Author's Perspective: First of all, I don't have to tell you that having diabetes is very stressful. And, on top of that, having a lot of stress makes your diabetes worse! 

Stress and high blood sugar are connected, so your ability to manage stress plays a major role in managing your diabetes. So, in effect, you are in a vicious cycle of stress and poor diabetes management.

The key is to break the cycle by reducing your stress and/or by improving your diabetes and blood glucose control.

Author's Sidebar #1:  During a management training class when I was moving up the corporate ladder, we were asked to fill out a flip chart page about stress at work and present it to the class.

After everyone in the class had presented, the instructor approached me to present, but he noticed that my flip chart was blank. He asked me if I needed more time, but I said that I was ready to present.

I explained that how we perceive what is stress is relative and based on our upbringing and life experiences.

I went on to explain how my father worked 4 jobs and my mother worked 2 jobs to make ends meet and take care of 7 siblings. I, on the other hand, here in Corporate America, only had to work 1 job and take care of 1 child, plus I made more money in two months than my father made in a year. So, where's the stress?

The instructor smiled and said: "That's an interesting and healthy perspective -- looks like you're not going to be one of those stressed-out managers. :-)

Author's Sidebar #2: Being a community volunteer for the American Diabetes Association (ADA) and for two of the local churches kept me so busy that I was visiting a new church almost every other week!  All of this helped to reduce the stress in my life because I was so preoccupied with helping other people, I forgot about my own problems. 

What is Stress?

Stress is a response produced by your body when you are subjected to various types of demands, whether physically, mentally, or emotionally.

Contrary to what most people believe, stress is not always a bad thing. In fact, stress can provide a positive effect.

When something that takes place or is about to take place in the environment is producing stress in a person’s body and you feel some of the symptoms of stress, it results into the release of certain chemicals into your bloodstream.

On the positive side, these chemicals can be utilized to produce more energy or added strength. This is helpful when the cause of your stress is something physical.

But when you are dealing with emotional stress or chronic stress, it can cause a negative effect on your body since there is no outlet for releasing that extra boost of energy and strength. Therefore, stress results to various types of emotional or physical responses because each individual’s body respond differently to the stimulus.

Types of Stress

Whether you admit it or not, stress is a part of everyday life. Whether you are at school, at the office, or just about anywhere you are forced to deal with people and the environment. Hence, the types of stress is closely associated with its cause. And because your physical body is closely connected to your emotional and mental state, you will notice some connection to their effects when you begin to experience stress. This is also the reason why it is important to combat the cause of stress since it affects several vital aspects of your body in order to function.

Here are some of the most common types of stress that you must be deal with on a daily basis.

Internal Stress: If you're diabetic, you may experience a lot of internal stress. The primary reason for this is because of the negative feelings you get from your doctor and the people around you. Now, it's not their fault that they feel this way. It's because they realize that they can't really help you. And, if you feel that negativity, then, this can create internal stress, which, only makes your blood sugar worse.

Another reason why you may feel this internal stress is because of your own lack of knowledge about diabetes, which creates feelings of anxiety, uncertainty and dread. However, you can reduce this internal stress simply be educating yourself about diabetes, nutrition and how to fight this disease.

There are other times when you may constantly worry about your blood sugar, what food to eat, and other events without having enough control to determine its outcome, creating a lot of unnecessary anxiety.

Internal stress is also one of those kinds of stress that needs to be addressed quickly -- don't let it fester. Most of the source of this kind of stress is rooted in your mind, which can make it difficult to manage and get rid of.

In some cases, people suffering from internal stress subconsciously may put themselves in stressful situations or feel stressed out about things that aren’t stressful to begin with. So, be consciously aware of what you're thinking and what you believe internally.

And, keep in mind that a significant stressful event such as a car accident, major surgery, the loss of your job, or a death in your family may cause your blood sugar to rise and remain there unless you are able to properly handle the stress.

When you lose a loved one, you will go through the five stages of grief (denial, anger, bargaining, depression, acceptance), but, everyone goes through these stages differently. However, in most cases, you will experience spikes in your blood sugar that may remain high until you get through the grief. 

