Monthly Archives: March 2014

How Stress Affects Diabetes

The Link Between Stress and Blood Sugar

Feeling frazzled? High stress can make your blood sugar levels soar. Here’s how to bring both down again
WebMD Magazine – Feature


Sherri Buffington knows right away when she’s stressed out.

“I’ll start to feel hot,” she says. Once the warmth floods her body, she tests herblood sugar. It’s almost always high.

Buffington isn’t imagining the connection. Stress is known to spike blood sugar, also called glucose. “It’s a very common occurrence,” says Kevin Pantalone, DO, staff endocrinologist at Cleveland Clinic. “Stress can increase levels of hormones in the body, particularly cortisol, which can make blood sugar rise.”

Hormone release is part of the body’s fight-or-flight response, which readies it to take action at the first sign of trouble — or bolt in the other direction. Cortisol and other hormones release a surge of energy in the form of glucose (sugar), which the body can use to fight or flee.

That rush of glucose is no problem if your body’s insulin response is working correctly. But for people with diabetes, whose bodies can’t move glucose as efficiently into cells, it leads to a buildup of sugar in the bloodstream.


The Long-Term Connection Between Stress and Blood Sugar

“The stress can make my numbers go up faster than if I eat a cheesesteak and French fries,” Buffington says.

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Yet food is another important part of the equation. “Patients who are under stress may turn to food as a means of stress release,” Pantalone says. “And if they make bad choices, that can certainly cause significant elevations in blood sugar.”

Stress can also make you neglect your health. “Stress makes managing diabetesmore difficult,” Pantalone says. When your attention is focused on a bad job or troubled marriage, you have less energy to think about taking your insulin or eating healthy meals.

A chronic condition like diabetes can launch you into a never-ending cycle. You get stressed and your blood sugar rises, which stresses you out even more. Buffington says she’s found relief from a progressive muscle relaxation CD. “If I do get stressed out or upset about something, my numbers may go up a little, but not as much,” she says.

Baby Steps to Ease Stress

Want to get a better handle on your stress? Pantalone shares a few tips.

Be realistic. The idea of running 3 miles a day might sound like a good plan. But if you can’t devote even 10 minutes to a daily workout — much less a couple of hours — your best ambitions will quickly go bust. “If you set the bar too high, you’re setting yourself up for failure.” Choose a more realistic amount, like 15 or 30 minutes a day to start, and stick to it.

Take small steps. You don’t need to overhaul your entire life. “Small things add up,” he says. Meditate for a few minutes a day. Start a new hobby, such as sewing or crossword puzzles. Memorize a poem that gives you peace. Take a 10-minute walk to get your mind off diabetes.

Assemble a dream teamTreating diabetes shouldn’t be a solo effort. Your team should include a doctor, nurses, diabetes educators, a social worker, and your family and friends. They all should be ready to support you and cheer you on when you need encouragement.

5 Most Surprising Reasons to Drink Coffee

Feeling jittery about whether to drink coffee? Percolate on this: Coffee’s benefits considerably outweigh its negatives, researchers now believe. Although caffeine can cause anxiety and insomnia in some people, the beverage’s unique properties — such as more powerful antioxidants than from any other source in the American diet, including fruits and vegetables — can do a lot of good. Just be sure to spring for organic coffee, says Beth Reardon, director of nutrition for Duke Integrative Medicine, since coffee beans are among the most heavily sprayed crops (all those chemicals can undo the benefits).

Here are the five surprising reasons to sip coffee:

1. Coffee Slashes Your Risk of Developing Type 2 Diabetes

The health benefit: The more coffee you drink, the less likely it is you’ll develop type 2 diabetes, numerous studies have shown. For example, postmenopausal women who drink at least four cups of coffee a day are less than half as likely to develop type 2 diabetes as those who don’t drink coffee, according to a 2011 study of more than 700 women by the UCLA Schools of Public Health and Medicine.

