Sugar Matters
June 28, 2011
Life affecting Diabetes. Week 2: Stressful events

So you are chugging right along, diabetes is pretty well controlled and you feel like you have a GOOD handle on this disease. Then BANG:

You change jobs OR

You get fired OR

You get into a car accident OR

You find out there is a major illness in the family, or heaven forbid, a death.{{more}}

You get the idea here. What I am driving at is a new major stress in your life, something unexpected that throws everything out the window. We get questions about the effects of stress on diabetes all the time. It is a common belief that stress makes blood sugars go up, and that is actually correct. Stresses for any person makes them produce more cortisol, among other hormones, which affects how blood sugars are handled in the body. The end result is that for many people with diabetes, blood sugars do go up during very stressful periods. The question is then, what to do?

The WRONG answer is to simply say, “Well, this is stress and I should expect my blood sugars to be 300.” Just because it is a normal reaction does not mean it is not harmful to you, especially if your blood sugars become very high and/or stay that way for a long period of time. Don’t forget: high blood sugars could not care less WHY they are high! The damage will be done, no matter the cause.

A better approach to stress-induced high blood sugars is to first try to reduce the stress, if you can. I know, easier said than done! But you should at least try. It may involve talking to someone, just to get feelings off your chest; it may be exercising more, getting more sleep etc. But try to find a healthy way to deal with your stress. Second part is adapting your diabetes treatments. If your blood sugars go up for 1 or 2 days, then it is probably not much of a big deal as long as your blood sugars are not super-high. But if this pattern continues, you will need to change your medications for the time being.

I have had patients increase their insulin or sometimes their diabetes pills for several weeks during high stress then reduce back to prior doses. Sometimes we switch medications all together for a while, and then switch back. We do whatever the body NEEDS in order to prevent high blood sugars from doing their damage while the person is trying to deal with the stressful period of time. And, as always, general rules also continue to apply: try to eat healthy, drink water, exercise, and get sleep. These all help to diminish the effects of a new (and hopefully temporary) stress.

More next week. Until then, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227