Living With Type 2
Diabetes affects about 9.3% of the population in the United States. If you are reading this, chances are you are affected, or you know someone who has diabetes. Diabetes can be of two types: Type 1 where the body does not produce insulin, and Type 2, in which the insulin produced is unable to keep blood sugar levels in check.
To understand how stress and diabetes are linked, let’s go back to the basic human response towards a fight-or-flight situation. Dr. Madhavi Kathpal, who has been in medical practice for more than two decades and is a meta-medicine expert, says it best. “When you are stressed, be it from getting up late for work, missing a flight, or even something as common as making a mistake, the body feels threatened and acts as if it’s under attack from a wild animal. This primal instinct pushes it to find resources to create the energy needed to tackle the situation. The stress hormone called cortisol is elevated, which further signals the liver to release stored sugar into the bloodstream.”
If you were indeed escaping from a wild animal, this extra sugar would be used up in the intense physical activity of the escape. However, when there is no such outlet, the sugar just sits there. Since this sugar can damage delicate organs and blood vessels, the body tries to produce more insulin, to remove the excess sugar from the blood stream and into the cells. If the stress situation is a rare occurrence, as it used to be during our early evolution as hunter-gatherers, the body can handle these rare instances of sugar and insulin spikes well and then return back to peace-time or “homeostasis”.
However, the 21st century is full of stressors that throw us into “emergency” mode every few minutes and the excess sugar in the blood stream sits right there. Increasing doses of insulin from the pancreas can’t get the sugar into the cells, since the cells “resist” being stuffed with so much sugar all the time. Finally, the pancreas also begins to struggle to keep up with the increased insulin demands and begins to suffer damage. If we exercised regularly, at least some of the excess sugar would get used up. However, many of us lead sedentary lifestyles, stuck in front of our laptops and TV screens.
Imagine all this happening to a person who already has type 2 diabetes and you can see how stress fuels the perfect storm. Already too much sugar in the blood, insulin resistance locked in too and now you dial in the minute-to-minute stress…
While several factors could cause diabetes, recurring stress has been the acknowledged and recorded cause of the disease as early as from the 17th century when an English physician, T. Wills, linked diabetes to ‘prolonged sorrow’ in his study. From then on, the link between diabetes and stress has been studied through various experiments and surveys.
A study conducted in Japan by the World Health Organization found that excessive overtime is associated with 4-fold higher risk of type 2 diabetes, independent of other risk factors.
The increasing work pressure over the years has led to extended working hours, contributing to overall stress. Dr. Kathpal has an interesting take on technology – “It (technology) is focused on making life more “comfortable” and “convenient”, reducing the need to be active. This sedentary lifestyle leads to higher susceptibility of diabetes.” Other major factors causing stress would be relationships, the loss of a loved one, financial crisis, moving to a new place, etc.; all negatively impacting your health.
Studies have shown that meditation counters stress and brings about a positive change in the body. A study of the sitting-breathing practice (Somporn Kantaradusdi-Triamchaisri technique 1 – developed in Thailand) in type 2 diabetic patients demonstrated reduction of post-meal blood sugar as well as a slight reduction in blood pressure and heart rate,
The participants were made to sit and inhale slowly, while mentally counting from 1-5. After holding their breath (counting 1-3), they exhaled slowly (counting 1-5 once again). This cycle was repeated 30 times, and the session lasted 30 minutes (once a week for a period of two weeks). It was observed that SKT1 practice for a two-week period might also benefit in the prevention of cardiovascular risk factor.
Transcendental Meditation or TM is a form of meditation that uses repetitive mantras or sounds. Introduced in the mid-1950s by Maharishi Mahesh Yogi, it has grown into an organization with certified teachers teaching millions of people worldwide. Celebrities including Oprah Winfrey, Hugh Jackman, David Lynch, and Katy Perry have endorsed TM as being transformative.
A randomized clinical trial on 103 patients revealed that transcendental meditation performed for 16 weeks improved blood pressure and insulin resistance. It was conducted twice daily, with sessions lasting up to 20 minutes.
Meditation and altered mental states can remarkably improve physiological functions; it relaxes the body and mind leading to reduced stress with higher average levels of serotonin. Metabolic changes have also been observed on a cellular level, as a benefit of meditation. It’s been known to greatly improve cardiac and respiratory function as well.
Yoga helps calm down the nervous system and helps reduce anxiety. A study published in the Nepal Medical College Journal took twenty mild-to-moderate diabetics in the age group of 30-60. The patients underwent a 40-day yoga asana regime under the supervision of a yoga expert. 13 specific asanas were included in this exercise, including Surya Namaskar, Sukhasana and Padmasana. The results showed a significant decrease in fasting glucose levels and reduced the waist-hip ratio while improving glucose utilization. Yoga impacts Type 2 diabetes through both physical and mental pathways. Since hatha yoga sessions are often a series of physical stretches, holds and breathing exercises, we have compiled the ones that have been proven to work on Type-2 diabetes. You can watch a qualified yoga expert demonstrate these poses here.
Mind-body medicine is a field that focuses on “the interactions between the brain, mind, body and behavior, and on the powerful ways in which emotional, mental, social, spiritual and behavioral factors can directly affect health.” Mindfulness-based Stress Reduction (MBSR) was developed in 1979 at the University of Massachusetts Medical Center.
It encourages open monitoring of moment-to-moment experience, and observing the immediate content of experience, specifically, the transient nature of thoughts, emotion, memories, mental images, and physical sensation. It combines mindfulness meditation and Hatha yoga into a structured clinical program. Hatha yoga involves simple stretches and postures.
Body scanning is one of the techniques of MBSR. “You lie on your back with your eyes closed, and focus on every body part starting from the toes, all the way up to the top of the head,” explains Dr. Kathpal. “It helps in controlling one’s focus, and processing latent emotions.”
The two specific forms of meditation introduced in MBSR are:
Focused attention – where the attention is focused on the sensations induced during breathing, while also assessing the quality of attention.
Open monitoring – where you simply observe the present experience, without focussing on specific objects.
In a 14-patient study on MBSR, patients with type 2 diabetes reported increased feeling of well-being, and while factors such as medication, diet and body weight remained the same, the patients saw a decrease in depression, anxiety and psychological distress.
While several research studies have proven that dietary supplements improve diabetic lab measures, they often work through mechanisms that are both physical and mental, to reduce stress levels and positively impact diabetes.
For instance, the herb Ashwagandha (Withania somnifera) has shown to help with glycemic control and management of stress. A clinical study on Type 2 diabetics carried out for six weeks showed that stress levels in patients saw a significant reduction. Ashwagandha continues its positive effects on the mind and body for up to six weeks even after withdrawing the medication. Medical marijuana, legal to use in some states of the U.S, has shown positive effects with diabetics, especially when the diabetes has high stress levels as one of the main causes in the patient. Do look at the research that supports #Dia-beat_it”the best dietary supplements for type 2 diabetes patients and share it with your medical practitioner as well.
While some doctors are achieving reversal of type 2 diabetes with diet management, intermittent fasting, weight loss and different kinds of exercise including yoga, stress reduction through meditation can also go a long way in addressing the stress-induced pathways of type 2 diabetes.