In fact, every additional cup is thought to reduce the excess risk of type 2 diabetes by 7 percent, according to Australian researchers in a 2009 Archives of Internal Medicine meta-analysis of 18 different studies, which linked coffee drinking and diabetes prevention.

How it works:
Coffee is thought to improve the body’s tolerance to glucose by speeding metabolism and improving insulin tolerance.

The UCLA researchers discovered one possible molecular mechanism for this. Coffee consumption increases blood levels of a protein called sex hormone-binding globulin (SHBG), which seems to offer protection against type 2 diabetes in those who have a certain type of genetic mutation. (Decaf coffee didn’t show this effect, however.)

If you’re already showing signs of prediabetes, of course, you’ll want to refrain from dunking doughnuts in that joe.

2. Coffee Can Counter Cancerous Cell Damage

The health benefit:
Coffee was once believed to cause cancer — but that was before researchers factored in such related behaviors of frequent sippers as smoking and drinking alcohol. Today, there’s mounting evidence that coffee may be protective against certain cancers, possibly by enhancing DNA repair.

Some of the best evidence concerns liver damage and liver cancer, which strikes more than 18,000 Americans a year. Multiple studies have found an inverse relationship between coffee consumption and liver cancer risk, including a 2007 meta-analysis of nine different studies.

Cancer-prevention researchers are finding similar benefits of coffee drinking versus other forms of the disease. In 2011, for example, a Harvard team found that women who drink several cups of coffee a day (caffeinated or decaf) have a lower risk of endometrial cancer. Another 2011 Harvard study reported that for men who consumed six cups of coffee a day, their risk of lethal prostate cancer was fully 60 percent lower than lesser coffee drinkers, and their risk of any kind of prostate cancer was 20 percent lower.

Other studies have linked coffee drinking to a reduced risk of colon cancer, rectal cancer, oral cancer, and esophageal cancer.

How it works:
Coffee contains hundreds of chemical compounds — among them antioxidants and anti-inflammatory compounds that can decrease markers for the damaging process of inflammation. The highly active antioxidant compound methylpyridinium, for example, is found almost exclusively in coffee (both caffeinated and decaf types), due to the beans’ roasting process. Espresso has two to three times the amount of this anticancer compound as a medium-roast coffee, according to the German researchers who identified it in coffee.

3. Coffee May Lower Your Risk of Dementia

The health benefit:
Scientists still don’t fully understand what causes the brain changes associated with Alzheimer’s disease, but they’re learning more about risk factors for dementia — and a hearty coffee-drinking habit seems to lower the risk.

When researchers in Sweden and Finland tracked coffee consumption in a group of more than 1,400 middle-aged subjects for an average of 21 years, they found a clear connection. Those who quaffed three to five cups a day were 65 percent less likely to have developed dementia than the two-cups-or-fewer crowd. (Drinking five or more cups a day also seems to reduce the risk, although this group was too small to allow researchers to draw statistically significant results.)

How it works:
Researchers believe the antioxidant properties of coffee may work to reduce vascular forms of dementia. Drinking coffee is already known to be protective against type 2 diabetes, a chronic disease that raises the risk of dementia. (Having diabetes together with depression, for example, doubles dementia risk.)

Another theory: Animal studies indicate that the caffeine in coffee may improve the efficiency of the blood-brain barrier, thwarting the negative effects of high cholesterol on cognitive functioning. Caffeine added to rats’ water improves their cognitive functioning and reduces by half the amount of abnormal amyloid protein in their brains, which has been linked to Alzheimer’s disease.

It’s also possible that coffee drinkers simply have more energy and move more; researchers point out that exercise is protective against dementia, too.

4. Coffee Protects Against Parkinson’s Disease

The health benefit:
It seems pretty clear that coffee helps lower the odds of developing Parkinson’s disease. When researchers looked at almost 305,000 participants in the National Institutes of Health – AARP Diet and Health Study, they found that those who consumed the most caffeine had the lowest risk of Parkinson’s, echoing earlier studies.

They also ran a meta-analysis of previous studies and found that this held true for both men and women. (Some earlier research had claimed a gender difference, with more benefit to men, probably due to smaller numbers of people studied.)

