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  • With Mayo Clinic diabetes educators

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

    read biography
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  • Living with diabetes blog

  • April 3, 2013

    Stress, illness and high blood sugar

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

70 comments posted

Controlling Your Diabetes

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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  • Bad insulin (outdated insulin or insulin that has been exposed to extreme temperatures)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

blog index
  • April 13, 2012 6:08 p.m.

    i am having severe pain from a torn rotor cuff and will most likely have to have surgery and now for the past week my sugar has been holding between 160 and 275. is stress causing this priblem?p5MLRq

    - ruth

  • February 18, 2012 10:21 a.m.

    Thank you so much for the info I been diabetic for over 12 years and recently got a head cold.Well to make long story short my blood sugars have sometimes been over 400 since I got the head cold.I know now that it must be this cold that is causing my high blood sugars.Cause I always take my meds and insulin.

    - Ray

  • February 12, 2012 11:24 p.m.

    I have type two diabeties and a lot of stress. The stress is multiplied by my birth daughter who just told my boyfriend's family that he is a druggy and used to have sex with underage girls. These are all lies but the damage is done and now I just want to crawl in a hole and die. I have prayed and asked for help but so far nothing and the pain of everything is too much for me. I just took my shot an hour ago and my blood sugar is still 261. HO GOD HELP ME PLEASE!!!!!!!!!

    - LaDayna

  • January 9, 2012 4:06 p.m.

    I have been diagnosed with type2 diabetes and depression. I am having a hard time with the fact I am insulin dependant and not taking my injections when I should. My blood sugars in the am have all been over 300 sometimes spiking to 420 or so, should I contact my physician or ER when this occurs for more than a week?

    - holly

  • January 2, 2012 9:10 p.m.

    I am a 65 y/o woman with Type 2 diabetes. I have been very ill for the last month with an infection that affected my sinuses, throat and lungs. Being unusually ill, I saw a lung specialist who informed me, after examination, that I am as sick as I am because I also have intermittent asthma. I am on antibiotics and Spiriva (5th day) and my question is this: My sugars are in the 180-250 range, in spite of the fact that I am only consuming about 24-36 gm. of good carbohydrates, per meal. I take 2000 mg. Metformin, 100 mg Januvia, 20 mg. Glipizide and 2500 mg. Welchol, per day (in addition to other drugs and supplements). Should I be concerned about the levels of glucose? Or, should I just keep monitoring my numbers, 2-3X per day? What's normal, considering I'm so sick? Thank you!

    - Nikki

  • October 28, 2011 2:43 a.m.

    just read all the blogs. wanted to pass this on.. when i went into a coma, my blood sugar was so high they could not get a reading. i now suffer from short term and long term memory issues. i am told this is because my blood had so much sugar that it couldnt take enough oxygen to my brain. so, its important to watch yourself. as well.. i ended up in the hospital once in a non diabetic issue, my blood sugar, which should be around 7.0, was tested at 0.5, they had no idea how i was still walking around. high and low levels need to be taken seriously, and those of you who have a doctor, dont be shy to ask questions, you need information.

    - shirley

  • October 28, 2011 2:32 a.m.

    i am a diabetic, and have no family doctor. i had gone into renal failure 2 years ago. my blood sugar has been out of control for over a month, and our emergency dept at hospital doesnt take non emergency. my blood has been very high, and after taking double the amt of insulin i usually take.. i have been over 18.0 for almost a month.. and was scared. nobody to help.. no doctors. i found this web site, and went thru each reason for high blood sugar, and decided the non absorbtion was a possible. i injected at a different spot, usually my stomach, but now my leg. my sugar went down to 11.3 within 2 hours. having information like you provided gave me an option to help myself. thank yu.

    - shirley

  • October 27, 2011 9:55 p.m.

    My daughter is 12 and has been experiencing increasing blood sugar levels over this past year now averaging 14 to 18. This past month she has had readings as high as 24 and 27. She recently had a reading of 32 but has never had any symptoms at all including no ketones in urine. She also has a growth hormone deficiency and a small cyst on her pituitary gland. Ultimately her local pediatrician has just prescribed lantis to try to reduce her morning fast blood sugar reading and keep it maintained through teh day. Other than that, medical professionals are stumped as to why sheis exhibiting no symptoms with such high levels. We are looking for any specialists to talk to that might have some other ideas outside the "diabetes" box that might be able to determine why this is happening. Can you direct us?

