Yep, Sleep and Stress Affect Diabetes!

I recently started using a CGM (continuous glucose monitor), something I chronicled in this blog recently. It’s been an eye-opening change for me, and the detailed picture it reveals of my blood sugar moment-to-moment has been invaluable. Seeing that stunning detail has also confirmed a number of long-standing truisms that I’ve always been told by my diabetes educators and doctors but couldn’t quite see for myself. Among them: Fiber really DOES slow down the absorption of carbs and lessen the spike. Along the same lines: Lower-glycemic foods really do have a milder spike than a refined-carb bomb like a bagel! The pizza effect? Uh, yeah, absolutely a thing, and an annoying one at that — in fact, this is one of the main reasons I am back to looking into finally switching from daily injections to a pump (actually, I just found out that my insurance WILL cover the costs of the pump and supplies, a very welcome change since the last time I looked into it).

The biggest eye-opener of all, however, has been seeing the profound impact sleep and stress can have on blood sugar. The importance of good sleep is something everyone is told about going back to childhood, and it falls into that category of commands that can be easily shrugged off. “Oh, it’s not gonna matter THAT much, right?” The same is true for the effects of stress on the body. Sure, we all give the idea lip service, but I think deep down, many of us have held to a belief that the impact can’t really be that substantial.

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But the past few weeks have proven both of these to me in a big way. Let’s start with stress. As you may know, stress is not always negative in how it feels. There is negative stress and positive stress. Negative stress is the kind we tend to avoid and dislike — work deadlines, holiday discussions about politics (particularly this year…), and so on. But positive events can cause a stress reaction, too. In my case, it is important musical performances that trigger this. Stress is really just the body “priming itself” for a big moment, and that big moment could certainly be an important performance.

I have had two performances over the past month that would qualify as “big” shows — both of them in front of relatively large, ticketed crowds, and both important stepping stones for the project playing them (the project being “Woodsmith & Hersch,” a new band that you should all check out — thank you for that bit of shameless self-promotion). For both shows, I saw my blood sugar surge from a perfectly normal 100–120 range number into the 180s during the course of the performance. Both times, there was no other explanation for it. I hadn’t eaten exotic or unpredictable foods beforehand, I hadn’t forgotten to take my regular dose of long-acting insulin, or any other identifiable cause.

Clearly, I need to reinstate my preshow ritual of meditating. And maybe I’ll take a couple extra units of insulin next time, too, just to be safe.

The other big eye-opener has been the impact of sleep on my numbers. For a two-week stretch, I was chronically short of sleep, and my need for insulin, both basal and bolus, increased to almost 160%! Now, that lack of sleep was because of a hectic schedule that also meant stress was involved (so the sleep wasn’t solely responsible for the increase). But nonetheless, it got me curious, and after searching around online, I discovered a study that showed that people with Type 1 diabetes who were only able to sleep 4 hours a night saw a 20% increase in insulin resistance! Couple that with the elevating effects of the stress thanks to the nonstop schedule, and that big increase in insulin isn’t that surprising!

So remember, the next time you assume that stress and sleep aren’t really that important, think again. They matter, in a big way!!