Cortisol and Glucose: Understanding the Stress-Sugar Connection

Key Takeaways

• Chronic stress and prolonged elevated cortisol levels disrupt glucose metabolism and impact all organs and systems within the body.
• High cortisol levels can lead to elevated blood sugar levels, increasing the risk of type 2 diabetes, weight gain, and heart disease.
• Manage cortisol levels with an anti-inflammatory diet, regular physical activity, and stress-reducing activities like time in nature or deep breathing.

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Our bodies are a complex system influenced by the constant stresses of daily life. Cortisol plays a key role in how our bodies respond to stress.¹ 

Cortisol impacts glucose production and blood glucose levels. Prolonged high cortisol levels can harm our health.¹ Fortunately, lifestyle changes and natural strategies can help manage cortisol levels and reduce its negative effects.

This article explains the relationship between cortisol and glucose metabolism, how it impacts blood sugar levels, the health implications of prolonged elevated cortisol, and strategies for managing cortisol levels with lifestyle changes.

What is Cortisol?

Cortisol, the body’s stress hormone, is regulated by a complex system (HPA axis) involving the hypothalamus and pituitary gland from the brain and two adrenal glands on top of the kidneys. This HPA system controls the production and release of cortisol, a glucocorticoid hormone.¹ 

Cortisol receptors are present in almost every body tissue, meaning cortisol can impact all organs and systems, including the immune, cardiovascular, and reproductive systems.¹ 

Cortisol's primary function includes regulating the stress response, immune function, and metabolism (helping manage energy and growth).¹ 

The body constantly responds to stressors, determining if a response is needed. When the body perceives a threat, cortisol is released. This release provides you with the energy in the form of glucose to ‘fight or flee.’¹ 

Unfortunately, our bodies release cortisol too often in our stressful world, harming our health and well-being. 

How Cortisol Affects Glucose Metabolism

When the body perceives a threat, it releases cortisol, which triggers the release of epinephrine. This constricts blood vessels and increases heart and breathing rates to prepare the body for action.¹ 

Cortisol also ensures adequate glucose is available for either fight or flight responses.¹ 

Cortisol:

• Increases the availability of blood glucose to the brain.
• Increases gluconeogenesis (making glucose from non-carbohydrate sources) in the liver.
• Decreases the production of glucose storage forms (glycogen) in the liver.
• Increases the availability of energy in the muscles.
• Increases the release of fat from stored fat cells, which are converted to energy.
• Decreases insulin in the pancreas to prevent glucose from being stored.

Your body works in overdrive to ensure that you have the energy you need, through higher blood sugar levels, to confront a threat. Typically, the body maintains a healthy balance of cortisol levels but can malfunction.¹ 

Prolonged elevated cortisol produces excessive glucose, leading to increased blood sugar levels and other health implications.¹ 

Health Implications of Elevated Cortisol Levels

Elevated cortisol levels impact every organ in the body. Chronic high levels of cortisol can lead to health consequences, including increased risk of type 2 diabetes, weight gain, and heart disease. 

Type 2 Diabetes

Type 2 diabetes is a chronic health condition marked by high blood sugar levels caused by insulin resistance and inadequate insulin production in the pancreas. High blood sugar levels develop gradually, and prolonged elevated levels increase the risk of health problems.² 

Excessive cortisol is associated with elevated blood sugar levels and insulin resistance, increasing susceptibility to type 2 diabetes. Researchers have found that elevated evening cortisol levels predict a 10 to 15% increased risk of new-onset type 2 diabetes among 3,270 adults.² 

In the United States, black adults are almost twice as likely as white adults to develop type 2 diabetes. Researchers have been investigating the reasons behind this increased risk.³ 

Interestingly, the HPA system, which regulates cortisol, differs by race and ethnicity. Research suggests that black adults experience a less favorable cortisol response, independent of socioeconomic status, which may increase their risk of developing type 2 diabetes.⁴ 

A 2019 study of 4,206 African Americans found that higher morning cortisol levels were associated with higher fasting blood sugar levels and reduced insulin function in adults without diabetes. In those with diabetes, elevated cortisol was associated with higher fasting blood sugar and hemoglobin A1C levels, indicating poor blood sugar control.⁴

A body constantly in a state of elevated blood sugar levels, along with impaired insulin function, is a recipe for deteriorating blood glucose control, leading to pre-diabetes and type 2 diabetes. 

