Managing Stress With Diabetes

Written by Keri Wiginton
Medically Reviewed by Michael Dansinger, MD on May 30, 2025
8 min read

Stress doesn’t just mess with your mood, it can also boost blood sugar. Over time, that may up your chances of type 2 diabetes or make the condition harder to manage if you already have it.

“Severe physical stress has been long known to promote insulin resistance and increase blood sugar,” says Gerald Shulman, MD, PhD, a diabetes researcher and co-director of the Yale Diabetes Research Center. “We see it often in hospitalized patients who weren’t diabetic before they were admitted.”

Emotional strain can also take a toll. Research shows that people with diabetes tend to feel more stressed and anxious than those who don’t.

In the short term, a strong stress response can help you heal or respond to a threat. But if your body is always in fight-or-flight mode, this can throw off your metabolism. Here’s what happens:

  1. Your brain releases a hormone called corticotropin-releasing hormone (CRH). 
  2. CRH tells the pituitary gland to release another hormone called adrenocorticotropic hormone (ACTH). 
  3. ACTH signals the adrenal glands to release cortisol (a key stress hormone).
  4. Cortisol tells the liver to make more glucose and release stored sugar into your bloodstream.

Over time, too much cortisol can lead to insulin resistance. 

It all makes sense from an evolutionary viewpoint. Insulin promotes energy storage, and you don't want it around when you need to tap into your glucose reserves. 

“It’s important for survival when you’re running away from an animal that wants to eat you or you need energy to look for food,” Shulman says.

But when the stress response doesn’t turn off, it puts more pressure on your body’s ability to regulate blood sugar.

Luckily, you don’t have to get rid of stress completely to feel better. With the right tools, you can learn to manage it. And when stress levels come down, it’s often easier to eat well, move more, sleep better, and stick with your treatment plan.

Here are some tips to combat stress and keep your blood sugar steady.

Stress can raise blood sugar. But by how much? That depends on the situation and your body. The best way to find out is to track your stress levels alongside your glucose levels. 

When you feel physically or emotionally stressed, take a moment to note:

  • How distressed you feel on a scale of 1-10
  • What your blood sugar is at the time
  • What was going on in that moment

Notice any patterns. These can help you spot stress triggers and calming moments. If you use a continuous glucose monitor (CGM), you may even catch quick spikes.

Studies show that practicing self-compassion can lessen overall anxiety, depression, and stress. It can also make you more likely to take healthy steps. 

Giving yourself a break, especially during hard times, may lead to:

  • Higher satisfaction with life
  • Better blood sugar control
  • Greater ease in managing diabetes
  • Better A1c levels

Stress often comes from things that feel outside of your control. That might include changes in your blood sugar, a new diagnosis, or other parts of life that affect diabetes care. But there are small steps you can take to support your health and ease stress. Try to:

  • Take your medications as prescribed.
  • Plan meals or snacks ahead of time.
  • Stay active in ways that feel doable, like a 30-minute walk most days of the week.
  • Go to bed and get up at the same time every day.
  • Reach out for help when you need it.

If you’re not sure where to start, talk to your doctor, diabetes educator, or mental health provider. They’ll work with you to figure out small changes that fit your lifestyle.

Physical activity can boost insulin sensitivity and lower blood sugar naturally. 

“Exercise is like taking insulin,” Shulman says. “It promotes glucose uptake in your muscles, even if you’re insulin resistant.” 

That’s just one of the many ways movement benefits your body. Regular physical activity can also: 

  • Calm inflammation and cortisol levels
  • Boost your mood and thinking abilities
  • Ease tension, anxiety, depression, and other stress symptoms
  • Help you lose weight and keep it off
  • Lower your resting heart rate and blood pressure
  • Boost your immune system

Aim for at least 30 minutes of moderate to vigorous activity most days of the week. Add in two to three days of strength training to build muscle.

“But the most important thing is to find something you like to do, because then you’ll stick with it,” Shulman says.

You can blow off steam with hard exercises such as biking or boxing, recharge on a hike, go dancing, or do a relaxing mind-body activity such as yoga or tai chi. But whatever you pick, talk with your doctor before you start a new exercise program. Ask what type of exercise might be best for you.

Tools that can help you wind down include muscle relaxation, deep breathing, meditation, or visualization. Get started with these tips:

Relaxation exercise. Close your eyes while sitting in a comfortable chair or lying down. Starting with your toes, slowly clench one body part at a time. Hold for five seconds and relax. Keep going until you've tightened and relaxed every part of your body.

