As the prevalence of prediabetes continues to rise in urban India, emerging evidence suggests that stress and poor sleep are not just lifestyle inconveniences but key drivers in the progression to full-blown diabetes. In an exclusive input for The Sunday Guardian, Dr. Manisha Arora, Director of Internal Medicine at CK Birla Hospital®, Delhi, explains how stress hormones alter blood sugar levels, why sleep hygiene is a vital pillar of metabolic health, and how early screening and lifestyle interventions can reverse the trajectory of prediabetes.
Q. How does stress physiologically impact blood sugar levels in people with prediabetes?
A. Stress plays a significant physiological role in elevating blood sugar levels, particularly in individuals with prediabetes. When a person experiences stress, the body releases stress hormones such as cortisol and adrenaline as part of the “fight or flight” response. These hormones make the body less sensitive to insulin, leading to a condition known as insulin resistance. Even though insulin is present, it cannot effectively transport glucose into the cells, which can be likened to a “lock and key” mechanism where the key (insulin) cannot open the lock (cell receptor) due to a blockage. Additionally, cortisol stimulates the breakdown of glycogen stores in the liver, further increasing blood glucose levels. Elevated cortisol levels also enhance cravings for simple carbohydrates and promote fat storage, both of which contribute to worsening blood sugar control. Over time, this stress-induced hyperglycemia can push a person from prediabetes into full-blown diabetes if not managed appropriately.
Q. What role do stress management techniques (like yoga, meditation, or breathing exercises) play in prediabetes management?
A. Stress management techniques such as deep breathing exercises, meditation, and yoga are highly effective tools in the management of prediabetes. These practices help calm the nervous system, reduce cortisol levels, and improve insulin sensitivity, thereby directly addressing the physiological pathways through which stress impacts blood glucose. By decreasing stress and anxiety, such interventions can prevent or delay the onset of diabetes in individuals with prediabetes, a stage that is still reversible with timely action. In fact, several studies have demonstrated that regular engagement in these practices can lead to significant improvements in blood sugar control. Beyond the physiological benefits, participating in group yoga or meditation promotes social interaction, enhancing emotional well-being and reducing stress.
Q. How important is sleep hygiene in preventing the progression from prediabetes to diabetes?
A. Sleep hygiene is a crucial yet often overlooked pillar in the prevention of diabetes. Along with nutrition, physical activity, and stress management, sleep is one of the four foundational components of metabolic health. Poor sleep, either in duration or quality, increases cortisol levels, which worsens insulin resistance and raises blood sugar levels. A lack of restorative sleep can impair glucose metabolism and diminish insulin sensitivity, accelerating the transition from prediabetes to diabetes. In the modern era, increased screen time and irregular sleep schedules are common among both children and adults, further exacerbating the problem. Chronic sleep deprivation not only leaves individuals fatigued but also contributes to metabolic dysregulation. Therefore, maintaining consistent sleep patterns and limiting screen exposure before bedtime are essential steps in prediabetes care.
Q. Should stress and sleep screenings be a routine part of prediabetes management in clinical settings?
A. Yes, incorporating stress and sleep screenings into routine clinical management for prediabetes can be highly beneficial. Given the strong connection between stress, sleep disturbances, and elevated blood sugar levels, such screenings can help identify high-risk individuals early in the disease trajectory. By understanding the underlying causes of stress and sleep issues, healthcare providers can offer tailored interventions through stress management techniques, sleep hygiene counseling, or behavioral therapy. Regular monitoring of stress and sleep quality also allows clinicians to evaluate the effectiveness of interventions over time. Integrating these screenings into standard care practices supports better glycemic control and promotes a more holistic and preventative approach to managing prediabetes.