Managing insulin-requiring diabetes is complicated. There are dozens of variables to consider, each impacting the insulin dose that people have to calculate for themselves or their children.
Some of these variables are quantifiable, even if the measurements and methods used may differ. Food, activity levels, medication dosages and timing, even temperature and altitude are all things we can measure. But biological factors like stress are not as easy to weigh. What we do know is there is a clear connection between stress and blood glucose management. Looking at the hefty load of things to try to balance in the name of health; is the diabetes management load the chicken or the egg? In this case, it can be either or both.
To help us make sense of some of the challenges of blood glucose management under times of stress, we connected with Mark Heyman, a licensed Clinical Psychologist and Certified Diabetes Care and Education Specialist who has been living with diabetes for over 20 years, for some insights and advice.
During times of stress, your body goes into fight or flight mode. Your body is activated with adrenaline and releases glucose as a source of energy to allow you to run or fight. As people with diabetes, our bodies do not have the ability to counteract that rush of glucose. Normalize the fact that stress highs are real, and sometimes they are unavoidable.
When you’re feeling stressed, it can be extremely difficult to take care of yourself., Self care can fall to the bottom of your priority list. Oftentimes, the foods that activate our pleasure center in our brains include fat and sugar to calm ourselves down, both of which can create some challenges to blood glucose control if left unchecked. Your bandwidth is stretched, you’re tired, and not motivated. There is a behavioral correlation between stress and blood glucose results. Normalize that making good diabetes decisions during times of stress can be really difficult (but not impossible!)
It is important to recognize that stress is a natural part of being human. Should and shouldn’t is not a part of the equation. If you are allowed to get stressed at work, the same is true of diabetes - that other job no one signed up for. ‘Dealing’ with stress does not mean ‘getting rid’ of it, it is more about navigating around it. Normalize that the cognitive and emotional burden of living with diabetes is a heavy load.
So what do we do after we’ve normalized some of the aspects of balancing stress and blood glucose management? Using data can be a really helpful tool when navigating this particular challenge, especially when you are feeling out of control.
Data can help you feel empowered. What is happening? Why is it happening? You can see patterns and make predictions and accordingly make adjustments to smooth things out. Anticipating what may happen in the future, even if you don’t have the bandwidth to make adjustments right now can still be empowering. Sometimes simply having a plan can be enough of a step to help reduce stress.
You don’t have to engage with your data all the time, because we know adding to your plate isn’t necessarily the right answer. But when you are ready to dive in, know that your data can be a real asset and Tidepool’s software is ready to support you.
With the current state of the world, you are not alone if you are navigating a season of any kind of burnout. Please check out a few resources to help find a Mental Health Provider in your area that has expertise in diabetes care:
As a nonprofit organization, we are able to focus on this larger impact on the diabetes community instead of on returns; but we need your help. We invite you to join us along the pathway we’re building to make an interoperable automated insulin dosing system a reality and drive change across all levels of the diabetes industry.
We can Redefine Diabetes together when you support Tidepool with a donation at tidepool.org/donate.