Why it works:
Researchers aren’t sure what the protective mechanism at play is, or even whether it’s the caffeine or other protective compounds that are behind the benefit. Genetics may play a role: One 2011 study found that subjects who carried certain types of a gene called GRIN2A received more neuroprotective benefits against Parkinson’s from coffee (although coffee drinkers with all forms of the gene still had a lower risk of developing the disease).

5. Coffee May Buffer Depression

The health benefit:
Another large study links long-term coffee use with a reduced risk of depression. Researchers at the Harvard School of Public Health tracked 50,000 nurses in the Nurses’ Health Study for more than a quarter century. In 2011, they reported that those who drank four cups of coffee or more per day had a 20-percent lower risk of developing depression, compared with those who rarely or never drank it. Those who downed two to three cups a day had about a 15-percent lower risk.

A much smaller study in Finland linked coffee consumption to a decreased risk of suicide in men when 7 or less cups a day were consumed. (Then the risk went up after 8 cups a day. There’s also some evidence that coffee protects against depression, too.

How it works:
Nobody’s sure, but one theory is that coffee drinking causes a short-term boost to energy and mood. The caffeine in coffee is probably the substance causing this effect — the Harvard researchers saw a similar decrease in depression among those who drank caffeinated soft drinks and ate chocolate, both of which contain caffeine.

Brain receptors that respond to caffeine are found in the basal ganglia, the part of the brain where neurotransmitters critical to depression are concentrated. Repeated low-dose stimulation of these receptors may help protect against the development of depression.

The Truth About Sweets and Diabetes

. Sweets like candy and cake are off limits to people with diabetes.

The correct answer is: FALSE

Sweet indulgences — candies, pies, cakes — were once off-limits for people withdiabetes. Not any more.

In fact, research has shown that starches like potatoes and white bread affectblood glucose levels much like sugar — causing sometimes-dangerous spikes in blood sugar. Carbohydrates found in most vegetables or whole grains don’t affect blood sugar as much.

So today, counting carbs and choosing the healthiest of them is more important than eliminating sugar altogether. A little sweet treat is fine. If you’re at a wedding, for instance, you can have a small slice of cake — very small. Just substitute it for another starchy carb you might eat, like a small potato or a piece of bread.

If you really have a sweet tooth, choose desserts, candy, and sodas made with sugar substitutes. Many artificial sweeteners contain no carbohydrates or calories, so you don’t need to count them in your meal plan. Others contain carbohydrates that are absorbed into the blood more slowly than table sugar — so they don’t pose a threat to your blood sugar levels. However, once you come off sugar and sweeteners for a few weeks, your body and taste buds will adapt and you won’t require or crave as much sweetness. This will also make natural foods and fruits taste sweeter and more satisfying.


2. A glass of wine with dinner is fine for people with diabetes.

The correct answer is: TRUE

Within limits, of course, alcohol is fine. Experts say that women can safely have one drink a day; two drinks are fine for men.

Keep the portions small. Four ounces of wine or 12 ounces of beer equals a serving. And just 1.5 ounces of hard liquor equals one serving.

But there are exceptions: People whose blood sugar levels are not under control — or who have nerve damage from diabetes — shouldn’t drink alcohol.

3. Foods high in fiber, such as beans, can help lower blood sugar levels.

The correct answer is: TRUE

A high fiber diet (more than 50 grams/day) has been shown to help lower blood sugar levels. How? Your body digests fiber-rich foods more slowly — which means glucose (a form of sugar) is absorbed into the blood gradually, thereby helping to moderate blood sugar levels.

But you have to eat a very high fiber diet to attain this effect!

High fiber diets have also been shown to help lower cholesterol levelslose weight, feel fuller, and stay regular.

Other fiber containing foods choices include: fresh fruits and vegetables, whole-grain bread and crackers, and bran cereal. Remember, always check food labels for carbohydrates and sugars. Many high-fiber foods have sugar added to help them taste better.