    - Lynn

  • September 7, 2011 10:54 a.m.

    Suraj, Your blood glucoses indicate you have diabetes. I have seen individual's with high blood glucoses that did not have the classic symptoms of hyperglycemia (increased thrist, increased urination, and fatique). Continue to follow up with your health care provider. Nancy

    - Nancy and Peggy

  • September 5, 2011 12:58 p.m.

    Hi Nancy, hi, last week I had been for general check up and my Random Blood Sugar reading was 294 mg/dl, so my Doc told me to get checked for Blood Sugar... yesterday I took test.. and the result is : Fasting BS : 344 mg/dl and 2hrs After meal : 444 mg/dl But I dont have any symptoms of Blood Sugar... i.e 1. I dont frequently urinate 2. Dont often feel thirsty 3. MY skin is usually moist 4. Dont feel drowsy 5. My wounds heal normally 6. Blood Clots good 7. No frequent headaches 8. Since past 1 yr or so I have not fell ill 9. I am not infected since 5-6 months 10. I am normally an active man Please advise am I diabetic or do I have any other disease? P.S: Due to some project deadlines I am going tru stress & sleeplessness..... I am a direct oral tobacco addict but non alcoholic...

    - Suraj

  • July 17, 2011 12:11 p.m.

    I got the scare of my life this past week. Didn't know the symptoms of high blood sugar -had never been diagnosed with diabetes.While out of state visiting my ill dad, I all of a sudden couldn't get enough to drink. I would drink anything I could get my hands on but I mostly craved water. I'd drink a liter bottle in 10 -15 seconds tops without taking a breath. I thought it was the dry heat of Arizona and that I may have been dehydrated. It wasn't until 8 days later when I returned home and noticed that I was having a problem with dry mouth (that I wasn't producing any saliva). My mouth was so dry it started to hurt. I noticed occassional muscle cramps in my legs and feet.Eventually, my finger tips became numb.Didn't realize that my vision was gradually decreasing at the same time until I attempted to drive home from work one evening and couldn't read the license plate in front of me.All of these symptoms topped with stumbling dizziness (10 days of being back home), I finally realized it was more than lingering dehydration.I shared my symptoms with my provider, and she had me come in. I was told my urine sample reeked of sugar and that my AC1 level was 470!Off to ER I went. I'm a woman of regularly high stress levels. I've always known this and somehow managed it all.I guess being told that my dad has a 50/50 chance of living past 6 months due to congestive heart failure, pushed my stress level to the breaking point thus my critical blood sugar level.Beware of stress/trauma

    - Cynthia

  • May 11, 2011 10:26 a.m.

    I HAVE BEEN SUFFERRING LATE OF LOW AND HIGH BLOOD SUGAR AND IT LIKE A ROLLER COASTER,ALSO MY BLOOD PRESSURE BEEN REALLY LOW,I HAVE BEEN TO ENDOCRINOLOGY AND SHE SAID I AM BORDERLINE DIABETIC NOT A DIABETIC,I NEED TO FIGURE OUT WHY MY SUGAR GOES UP AND THEN DROPS DRASTICALLY TO 50 OR 40,IN A PERIOD OF ONE HOUR. IT DRAINES EVERY SINGLE ENERGY OUT OF MY BODY,I FEEL LATHARGIC,DRAINED AND MY BP ALSO DOES THE SAME IT DROPS IT DOES NOT GO UP

    - ZULA

  • December 12, 2010 5:51 p.m.

    My son's routine yearly blood test showed fasting blood sugar of 311. His triglicerides (sp?) were 1040. He has never had abnormal labs before. He is 45 years old. His doctor put him on metformin two days ago. His morning blood sugar the sedond day after starting meds was 216 but he didn't feel like eating and skipped breakfast and lunch. By dinner, with no food for the day (and no metformin) his blood sugar was 365. How could that be? Could something other than diabetes be causing elevated blood sugar?

    - Harriet

  • December 11, 2010 5:22 p.m.

    So they can take you to the hospital if need be? It is more risky to not begin insulin, with numbers consistently like 350+ is high! What are the risks of taking insulin, is that what you are trying to ask? Like can you overdose, or go into a coma from too much insulin, you are more likely to go into a dibetic coma from not using insulin to regulate your blood sugars? (I believe) You may be afraid at beginning your first insulin treatment...but nothing compares to the risks of not beginning treatment for high A1c readings!