Weight Gain

Earlier, one of the ways the body converted energy in response to cortisol was by releasing fat from fat storage (subcutaneous) and moving it to abdominal (visceral) fat. Visceral fat is more readily available for energy than storage fat.^1,2 

Visceral fat is a risk factor for many chronic diseases like type 2 diabetes, high blood pressure, and heart disease. Visceral fat surrounds your organs, is metabolically active, and releases more hormones (like cortisol), increasing inflammation.⁵ 

Higher body mass index (BMI) is associated with elevated cortisol levels and an abnormal response.²

Additionally, there is a strong connection between the HPA system and energy regulation. People with abdominal obesity (visceral fat) tend to have elevated cortisol levels, which can lead to increased consumption of fatty and sugary foods. Researchers also suggest that some people are high-responders to cortisol and may be more likely to gain weight than low-responders.⁶ 

Heart Disease

Stress is a significant factor in the development of high blood pressure and heart disease.⁷ 

A 2021 study of 412 adults found that people with higher levels of stress hormones, such as cortisol and epinephrine, were more likely to develop high blood pressure over the next six to seven years.

Elevated urinary cortisol levels were associated with an increased risk of heart attacks and strokes. Throughout an eleven-year follow-up period, there was a 90% increased risk of heart events with each doubling of cortisol levels.⁷ 

Stress, with its elevated cortisol response and damaging effect on the body, can be managed with different strategies to help prevent negative outcomes. 

Unchecked stress can powerfully affect all body systems, impacting your heart, body size, and glucose metabolism. 

Strategies to Manage Cortisol Levels

Stress, with its elevated cortisol response and damaging effect on the body, can be managed with different strategies to help prevent negative outcomes. 

Breaking the cycle of elevated cortisol is crucial to regaining balance and healthy body systems. 

Many strategies can help you manage stress and enhance nutrition, which helps lower cortisol levels and improve your overall health. 

• Adopting an anti-inflammatory diet rich in vegetables, fruits, whole grains, fish, lean proteins, and healthy fats, like the Mediterranean Diet, may counteract stress and inflammation, preventing future health problems.⁸ 
• Regular physical activity is an effective strategy to lower cortisol levels. Physical activity helps regulate cortisol and also improves sleep. Poor sleep is associated with elevated cortisol levels.⁹
• Stress management techniques like five minutes of deep breathing can calm the nervous system, heart rate, and blood pressure. A review article of 58 studies found that deep breathing effectively reduces stress and anxiety in both children and adults.¹⁰
• Time in nature helps relieve stress and increase mindfulness. Research shows that being more mindful or aware can help you cope well in times of stress.¹¹ 

The Bottom Line

Chronic stress and elevated cortisol levels can disrupt glucose metabolism, increasing the risk of chronic diseases, such as type 2 diabetes, weight gain (particularly abdominal fat), and heart disease. 

Understanding the stress-sugar connection empowers you to prioritize cortisol balance through nutrition, exercise, and stress management. 

Making small, sustainable lifestyle changes can help you regulate cortisol and blood sugar levels, counteracting the negative effects of stress. 

Learn More About How to Improve Blood Sugar Health With Signos’ Expert Advice

A Signos continuous glucose monitor (CGM) tracks your blood sugar levels, helping you understand how stress, diet, and exercise affect your body and levels. These positive changes can help you improve your health, prevent type 2 diabetes, and lose weight. 

A healthcare professional can help you choose the proper medication (if needed) to help manage your health conditions, blood sugar levels, and weight. 

Learn more about nutrition and healthy habits on Signos’ blog. Take a quick quiz to determine if Signos is right for you!