Relationship Stress: This is the type of stress that you feel around loved ones, family members and friends who are negative and complain all the time, but, more importantly, they don't help or support you with the dietary and lifestyle changes that you need to make.

Sometimes they mean well, but, they tend to know very little about diabetes; but, they talk and give advice like they know what they're talking about! Most of the time, they only know what they know because they overheard someone else or they heard something on the radio or TV.

These people tend to feed the negative talk-track in your mind and provide very little positive support. This is one of the reasons why the Death to Diabetes Cleanse and Detox Program requires that you detox your mind as part of a "full body" detox.

Survival Stress: This type of stress deals with the danger, mostly physical, that you are subjected to as a diabetic. It can be prompted by a low or high blood sugar attack that can make you feel thirsty or have blurry vision. In more serious situations, it can make you pass out or go into a coma.  

Therefore, your body releases this burst of energy that you need to utilize to respond quickly about the situation at hand whether to confront it or escape from it.

But, please be aware that, in some cases, if your blood sugar is too low or too high, you may not be able to respond!

Environmental Stress: This type of stress is your body’s way of responding to changes or activities in your environment that could produce stress, such as extreme levels of noise or pressure from work.

These extreme levels can trigger the release of adrenaline or stored glycogen and spike your blood sugar.

As compared to the other types of stress already mentioned above, this one is a lot easier to deal with. The best way to get started combating this stress type is to determine the source. Once you have identified the source of environmental stress, find a way to avoid the source.

Stress Due To Work and Fatigue: Another common type of stress and probably the most prevalent is due to your job. This type of stress usually doesn't happen right away, but rather builds up over time.

And, your stress builds up, so does your blood sugar and your body's resistance to insulin.

When you are spending too much time at work or if you are forced to get a lot of work done in a short period of time, this can be very stressful and can take its toll on your body.

When you're spending too much time at work, you tend to miss meals or you go for the vending machine because it's quick and convenient.

To deal with work stress, it is important that you find time to eat a healthy lunch or have a healthy snack. Also, find time to relax, take a walk during lunch or talk with a friend or colleague. It is also very important that you get enough quality sleep so that your body can recover from the tremendous amount of work. 

Sources of Stress

So, where exactly does stress come from? Our stress comes from two main places:

1. External sources: such as demanding jobs, your environment, problematic relationships, negative people, and financial problems.

2. Internal sources: how we perceive and respond to these and other events within our minds. 

Biological Impacts of Stress on Your Health

Stress impacts your entire being and every part of your body, physically, emotionally and spiritually.

Key areas that are affected by stress include your cardiovascular system, gastrointestinal system, endocrine system, nervous system and immune system. Some of the effects include high blood pressure, indigestion, high blood sugar, twitching, frequent colds, and anger outbursts.

Here is a diagram that depicts some of the many ways that stress affects your health.

How Stress Impacts Your Health

The Connection Between Stress and Blood Sugar

When you are under stress, your body works overtime to help you cope. One of the ways it does this is to release hormones, such as epinephrine and adrenaline, both which give you added energy and concentration.

But, in addition to the hormones, your body also releases glucose (sugar) from your liver, muscles and stored fat reserves. This bodily response to stress is called the “fight or flight” response.

For example, if you needed to fight off or run away from a angry bear, these hormones and extra glucose would give you an enhanced ability to do so. In the process of running or fighting the bear you would use up the hormones and glucose and your body would quickly regain an internal balance.

But short, acute situations like the bear scenario are not our main source of stress. The stress that plagues most of us is chronic stress; the kind that goes on for days and weeks.

The same “fight or flight” stress response occurs with chronic stress as in acute stress. The difference is that we keep it turned on perpetually for long periods of time because we feel an ongoing anxiety about our finances, jobs, health and people we love.

More specifically, acute stress — stress that is momentary or short-term such as meeting deadlines, being stuck in traffic or suddenly slamming on the brakes to avoid an accident — causes an increase in heart rate and stronger contractions of the heart muscle, with the stress hormones — adrenaline, noradrenaline and cortisol — acting as messengers for these effects.

