- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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April 3, 2013
Stress, illness and high blood sugar
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
A number of you have mentioned that your blood sugar runs higher when you are ill or under stress.
Illness or stress can trigger high blood sugars because hormones produced to combat illness or stress can also cause your blood sugar to rise.
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 sugar 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 be a detective. Here are some possible causes of high blood sugars:
- Not enough insulin or oral diabetes medication
- Eating or drinking more carbohydrate 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)
- 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)
In rare incidences, stress can cause blood sugars to drop low.
Make sure you know the symptoms of high blood sugar.
| 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 sugars
- Ongoing diarrhea or vomiting for more than 24 hours — or sooner if you're becoming dehydrated
- Fever that lasts more than 24 hours
- Blood sugar 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 sugar.
Please share your experiences. Thanks.
- Nancy
70 comments posted
June 18, 2013 8:39 a.m.
Florence: Diabetes is a progressive disease. Discuss with your healthcare provider the next step to managing your blood sugar.
- Nancy and Peggy
June 9, 2013 5:04 p.m.
I have type 2 dibetes and have had it for 16 years. My blood sugar readings have always been well controlled. But lately the morning readings are high and yesterday I even had a hypo in the afternoon. Nothing has changed except that I had some negative stresses. I am on almost the maximum dose of medication. My last A1C was 6.9 three months ago. Not sure what to do.x
- Florence
June 3, 2013 10:43 a.m.
adv. siddiqui: So sorry, we do not understand your question. It would be best to ask a pharmacist or your provider.
- Nancy and Peggy
June 3, 2013 10:39 a.m.
Anselmo: The a1c test IS used to diagnose diabetes, at least here in the United States. According to the American Diabetes Association: There are three different tests your doctor can use to determine whether you have prediabetes or diabetes: •The A1C test •The fasting plasma glucose test (FPG) •or the oral glucose tolerance test (OGTT).
- Nancy and Peggy
June 1, 2013 10:26 a.m.
If the sugar patient can take the tablet prandial M0.2 in two times in place of glimister1 mg tablet then how much time is requride to control sugar level
- adv.siddiqui
May 27, 2013 9:50 a.m.
An A1C test, also known as a glycated hebmologin test, isn't used for diagnosing prediabetes or diabetes. Instead, it gauges how well you're managing your diabetes.Unlike a fasting blood glucose test or a daily finger stick, both of which measure your blood sugar level at a given time, the A1C test reflects your average blood sugar level for the past two to three months. Test results show what percentage of your hebmologin — a protein found in red blood cells — is sugar coated (glycated).
- Anselmo
May 5, 2013 11:02 p.m.
I have PTSD, anxiety, depression, panic attacks (that can last as long as 40 minutes). I know stress causes high blood sugar. What can I do? I have 3-5 episodes per day. Doctors I talk to don't understand the hormones released during these attacks and just treat the high sugar. Is there more that can be done?
- sly288
April 16, 2013 2:51 p.m.
Arlayne, Wow fibromyalgia and type 1 diabetes!I would see your provider about setting up a rapid insulin correction scale to cover your blood glucoses the days that the fibromalgia pain elevates the blood glucoses.
- Nancy and Peggy
April 16, 2013 1:30 p.m.
T2 and quit Metformin. Some people are not able to tolerate the gastro intestinal side effects of Metformin and need to quit taking it. Please talk with your provider about other diabetes mediations that do not have the GI side effects. Take care.
- Nancy and Peggy
April 15, 2013 12:53 p.m.
What a kind, helpful & intelligent comment from Jennae to Holly. Holly, Jennae is giving you exactly the right advice. Reach out! You're not alone -- and we never have to be alone with all the help that is available to us Type 2's. It's a very very tough disease to accept and to deal with. But you can do it. I, too, suffer from clinical depression and Type 2. My blood sugars were over 500! For the longest time! But now, with medication, lots of effort, and my great medidal team behind me, I average 124. That's a life-changing number, believe me....and I want that for you, too. Call today -- ask for a nurse practitioner or a diabetic educator. You'll never regret reaching out. Good luck -- you're in my prayers, Holly.
- Linda
April 10, 2013 1:56 p.m.
I'm a T2 and quit taking metformin due to constant diarrhea, bloating and cramps. Am I alone??
- tracy
April 9, 2013 1:14 p.m.
@Holly Holly, you need to seek real help, not post and hope. Sticking your head in the sand is not an unusual response to newly diagnosed diabetes, but it sure is an unhealthy one. Make the call today to get psychological support and to see a nurse specialist that can take time to guide and check in on you. Most of us Type 2's dug our own hole with overeating,true, but the wonderful thing is, we can use our diabetes as a most wonderful motivator to change our lives. Your depression is too heavy to handle alone. I hear you and hope you have a primary care doctor to call for a referral. If not, please do call your local 211 assistance line or see your pastor if possible. Without a change, you are simply committing a very slow and unpleasant suicide. Please don't. Please take a positive action today for yourself.
