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Stress is a person’s physical and emotional response to change or a perceived threat. Certain amounts of stress are normal, but excessive levels can be a risk factor for the development of diabetes and may complicate its treatment.

Stress comes from many sources. For example, major life events, such as a birth, job change or divorce, are common sources of stress. Other stressors include daily encounters such as heavy traffic, personal conflicts and workplace pressures. And factors such as toxins, viruses or certain medications can stress organs including the pancreas.

Stressful periods trigger the release of hormones by the endocrine system. These hormones prepare the body for an immediate “fight or flight” response, in which it either combats or flees from the perceived danger. The amount of glucose in the bloodstream increases in the presence of the hormones. Blood pressure and flow also increase to  provide energy to the muscles. In addition, the stress-response hormones cause the suppression of the immune, digestive and other systems that are not immediately needed.

In the short term, stress can be a positive response. However, chronic stress may damage tissues and contribute to a variety of medical conditions. For people with diabetes, the stress response can impair control of glucose. Stress may also cause patients to make poor dietary choices and skip glucose checks and medications.

Stress management techniques including exercise, relaxation techniques, counseling and establishment of a sick-day plan can help patients control stress and diabetes.