Blood sugar levels affect your physical health. But they can also affect your mental well-being. Recent research suggests that the ups and downs in your blood glucose could be linked to a higher risk of depression and anxiety.
Small fluctuations might seem harmless, but over the long term, they could have a significant impact on your mood and mental health. So, what steps can you take to keep your blood sugar — and your mind — on an even keel?
What is Glycemic Variability, and Why Does It Matter?
Glycemic variability (GV) refers to the fluctuations in blood glucose levels that occur throughout the day, from peaks after meals to lows during fasting or sleep. Unlike average blood glucose or hemoglobin A1c, which measures long-term blood sugar control, GV captures the highs and lows that can happen within a single day or over a period of time. These fluctuations — often unnoticed — are important in general health. Particularly in relation to the risk of diabetes complications and mental health disorders.
The Impact on Physical Health
GV is increasingly recognized as a necessary factor in managing diabetes. Research shows that higher GV is associated with an increased risk of both microvascular and macrovascular complications. Additionally, these fluctuations can lead to oxidative stress and inflammation, which damage blood vessels over time.
Why It Matters for Everyone
You might think that GV is only relevant for people with diabetes, but that’s not entirely true. Glycemic variability can also be influenced by diet, stress, sleep patterns, and even exercise in those without diabetes. For instance, consuming a diet high in refined sugars and processed foods can lead to more significant blood sugar fluctuations.
These fluctuations may increase the risk of developing insulin resistance over time. A precursor to type 2 diabetes. Furthermore, those without diabetes who experience high GV may still be at risk for cognitive decline and cardiovascular issues.
What Does the Research Say About Long-Term Glycemic Variability?
A notable study titled “Risk of Depression and Anxiety Disorders According to Long-Term Glycemic Variability” provides valuable insights into this connection. It is conducted using the National Health Insurance Service-National Sample Cohort database. The researcher analyzed data from 151, 814 participants over a period spanning from 2002 to 2013. Participants underwent at least three health screenings between 2002 and 2010, allowing researchers to measure visit-to-visit fasting plasma glucose (FPG) variability. Which is a key indicator of glycemic variability.
The study employed the variability independent of the mean (VIM) method to quantify GV and assessed the incidence of depression and anxiety disorders diagnosed using ICD-10 codes. The researchers aimed to uncover whether fluctuations in blood glucose levels were linked to the development of these mental health conditions.
Key Findings: Glycemic Variability and Mental Health Risks
The results of the study were telling. During the follow-up period 7,166 participants were newly diagnosed with depression. While 14,149 were diagnosed with anxiety disorders.
It was found that those in the highest quartile of FPG-VIM had a significantly greater incidence of both depression and anxiety disorders compared to those in the lowest quartile. Specifically, the adjusted hazard ratio for depression was 1.09 (95% confidence interval [CI]: 1.02 – 1.17), and for anxiety, it was 1.08 (95% CI: 1.03 – 1.14).
In simpler terms, participants who experienced higher variability in their blood glucose levels over time were more likely to develop depression and anxiety disorders. Additionally, the study found that individuals with persistent hyperglycemia — consistently high blood sugar levels — were at an even greater risk. Those in this group had a 1.43 – fold increased risk of developing depression compared to participants with consistently low FPG levels.
Why Does This Matter?
These findings are noteworthy because they suggest that not only average blood glucose levels but also the fluctuations in these levels over time can have profound effects on mental health. The association between GV and mental health disorders underscores the importance of maintaining stable blood glucose levels. Not just for preventing physical complications like cardiovascular disease and retinopathy but also for safeguarding mental well-being.
These results emphasize the need for healthcare providers to consider GV when treating patients with diabetes or prediabetes. It’s not enough to focus solely on lowering HbA1c. Monitoring and minimizing glycemic fluctuations could be just as important for improving patient outcomes. This also calls for a more holistic approach to diabetes care. One that includes mental health screening and support as part of routine diabetes management.
Beyond the Numbers: Real-World Implications
While the study provides strong evidence linking GV to mental health disorders, it also has practical implications. For individuals living with diabetes, this research stresses the importance of consistent blood sugar monitoring and lifestyle adjustments to minimize glycemic fluctuations. Adopting a balanced diet, regular physical activity and stress management techniques can help achieve more stable glucose levels. Thereby potentially reducing the risk of developing depression and anxiety.
Moreover, the study’s findings may encourage further research into the mechanisms by which GV influences mental health. Understanding these mechanisms could lead to new interventions aimed at reducing GV and improving mental health outcomes for those at risk.
So, Can Better Glycemic Control Prevent Mental Health Disorders?
Yes, better glycemic control may help in reducing the risk of mental health disorders. While it’s not a guaranteed prevention method, managing glycemic variability (GV) can lower the chances of developing depression and anxiety disorders. Especially for individuals with diabetes.
The reason is fluctuations in blood sugar levels have been linked to mood instability, cognitive issues, and increased stress responses. All of which can contribute to mental health challenges. Individuals may mitigate some of the risk factors associated with these disorders by stabilizing blood glucose levels.
