Impact of Stress on Blood Sugar Levels Shown in Medical Students

Examination Stress Linked to Measurable Glucose Spikes

Acute psychological stress raises blood glucose levels in non-diabetic individuals during academic tests and the days preceding them. Researchers presented these observational findings at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy. The investigation evaluated healthy university students to determine whether routine examination pressure generates measurable metabolic shifts.

Continuous Glucose Data across the Examination Timeline

Continuous glucose monitoring (CGM) recorded the highest daily average glucose reading on the day of testing at 5.72 mmol/L. That figure marked an increase of 0.37 mmol/L from 5.35 mmol/L recorded four days prior to the exam. Levels dropped by 0.30 mmol/L to 5.42 mmol/L on the day following the test.

Overnight readings showed an upward trend as the examination approached. Sleep glucose rose from 4.70 mmol/L on the seventh night before testing to 4.93 mmol/L on the final night. During the exam period itself, glucose peaked during the written evaluation at an average of 6.14 mmol/L.

Hormonal Release and Liver Glucose Output

Elevated psychological stress triggers the release of cortisol, which prompts the liver to release stored glucose into the bloodstream. This biological response supplies rapid energy to handle demanding conditions. Self-reported anxiety measured on the State-Trait Anxiety Inventory (STAI) questionnaire correlated directly with higher glucose readings before the exam and steeper drops afterward.

Study authors noted that while these short-term elevations stayed within normal physiological boundaries, repeated stress exposure across months could alter typical metabolic ranges. Author Natalia Michalcova noted that recurring elevations may potentially contribute to the risk of type 2 diabetes over prolonged periods.

Cohort Parameters and Study Limitations

The observational study evaluated a small sample of 22 healthy second-year medical students, consisting of 13 women and 9 men. Participants had an average age of 21 years and an average body mass index (BMI) of 21.9 kg/m². Sensor readings were captured every 15 minutes starting seven days prior to a biochemistry exam and concluding three days afterward.

The findings represent observational data from a single cohort at Charles University and Motol University Hospital in Prague. Lead researcher Dr. Jan Broz highlighted basic lifestyle behaviors to help manage situational stress, including consistent sleep, balanced nutrition, hydration, regular exercise, and limiting excess caffeine intake.