In addition, the blood vessels that direct blood to the large muscles and the heart dilate, thereby increasing the amount of blood pumped to these parts of the body and elevating blood pressure. As previously mentioned, this is also known as the fight or flight response.

Once the acute stress episode has passed, the body returns to its normal state.

However, chronic stress, or a constant stress experienced over a prolonged period of time, can contribute to long-term problems for heart and blood vessels.

The consistent and ongoing increase in heart rate, and the elevated levels of stress hormones and of blood pressure, can take a toll on the body. This long-term ongoing stress can increase the risk for hypertension, heart attack or stroke.

Repeated acute stress and persistent chronic stress may also contribute to inflammation in the circulatory system, particularly in the coronary arteries, and this is one pathway that is thought to tie stress to heart attack. It also appears that how a person responds to stress can affect cholesterol levels.

The risk for heart disease associated with stress appears to differ for women, depending on whether the woman is pre- or post-menopausal. Levels of estrogen in pre-menopausal women appears to help blood vessels respond better during stress, thereby helping their bodies to better handle stress and protecting them against heart disease.

Postmenopausal women lose this level of protection due to loss of estrogen, therefore putting them at greater risk for the effects of stress on heart disease.

Stress also affects our eating habits. Usually, when we're under stress, this triggers food cravings so we'll gravitate to bad foods such as a high sugar food (like some candy or chocolate) or a high fat or comfort food (like macaroni and cheese).

Instead, grab a handful of walnuts or almonds along with a piece of whole fruit -- the fruit and the nuts will still give you the energy burst but you'll feel a lot better in the long run.

As you can see, chronic stress is not healthy for anyone but it is especially troublesome for people with diabetes because you do not need the additional glucose being continually released into your bloodstream, wreaking havoc and damage to the arteries and other parts of the body.

In addition to the cardiovascular system, stress affects the gastrointestinal system, immune system, nervous system, and other parts of the body. For more details, refer to the Death to Diabetes Blog and the Stress ebook.

Stress Management | 7  Strategies| Learn to Control What You Can

It’s not realistic to think you can avoid stress completely. There are some things over which you don’t have complete control: roofs occasionally leak, jobs can be a hassle, relationships can end and investments sometimes go down in value.

Worrying about things you have no or limited control over is not your best strategy for your overall health or for managing your diabetes. Instead, focus on managing your response to these kinds of events.

You have the ability to control your attitude, help calm your bodily reactions to stress and make sound choices. The goal is to mobilize the available resources to help you cope with stress in a healthy manner.

In addition, ensure that you eat balanced meals such as the super meals. These types of meals will provide your body and its cells with the proper nutrients so that you can handle stress and prevent stress from causing damage to your body.

Stress: Ways to Manage It

Stress Reduction:  The 7 Strategies

Here are 7 key strategies to help you handle and reduce the stress in your life.

1. Manage What You Can Control

The all-important first step is to distinguish between those parts of your stress that you have some measure of control over and those you don’t. You want to focus your energy on the areas over which you have some control.

For example, you cannot change the fact that your boss is a dimwit but you can choose how you respond to him. Spend your limited time and energy on trying to make the situation better instead of being anxious about the current state.

2. Examine Your Coping Style and Avoid Triggers

Why does one person faced with diabetes rise to the challenge while another person struggles with continual feelings of failure? It often has a lot to do with coping style. Many people have what’s called “learned helplessness.” They respond to adversity in a passive manner believing that fate will inevitably have its way.

But this coping style usually fails to see the many choices that are actually available. If you are prone to learned helplessness, start asking yourself what choices you have that could change your situation? Write them down. Be proactive. Diabetes doesn’t have to control your life.

One of the keys to successfully fighting this disease includes recognizing and avoiding physical and emotional triggers.

Examples of emotional triggers include fear, anger, loneliness, anxiety, jealousy, and hopelessness.

Examples of physical triggers include being tired, traveling, driving by your favorite fast food restaurant, walking through a shopping mall and smelling pizza, some social events, crowds, etc.

