How Stress Contributes To Insulin Resistance And Diabetes

Feb 12, 2021
Sep 13, 2021
6 minutes

Medically reviewed by

Ford Brewer, MD, MPH
Ford Brewer, MD, MPHFord Brewer, MD, MPH
Head of Prevention at PrevMed
Dr. Brewer is a board-certified preventative & occupational medicine specialist. Dr Brewer is also a globally recognized speaker and thought leader particularly for heart attack, diabetes, prediabetes & stroke prevention.
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Feeling more stressed than usual lately? You’re not alone. The pandemic has meant many of us aren’t able to relieve stress the way we used to, by seeing friends or going to the gym.

Extra stress is expected in these times. But that doesn’t mean you should let stress take over. For our long-term health, we need to find ways to reduce our stress levels. Tackling stress and anxiety is especially important for people with diabetes or insulin resistance (prediabetes).

Can stress cause diabetes?

This is a question I often get asked. Here’s my answer. Based on evidence available today, no, stress doesn’t directly cause diabetes. However, high cortisol levels caused by stress can impact your blood sugar, weight and eating habits. In other words, stress is one of many factors that can contribute to insulin resistance (prediabetes) and diabetes risk.

Symptoms of stress

Stress can present very differently from one person to the next. Stress can cause a range of physical and mental effects, including:

  • Anger or irritability
  • Difficulty sleeping
  • Shallow breathing
  • Feelings of fear or nervousness
  • Digestive issues, such as diarrhea or constipation
  • Muscle soreness
  • Headaches

How stress plays a role in diabetes & prediabetes

1. Stress leads to sugar spikes

When we’re faced with a stressor, our whole body responds. A stressor for our ancestors might have been a bear in the wild, while a common stressor today is the fear of losing a job. But the body’s response is the same. Our adrenal glands produce hormones called cortisol and epinephrine (aka adrenaline), which prepares the body to act. These hormones trigger the liver to release glycogen, which are long chains of sugar molecules that we store just for purposes like this. The rush of sugar can give us an energy boost to run from, or confront, a threat.

That’s a natural and needed response to help us deal with a crisis. But what happens when we’re repeatedly feeling stressed over issues we can’t immediately resolve? We end up with chronic stress. This means our hypothalamus – the fear center of the brain – is almost always activated to some degree. We end up with high stress hormone levels that frequently cause our bodies to release stored sugars. (We also “stress eat” to restock our sugar stores).

The repeated sugar spikes mean the insulin receptors that let sugars pass into our cells get worn out. Over time, the pancreas has to release more and more insulin to help get the sugars through the worn out insulin receptors. This is known as insulin resistance.

Eventually, the pancreas can’t produce enough insulin process sugar, leading to diabetes. A review of dozens of studies found people with long-term anxiety and depression were more likely to develop diabetes. Read more in our guide to insulin resistance.


2. Stress causes weight gain, which is associated with insulin resistance

It’s well known that stress contributes to obesity, because in addition to encouraging our liver to release sugars, too-high levels of cortisol lead us to accumulate fat. As I’ve explained before, fat cells, especially those around our abdominal organs, are ‘active’. They release proteins, known as cytokines. These proteins further interfere with the proper functioning of our insulin receptors.

In other words, encouraging the body to store fat is another way that chronic and high stress indirectly contributes to insulin resistance.


3. Stress is especially bad for people with diabetes

Once insulin resistance has progressed to diabetes, stress can be especially dangerous. That’s because, as I’ve mentioned, the stress hormones trigger the liver to release a huge amount of sugar into the bloodstream.

But people with diabetes aren’t able to make enough insulin to process this sugar. This can make managing diabetes especially tough.


4. Lowering your stress levels can help reverse diabetes and pre-diabetes

 The good news is that even if stress hormones are leading to sugar spikes and insulin receptor damage, the damage isn’t permanent. If you have insulin resistance or diabetes, studies show that lowering your stress levels can help reverse your insulin resistance.

Try it yourself. Test your blood sugar and insulin levels in a period of stress, and test them again when you’re fully relaxed – perhaps when you’re on vacation and you’ve gotten the chance to unwind for a few days. Seeing for yourself how stress plays a role in your sugar metabolism can be a powerful motivator to reduce your stress levels.

How to lower your stress


Recognize stress

The first step to lowering stress is recognizing when it’s building, and knowing which situations make you stressed. When people are stressed, they are often quick to respond in anger, and may breathe in a more fast, shallow way. People who are chronically stressed may notice they frequently feel restless, depressed or worried. They may also engage in behaviors like eating too much or drinking too much.

By recognizing your stress, and how it affects your health, you can take steps to lower your stress. Try testing your blood sugar and insulin levels at different points throughout the week or month to see how stress affects you personally.



Studies show that mindfulness meditation is one of the best ways to lower your cortisol levels immediately and over time. While many find meditation intimidating or boring at first, mindfulness meditation is essentially slowing down to breathe and contemplate your racing thoughts. And as you get used to it, it will become easier.

You don’t have to pay for a course or go on a retreat. You can find free videos online, like this one or this one. You’ll be glad to hear meditating for just ten minutes a day has profound effects on stress levels.


Get proper sleep 

When we sleep, our cortisol levels drop. They begin to pick up again around three in the morning, in the hours before we wake up. In fact, this is why many people experience the dawn effect, an increase in blood sugar in the morning triggered by higher cortisol.

If we don’t get enough sleep, we disrupt the cycle. Poor sleep over time, including not enough sleep and inconsistent bedtimes and wake times, can lead to chronically high cortisol levels.

By going to bed at the same time every night and aiming for at least 7 hours of sleep, you can keep cortisol levels down, which will lower your stress throughout the day.



Studies show that people who exercise regularly have lower levels of anxiety. Even a brisk walk can be game-changing for our stress levels. Walking in nature is even more effective, as natural scenes have been shown to be calming. 

You’ll be glad to know that exercise doesn’t just help reverse insulin resistance because it lowers stress. Vigorous and moderate-intensity exercise prompt our muscle cells to more efficiently take up sugar without requiring high amounts of insulin. Over time, this means we don’t have to release as much insulin to process sugar.



It may seem like common sense that people who have social supports have less stress, and this has been shown scientifically as well. Being around others lowers our stress levels and helps us put our problems in perspective. While we can’t always meet in person due to the pandemic, outdoor visits, phone calls and online visits are a meaningful alternative, and can have the same stress-busting effect. If you have Type 2 diabetes, other people with this condition can be especially helpful, as they understand your day-to-day struggles and fears. Here is a list of online support groups for people with diabetes across the US.

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