Stress and Illness Do Cause Hyperglycemia

Have you had higher that expected blood glucose readings lately? If so, have you been ill or do you have an infection? Have you checked your feet and lower legs lately? Or, are you coming down with an illness?

If none of these is answered yes, do you have extra stress in your life – from your job, or possibly marital stress, or financial stress?

All of the above can cause higher than normal blood glucose levels or hyperglycemia. Stress or illness can trigger high blood glucose because hormones produced to combat illness or stress can also cause your blood glucose levels to rise. So, what is hyperglycemia you ask? Simply stated, hyperglycemia is any blood glucose reading above normal. Normal is a more difficult measure and varies by who you are talking about and which diabetes organization you believe.

The American Association of Clinical Endocrinologists generally says that anything over 140 mg/dl is hyperglycemia. The young people below age 21 can have a higher reading. The American Diabetes Association is much more liberal. For adults 180 mg/dl is the start of hyperglycemia. For below the age of 21, they allow 225 mg/dl for school-age children and up to 250 mg/dl for preschoolers.

People who do not have diabetes can make enough extra insulin to keep their blood sugar in a normal range during times of stress and illness. People with diabetes may need to take extra diabetes medication to keep their blood glucose near normal during times of illness or stress. If you haven't been given special instructions on how to manage your diabetes medications during illness, please contact your healthcare provider for advice.

Sometimes you may need to turn detective. Here are some possible causes of high blood glucose:

• Not enough insulin or oral diabetes medication
• Eating or drinking more carbohydrates than usual
• Less activity or exercise than usual
• Illness or infection (cold, urinary tract infection, heart attack)
• Injury or surgery
• Pain
• Positive stress (wedding or vacation) or negative stress (a death in the family or job change)
• Any change in your normal daily routine
• Certain medications
• Poor absorption of insulin at injection sites
• Insulin pump, insulin pen or meter (device issues)
• Bad insulin (outdated insulin or insulin that has been exposed to extreme temperatures)

The above are also some of the check points I use and referred to in a previous blog.

In rare incidences, stress can cause blood glucose to drop low.

Make sure you know the symptoms of high blood glucose.

Early signs/symptoms	Later signs/symptoms
Increased thirst	Fruity-smelling breath
Increased urination	Nausea and/or vomiting
Fatigue	Abdominal pain
Blurred vision	Rapid breathing
	Weakness
	Confusion
	Unconsciousness

When to contact your healthcare provider:

• You notice symptoms of high blood glucose
• Ongoing diarrhea or vomiting for more than 24 hours — or sooner if you're becoming dehydrated
• Fever that lasts more than 24 hours
• Blood glucose readings greater than 250 mg/dl (13.9 mmol/L) for more than 24 hours during illness
• If you have been instructed to check urine ketones and they are present (type 1 diabetes)

Call the emergency department if you experience any of the later signs and symptoms of high blood glucose.