Keep a daily journal to help you with recognizing stressful events and triggers so that you can be proactive and avoid them in the future; or, learn how to better handle those situations in the future.

In addition, make sure that you continue to educate yourself about diabetes and nutrition -- the power of knowledge will help you to cope a lot better.

3. Acquire Knowledge about Diabetes and Nutrition

Taking a class or doing research to acquire knowledge about diabetes and nutrition is an excellent way to remove the fear, anxiety and uncertainty that comes with understanding and managing your diabetes on a daily basis.

When you don't understand what's happening to you, this creates internal fear and stress. Internal fear and stress creates uncertainty, hopelessness, depression, and poor food choices, which only makes your diabetes worse!

However, understanding how diabetes works and how to fight it with proper nutrition empowers you and relieves the internal fear and stress.

Knowledge is truly powerful  especially when you're able to use it and reap the benefits of better blood glucose control and better overall health.

4. Eat Anti-Stress Foods

In addition to eating healthy foods to control your blood sugar, you should eat specific "anti-stress" foods that help to reduce the negative effects that stress can have on your cardiovascular system and other systems in your body. Examples include avocados, nuts, seeds, and green, leafy vegetables.

In today's world, it is impossible to avoid stress completely. That's why it's so important to eat the right kinds of food because these foods contain the proper nutrients that help to limit the damage that stress can cause physically. 

Refer to the Top 10 Stress-Fighting Foods web page for more details.

5. Tap into Your Inner Spirit and Spirituality

We are all spiritual beings, so we should learn how to tap into our spirituality or inner spirit in order to motivate us to change our eating habits and make better lifestyle choices, e.g. exercise, stop drinking, stop smoking.

We should also ensure that we get enough rest and quality sleep because this will help to reduce our internal stress and reduce the release of stress hormone such as cortisol.

We should use Eastern methods such as meditation and yoga to help us relieve the stress, tension, anxiety, anger and other negative emotions that we deal with on a daily basis.

Yoga Reference:

In addition, we should look for the joy in our lives, find some humor in day-to-day events and have the humility to laugh at ourselves or just laugh for the sake of laughing. Why? Because laughter releases serotonin (a feel-good hormone) and helps to relax us and even lower our blood pressure!

Take the time to figure out what is your Purpose in Life. If you believe in the Creator, then, you realize that you were put on this planet for a reason -- a specific purpose. Use your God-given skills and life experiences to become a servant to help others in your community.

Once you understand your real Purpose in Life, you will find that you have more passion and more energy to help others, which will dramatically reduce the stress in your life while allowing you to receive more joy and happiness.

6. Choose to Enrich Your Life

In our fast-paced society, many people never give themselves a chance to fully recharge their physical, mental and emotional reserves. As a result, our minds and bodies stay tightly wound and increasingly stressed with each passing day.

Instead of trying to distract yourself from these stressors by plopping in front of the television or going out to eat, do something that you find truly enriching.

Consider these ideas for starters:

  • Join a diabetic support group
  • Help a friend 
  • Go for a ride or visit the mall
  • Tour a museum
  • Take a walk in nature
  • Write in your journal
  • Talk with a close friend
  • Take a bubble bath
  • Get a massage
  • Read a good book like Death to Diabetes :-)

7. Use Exercise Techniques to Manage Your Stress

Regular practice of the following exercise disciplines will immediately help you reduce your stress level, and, over time, bring your glucose levels down as well:

Diaphragmatic breathing. In a sitting or lying position, breathe in through your nose, pulling the air deeply into your lungs until you feel your lower abdomen begin to extend. Take in as much air as you can. Hold it for a count of five and then slowly exhale through your mouth. Do this several times.

Progressive relaxation. In a lying position, tense one muscle group (calves, for example) for a slow count of 10 while keeping the rest of your body relaxed. Stop tensing that muscle and relax for a few seconds. Then move to the next muscle group (thighs) and repeat. Progressively work your way through the entire body. This exercise is great to help bleed out the tension in muscles before sleeping.