What Are the Practical Steps to Reduce Glycemic Variability?
Reducing glycemic variability is essential for both physical and mental health. Some steps that can help:
1. Consistent Monitoring of Blood Glucose Levels
Continuous glucose monitors (CGMs) provide real-time feedback on blood glucose levels. Allowing for quick adjustments in diet, exercise, or medication. For those without access to CGMs, frequent finger-stick tests can still offer valuable insights. So consistent monitoring helps identify patterns and triggers for blood sugar fluctuations, enabling better control.
2. Adopt a Balanced Diet
Diet is important in managing glycemic variability. Foods high in refined sugars and simple carbohydrates can cause rapid spikes in blood glucose levels. Instead, focus on a diet rich in whole grains, fiber, lean proteins and healthy fats. These foods are digested more slowly. Gradually releasing glucose into the bloodstream, which helps stabilize blood sugar levels.
Here’s a practical tip: Include foods like oatmeal, beans, and vegetables that have a low glycemic index. They help maintain steady blood sugar levels throughout the day. Also consider portion control. Large meals can lead to significant glucose spikes. So smaller, more frequent meals might be a better option for some.
3. Regular Physical Activity
Physical activity increases insulin sensitivity, allowing your body to use glucose more effectively. However, the type, duration and intensity of exercise can all impact blood glucose levels differently.
For instance, high-intensity workouts might cause a temporary spike in blood glucose levels. While moderate, consistent exercise like walking or cycling can help maintain steady levels.
For best results, aim for at least 150 minutes of moderate aerobic exercise per week as recommended by health experts. Additionally, incorporating strength training exercises twice a week can further enhance insulin sensitivity and contribute to more stable glucose levels.
4. Manage Stress Effectively
When stressed, the body releases hormones like cortisol, which can increase blood sugar levels. Long-term stress may lead to persistent hyperglycemia. Contributing to greater glycemic variability and increasing the risk of mental health disorders.
To manage stress, consider mindfulness practices such as meditation, deep breathing exercises, or yoga. These activities can help lower stress levels and, in turn, stabilize blood glucose levels. Also, ensure you have a strong support system in place. Talking to friends, family, or a counselor can be incredibly beneficial.
5. Prioritize Sleep
Quality sleep is essential for overall health. Including blood glucose regulation. Poor sleep or sleep disorders, like obstructive sleep apnea can cause insulin resistance and elevate blood sugar levels. Establishing a consistent sleep routine. Going to bed and waking up at the same time every day can help regulate blood sugar levels.
And if you struggle with sleep, consider creating a calming bedtime routine. This might include reducing screen time before bed, creating a comfortable sleep environment and avoiding caffeine or heavy meals close to bedtime.
6. Medication Management
For those with diabetes, medications are important in controlling blood glucose levels. However, medication needs can change over time. Regular consultations with a healthcare provider can ensure that your treatment plan is optimized to minimize glycemic variability. In some cases, adjusting the timing or dosage of medications or adding new ones may be necessary to achieve better control.
Also never make changes to your medication without consulting a healthcare professional. Regular check-ins with your provider can also help you stay on track and make necessary adjustments as needed.
7. Avoiding Alcohol and Tobacco
Both alcohol and tobacco can affect blood glucose levels. Alcohol, in particular, can cause significant fluctuations, including dangerous lows. Especially in those taking insulin or certain oral diabetes medications. Tobacco use can increase insulin resistance, making blood glucose control more difficult.
Limiting or eliminating alcohol and tobacco use can contribute to more stable blood glucose levels and reduce overall glycemic variability.
The Role of TMS Therapy at TMS Institute of Arizona
For individuals struggling with mental health disorders, particularly those with co-existing conditions like diabetes, TMS (Transcranial Magnetic Stimulation) therapy can be an effective treatment option. The TMS Institute of Arizona utilizes TMS to treat conditions such as depression and anxiety. Offering hope to those for whom traditional treatments have not been effective.
TMS therapy works by stimulating specific brain areas involved in mood regulation. It’s a non-invasive treatment that has been shown to improve symptoms in patients with depression. Particularly those who have not responded well to medications. Importantly, TMS therapy has a low risk of side effects compared to traditional medications, making it a valuable option for individuals looking for alternative treatments.
Our patients receive personalized care for their unique needs. TMS therapy offers a promising pathway to improved mental well-being. It’s effective for those facing mental health challenges linked to glycemic variability or other conditions. Contact us.
References
Kwon, M., Lee, M., Eun Hwa Kim, Choi, D.-W., Jung, E., Keun You Kim, Jung, I., & Ha, J. (2023). Risk of depression and anxiety disorders according to long-term glycemic variability. Journal of Affective Disorders, 343, 50–58. https://doi.org/10.1016/j.jad.2023.09.017
Martinez, M., Santamarina, J., Pavesi, A., Musso, C., & Umpierrez, G. E. (2021). Glycemic variability and cardiovascular disease in patients with type 2 diabetes. BMJ Open Diabetes Research & Care, 9(1), e002032. https://doi.org/10.1136/bmjdrc-2020-002032