    - george

  • December 9, 2010 10:25 p.m.

    if you have readings of BG over 300 what does that mean? that you should learn how to administer insulin to yourself, once provided by your insurance and approvals, so what is the risk of living alone and beginning to learn how to control your body? Is it more highly recommended that you have someone by your side for a few days?

    - mikey

  • September 3, 2010 8:33 a.m.

    Thank you for your blog. I've learned more in 30 seconds about the relationship between diabetes, illness, and stress than I have from medical providers. Part of the problem may be you don't know what to ask and some medical providers don't think to inform you of all the implications of this disease. I think that is particularly true if the person with the disease is in a nursing home. That is the case with my mother.

    - Pam

  • August 15, 2010 2:26 p.m.

    I am 64 and of late I wake up sometimes when deeply sleeping with painful CRAMPS in feet /legs. I then need to stand up and walk a bit to stop it. Now I am getting some also while swimming. I have been taking medication for a thyroid condition for years--had surgery 30 years ago. Should I check for diabetes?

    - Ursula

  • July 27, 2010 3:13 p.m.

    Amber, there is a blood test that will determine if you have type 1 diabetes (C-peptide). I would continue to monitor your blood glucose a couple times a week and if you see you have elevated blood glucoses or if you have symptoms of diabetes (increased thirst, increased urination, fatique, blurred vision); follow up with your health care provider.

    - Nancy and Peggy

  • July 21, 2010 6:01 p.m.

    Nancy, I was diagnosed with gestational diabetes when I was pregnant about a year and a half ago. Last week I went to the doctor and my BG reading was over 300. I was immediately admitted to the hospital with a diagnosis of Type 1 Diabetes, but the doctor said I may be in the "Honeymoon" stage. This week, I went back to the doctor and he said that my A1C levels came out just fine and all of my tests show I am fine. So, he says that now I do not have Diabetes. I find this weird to have been diagnosed twice, but for them to revoke diagnosis, telling me that they have no explanation for my blood sugars spiking every now and then. What do you suggest I do? I still have my BG meters so I can check my levels, and I have an insulin pen on hand if need be. Thanks!

    - Amber

  • April 26, 2010 4:22 p.m.

    Cindy, A normal fasting blood glucose reading for the nondiabetic is 70-100 mg-dl or 3.8-5.5 mmol/L. Post meal a blood glucose should be below 200 mg/dl or 11.1 mmol/L.

    - Nancy and Peggy

  • April 21, 2010 5:12 p.m.

    what numbers are normal for blood sugar. Mine were 106. I don't know what that means.

    - cindy

  • February 5, 2010 10:51 p.m.

    I have a 13 yr.old son with diabetes he also has problems with adhd. and bipolar.Sometimes its really hard to get him to take care of his self because of his mood swings.Any suggestions that could help.

    - tiffany

  • December 19, 2009 10:56 p.m.

    I made a mistake in my last post. The doctor said there was no such thing as "borderline" diabetes instead of "pre-diabetes". Thanks.

    - JoAnn

  • December 19, 2009 10:37 p.m.

    I'm a 63 yr old female. Two and a half yrs ago, my doctor said I had diabetes. Not "pre-diabetes" since he said there was no such thing. My fasting blood sugar was 121 and I had no other symptoms as laid out on this website. I had just lost my mother a month prior and my father 4 months prior to my regular meds checkup. I have HBP and hypothyroidism, controlled by meds for several years. I also have elevated cholesterol which I take meds for on a daily basis. Since the diabetes diagnosis, I have regularly had bloodwork and check it myself regularly. The fasting blood sugar rarely gets above 100, and even the doctor has never treated me with meds and has been pleased with how low my blood sugar has been since diagnosed. Is it possible that I don't actually have diabetes and is it also possible that the loss of my parents could have been a factor in my blood count at the time I was diagnosed? I cannot get regular health insurance because of this, am not eligible for medicare and am forced to pay for high risk insurance which costs half of my monthly income. Is there a way to reverse the doctors diagnosis? Thank you so much!

    - JoAnn

  • December 17, 2009 8:35 a.m.

    I have been dianosed with Highblood diabetes, but they way it happened was so fast I had to asked myself is he sure. but any way I was put on Metrphorman, i want to know if you should all ways go to the bathroom with funny bowel and what can I do to remember to take my meds.

    - WANDA

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