Exercise. Find an aerobic activity (running, walking, swimming, cycling, water exercise, tai chi, dancing, etc.) that you enjoy and participate in it regularly. Exercise is one of the best ways to release tension and keep your blood sugar in check.

Laughter. OK, so, technically speaking, laughter is not a form of exercise. But, if you laugh heartily and for several minutes, it'll feel like exercise. :-) Laughter releases endorphins and makes you feel better; and, it reduces your own internal stress. 

The Importance of Laughter and Other Emotions

Research has shown that the health benefits of laughter are far-ranging. While more studies need to be done, studies so far have shown that laughter can help relieve pain, bring greater happiness, and even increase immunity.

Unfortunately, however, many people don't get enough laughter in their lives. In fact, one study suggests that healthy children may laugh as much as 400 times per day, but adults tend to laugh only 15 times per day.

Stress Management | Benefits of Laughter

Hormones: Laughter reduces the level of stress hormones like cortisol, epinephrine (adrenaline), dopamine and growth hormone.

When these stress hormones are reduced, this, indirectly, helps to lower your blood glucose. It also increases the level of health-enhancing hormones like endorphins, and neurotransmitters.

Laughter increases the number of antibody-producing cells and enhances the effectiveness of T cells. All this means a stronger immune system, as well as fewer physical effects of stress.

Physical Release: Have you ever felt like you "have to laugh or I'll cry"? Have you experienced the cleansed feeling after a good laugh? Laughter provides a physical and emotional release.

Internal Workout: A good belly laugh exercises the diaphragm, contracts the abs and even works out the shoulders, leaving muscles more relaxed afterward. It even provides a good workout for the heart.

Distraction: Laughter brings the focus away from anger, guilt, stress and negative emotions in a more beneficial way than other mere distractions.

Perspective: Studies show that our response to stressful events can be altered by whether we view something as a 'threat' or a 'challenge'. Humor can give us a more lighthearted perspective and help us view events as 'challenges', thereby making them less threatening and more positive.

Social Benefits of Laughter: Laughter connects us with others. Just as with smiling and kindness, most people find that laughter is contagious, so if you bring more laughter into your life, you can most likely help others around you to laugh more, and realize these benefits as well. By elevating the mood of those around you, you can reduce their stress levels, and perhaps improve the quality of social interaction you experience with them, reducing your stress level even more!

Tip: Watch a comedy, or laugh with your friends, your kids or partner every day. Even if you don't find something funny, just laugh! You'll feel better!

And, don't forget that other emotions such as crying are also important, because they also help to release hormones and reduce our stress level.

More Strategies to Reduce Stress

Here are some additional ways to handle the stress in your life:

Adversity: Embrace change and the adversity that you will face during your journey. Adversity will build your character or reveal it.

Connect: Send an email or use a social media platform like Facebook or Twitter to connect with a friend or colleague.

Forgiveness: Forgive your friends and relatives -- stop holding a grudge. These types of negative feelings can trigger health problems like cancer.

Gratitude: Show your gratitude to a relative or a friend; or, anyone who has helped you in some way. Show them that you don't take them for granted. If possible, show your gratitude towards that person publicly in front of their loved ones. 

Laugh!: Laughter is a wonderful stress-reducer. Laughter relieves muscular tension providing a discharge of nervous excitement. It improves breathing, regulates the heartbeat and pumps endorphins (the body’s natural painkillers) into the bloodstream.

Let Go: Learn how to let go of the anger, jealousy, and envy in your life. These negative emotions trigger the release of stress hormones and weaken the immune system, making you more susceptible to disease.

Motivation: Identify a strong motive for getting healthy, e.g. financial, your children, family, quality of life, religious, disdain towards drugs, fear of a painful death. Ensure that your motive is strong enough to overcome the setbacks you’re going to have during your journey.

Negative People: Avoid the emotional vampires and toxic relationships that drain your hope and your soul.

Phone Call: Just pick up the phone and call a friend or colleague just to say Hi. They'll feel great that you called; and, so will you.