Deep breathing. Sit in a chair with your feet flat on the floor. Close your eyes and focus on your breathing. Inhale slowly and deeply through your nose, filling up your lungs. Hold for a few seconds. Exhale slowly through your mouth. Let all the air out of your lungs like you’re letting air out of a balloon. Repeat as many times as you need to.

Yoga. Slowly relax into a downward dog or a warrior’s pose. This forces you to focus on your breathing, stretching, and how you place your body. Consider taking a yoga class at a gym or a local community center. Online options are available, too, along with smartphone apps. If you don’t have time for a full class, even 5 or 10 minutes of yoga posing or breathing makes a difference.

Diabetes distress is real. If you feel tired, frustrated, or burned out, you’re not alone. Up to half of the people with diabetes say they feel this way at times. Talking to someone is a powerful first step toward feeling better. 

Here are a few places to start:

Ask about cognitive behavioral therapy (CBT)

Led by a licensed mental health professional, CBT is one of the most common types of therapy. You learn how to identify and change unhelpful thoughts, feelings, and actions. You also learn skills to cut stress and deal with diabetes in a healthy way.

Look for someone who works with people who have diabetes or chronic illness. You can also search the American Diabetes Association’s mental health provider directory. If cost is a concern, look for someone who offers services on a sliding scale. That means it’s based on your income. 

Try mindfulness-based stress reduction (MBSR)

This teaches relaxation and breathing techniques along with mindfulness meditation. Mindfulness is when you pay attention to the present moment without judging it. MBSR has been shown to ease stress, boost emotional well-being, and help with blood sugar in people with type 2 diabetes. A licensed mental health professional can guide you. Online options and apps are also available.

Join a support group

Whether online or in person, connect with people who have diabetes. Just talking to someone who understands what you’re dealing with may be enough. You can find like-minded folks through the American Diabetes Association, Defeat Diabetes, or the American Association of Clinical Endocrinology, among others.

Studies show that regularly focusing on what you’re thankful for can improve your mood, ease depression and stress levels, and help you sleep better. As a result, you may have better blood sugar control. 

Here are some ways to practice gratitude: 

  • Appreciate the beauty of nature.
  • Be thankful for time with friends and family.
  • Spend time with your pet or someone else’s. 
  • Enjoy a good book.
  • Keep a daily gratitude journal.
  • Do something nice for someone.
  • Take a moment each day to think of three things you’re thankful for.

Beyond diet, medication, and movement, there are other ways to ease stress and support healthy blood sugar. To feel more balanced, consider these tips:

Listen to calming music

Music therapy has been linked to lower blood pressure and reduced anxiety. Research suggests it may help cut blood sugar levels in people with type 2 diabetes. Try something relaxing, such as classical music or nature sounds.

Use guided imagery

This practice involves picturing a peaceful scene using your senses. That includes what you see, hear, and feel. Research suggests that such mind-body practices may calm anxiety and improve blood sugar control by easing stress.

Try aromatherapy 

Scents like lavender, peppermint, or clove may help lower anxiety in some people. While it’s not a treatment for diabetes, essential oils can be a tool in your stress-relief kit.

Make time for hobbies

Do something just because you enjoy it. This might include drawing, gardening, knitting, painting, or reading. Hobbies shift your focus from stress, if only for a little while. People who regularly engage in leisure activities tend to have lower blood pressure, reduced cortisol levels, and better mental health.

Stress can raise your blood sugar and make diabetes harder to manage. But there are steps you can take to take back control. Start by tracking your stress and blood sugar to spot any patterns. Move your body each day, even if it’s just for a few minutes at a time. Try deep breathing, meditation, yoga, or other relaxation techniques to ease everyday stress. And if it ever feels like too much to handle, reach out to your care team.

Can stress affect blood sugar in pregnancy?

Yes. Studies show that mental stress is linked to higher glucose levels during pregnancy. Researchers have also found that anxiety and depression can have a big effect on blood sugar control, especially in pregnant people with gestational diabetes. 

Can stress make you insulin resistant?

Yes. Long-term physical and emotional stress can raise levels of cortisol, a stress hormone that makes it harder for your body to respond to insulin. This is more likely if you already have high blood sugar or obesity. 

Can stress cause you to get diabetes?

People who experience a lot of stressful life events are more likely to get diabetes. Ongoing stress can lead to habits such as eating poorly, moving less, or not taking your medicine. It can also make it harder for your body to use insulin and manage blood sugar.

How to manage diabetes stress

Ask your doctor or a diabetes educator for support. Exercise regularly, lean on friends and family, and make time for things you enjoy. Reach out to other people who have diabetes. If your stress feels too big to manage on your own, talk to a mental health professional.