- Jennae
April 9, 2013 12:29 p.m.
Arlayne Did your Dr. inform you that stress and pain can also play apart why your blood sugars my be high? You mention you have Fibromyalgia that may be causing the pike in your blood sugars. Keep watch of your diet,excerise if you can. Hormones can also increase blood sugars .
- m.j
April 9, 2013 12:20 p.m.
Be patient. The first year is the hardest . Watch what you eat and measure your carb intakes. Rice,breads,potatoes will pike up your blood sugars. Excerise helps lower blood sugars. If you are able to do some walking daily and you will see results .
- m.j
April 9, 2013 11:21 a.m.
I am a newly diagnosed Type 1 diabetic and I'm still trying to get my A1C 10.9 down. I also have fibromyalgia and it is very dibilitating when I have a flareup, which started about 2 weeks ago. My sugar levels have been fluctuating between 140-300, which is higher than my doctor wants it to be. Does anyone have any suggestions on how I can counteract higher levels during a flareup?
- Arlayne
December 10, 2012 8:16 a.m.
I have Cramp Fasciculation Syndrome and since the symptoms have developed my blood sugar has risen. I have type 2 diabetes which was previously in excellent control. Now that has changed from my illness.
- Margie
December 5, 2012 5:19 p.m.
CGM and stable state. It appears to me that this new feature does a good job of monitoring your levels as look as your in a tightly controlled range. But if I see 140 on my read out I may be 270 and if I go low it also seems to loss range moving away from what my actual B/S is. As a long time type One the information I need is mainly when I am out of range. Maybe the Engineers forgot that. I am using the new CGM more to show direction shifts and increasing my basal/or bolus if I see a move up above 130. Don't get me wrong this is a great improvement from urine testing. Any thought?
- Billum
November 6, 2012 1:36 p.m.
I have had type 1 diabetes for 43 years and avg 7.8 A1c..feel I am moderately controlled under the circumstances blood sugars usually between 70-200. I am on an insulin pump and recently have had some unusually high blood sugars 3 of the last 4 evenings even though I have not done anything...eating..exercise, stress out of the normal. I normally take about 43 units a day but on these evenings I have had to take an extra 30 units to get me out of these high readings and it seems like it takes forever-5 to 8 hours. they start out at 375 and when I take a bolus they go up 50-75 and then another bolus and go up slightly higher to 500 or maintain their high levels in the high 400s for 5 -8 hours. I have switched pump sites, changed insulin bottles and even injected insulin twice in my leg with a syringe but it still takes 5-8 hours before they come down below 200. Any thoughts on what might be occuring or tests I should consider taking to determine what is causing this? Appreciate any insight you might have into this puzzling and unusual occurrence for me.
- John
July 19, 2012 1:22 p.m.
Counter-regulatory hormones in the body react to stress and raise the blood glucose.
- Nancy and Peggy
July 13, 2012 8:44 p.m.
I have been a type II Diabetic for two years. Just lately my reading have been running higher and higher. Mornings could be 148 and 156 but I was having at leastt lower readings during the day, like 120 or so. Now I took my sugar tonight and it's 199. Yes I have had quite a few health issues since it's started. Two knee replacements, a revision of one, an artery nicked during the replacemnt. Now on my second hand operation of carpol tunnel. I never really without pain, so how can my sugars go down. Just thinking about it going up, I think makes it go up.
- Jo-Ann
July 8, 2012 8:14 a.m.
I take my readings 5 to 7 times daily. Some weeks my readings at morning fasting are 95 to 115. Other weeks they are at 120 to 130. I am prediabetic and take metformin. Why the big difference? I don't eat anything differently and exercise everyday. Jog 1 to 3 miles daily.
- Steve
June 7, 2012 7:26 p.m.
thanks for your help sugars are running in the 300-350 A1c is 7.6 there is a great deal of stress have lost 6lb in 4 weeks
- sue
June 1, 2012 6:14 a.m.
Thanks for the info Nancy, I had a back injury on monday and after running 60-110s for the past year with my A1c going to 5.1, I am now running 250 and above...going to MD today !!
- Mary
May 21, 2012 7:55 p.m.
525 sugar this AM. Wondered what the cause of such a spike could be and how dangerous . It is down to 200 now.
- Jerry
April 18, 2012 8:13 a.m.
Yes, pain can raise the blood glucose.
- Nancy and Peggy
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