How Hormones Affect Blood Sugar Levels

Dexcom Warrior with Dexcom G7 and Apple iWtach

The CGM Blog

Four Important Hormones that Affect Blood Sugar Levels

Our bodies rely on many complex, interconnected processes to function. Many of these processes are coordinated by chemicals known as hormones. One of the most important activities hormones help regulate is blood sugar management.¹ Understanding how hormones affect blood sugar levels can give you a little insight into what’s going on in your body as you work to manage diabetes.

What are hormones?

Hormones are chemical messengers that carry signals through the blood that tell different parts of your body what to do.¹ Hormones are like air traffic controllers sending out instructions to your organs and the tissues that make up your body. They help coordinate all of the processes that allow the body to function. This is similar to the way air traffic control manages planes coming into and out of the airport and ensures that pilots have the information they need to safely take off, fly, and land.

Hormones are made by specialized cells and glands in the body. The network of glands and the hormones they produce is called the endocrine system. You may be most familiar with sex hormones such as estrogen and testosterone, which influence the development of the reproductive system. However, hormones are responsible for supporting many other processes in the body, including our sleep cycle, stress response, blood pressure, digestion, and blood sugar management.²

Hormones that Affect Blood Sugar

The endocrine system is extremely complex, and so is its relationship to diabetes. Several hormones help regulate the metabolism, which is the process of digesting food and turning it into energy.³ Hormones that influence metabolism play a role in the regulation of blood sugar, also known as glucose. The main hormones related to glucose control in the body are insulin and glucagon.

Insulin

Insulin is the main hormone that’s impacted by diabetes. This hormone is made by cells known as beta cells in the pancreas, which is an organ that sits just behind the stomach.⁴ Insulin controls how the body uses glucose, or sugar, for energy. Once glucose enters the bloodstream from the foods we eat, insulin acts like a key that unlocks the cells in our body so that the glucose can get in. Without insulin, cells can’t properly absorb glucose, so it stays in the blood, leading to high blood sugar levels, or hyperglycemia.⁵

In individuals living with type 1 diabetes (T1D), an autoimmune event has destroyed the beta cells and so the pancreas can no longer make insulin at all. For those living with type 2 diabetes (T2D), the cells in the body either become less receptive to insulin, known as insulin resistance, or the pancreas can no longer produce enough insulin to meet the body’s needs.⁶

Individuals living with T1D require regular insulin injections to make sure that they can absorb the glucose they need.6 Insulin is also a treatment option for those living with T2D.6 There are several different types of insulin that can help manage glucose throughout the day and control glucose spikes after meals.⁶

Glucagon

Glucagon is another hormone that’s made by the pancreas. It’s produced by alpha cells. This hormone is responsible for making sure your glucose levels don’t drop too low. It does this by telling the liver to release stored glucose, known as glycogen, or instructing the liver to stop absorbing extra glucose from the bloodstream. It also tells the body to convert other chemicals and molecules—such as amino acids and fat—into glucose so the body can use it for energy.⁷

Without glucagon, the body can’t bring glucose levels back up when there isn’t enough sugar coming in via digestion. This can result in low blood sugar, or hypoglycemia.⁷ In individuals living with T1D, low blood sugar may not effectively trigger glucagon production. This means it’s harder for the body to make up for low glucose levels. Emergency glucagon injections are used to help individuals experiencing severe hypoglycemia.⁸

On the other hand, individuals living with diabetes may also have elevated glucagon levels. Those living with T2D are more likely to have more glucagon production, which can contribute to hyperglycemia.¹ For individuals living with T1D, elevated glucagon levels can lead to diabetic ketoacidosis.⁹ This happens when glucagon tells the liver to turn fat into ketones, which can be used for fuel instead of glucose.¹⁰

Stress and Hormonal Changes that Influence Blood Sugar

Stress has an impact on the way the body handles glucose. When the body senses a threat, it triggers a cascade of hormones to help us cope with the circumstances.¹¹ Among other important hormones, the body primarily uses adrenaline and cortisol to help us manage stressful events.

