When your body is under the stress response, your cortisol and insulin levels rise. These two hormones tend to track each other, and when your cortisol is consistently elevated under a chronic low-level stress response, you may experience difficulty losing weight or building muscle. Additionally, if your cortisol is chronically elevated, you’ll tend to gain weight around your midsection, which is a major contributing factor to developing diabetes and metabolic syndrome.

Research published in the journal Stress also looked into whether stress responses are associated with abnormalities in glucose tolerance, insulin sensitivity and risk of Type 2 diabetes, concluding that there does appear to be a strong link.

“The results of the present study indicate that NDDM [newly detected diabetes mellitus] subjects display significantly higher chronic stress and stress responses when compared to subjects with NGT [normal glucose tolerance]. Chronic stress and endocrine stress responses are significantly associated with glucose intolerance, insulin resistance and diabetes mellitus,” the researchers wrote.

Not to mention, if you’ve been diagnosed with diabetes or pre-diabetes, stress hormones can make it more difficult to control blood sugar levels, as well as encourage less-than-healthy lifestyle choices that further add to your risk.

“Research has indicated that stressful experiences have an impact on diabetes. Stress may play a role in the onset of diabetes, it can have a deleterious effect on glycemic control and can affect lifestyle,” according to a review in Diabetes Spectrum, which is why it’s so important to tend to your emotional health in order to protect your physical condition.

There are a number of ways that mental health ties in to diabetes, not the least of which is that managing the condition, or worrying about complications, can lead to stress and anxiety — a condition known as “diabetes distress.” On a physical level, swings in blood sugar can also wreak havoc on your mood.

If you’re under stress and your blood sugar levels are high, for instance, it can make you feel nervous or tired or make it difficult to think clearly. Further, people with diabetes who have psychiatric disorders as well are more likely to have poor control of their blood sugar levels

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