As a diabetes dietitian, people think that mostly what I talk about is food. But actually, what I talk about a LOT is feelings. I want to know how you feel about your food, your body, your weight, and if you have diabetes or worry about having diabetes, I want to know how you feel about your blood sugar, too.
That’s because how you feel about your blood sugar can affect your blood sugar (kind of like how you feel about your eating can affect how you eat). This is especially apparent if you have diabetes and look at your blood sugar numbers 5, 10, 20 or more times per day. And sometimes, how you feel about your blood sugar can affect your actual blood sugar even more than food does.
Let’s take a look at why:
1 - There is a documented relationship between psychological stress and increased blood glucose variability
This amazing study followed 33 people with T1D (type 1 diabetes) really closely for a week. The study participants wore CGMs (continuous glucose monitors) and recorded daily ratings of psychological stress. Researchers found a significant relationship between amount of stress and blood glucose variability/instability, meaning that the more stressed out a person was, the more variable their blood sugar was. (They also found a significant relationship between higher stress and decreased carbohydrate consumption, but we’ll save my thoughts on that one for another post!)
2 - The CBT Triangle
Have you ever heard of Cognitive Behavioral Therapy? It’s a type of therapy that is useful for a variety of conditions, including depression, anxiety, eating disorders and severe mental illness. One of the main tenets of CBT is the CBT Triangle:
Basically, what it’s saying (in a dietitian’s understanding of it) is that your thoughts affect your feelings, which affect your behavior, which affect your thoughts, and round and round it goes.
An example for people with diabetes: have you ever had a high blood sugar that isn’t coming down and you give a couple of extra insulin “rage boluses” which results in a hypo later on? Those are your thoughts (“uuuugh diabetes why are you being such a jerk?”) affecting your feelings (anger, frustration) affecting your behavior (giving extra insulin that you didn’t actually need after all) affecting your thoughts (“Ugh I’m such a bad diabetic!), and on and on.
3 - HORMONES
Have you ever taken a medication that your pharmacist advised would probably make your BG run higher? If so, that was probably a steroid. Guess what hormone increases when you are stressed? cortisol. Guess what cortisol is? a STEROID!
During stressful situations, epinephrine (adrenaline), glucagon, growth hormone, and cortisol play a role in blood sugar levels. If you are someone that feels their emotions very strongly (*hand raised*), you might have stronger hormone responses. Stronger hormone responses result in increased glucose variability. That means if you have a diabetes day that is making you extra stressed, and you then see your blood sugars running all over the place, and have extra extra stressed feels about those shoogs, what do you think is gonna happen? Extra cortisol, extra adrenaline, higher blood sugar.
There are probably other reasons that I’m not thinking of right now, but these are some important ones to consider. If you’re feeling burned out by diabetes or feeling like restricting or being extra controlling with food, get yourself a therapist and/or (fat-positive) diabetes dietitian for some extra support. I promise it can get better.