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  • With Mayo Clinic diabetes educators

    Nancy Klobassa, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • Jan. 17, 2009

    Stress, illness and high blood sugar

    By Nancy Klobassa, R.N., and Peggy Moreland, R.N.

20 comments posted

Hello again, 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  • Bad insulin (outdated insulin or insulin that has been exposed to extreme temperatures)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
  • Fever that lasts more than 24 hours
  • Blood sugar readings greater than 250 mg/dl 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

20 comments posted

blog index

  • November 25, 2009 10:11 a.m.

    A few weeks ago I hit a lady with my car. It was completely my fault but luckily I was travelling slowly..under 5 mph. The lady was bruised quite badly but she was ok and didn't need to go to hospital. I have heard today that she is in a diabetic coma. Could this possibly be my fault? Could the coma be as a result of the injury? I feel so awful about this and can't bear to think I've done this to her.

    - Sally

  • October 27, 2009 2:50 p.m.

    I was just told by my doctor that my blood sugar was 305 the last two test. My doctor is at the local VA. She did not seem to concerned. My lipids are 365 and colesterol is high. I take meds for high blood pressure and colesterol. Should I be more concered?

    - Fred

  • October 22, 2009 1:58 p.m.

    Linda, when my dad went into a diabetic coma, his sugars were over 700, but still, I would be concerned about your mom's numbers and be contacting either her doctor or taking her to the emergency room.

    - Kathy

  • October 21, 2009 8:14 p.m.

    how high does blood sugar have to get before you go into a coma? My mother's is over 500 today.

    - Linda

  • August 7, 2009 9:09 a.m.

    Debbie, yes a cortisone injection will generally increase the blood glucose in individuals with diabetes, but the affect on the blood glucose is different from person to person. Often, I will see the major impact of the cortisone injection on the blood glucose the first 72 hours and then it wanes down, but in some cases it's affects will hang on for several weeks. The blood glucose may even shoot up 100-200 mg/dl or 5.5-11.1 mmol/L above what you generally run. On the other side, a cortisone injection may not affect the blood glucose much at all. Nancy

    - Nancy and Peggy

  • August 6, 2009 4:52 p.m.

    I want to know if a cortisone injection into a knee or knee joint increases blood sugar.?. Thanks Debbie

    - Debbie

  • June 4, 2009 11:25 a.m.

    I was diagnosed with juvenile diabetes 12 years ago. I have been on the pump for 3 years. I have found that when I am stressed, my sugar bottoms out. My blood pressure also drops. Has there been any research on this? I also suffer from migraines with stroke like symptoms. Are migraines common for diabetics?

    - Rebecca

  • May 13, 2009 10:44 a.m.

    Debbie, no ifs, ands, or buts, this co-worker needs to be seen by a healthcare provider immediately.

    - Nancy and Peggy

  • May 8, 2009 4:35 p.m.

    I would like to know what you do for a person who has a high blood sugar level, but who is not on medication. This person has a history of diabetes in her family, her doctor says she usually has low blood sugar. This is one of my employees and we sent her home because she was complaining she didn't feel good and her eyes hurt and she felt like she was going to pass out. We got her home and her sister tested her blood sugar and she had a count of over 400. So, other then making the person go to the doctor, is there something to do for her.

    - Debbie

  • April 4, 2009 11:34 a.m.

    I am a type II diabetic and I also have lupus. Because of renal vasculitius the only anti-inflamatory I can take is Prednisone. None of my health care team have a clue on how to manage my insuin so I am reactive instead of proactive and just flying blind. I can handle sick days, but the Glucose levels on prednisone are unpredictable.

    - cschwartz

  • February 2, 2009 8:52 a.m.

    If I have diabetes type 2, what can I take when I have a cold? When ill my sugars run a bit high, 140's.

    - Sam

  • January 26, 2009 8:51 a.m.

    Cinnamon is an interesting topic. Whether it works or not, opinions vary on this topic. Check out Dr. Maria-Collazo's comments on cinnamon in the "Diabetes Center" mayoclinic.com Is any one using cinnamon to help their blood glucose? What do you think?

    - Nancy and Peggy

  • January 23, 2009 9:18 p.m.

    Any suggestions for dealing with stress? I find that having been diagnosed less than a year ago that I fear going back to the old patterns of no exercise and poor eating choices. ONe thing that seems to be really helpful is to be absolutely certain I do not go longer than 4-5 hours without eating. Any other suggestions or ideas? Thanks, Julie B

    - Julie B

  • January 23, 2009 3:27 p.m.

    Is there any current information on the use of cinnamon to help control diabetes.

    - John Marckstein jmarck@sbcglobal.net

  • January 23, 2009 8:19 a.m.

    Hi, just a couple responses to the blog comments. Yes, it is not uncommon for the blood glucose levels to run a little higher before your menstrual period starts. Also, fasting blood sugars between 101-125mg/dl (5.5-7.0 mmol/L) is prediabetes and needs to be monitored. I would recommend testing the blood sugar fasting once a week.

    - Nancy and Peggy

  • January 21, 2009 9:13 a.m.

    In reference to Susan's comment. I too have been diagnosed with type 2 and I would like to know the medication she thinks brought on her diabetes. I had a drug interaction and was diagnosed with type 2 after recovery. If it is the same drug or drug family, I would like to know to research my own situation. Thanks.

    - Brenda

  • January 20, 2009 6:14 p.m.

    I have cancer in the liver. Lymphodema in the right arm from 10 lymph nodes and right breast removed cancer. I am on a hormone therapy pill for cancer and diuritic high blood pressure medication. Dr. gave me another high blood pressure pill and it took me down to low and I fell horrible for 1 day and 1/2. the diuritic I am on is one of medications listed to not take this other medication. What is a person to do. My blood pressure is now coming back up. I have uti often and I am also taking a potassium prescribed pill. I have just been diagnosed as a type 2 diabetic. and the diabetic medication makes me feel like I am going to pass out. I have problems with medications. She was going to give me a medication with sulphur and the druggist called and said he was going to check with the doctor first. I like to died when I was five years old given sulphur and I have it listed as a drug I can't take.what to do.

    - Molly Clark

  • January 20, 2009 4:32 p.m.

    My Dr. just told me that my sugar level was 126 at one of my last blood tests, and at my last appt. my level was 111. She seemed a little concerned. Should I be concerned? I'm going through a lot of stress right now and am treating a uti also with antibiotics. Should I be watching closely?

    - Barbara

  • January 20, 2009 4:10 p.m.

    I have noticed that my blood sugars run higher when I am menstruating; it's noted in this article that hormones can have an affect on your blood sugars, and for me, that is definitely the case!

    - Stacey

  • January 17, 2009 10:15 p.m.

    I was diagnosed with diabetes on Jan 16. I never would have known had I not been over at my friend's house and she and her husband were coding their glucometers. Mike took blood from my finger and it read 325! I was always hypoglycemic with my blood suger around 59. My mother was daignosed with Alzheimer's in August and she hallucinates (she sees people). My doctor seems to think my diabetes was brought on by the added stress and from a pill I was on for 2 years that had a side effect of possible diabetes

    - Susan

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