July 13, 2020
A clear link exists between a stress hormone and higher blood sugar levels in people with type 2 diabetes, Ohio State University researchers found.
Cortisol, the body's primary stress hormone, releases sugars into the bloodstream. When cortisol levels are more flat throughout the day – an indication of sustained stress or depression – people with type 2 diabetes have higher glucose levels, according to the study.
By managing stress, people with type 2 diabetes can better control their disease, researchers said.
"Most people with type 2 diabetes know the importance of exercising regularly, eating a healthy diet, and getting plenty of rest," said Dr. Joshua J. Joseph, an endocrinologist at The Ohio State Wexner Medical Center. "But stress relief is a crucial and often forgotten component of diabetes management.
"Whether it's a yoga class, taking a walk or reading a book, finding ways to lower your stress level is important to everyone's overall health, especially for those with type 2 diabetes."
More than 30 million Americans have been diagnosed with type 2 diabetes, according to the Centers for Disease Control and Prevention. The chronic illness prevents the body from using insulin properly.
Medication or insulin is often needed to help people manage their blood sugar levels, but sometimes lifestyle changes are enough. That includes finding ways to reduce stress.
"In healthy people, cortisol fluctuates naturally throughout the day, spiking in the morning and falling at night," Joseph said. "But in participants with type 2 diabetes, cortisol profiles that were flatter throughout the day, had higher glucose levels."
Researchers based their findings on an analysis of more than 500 people enrolled in the Multi-Ethnic study of Atherosclerosis. The study included people with diabetes, prediabetes and some without the disease.
Researchers examined the association between changes in daily cortisol levels and changes in fasting glucose over a six-year period.
Among people with diabetes, a 1% flatter cortisol profile was associated with a 0.19% increase in annual percent changes in fasting glucose.
"These results suggest a detrimental role of cortisol contributing to glycemia among individuals with diabetes," the researchers wrote. Glycemia refers to blood sugar.
Previous research has shown that stress and depression are two of the biggest causes of a flatter cortisol profile, which makes controlled blood sugar levels and managing diabetes more difficult.
"We have begun a new trial to examine if mindfulness practices can lower blood sugar in those with type 2 diabetes," Joseph said. "But this isn't the only effective form of stress relief. It's important to find something you enjoy and make it a part of your everyday routine."
While the link between cortisol and glucose was only observed in people with diabetes, researchers believe the stress hormone also plays a role in diabetes prevention. They will continue to investigate the stress hormone's role in the development of diabetes and cardiovascular disease as well.
The study was published online in the journal Psychoneuroendocrinology.