Adrenaline

When we experience something frightening or stressful, the body releases adrenaline, also known as epinephrine. This hormone is responsible for our “fight or flight” response which helps us handle threats in the moment. Adrenaline affects the entire body, causing elevated heart rate and faster breathing and directing more oxygen to the muscles and the brain. It also tells the body to release stored glucose and start burning fat for additional energy.^12,13

Cortisol

If the body perceives that a threat persists, the body switches to producing cortisol. Cortisol ensures that the body continues to stay on high alert.¹⁴ One of the ways that it keeps the body ready is by ensuring there’s plenty of glucose to use for energy to fight or run away. It does this by promoting the process of turning other substances into glucose. It also conserves glucose levels by telling the muscles to break down protein instead of glucose. Finally, it stimulates the production of glucagon and slows down the production of insulin so that there’s as much glucose available in the bloodstream as possible.¹⁴

Stress Hormones and Diabetes

Adrenaline spikes blood sugar and cortisol keeps it high, which can lead to hyperglycemia both in the moment and over time. This is why stress management is an important part of diabetes management. It’s also important to be mindful about the role exercise can play in the stress response. Adrenaline may be released during very intense physical activity—like heavy weightlifting, sprinting, or competitive sports—which means it’s important to keep an eye on your glucose levels when you exercise.¹⁵

Most people experience a natural rise in cortisol in the morning which helps wake the body up. Cortisol then decreases throughout the day and as we prepare for sleep. Studies have shown that in individuals living with T2D who are experiencing stress, elevated cortisol levels don’t follow the natural rhythm of peak and decline over the course of the day. This steady cortisol production has been linked to higher glucose levels.¹⁶

Hormonal Conditions Related to Diabetes

Diabetes is sometimes caused by hormonal changes that are due to other conditions that affect the endocrine system. Experiencing certain hormonal changes or living with an endocrine condition can increase the risk of developing prediabetes or T2D.

Hyperthyroidism and Hypothyroidism

Hyperthyroidism and hypothyroidism are thyroid diseases. The thyroid is a gland in the neck that produces hormones that help control the metabolism.¹⁷HYPERthyroidism happens when the thyroid produces too much of the hormones it makes. HYPOthyroidism happens when it doesn’t make enough. Both conditions can impact the way glucose is regulated in the body.¹⁷ HYPERthyroidism can cause an overproduction of insulin, leading to insulin resistance. Hypothyroidism makes it harder for the body to absorb glucose for energy and slows down the process of glucose being released from the liver. Individuals living with diabetes are more likely to experience thyroid diseases^.17

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) causes issues with hormone regulation in the body. It happens when cysts form around the ovaries, preventing the release of eggs into the uterus which results in irregular menstruation.¹⁸ PCOS is often accompanied by insulin resistance, which increases the risk of diabetes. Over half of those with PCOS develop T2D by age 40.¹⁹

Menopause

Menopause happens at the end of a person’s reproductive years when the menstrual cycle stops. During menopause, hormones change dramatically. These shifts impact weight as well as insulin production and sensitivity, which puts those going through menopause at higher risk of developing T2D.²⁰ Individuals living with T1D or those diagnosed with T2D before they were 20 years old are more likely to experience early menopause.²¹

Gestational Diabetes

Gestational diabetes is a type of diabetes that occurs during pregnancy. One of the factors that influences the development of gestational diabetes is hormones secreted by the placenta, including estrogen and cortisol.²² These extra hormones can increase insulin resistance. Gestational diabetes happens when the body can’t make enough insulin to cope with insulin resistance. Individuals who experience gestational diabetes may be more likely to develop T2D.²²

Understand How Hormones Impact Your Glucose

It’s not always easy to know how your hormones affect glucose levels. Using a continuous glucose monitoring (CGM) system can offer insight into changes in your glucose levels in the moment, and over time, giving you and your doctor more data to inform your diabetes care plan.

