Living with diabetes blog

Stress, illness and high blood sugar

By Nancy Klobassa Davidson, R.N. and Peggy Moreland, R.N., C.D.E. April 3, 2013

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  • Bad insulin (outdated insulin or insulin that has been exposed to extreme temperatures)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

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

April 03, 2013