A New Strategy for Blood Sugar Management

If you have diabetes, it may not be long before the prescriptions you receive from your doctor to help control the condition includes a recommendation to relax.

According to Richard S. Surwit, PhD, a growing body of scientific evidence suggests that relaxation and stress reduction techniques can enhance your body's ability to regulate your blood sugar levels.

Surwit's 2004 book, The Mind Body Diabetes Revolution: A Proven New Program for Better Blood Sugar Control, provides a detailed explanation of how emotional states such as stress, depression, and anger can affect blood sugar levels for patients with type 2 diabetes, as well as step-by-step methods for regulating these factors.

The idea of using stress management techniques to treat type 2 diabetes is a relatively new one. “The treatment of diabetes has changed little over the past 40 years,” Surwit says.

“Although many new medications have been developed, patients must still watch their diets closely, exercise, and take insulin or oral medications throughout the day.” Even with a closely followed regimen of treatment, he points out, patients still often struggle to keep their blood sugar at a healthy level.

Stress and Blood Sugar: An Intimate Connection

Surwit has been researching the connection between stress and blood glucose levels for more than two decades.

"The hormones that control blood sugar are the same hormones that are activated during stress," he says. "The endocrinologists call them counterregulatory hormones; the psychologists call them stress hormones. But the only real difference between them is that they're used by the body in different ways."

That's why controlling stress can have a huge impact on blood sugar levels. "We've found that the effect of stress hormones on glucose metabolism is profound," Surwit says. "So even relatively simple stress-management techniques can have clinically meaningful effects on glucose control in people with diabetes."

Part one of Surwit’s book describes the mind-body connection in diabetes control. He provides summaries of the research that links stress, depression, and anger to blood sugar levels. He calls these three emotional states “blood sugar boosters.” They all contribute to an increase in stress hormones, which tell the liver to release sugar into the blood.

At the same time, these hormones can interfere with the pancreas’s insulin production, triggering or aggravating diabetes in those predisposed to the condition.

The relationship between bleak moods and erratic blood sugar control is often behavioral as well as biochemical: Surwit explains that people suffering from depression often have problems following their diet and exercise regimens, or even taking their medication on time.

Since writing the book, Surwit has found less of a relationship between mood disorder treatment and glucose control. A study by Surwit and other Duke researchers showed no link between depression therapy and blood sugar stability. Scientists are continuing to study whether diabetic patients with more atypical types of depression experience glycemic gains from treatment.

Regardless, Surwit says all patients with diabetes will benefit from stress-management techniques. "Learning to relax will help people with diabetes control their blood sugar."

A Menu of Mood-Management Options

Part two of the book provides two mind-body programs that diabetes patients can use. A personality test at the beginning of the section helps readers determine which program will be most beneficial, although patients can use the techniques in tandem for overall stress management.

Program one focuses on progressive muscle relaxation techniques, which help to reduce stress-related symptoms. Patients focus on tensing and relaxing each muscle group of the body individually, concentrating on each group with a clear and focused mind. The program also incorporates breathing and visualization techniques to induce a more relaxed state.

Program two uses cognitive behavior therapy for those suffering from depression or hostility. Patients are directed to examine their negative thoughts and beliefs, recognize when and why they occur, and replace them with positive ones. They then translate these new emotional states into everyday actions.

A Helpful Complement to a Healthy Regimen

Part three provides additional information on mind-body techniques for maintaining a healthy weight and diet, as well as other ways to get the most out of the two programs detailed in the book.

Surwit stresses that these techniques are not a substitute for traditional diabetes treatments, but an important complement to them -- as he puts it, “the important final ingredient to your blood sugar control arsenal.”

"This technique has been shown in over 50 years of research to reduce circulating stress hormones," Surwit says.

"In our research, we've shown that the technique will produce a clinically significant change in blood sugar in most of the people who use it. Once they get good at this (technique), they become more aware of when their body's stress levels are deviating from what they should be and they have a very good way of dealing with it."