The Dexcom G7 CGM System can provide real-time glucose readings to help you manage your glucose levels with greater confidence. You and your doctor can use the Dexcom Clarity app integrated with your Dexcom G7 to view glucose trends over weeks or months to understand how factors like stress or hormonal shifts impact your glucose management. Dexcom G7 can also be used by those experiencing gestational diabetes to look after their glucose levels throughout pregnancy.^23,24

See how Dexcom G7 works

1 Hormones. Cleveland Clinic. Reviewed February 23, 2022. Accessed October 19, 2023. https://my.clevelandclinic.org/health/articles/22464-hormones
2 Hormones and the Endocrine System. Johns Hopkins Medicine. Accessed October 19, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/hormones-and-the-endocrine-system
3 Metabolism. Cleveland Clinic. Reviewed August 30, 2021. Accessed October 19, 2023. https://my.clevelandclinic.org/health/body/21893-metabolism
4 The Pancreas. Johns Hopkins Medicine. Accessed October 19, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/the-pancreas
5 Insulin Resistance. Centers for Disease Control and Prevention. Reviewed June 20, 2022. Accessed October 19, 2023. https://www.cdc.gov/diabetes/basics/insulin-resistance.html
6 What Is Diabetes? Diabetes Canada. Accessed October 19, 2023. https://www.diabetes.ca/about-diabetes/what-is-diabetes
7 Glucagon. Cleveland Clinic. Reviewed January 3, 2022. Accessed October 19, 2023. https://my.clevelandclinic.org/health/articles/22283-glucagon
8 Haymond MW, et al. Use of Glucagon in Patients With Type 1 Diabetes. Clin Diabetes. 2019;37(2):162-166. doi: 10.2337/cd18-0028. PMID: 31057222; PMCID: PMC6468823
9 Goguen J, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Hyperglycemic Emergencies in Adults. Can J Diabetes. 2018;42 Suppl 1:S109-S114. doi:10.1016/j.jcjd.2017.10.013
10 Diabetic Ketoacidosis. Centers for Disease Control and Prevention. Accessed October 19, 2023. https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
11 Body's Response to Stress. American Psychological Association. Updated March 8, 2023. Accessed October 19, 2023. https://www.apa.org/topics/stress/body
12 Understanding the Stress Response. Harvard Health Publishing. July 6, 2020. Accessed October 19, 2023. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
13 Epinephrine (Adrenaline). Cleveland Clinic. Reviewed March 27, 2022. Accessed October 19, 2023. https://my.clevelandclinic.org/health/articles/22611-epinephrine-adrenaline
14 Thau L, et al. Physiology, Cortisol. StatPearls Publishing. Updated 2022 Aug 29. Accessed October 19, 2023. https://www.ncbi.nlm.nih.gov/books/NBK538239/
15 Why Does Exercise Sometimes Raise Blood Sugar? American Diabetes Association. Accessed October 19, 2023. https://diabetes.org/health-wellness/fitness/why-does-exercise-sometimes-raise-blood-sugar
16 Dias JP, et al. The longitudinal association of changes in diurnal cortisol features with fasting glucose: MESA. Psychoneuroendocrinology. 2020 Sep;119:104698. doi: 10.1016/j.psyneuen.2020.104698. Epub 2020 Jul 13. PMID: 32674946; PMCID: PMC8046490
17 Biondi B, et al. Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders. Endocr Rev. 2019;40(3):789-824. doi:10.1210/er.2018-00163
18 Polycystic Ovary Syndrome (PCOS). Mayo Clinic. September 8, 2022. Accessed October
19, 2023. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
19 Polycystic Ovary Syndrome (PCOS). Centers for Disease Control and Prevention. Reviewed December 30, 2022. Accessed October 19, 2023. https://www.cdc.gov/diabetes/basics/pcos.html
20 Paschou SA, et al. Type 2 Diabetes Mellitus and Menopausal Hormone Therapy: An Update. Diabetes Ther. 2019;10(6):2313-2320. doi:10.1007/s13300-019-00695-y
21 Yazdkhasti, M, et al. The association between diabetes and age at the onset of menopause: a systematic review protocol. Syst Rev. 2019;8(80). doi:10.1186/s13643-019-0989-5
22 Gestational Diabetes. Johns Hopkins Medicine. Accessed October 19, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes
23 American Diabetes Association Professional Practice Committee. Diabetes Care. 2022;45(Supp 1):S232–S243.
24 The American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;131(2):e49-e64.

Our experts are here to help.