لماذا عندما يتعرض بعض الاشخاص لصدمه نفسيه او خبر مفاجئ يصاب بداء السكري؟

Dear Sir,

== It's hard to dispute that most of us live life at breakneck speed. It's the nature of a fast-paced society, where numerous family, social, and work obligations can easily overpower your precious time and resources. But for people with diabetes, both physical and emotional stresscan take a greater toll on health.

== When you're stressed, your blood sugar levels rise. Stress hormones like

Epinephrine and cortisol kick in since one of their major functions is to raise blood sugar to help boost energy when it's needed most. Think of the fighter- flight response. Their net effect is to make a lot of stored energy — glucose and fat — available to cells. These cells are then primed to help the body get away from danger. You can't fight danger when your blood sugar is low, so it rises to help meet the challenge.

== Sources of stress can be physical, like injury or illness. Or they can be mental, like problems in your marriage, job, health, or finances. Both physical and emotional stress can prompt an increase in these hormones, resulting in an increase in blood sugars.

== Anything upsetting like going through a breakup or being laid off is certainly emotionally draining. Being down with the flu or suffering from a urinary tract infection places physical stress on the body. It's generally these longer-term stressors that tax your system and have much more effect on blood sugar levels.

== Many sources of stress are long-term threats. For example, it can take many months to recover from surgery.

-                     Stress hormones that are designed to deal with short-term danger stay turned on for a long time.

-                     As a result, long-term stress can cause long-term high blood glucose levels.

-                     Many long-term sources of stress are mental. Your mind sometimes reacts to a harmless event as if it were a real threat, like physical stress, mental stress can be short term: from taking a test to getting stuck in traffic jam.

-                     It can also be long term: from working for a demanding boss to taking care of an aging parent.

-                     With mental stress, the body pumps out hormones to no avail. Neither fighting nor fleeing is any help when the "enemy" is your own mind.

== Since stress has virtually become a way of life, you may not even notice you're frazzled. A lot of people will identify stressors such as an illness in the family (something large) but may not recognize the stress of the holidays or a hectic time at work (something smaller or shorter in duration).

== The problem may be compounded because under these pressures, you may lose your appetite and skimp on eating, or reach for not-so healthy quick fixes like candy or chips. Some people actually "stress eat" (overeat during stressful periods).

Others skip their daily workout because they're too strained or run down to keep it up, which can create a vicious cycle since exercise is an excellent way to lower blood sugar.

== Another theory assumes that many patients believe that their diabetes has been caused by stress or an adverse life event. Whereas there is strong evidence that psychological stress is related to a deterioration in glycemic control in established diabetes, there is much less evidence that psychological stress can cause diabetes in humans de novo.

== It seems more likely that psychological stress produces deterioration in glycaemia in the non-symptomatic patient which in turn makes diabetic symptoms and the diagnosis evident.

== People who aren't diabetic have compensatory mechanisms to keep blood sugar from swinging out of control. But in people with diabetes, those mechanisms are either lacking or blunted, so they can't keep a lid on blood sugar; i.e. when blood sugar levels aren't controlled well through diet and/or medication, you're at higher risk for many health complications, including blindness, kidney problems, and nerve damage leading to foot numbness, which can lead to serious injury and hard-to-heal infections. Prolonged elevated blood sugar is also a predecessor to cardiovascular disease, which increase the risk of heart attacks and strokes.

== In diabetes, because of either an absolute lack of insulin, such as type1 diabetes, or a relative lack of insulin, such as type2, there isn't enough insulin to cope with these hormones, so blood sugar levels rise. Besides, the fight-or-flight response does not work well in diabetic patients.

== Being in tune to your stress level and how you feel when the going gets tense is important. One good gauge is writing down your stress level in a journal each time you check your blood sugar. Many glucose meters have the capability to enter personal notes and data when you perform checks, or jot it down in a stress journal.

== It's easy to find out whether mental stress affects your glucose control. Before checking your glucose levels, write down a number rating your mental stress level on a scale of1 to10. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may affect your glucose control.

== Once you begin recording stress levels, most people with diabetes figure out pretty quickly what makes their blood sugar go up. Often insulin will be needed or adjusted during this period, so recognizing periods of stress is crucial for people with diabetes.

== Stress plays a more direct role in the control of blood sugar than it does in any other disease. People with diabetes should stay conscious of eating well and exercising regularly. It's a good idea to check blood glucose levels more frequently when you're ill or under stress and to drink plenty of fluids as so as not to get dehydrated.

== In order to reduce your Mental Stress; you have to do the following:

a-                 Making Changes to get rid of some stresses of life; by finding a new route to work if traffic upsets you. For such problems, stress may be a sign that something needs to change, like starting an exercise program, joining a sports team, starting a new hobby or learning a new craft.

b-                 Coping style: by learning how a person deals with stress. For example, some people have a problem-solving attitude. They say to themselves, "What can I do about this problem?" They try to change their situation to get rid of the stress.

c-                 Learning to Relax: in order to control stress with relaxation therapy that seems to help some people with diabetes type2 diabetes than people with type1 diabetes. Because Stress blocks the body from releasing insulin in people with type2 diabetes, so cutting stress may be more helpful for these people. People with type1 diabetes don't make insulin, so stress reduction doesn't have this effect.

d-                 Breathing exercises: by sitting or lying down and uncrossing your legs and arms. Take in a deep breath. Then push out as much air as you can. Breathe in and out again, this time relaxing your muscles on purpose while breathing out. Keep breathing and relaxing for5 to20 minutes at a time. Do the breathing exercises at least once a day.

e-                 Progressive relaxation therapy: In this technique, which you can learn in a clinic or from an audio tape, you tense muscles, and then relax them.

f-                  Exercise: is another way to relax your body is by moving it through a wide range of motion. Three ways to loosen up through movement are circling, stretching, and shaking parts of your body.

Regards,

lubna al-Sharif

يبدو أن هذا الأمر ينعكس على إفراز الهرمونات الرافعة لسكر الدم كالأدرينالين وهومونات قشر الكظر ويؤثر سلبا على إفراز البنكرياس للأنسولين فيتعبها

Increase sympathetic nervous system >>>>increase secretion of anti-insulin hormons as adrenalin and noradrenalin >>>> decrease insuline secretion & increase glucose level