You probably know how stress feels: rapid heartbeat, butterflies in your gut, tense muscles. But there are some sneaky, less noticeable ways that stress can affect the body. Messing with your blood sugar levels is one of them. That makes managing your stress especially important if you have diabetes.

Stress causes the body to release hormones, including cortisol, that cause blood sugar to rise. This is a normal “fight or flight” response. It helps you react quickly to an emergency. But it also happens in non-emergency situations, such as when you’re stressed about a presentation or deadline. Unfortunately, those kinds of stressors are an everyday thing in modern life.

What’s more, just being diagnosed with diabetes and dealing with the condition can be stressful, says Subbulaxmi Trikudanathan, MD. Dr. Trikudanathan is a clinical associate professor of medicine at the University of Washington in Seattle.

But the more proactive you are about managing your diabetes, the less likely you’ll stress about it. Here are 4 ways to actively take part in managing your health and keeping your stress in check.

1. Create a diabetes action plan.

When you have diabetes, you have a lot to juggle: blood sugar testing, diet, medications, and doctor’s appointments. To make it all feel more manageable, come up with an action plan.

An action plan is a document you create with your doctor. It guides how you track and treat your diabetes symptoms. Your plan can include:

• A list of your medications and when you need to take them.
• Signs that your blood sugar is too high or too low.
• Steps to take if your blood sugar is too high or too low.
• Reminders to check in on how you’re feeling mentally or physically every day.

Having a written plan can make you feel more in control of your diabetes. It can also take away some of your anxiety about not knowing what to do if your health takes a turn for the worse.

2. Get moving.

Exercise tops the list of natural stress busters. It reduces levels of cortisol and adrenaline, which are stress-related hormones. And it increases feel-good chemicals such as endorphins.

Physical activity can also help lower your blood sugar levels. That’s because when we exercise, our bodies shuttle more blood sugar into muscles to be burned for energy. And the more muscle you have, the more blood sugar you can burn. Talk about inspiration to strength-train.    

But that doesn’t mean you have to hang out at the gym every day. You can also take a brisk walk, dance, garden, or play a sport. Slower, calmer activities have also been shown to help reduce stress. (Think: meditation, yoga, and even deep breathing.) Just find something you enjoy and stick with it.

3. Talk to someone you trust.

We’ve all experienced a time when we feel better after talking about something that’s bothering us. Research shows that when we put our feelings into words, it has a calming effect on the part of the brain that controls decision-making and emotions such as fear and anxiety.

Try talking to a close friend or family member to air out your worries. Or join a diabetes support group, where you can talk to people who share your struggles. You might also want to see a therapist. Some therapists specialize in working with people who have chronic illnesses. A therapist might be able to help you:

• Learn strategies for taking your medications on time and monitoring your blood sugar.
• Cope with symptoms of depression if needed. (People with diabetes are 2 to 3 times more likely to be diagnosed with depression than those without.)
• Deal with feelings of guilt, disbelief, and anxiety around your diabetes.
• Manage stress and temptations such as those from food or drinks.

4. Hydrate, hydrate, hydrate.

Drinking enough water is important for everyone. But that’s especially true if you have diabetes. That’s because when you’re dehydrated, you have higher levels of blood sugar in your body. Staying hydrated helps your kidneys flush out excess sugar through your urine.

There is also a connection between hydration and mood. Research suggests that adults who drink more water are less likely to develop depression or anxiety than those who don’t drink enough water. It may be that drinking water helps lower levels of the brain chemical norepinephrine. High levels of the chemical are linked with depression. Think of it as good motivation to drink 8 ounces of water every hour, Dr. Trikudanathan says.

[Sources:]

[1] Zamani-Alavijeh F, Araban M, Koohestani HR, et al. “The Effectiveness of Stress Management Training on Blood Glucose Control in Patients with Type 2 Diabetes.” Diabetology & Metabolic Syndrome, vol. 10, no. 39, 2018.

[2] Lieberman MD, Eisenberger NI, Crockett MJ, et al. “Putting Feelings into Words: Affect Labeling Disrupts Amygdala Activity in Response to Affective Stimuli.” Psychological Stimuli, vol. 18, no. 5, May 2007: 421-8.

[3] Haghighatdoost F, Feizi A, Esmaillzadeh A, et al. “Drinking Plain Water is Associated with Decreased Risk of Depression and Anxiety in Adults: Results from a Large Cross-Sectional Study.” World Journal of Psychiatry, vol 8, no. 3, September 20, 2018: 88-96.