For most people, stress is simply annoying or unpleasant; for people with diabetes, it can have a direct impact on health. Stress hormones can cause blood sugar to rise and you may need more insulin or other medications to control blood sugar when you are under stress (being sick or physically injured can also do the same).

Your response to stress, however, can exacerbate the problem. If you skip meals, neglect exercise, or tend to eat poorly, your blood sugar may become too high or too low.

“There is a myth out there that it’s all about food as to why the blood sugar rises,” says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. The truth is that other factors play a role, he explains, including stress.

For example, if you’re a schoolteacher who takes insulin at breakfast, a morning meeting with a difficult co-worker can affect the insulin’s ability to control your blood sugar.

“That person will have, in many cases, a higher than normal glucose level at that time. Only part of it is due to what they ate,” Dr. Hellman says. “(Another) part of it is due to the fact that their hormones are churning out adrenaline and other stress hormones.”

If you’re under stress, you may need to take more insulin to correct for extra-high blood sugar, or less if you change your behavior.