How Effective Stress Management Led to Diabetes Remission in a Woman

Stress doesn’t just weigh on your mind—it can take a serious toll on your physical health too. You may have heard of “Broken Heart Syndrome,” a condition medically known as Takotsubo cardiomyopathy. This occurs when severe, prolonged stress affects the heart, leading to symptoms similar to a heart attack.

Chronic stress doesn’t stop there. You’ve probably seen scenes in movies or TV shows where someone suffers a heart attack or stroke after a tragic event like the death of a loved one or a financial crisis.

While it might seem dramatized, this is grounded in reality. Intense emotional distress can trigger dangerous physical reactions, including heart problems.

In real life, people who live with anxiety or long-term stress are more likely to develop hypertension (high blood pressure) and diabetes.

Here’s why:

When you’re under severe stress, your body releases a flood of stress hormones, including adrenaline and cortisol.

These hormones prepare your body for a “fight or flight” response but can also disrupt normal processes.

For example, they can spike blood sugar levels, sometimes leading to severe hyperglycemia (high blood sugar).

For individuals already at risk—such as those with prediabetes or metabolic syndrome—stress can push them over the edge, potentially triggering diabetes. In some cases, diabetes can even develop suddenly due to chronic stress exposure.

Understanding how stress impacts your physical health is key to managing it effectively and preventing serious conditions like heart disease, diabetes, and stroke.

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Here is a story of a woman who had severe uncontrolled diabetes and anxiety …

This is the inspiring story of a woman who struggled with severe, uncontrolled diabetes and anxiety. When she first visited our dibesity clinic, she was accompanied by her husband who was very supportive.

Despite coming from a well-off family of doctors—her father even ran a private hospital—she faced significant challenges in managing her health.

Initial Assessment

At the time of her visit, her condition was alarming:

• Blood Sugar Levels: Fluctuating between 250–350 mg/dL
• HbA1C: 10.8%
• Medications:
  • Glimepiride 4 mg
  • Metformin 1000 mg twice daily
  • Sitagliptin 100 mg
  • Prothiaden (Dosulepin)
  • Bromazepam
  • Exforge (Valsartan and Amlodipine)
  • Concor (Bisoprolol)

She complained of insomnia, fatigue, low mood, palpitations, frequent crying episodes, and a persistent sense of dread. During her consultation, she avoided eye contact, and her voice revealed emotional distress.

The Plan of Action

Recognizing that her physical and emotional health were intertwined, we devised a comprehensive plan:

1. Dietary Changes:
   • Avoid sugary foods, beverages, sweets, and bakery items.
   • Limit high-sugar fruits like dates, grapes, bananas, and mangoes.
   • Restrict rice to once a week.
   • Include salads before each meal and avoid overeating.
2. Lifestyle Modifications:
   • Start early morning walks for at least 30 minutes.
   • Incorporate activities like hiking, cycling, swimming, or gym sessions.
3. Blood Sugar Monitoring:
   • Twice weekly checks: fasting on Saturdays and post-meal on Sundays.
   • Target blood sugar levels: 120 mg/dL (fasting) and 160 mg/dL (post-meal).
4. Medication Adjustments:
   • Introduced Prozac (Fluoxetine) 20 mg for anxiety.
   • Replaced her diabetes medications with combinations tailored to her condition:
     • Janumet (Sitagliptin/Metformin) 50/1000 mg after dinner.
     • Empagliflozin/Metformin 12.5/1000 mg after breakfast.
     • Pioglitazone/Glimepiride 4/30 mg after breakfast.
   • Maintained her blood pressure medications: Exforge and Concor.
5. Psychiatric Referral:
   • Suggested she consult a psychiatrist for comprehensive mental health support.

Before finalizing her diabetes management regimen, I discussed the possibility of starting her on insulin therapy. Given her severely elevated blood sugar levels, insulin could have been a logical step for rapid control.

However, she expressed significant fear and nervousness about using insulin. Recognizing her heightened anxiety and the potential for a panic attack, I decided against initiating insulin at that time.

Instead, I opted for an oral regimen tailored to her needs, ensuring better compliance while minimizing the risk of exacerbating her anxiety.

Progress and Results

During her 2-week follow-up visit, her blood sugar levels were well within range. She even had a few episodes of hypoglycemia. Her stress levels had significantly improved, but insomnia persisted. To address this, we:

• Reduced her Pioglitazone/Glimepiride dose.
• Introduced Eszopiclone (Lunesta) for sleep.

Over subsequent visits:

• Her weight dropped from 84 kg to 65 kg, significantly improving her overall health.
• Her diabetes medications were simplified to a single tablet: TriJardy XR (Empagliflozin/Linagliptin/Metformin).
• Eventually, all diabetes medications were discontinued, and she maintained normal blood sugars with diet control alone.

The Role of Stress Management

Her psychiatrist later adjusted her antidepressant regimen. She was switched to Zoloft and Alprazolam but this regimen didn’t suite her.

She requested to change her sleep medicines and we switched her back to a combination of Fluoxetine and Olanzapine (Symbyax (Fluoxetine/Olanzapine), which helped stabilize her mood and sleep.

During her last visit, she reported taking diabetes medications (Linagliptin and Empagliflozin – Glyxambi) only occasionally—when indulging in sweets or ice cream.

A Remarkable Turnaround

Whether it was her effective stress management, significant weight loss, or a combination of both, this woman achieved something extraordinary: diabetes remission.

Her story is a testament to the power of holistic care and the interconnectedness of physical and emotional health.

If you or someone you know struggles with similar challenges, know that transformation is possible with the right support and lifestyle changes.

Here is a table demonstrating how stress can affect various body functions:

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