Managing Stress and Diabetes

By Joseph Napora, PhD, LCSW-C

We hear about stress all the time. Often, you hear people say, “I’m under a lot of stress,” or “I’m so stressed,” or “This is stressing me out.” What exactly is stress?

What Is Stress?

Stress is a physical and mental reaction to perceived danger. Conditions that seen uncontrollable or require emotional and behavioral change tend to be perceived as a threat.

When the body and mind sense a threat, they get ready to either run or fight. Whether the threat is real or imagined, the body prepares for survival by turning up some bodily functions while turning others down. In either case, over time these changes are serious and over time are harmful.

Stress and Diabetes

Diabetes management is a constant process; for many, it is an ongoing challenge that may be complicated by the impact of stress. Excessive stress is a major barrier to effective glucose control and a danger to one’s general health.

When a child has diabetes, the family’s potential for stress is high. The child with diabetes, parents and siblings all feel their own share of stress.

How Can Stress Be Harmful?

Excessive stress works against diabetes management by:

  • Increasing blood glucose levels (quickly and substantially)
  • Inciting strong negative emotions
  • Impairing sound thinking and decision-making
  • Tempting compulsive, poor eating

Whether or not you have diabetes, over time, stress is harmful because it causes so much wear and tear on the body.

For example, the heart works faster and harder in preparation for physical action. The increase in pulse and blood pressure causes a strain on the heart, veins and arteries.

Prolonged stress also has a negative impact on other bodily systems:

  • Immune
  • Digestive
  • Renal (kidney)
  • Reproductive

In addition, the ability to think clearly and to make good decisions is impaired when the mind is burdened with worry, anxiety or fear. This constant mental strain can also increase the risk for depression.

What Are the Symptoms of Stress?

  • Sleeping too much or not enough
  • Changes in appetite (eating more or less)
  • Significant weight loss or gain
  • Frequent bouts of crying
  • Trouble with memory and/or concentration
  • Anxious thoughts (often taking the form of “what if ____________ happens?”
  • Muscle tension (that crick in your neck)
  • Irritability
  • Feeling low or depressed.
  • Being easily angered; being angry a lot of the time.
  • Stomach problems (vomiting, nausea, stomachaches, diarrhea, constipation)
  • Loss of interest in sex
  • Avoidance of work or school tasks and/or difficulty completing them
  • A change in relationships (either avoiding or feeling the need to seek out the company of others more than usual)
  • Headaches
  • Feeling your heart beating (often occurs when trying to fall asleep)
  • Difficulty swallowing or feeling as though you are choking
  • Trembling, shakiness
  • Feeling faint
  • Profuse sweating
  • Teeth grinding
  • Feeling uneasy, on edge

Mindful Living─An Antidote to Stress

Most people feel some of these symptoms at different times in their lives. The good news is that there are many strategies and skills for keeping stress at a minimum. Most stress-busting techniques begin with living mindfully.

Being mindful is being aware of what is happening within yourself and in the world around you. It is being aware of what you are doing and why, being aware of what is working and what is not working for you.

It is always being aware of possibilities, of the choices you have in every situation.

Being stress smart is necessary for effective diabetes management. And the successful management of stress is essential to the well-being of everyone in a family with diabetes.

A mindful approach to coping with diabetes opens the way to using a variety of tools for preventing avoidable stress and keeping unavoidable stress at a minimum.


Joseph P. Napora, PhD, LCSW-C is a psychotherapist with over 38 years of experience. He has been teaching classes in stress management at the Johns Hopkins Comprehensive Diabetes Center since 1984 and at the Suburban Hospital Diabetes Center in Bethesda, MD, since 1999.

His book, Stress-Free Diabetes Your Guide to Health and Happiness is available for purchase through the American Diabetes Association.

  • Last Reviewed: July 25, 2013
  • Last Edited: October 28, 2013

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