Patients with type 2 diabetes who incorporate stress management techniques into their routine care can significantly reduce their average blood glucose levels.

Stress can increase glucose levels in people with diabetes, making them more susceptible to long-term physical complications such as eye, kidney or nerve disorders.

This is the first large study to show that a simple, cost-effective treatment can have a meaningful therapeutic effect on the control of blood sugar, said the researchers. Such stress management techniques include instructions on how to identify everyday life stressors and how to respond to them with such techniques as progressive muscle relaxation and breathing exercises.

Patients in the stress management group showed, on average, a 0.5 percent reduction on the hemoglobin A1c (HbA1c) test - a standard laboratory test used to determine average blood glucose levels in people with diabetes.

However, 32 percent of the patients in that group showed an even greater improvement by lowering their glucose level by 1 percent or more.

That amount of glucose level reduction is what the Food and Drug Administration (FDA) considers sufficient when reviewing drugs seeking approval for diabetes control.

The patients were randomly enrolled in the educational sessions either with or without stress management training. Stress-management techniques were taught by nurses or graduate students specifically trained for the study.

The training included progressive muscle relaxation, mental imagery, breathing techniques and instructions on how to modify one's physiologic, cognitive and behavioral responses to stress.

At the beginning of the study, and at subsequent times throughout the year-long tracking period, patients were tested using the HbA1c test to evaluate their blood sugar control and with various questionnaires to assess their trait anxiety. Such trait anxiety included perceived levels of stress, anxiety and psychological health. All participants were at least 30 years old and currently managing their diabetes with diet, exercise and/or non-insulin medications.

Experiencing stress is associated with the release of hormones that lead to energy mobilization - known as the 'fight or flight' response. Key to this energy mobilization is the transport of glucose into the bloodstream, resulting in elevated glucose levels, which is a health threat for people with diabetes.

Stress also can disrupt diabetes control indirectly through its effects on diet and exercise.

After six months, the control group began to show deterioration in their glucose levels, while the stress management group continued to improve.

By the end of one year, 32 percent of the patients randomized to stress management had HbA1c levels that were lower by 1 percent or more. In contrast, only 12 percent of the control subjects had levels that were this much lower. The effect cannot be explained by changes in body mass index, diet or exercise because the two groups did not differ on these variables during the year they were followed.

The HbA1c test has been shown to be effective in predicting coronary disease and other risks to people with diabetes, including the development of microvascular complications in the kidneys or eyes.

Diabetes Care January 2002

Dr. Mercola's Comments:

Quite impressive to see that managing one's stress can be such an effective solution to controlling one's blood sugar. The hemoglobin A1C test used in this study is one of the best indicators of long-term diabetic control. A one percent improvement does not sound like much, but an average reading should be about 5. Readings over 10 indicate terrible diabetic control and the higher the number is the worse the patient's diabetes is. I have only seen a HbA1c over 20 once. So if a person improved it by one point that would be a 20% overall improvement in the control of their diabetes, which is quite impressive, and nearly one third of the patients were able to do that. It is also impressive that these results were achieved with relatively ineffective tools compared to EFT. EFT, and other energy psychology techniques, are like performing stress management at the speed of light, as the results are generally instant and permanent. Last month I held a workshop that provides a basic framework to teach you how to perform EFT. The ten hours of video have a one year full refund guarantee. Unlike the other stress management tools, EFT can also be used to instill positive goals like exercise, which is critical in the management of diabetes. Through extensive research I have found another tool to use in the area of stress management that is a remarkably effective and efficient (and very affordable) way to help you achieve inner peace and significantly reduce stress and anxiety. The Insight audio CD , which I personally listen to and now recommend to my patients, is an exceptional tool to help you target the daily stresses in your life that act as prime contributors to all forms of diseases. In my experience over 95% of people are able to put their diabetes into remission by following the proper eating plan and exercise. I have helped many patients successfully get off of their diabetic medications, including improperly prescribed insulin for type two diabetes. Related Articles: Want to Stop Diabetes? Start Exercising Diet and Exercise Reduces Risk of Diabetes Exercise Reduces Diabetes by Reducing Insulin Exercise Helps Diabetics