Sleep/Relax: Ensure you obtain at least 6-7 hours of quality deep sleep each night. Find quiet time for yourself each day to relax, even if it's only 15 minutes.

Support: Join an ADA-sponsored or church-sponsored diabetic support group as part of your support system.

Talent/Passion: Look for ways to use your talent and your passion to help your family and/or your community.

Volunteer: Become a community volunteer to help others. You'll be amazed how good you feel after helping someone else.

Power Messages: Listen to positive and powerful messages that will help to motivate you. The following audio clip is an example of a very positive message from Les Brown (the renowned motivational speaker). His speech reminds me of my father, scolding and reminding us that "failure was for weak people and not an option for his kids." He felt that you had to be höngry* if you wanted to succeed at something and step into your greatness

Audio Clip (on DeWayne McCulley Google Site).

*Note: Höngry is an urban term that means "very very hungry". :-)

Food for Thought: There is a fine line between denial and faith: Denial is believing you can’t win the battle against the disease because of all the facts. Faith is believing that you can win the battle despite all of the facts.

Author FYI: During the 1990s I volunteered as a math tutor for one of the local high schools. Because I had been blessed with a father who drilled mathematics into us, and great teachers who taught me the "patterns of mathematics", I was able to help many students and give them their hope back. During many of these tutoring sessions, I shared some inspirational quotes that I had come across over the years -- from people such as Muhammad Ali, Oprah Winfrey, and Billy Graham. Maybe one of these quotes will help you.

Benefits of Volunteer Work

Author's Perspective: In my younger years, I was a math tutor volunteer for the Urban League for more than 15 years. Years later, I became a volunteer for the American Diabetes Association (ADA) to help people with their diabetes.

Some of the benefits that I received from doing volunteer work include the following.

Great Feeling: Volunteering makes you feel better when you help someone else -- especially when your advice helps to improve a person's health or some other aspect of their life. It was great being able to help high school kids with their math, algebra, geometry, trigonometry, and calculus. It was also a great feeling when diabetics would thank me for helping them improve their health.

Stress Reliever:  Volunteering reduces the stress in your life because you'll forget about your own worries when you're occupied with trying to help someone else.

Educational: When I was running a diabetic support group for the American Diabetes Association, I had to do research almost every week because members of the support group would ask questions that no one in the group could answer. 

Social: Volunteering allows you to connect to your community and helps you to make new friends, expand your network, and boost your social skills. I wasn't much of a public speaker, but, by helping other diabetics and running a diabetic support group, I gradually became more comfortable with public speaking.

Volunteering gives you the opportunity to practice and develop your social skills, since you are meeting regularly with a group of people with common interests. Once you have momentum, it’s easier to branch out and make more friends and contacts.

My biggest regret with the diabetic support group was not creating a diabetic contact list with names, phone numbers and email addresses.

Personal Growth: Because of my volunteer work with the ADA, I gained a lot of credibility with members of the diabetic support group. Later, when I wrote my book, many of the members either bought my book or told others about my book.

Volunteering also strengthens your ties to the community and broadens your support network, exposing you to people with common interests, neighborhood resources, and fun and fulfilling activities.

Health: Volunteering is good for your mind and body; and, provides many benefits to both mental and physical health. Studies have found that those who volunteer are less likely to develop depression or dementia; and, have a lower mortality rate than those who do not. Volunteering has also been shown to lessen symptoms of chronic pain or heart disease.

Volunteering increases your self-confidence, self-esteem, and life satisfaction. You are doing good for others and the community, which provides a natural sense of accomplishment. Your role as a volunteer can also give you a sense of pride and identity. And the better you feel about yourself, the more likely you are to have a positive view of your life and future goals.

Sense of Purpose: Volunteering provides direction and a sense of purpose. In my case, helping diabetics fueled me to learn even more about diabetes and how to help more people with diabetes. And, the more people I helped, the more I wanted to learn about diabetes, drugs, nutrition, complications, pathology, and other aspects of diabetes.

For more details about stress, read Chapter 13 of the Death to Diabetes book or get the How to Reduce Stress ebook.


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