What is the relationship between type 2 diabetes and stress?

Stress is a feature of everyone’s life but it can be particularly complex if you’re someone who has type 2 diabetes. It’s useful to consider both the cause and effect of stress when you have the condition, so to help you decipher the relationship between stress and diabetes, we’ve explored fight-or-flight chemical reactions and management strategies to help you find more balance and less stress in your day-to-day life.
Annabel Nicholson
min read
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Quick summary

  • Stress alone does not cause diabetes, however research suggests that exposure to stress can increase your chances of developing type 2 diabetes
  • Stress hormones make it harder for insulin to work properly, which means stress can be particularly dangerous for people with type 2 diabetes
  • Stress management is important for everyone’s health but it’s particularly important when you’re living with type 2 diabetes

Stress is a normal human reaction and it happens to everyone. It will ebb and flow throughout our lives and no one deals with stress in exactly the same way. For people with type 2 diabetes, stress manifests for different reasons and can set off a chain of chemical reactions that impact the way they manage their condition. 

Whether you’re newly diagnosed or have been managing type 2 diabetes for a while, learning about how it intersects with this universal predicament can help you move forward in a positive direction. It will also equip you for the times in life where your stress levels are particularly high, for example moving house, difficulties at work, or bereavement. 

There are many sources of stress in our lives but it’s important to recognise that type 2 diabetes can be stressful in itself, especially when you have just received a diagnosis. From time to time, you may feel overwhelmed by your diabetes, and stressed by how to deal with it—this is normal and natural. Understanding how stress impacts your body and condition also helps break down your triggers so that you can work towards a healthier balance—and a life you love!

What is stress?

The term ‘stress’ is partly derived from a Latin word meaning ‘drawn tight’.[1] This is a really good way to picture the strain that it puts on both the body and mind. It can often feel like being wound tight, tensing, a kind of pressure that weighs down on you when things are overwhelming.

When humans come up against stress, the body produces hormones that set off what’s called ‘the fight-or-flight-response’. The immune system is activated and it helps us react quickly—often in a split second—to threatening situations. Sometimes this stress response is beneficial, helping us push through fear to deliver a presentation, or work through the pain to finish a race. Typically, the body’s stress hormones will return to normal levels once the stressful event has finished.

However, too much stress can impact us in negative ways. Suspended in a permanent state of ‘fight-or-flight,’ we are left feeling unable to cope and fulfil normal everyday activities. Long-term, this can cause physical and mental health issues such as anxiety, irritability, depression, and panic attacks.   

Can stress cause type 2 diabetes?

As we know, diabetes is a complex condition, caused by a whole range of intrinsic and extrinsic factors. Stress alone does not cause diabetes, however research suggests that exposure to stress can increase your chances of developing type 2 diabetes.[2] A review of a number of different studies found that people who experience stress, depression, anxiety, or a combination of all these conditions, are at a higher risk of developing diabetes.[3]

Findings by Diabetes UK suggest that high levels of stress hormones might stop insulin-producing cells in the pancreas from working properly and reduce the amount of insulin they make, contributing to the development of type 2 diabetes.[4] 

High levels of stress hormones may prevent the pancreas from producing enough insulin

Diabetes UK

Stress can also increase the urge to comfort eat, a type of emotional eating, and this could lead to weight gain and obesity. This knock-on effect of stress can contribute to a person’s type 2 diabetes diagnosis. Taking the time to reflect more deeply on these types of cravings and decisions around food can help you identify how stress affects your eating patterns—from there, you can start to build a plan to make healthier choices in future stressful situations.

Effects of stress on people with type 2 diabetes

So, we know that stress doesn’t directly cause diabetes, although there are certainly links between high levels of stress and developing type 2. What about how stress impacts people with the condition? First things first, let’s think about what actually happens when a stressful event occurs. That fight or flight response kicks in and your body releases cortisol, the primary stress hormone. This increases the sugars (glucose) in your bloodstream, enhances your brain's use of glucose, and increases the availability of substances that repair tissues.

It also releases adrenaline (which quickens your heart rate), elevates your blood pressure, and boosts energy supplies. All things considered, this natural alarm system does what it came to do—communicating with the brain regions that control mood, motivation, and fear. It helps us act appropriately and quickly.

The drawback of this double-pronged attack of hormones is that they make it harder for insulin to work properly. Energy has a hard time getting into your cells as needed, so your blood sugar levels rise—a dangerous event for someone with type 2 diabetes. If they rise too much, you could have a hyperglycaemic (high blood sugar levels) reaction. This presents as vomiting, excessive hunger and thirst, a faster heartbeat, and vision issues. 

