Stressed Out? Elevated Cortisol Levels Can Lead To Type 2 Diabetes Diagnosis

Diabetes is a lifestyle disease that can affect anyone at any age. On World Diabetes Day, experts are drawing attention to an often-overlooked factor in the rise of type 2 diabetes: chronic stress and its key hormone, cortisol. A recent study presented at the American Diabetes Association 2025 Scientific Sessions highlighted that up to one in four people with difficult-to-control diabetes had higher-than-normal cortisol levels when tested. This reinforces what endocrinologists see in clinics – stress physiology can worsen blood sugar control even when medications are optimised.

What is Cortisol aka the Stress Hormone? 

Dr Vimal Pahuja, MD, Associate Director, Internal Medicine & Metabolic Physician, Diabetes & Weight Management Clinic, Dr LH Hiranandani

Hospital, Powai, Mumbai, explains, “Cortisol is a hormone released by the adrenal glands whenever we face stress. In short bursts, it helps us stay alert and manage emergencies. The problem arises when stress becomes chronic and cortisol stays elevated for months or years.”

Chronically elevated cortisol, often referred to as the ‘stress hormone’, can heighten the risk for acquiring Type 2 diabetes. When levels remain persistently high, such as during chronic psychological stress, obesity, or Cushing’s syndrome, it disrupts glucose metabolism and insulin balance. 

How does cortisol impact blood sugar and insulin?

Cortisol is a counter-regulatory hormone, opposing the action of insulin in that it raises blood sugar levels by stimulating gluconeogenesis in the liver and reducing glucose uptake in the muscles and fatty tissues, explains Dr David Chandy, Director of Endocrinology at Sir H.N. Reliance Foundation Hospital. Over time, this leads to insulin resistance, wherein the body’s cells become less responsive to insulin. The pancreas compensates initially by producing more insulin, but as the strain continues, beta-cell function declines with ensuing hyperglycemia and progression to type 2 diabetes.

Can high cortisol levels be lowered?

The good news, shares Dr Vimal, is that cortisol can be managed. Regular physical activity, particularly walking, yoga, or strength training, helps lower cortisol and improve insulin sensitivity. Seven to eight hours of consistent sleep, mindful breathing, and limiting caffeine or late-night screen exposure are simple but powerful interventions. 

A diet rich in complex carbohydrates, fibre, lean protein, and omega-3 fats supports stable blood sugar and curbs cortisol spikes. It’s also important to avoid excessive caffeine, alcohol, and refined sugars, which Dr David shares can help bring cortisol levels under control.

In patients presenting with unexplained weight gain, fatigue, or high blood pressure, especially those with worsening blood sugar control, medical evaluation of cortisol excess may be indicated. 

In short, chronic stress and increased cortisol provide the biological link between emotional stress and metabolic disease. Controlling stress is not just about mental well-being; it’s a significant step in the prevention of diabetes and maintenance of hormonal balance.