress by having a plan in place to help manage both stressful situations and spikes or drops in blood sugar levels. It can be difficult, but it’s not impossible to achieve if you make your health your first priority when stress is thrown at you. Frequently Asked Questions Does stress affect blood sugar levels? Yes, both physical and emotional stress can impact blood sugar and make it unpredictable. Most commonly, stress will raise blood sugar in people with type 1 and type 2 diabetes. However, in people with type 1, stress can also lower blood sugar levels. How does cortisol impact blood sugar? The stress hormone cortisol helps the body respond to a perceived threat. As part of the fight-or-flight response, cortisol triggers the liver to release glucose to fuel the body as it deals with danger.This primitive response, designed to keep you alive in the face of a deadly predator, is activated in the modern world when we are anxious, angry, frightened, or otherwise under stress. Physical stress also releases cortisol, including strenuous exercise, physical labor, illness, or injury. In most people with diabetes, the cascading effects of cortisol raise blood sugar levels. However, people with type 1 diabetes are prone to adrenal fatigue, which hinders the production of cortisol and can lead to low blood sugar. Why does exercise raise my blood sugar? Exercise can cause a temporary spike in blood sugar. Strenuous exercise prompts the release of cortisol, which triggers the release of glucose into the bloodstream to fuel your workout.This effect is only temporary. Your muscles will soak up the excess glucose. In fact, research shows that 30 minutes or more of moderate-intensity exercise can reverse insulin resistance for up to 48 hours. Why does my blood sugar dip when I'm stressed? Some people with diabetes experience low blood sugar when under stress. This can be due to adrenal fatigue, which is common in people with type 1 diabetes.The adrenal glands are responsible for the production and release of cortisol, which typically raises blood sugar. Healthy adrenal glands respond to low blood sugar by releasing cortisol to spur the liver to churn out glucose, which brings blood sugar back to normal levels. The adrenal glands can burn out over time causing an imbalance of blood-sugar-regulating hormones. 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kamba A, Daimon M, Murakami H, Otaka H, Matsuki K, et al. Association between higher serum cortisol levels and decreased insulin secretion in a general population. PLoS One. 2016 Nov 18;11(11):e0166077. doi:10.1371/journal.pone.0166077 National Center for Biotechnology Information. Physiology, Cortisol. American Psychological Association. Stress effects on the body. Liu X, Shan Y, Peng M, Chen H, Chen T. Human stress and StO2: database, features, and classification of emotional and physical stress. Entropy (Basel). 2020 Aug 31;22(9):962. doi:10.3390/e22090962 Passanisi S, Timpanaro T, Lo Presti D, Caruso-Nicoletti M. 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Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357-368. doi:10.1001/jamainternmed.2013.13018 Malin SK, Rynders CA, Weltman JY, Barrett EJ, Weltman A. Exercise intensity modulates glucose-stimulated insulin secretion when adjusted for adipose, liver and skeletal muscle insulin resistance. PLoS One. 2016;11(4):e0154063. doi:10.1371/journal.pone.0154063 See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit