Twenty five percent of the 24 million people in the U.S. who have diabetes don't even know they have it. Why? Type 2 Diabetes, the most common type, can have a slow onset, and early symptoms can be confused with signs of stress, being overweight, or having a poor diet. For people who have diabetes or pre-diabetes, stress plays a large roll in overall health. Stress hormones can cause blood sugar to rise and you may need more insulin or other medications to control blood sugar when you are under stress. When stress strikes, our bodies tend to respond with a “fight or flight” reaction. Hormone levels of epinephrine and cortisol rise quickly to make energy, or fuel, readily available. The body needs this extra fuel either to deal with the circumstances, or run from the situation. Although this is fine for people without diabetes, it creates an entirely situation for people living with diabetes. People with diabetes have insulin deficiency (type 1) or insulin resistance (type 2), so the body cannot use a high influx of glucose appropriately. The glucose in the bloodstream rises and cannot get into the cells, where it is used for energy. Therefore, in most cases, stress will increase blood glucose levels in people with diabetes. People who suffer from stress often feel exhausted much if not most of the time and therefore are not motivated to exercise regularly, which can lead to an increase in weight. For individuals who have progressed to pre-diabetes, studies have shown showed conclusively that intensive lifestyle interventions decreased the overall risk of diabetes by 58%. As you become stressed, stress hormones such as adrenaline and cortisol cause blood sugar to rise, sometimes uncontrollably. Blood sugar does not only increase due to food.  Furthermore, if you skip meals, neglect exercise, or tend to eat poorly, your blood sugar may become too high or too low. The key is stress management so you can balance your mood and your blood sugar. If you are stressed and have diabetes, talk to your doctor to be sure your medications are appropriate.   Yours in good health, Linda Hlivka Clinical Nutritionist