The imbalance in blood sugars caused by stress means it carries particular risks for people with type 2 diabetes. But don’t panic, periods of stress don’t tend to cause long-lasting damage to insulin receptors. That said, there’s plenty of evidence to suggest that lowering your stress levels could help control your blood sugar levels and play a role in the remission and reversal of type 2 diabetes.[5]

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Strategies for coping with and reducing stress

Stress management is important for everyone but it’s particularly important when you’re living with type 2 diabetes. The good news is, there are lots of ways to manage your stress and lessen the impact it has on your condition. It’s important to remember that everyone reacts differently to stress, which means that we’ll all have different stress management strategies that work for us. 

Here are a few ideas to help lower your stress levels (healthily!) in an increasingly stress-inducing world:

👀 See it to control it 

A great place to start might be testing your blood sugar and insulin levels in a period of stress, and try them again when you’re nice and relaxed, for example during a holiday or after a period of rest and relaxation. Actually seeing the role stress plays in your sugar metabolism can be a brilliant motivation tool to help reduce your stress levels. If you want to go deeper, tracking your blood sugar levels and stress levels in one place can help you determine how the two interact, and inform your healthy choices going forward. 

😌 Explore mindfulness and meditation

Meditating can help remove negative thoughts and allow your mind to relax, so consider exploring how to incorporate it into your day—for example, starting each morning with a 15-minute meditation can set a peaceful and positive tone for the rest of your day. One study found that among 60 people with type 2 diabetes, those who used mindfulness-based stress reduction techniques saw improved fasting blood sugar and HbA1c, and lower levels of anxiety and depression.[6] ‍Studies also show that mindfulness meditation is one of the best ways to lower your cortisol levels both immediately and over time.[7]

😴 Build a quality sleep routine

While you’re sleeping, your cortisol levels drop and they begin to pick up again around 3am in the morning, just before we (officially) wake up. This is why a lot of people experience the dawn effect—higher blood sugar levels in the morning, triggered by those higher cortisol levels. Not getting enough sleep will mess with this delicate cycle and if our quality of sleep remains poor for long periods of time, can create chronically high cortisol levels.[8] It sounds obvious, but keeping a consistent bedtime routine and getting enough sleep can keep cortisol levels low and lower stress levels when you’re awake. 

💪 Find a fitness style you love

We know that regular exercise can help you achieve your ideal weight, lower blood pressure, improve cholesterol, and help lower blood sugar levels, but it’s also an extremely effective way to lower stress levels and anxiety, helping improve insulin resistance as well. Daily exercise (such as a walk or gardening) will not only make your body feel better but will also give you some quiet time to reflect on the stresses you’re dealing with. 

The effect of stress on the mind and body is endlessly fascinating, and while it can feel overwhelming—especially when you’re in the midst of a stressful time—it’s important to remember that there are things you can do to help manage your stress levels. That being said, if it gets too much, speak to your doctor—there is absolutely no shame in asking for help. 


[1] Stress. Online etymology dictionary. Retrieved 31 March 2022. Accessible here.

[2] Merabet, N., Lucassen, P.J., Crielaard, L., et al. (2022). How exposure to chronic stress contributes to the development of type 2 diabetes: A complexity science approach. Front Neuroendocrin 65:100972. Accessible here.

[3] Pouwer, F., Kupper, N., Adriaanse, M. (2010). Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review from the European Depression in Diabetes (EDID) Research Consortium. Discov Med 9(45):112-118. Accessible here

[4] Can stress hormones protect beta cells? Diabetes UK. Retrieved 31 March 2022. Accessible here.

[5] Zamani‑Alavijeh F., Araban M., Koohestani, H.R., et al. (2018). The effectiveness of stress management training on blood glucose control in patients with type 2 diabetes. Diabetol  Metab Syndr 10:39. Accessible here

[6] Armani Kian A., Vahdani B., Noorbala A.A, et al. (2018). The Impact of Mindfulness-Based Stress Reduction on Emotional Wellbeing and Glycemic Control of Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2018:1986820. Accessible here.

[7] Mindfulness meditation: A research-proven way to reduce stress. American Psychological Association. Retrieved 31 March 2022. Accessible here.

[8] Hirotsu C., Tufik S., Andersen M.L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci 8(3):143-152. Accessible here.

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