Diabetes and Stress: How Stress Affects Blood Sugar
Diabetes and stress can be a difficult combination. Stress may affect blood sugar directly, while also making it harder to stay consistent with meals, exercise, medications, sleep, and other parts of diabetes management.
I’ve been through many stressful periods during my life with diabetes. One thing I’ve noticed personally is that when I’m under significant stress, my blood sugar often rises and becomes much more difficult to manage.
Quick Answer: How Does Stress Affect Diabetes?
Stress can affect blood sugar because the body releases hormones such as cortisol and adrenaline as part of its stress response. These hormones help make more energy available to the body and can contribute to higher glucose levels.
The effect isn’t identical for everyone. Mental stress tends to raise blood sugar in people with type 2 diabetes, while people with type 1 diabetes may experience an increase or decrease. Physical stress, such as illness or injury, can raise blood sugar in both type 1 and type 2 diabetes.1
Key Points
- Stress can affect blood sugar and make diabetes harder to manage.
- Stress hormones can contribute to increased glucose levels.
- Physical and emotional stress can affect diabetes differently.
- Blood sugar responses to stress vary from person to person.
- Diabetes itself can become a source of stress, sometimes called diabetes distress.
- Recognizing your own stress-related glucose patterns can help you respond more effectively.
Why Can Stress Raise Blood Sugar?
When you’re under stress, your body activates its natural “fight-or-flight” response. Hormones including cortisol and adrenaline help provide additional energy so the body can respond to a perceived threat.
Part of this response involves making more glucose available in the bloodstream. For someone with diabetes, that extra glucose can make it more difficult to keep blood sugar levels within their target range.
When stress becomes persistent, elevated stress hormones may also contribute to higher A1C over time.
The CDC includes stress among the factors that can increase blood sugar and recommends paying attention to how stress and other everyday factors affect your glucose levels.2
Stress can also affect diabetes indirectly. When you’re overwhelmed, you may find it more difficult to:
- eat according to your usual routine
- exercise regularly
- get enough sleep
- check your glucose
- take medications as prescribed
- make diabetes-management decisions
These effects can compound the direct effects of the body’s stress response.
Stress and Type 1 vs. Type 2 Diabetes
Stress does not affect everyone with diabetes in exactly the same way.
For people with type 2 diabetes, mental stress may increase blood glucose. For people with type 1 diabetes, the response can be less predictable—blood sugar may rise or fall. Physical stress can increase glucose in people with either type of diabetes.1
This is one reason your own glucose data can be valuable. It’s also important to recognize the high and low blood sugar symptoms that can occur when glucose moves outside your target range. If you’re going through a stressful period, look for patterns rather than assuming your blood sugar will respond a particular way.
What Is Diabetes Distress?
Sometimes diabetes itself is the source of the stress.
Diabetes distress refers to the emotional burden and worries that can come from living with and continually managing diabetes. Checking glucose, taking medications, making food decisions, worrying about complications, dealing with highs and lows, and managing diabetes technology can become exhausting.
Diabetes distress is different from clinical depression, although the two can occur together. The American Diabetes Association recommends screening people with diabetes for diabetes distress at least annually and at other important times, such as when treatment goals aren’t being met or complications develop.3
How to Manage Diabetes and Stress
You can’t eliminate every stressful situation, but you can take steps to reduce how much stress interferes with your diabetes management.
Watch Your Blood Sugar Patterns
Pay closer attention to glucose readings during stressful periods. If you use a continuous glucose monitor (CGM), look at trends over several days rather than focusing on a single high or low reading.
Keep Your Routine as Consistent as Possible
Try to maintain your usual medication, meal, activity, and sleep routines. Stress can make these habits harder to follow, but maintaining some consistency may make glucose patterns easier to understand.
Use Simple Stress-Management Techniques
Physical activity, mindful breathing, relaxation techniques, adequate sleep, and spending time doing activities you enjoy may help reduce stress.
The ADA also identifies approaches including cognitive behavioral techniques, structured problem-solving, mindfulness, and emotion-regulation strategies as options that can help address psychosocial concerns associated with diabetes.3
Talk to Your Diabetes Care Team
If stress is repeatedly affecting your blood sugar, don’t assume you simply have to live with it. Discuss the pattern with your healthcare team.
Your treatment plan may need to account for periods of illness, physical stress, changes in activity, or other circumstances that affect glucose.
When Stress Becomes Too Much
Occasional stress is part of everyday life. Persistent stress or diabetes distress deserves more attention, particularly if you’re feeling overwhelmed or having difficulty keeping up with diabetes care.
The ADA recommends psychosocial care as part of routine diabetes care and recommends referral to a qualified behavioral health professional when concerns cannot be adequately addressed during regular medical care.3
The Bottom Line
Diabetes and stress are closely connected, but the effect on blood sugar isn’t exactly the same for everyone.
Stress hormones can contribute to higher glucose, while the emotional burden of stress can make everyday diabetes management more difficult. If you’ve noticed that your blood sugar becomes harder to manage during stressful periods, pay attention to the pattern and discuss persistent changes with your healthcare team.
From my own experience living with diabetes, recognizing that stress affects my glucose has helped me pay closer attention during difficult periods. You may not be able to eliminate stress, but understanding how your body responds to it can make it easier to manage.
Frequently Asked Questions
Medically reviewed by Dr. Seshadri G. Das, MD
Board Certified in Endocrinology, Diabetes & Metabolism
Last updated: August 2026
References
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Helping Patients with Diabetes Manage Stress. NIDDK — Helping Patients with Diabetes Manage Stress [↩] [↩] [↩] [↩]
- Centers for Disease Control and Prevention (CDC). 10 Surprising Things That Can Spike Your Blood Sugar. CDC — 10 Surprising Things That Can Spike Your Blood Sugar [↩]
- American Diabetes Association Professional Practice Committee for Diabetes. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). ADA Standards of Care in Diabetes—2026: Positive Health Behaviors and Well-being [↩] [↩] [↩] [↩]
