How Chronic Stress Impacts Blood Sugar and Health: What You Need to Know

Stress and emergencies can take a toll on your body, especially if you’re living with or at risk for diabetes. When faced with acute or ongoing stress, your blood pressure and blood sugar levels tend to rise. Stress can also lead to behavioral shifts that impact your overall health such as emotional eating, forgetting to take medications, or skipping physical activity. As stress dominates your mental focus, it often pushes self-care to the back burner. The longer or more frequent the stress, the deeper the damage to your health and quality of life.

How Are Stress and Diabetes Connected?

When the body perceives a threat, whether physical, emotional, or psychological, it activates a "fight or flight" response. This protective reaction is intended to be short-term, but if the stress becomes chronic, those same protective mechanisms can begin to cause harm. Some effects are temporary, while others can be long-lasting or even irreversible.

Experts classify the body’s response to stress into four main categories:

• Physical changes: Increased blood pressure, rapid heartbeat, faster breathing, flushed or pale skin, body heat rise.

• Emotional reactions: Fear, anxiety, anger, guilt, loss of self-care or concern for surroundings.

• Behavioral symptoms: Muscle tension, shaking, irritability, crying, aggressive outbursts.

• Cognitive disruption: Confusion, distorted perception, trouble concentrating or making decisions, poor judgment.

In acute stress situations, your body flips into emergency mode, activating a full-body alert system designed to help you survive a threat.

When that state becomes long-term, it can weaken your body’s defenses and leave you vulnerable to a host of physical, emotional, and psychological conditions. Chronic stress becomes especially dangerous when it coincides with a genetic predisposition or risk factors for chronic diseases, such as diabetes.

The Three Stages of the Stress Response

Stage 1: Alarm Reaction

This is the body’s immediate response to danger. Stress hormones like adrenaline and noradrenaline surge, triggering a powerful activation of the sympathetic nervous system. Your body redirects energy and resources to immediate survival.

Stage 2: Resistance

If the stress continues, your body attempts to adapt. It releases a different set of hormones, including corticosteroids like cortisol, which help break down proteins into energy and preserve blood sugar supplies. Cortisol also tempers the immune system response to prevent it from becoming overactive.

Another role of these hormones is to retain sodium and excrete potassium — helping the body maintain high blood pressure to cope with ongoing stress.

This phase allows for short-term coping but puts strain on the cardiovascular system and metabolism.

Stage 3: Exhaustion

When the stress doesn’t go away, your body’s systems begin to wear down. This can lead to total collapse or dysfunction of specific organs. Chronic stress is especially hard on the heart, blood vessels, adrenal glands, and immune system. Over time, it increases the risk of:

• High blood pressure

• Cardiovascular disease

• Asthma

• Migraines

• Depression

• Frequent colds

• Ulcers

In recent years, there’s growing evidence linking chronic stress to the development of type 2 diabetes — especially in individuals with a genetic predisposition or existing risk factors.

A striking Israeli study during the Pillar of Defense military operation found that acute war-related stress correlated with significant spikes in blood glucose levels among hospitalized patients. Researchers emphasized the importance of long-term monitoring to track potential impacts on illness and mortality.

Why Some People Get Sick from Stress

Why does chronic stress cause serious illness in some, but not others? Some theories point to the “weakest link” in each individual’s system — their body’s most vulnerable organ or function. Other models focus on genetic susceptibility and how a person’s body overreacts or underreacts to stress based on their DNA.

How to Reduce the Health Risks of Stress

1. Manage Emotional Stress

Stress can drive blood sugar levels higher, especially in people with diabetes. Being aware of this pattern is key. Relaxation techniques such as deep breathing, guided imagery, mindfulness, and regular physical activity can help calm the nervous system and lower both blood sugar and blood pressure. Continuous glucose monitoring (CGM) can help you track fluctuations in real time and tailor your treatment accordingly.

2. Eat with Awareness

Stress eating — especially high-carb “comfort foods”, is a common coping mechanism. Consuming excess carbohydrates can spike blood sugar and lead to weight gain, and refined carbs also increase water retention and disrupt hormonal balance. Stick to regular mealtimes, balance carbs with vegetables and protein, and watch portion sizes.

Potassium-rich, low-sodium foods can help regulate hormone levels and support better health. Examples include:

• Salmon

• Mushrooms

• Broccoli

• Beets

• Bananas

• Avocado

• White beans

• Tomatoes

• Sweet potatoes

Using a CGM (Continuous Glucose Monitor) can provide insight into how meals affect your sugar levels, without painful finger pricks.

3. Get Moving

Exercise is one of the most effective tools for stress relief. It relaxes tense muscles, lowers blood sugar, boosts mood, and improves sleep. Physical activity stimulates the release of endorphins — natural chemicals that elevate mood and provide the well-known post-workout “high.” While aerobic exercises like running are particularly effective, even home workouts or movement in a safe space can help.

In today’s fast-paced world, high stress levels are nearly unavoidable. By committing to a steady routine, eating mindfully, moving your body regularly, and using simple stress-reduction tools, you’ll not only improve your mood, but you’ll support your physical health in the long run.

Prof. Julio Weinstein is the Director of the Diabetes Unit at Wolfson Medical Center and a senior diabetes specialist at the DMC Center for Diabetes Care.