Does Severe Illness Affect Blood Sugar Levels? Insights and Answers

Q: Does Severe Illness Affect Blood Sugar Levels? Insights and Answers

Dear Mr. Anonymous： 1. Conditions such as illness, infection, stress, pregnancy, irregular lifestyle, and the use of certain medications can lead to elevated blood glucose levels or significant fluctuations. 2. If anxiety is severe, it can indeed cause an increa

Does serious illness affect blood sugar fluctuations?

Hello Dr.
Hsiao,
Due to acute renal failure that occurred in the middle of this year, accompanied by severe edema and fluid accumulation in the body, various kidney indicators were significantly elevated, leading to my hospitalization.
On the morning of admission, my fasting blood glucose was 105 mg/dL, and it increased to 115 mg/dL by the evening.
I have known for some time that my fasting blood glucose tends to be elevated, usually around 95 mg/dL.
Seeing such a spike during this serious illness has made me very concerned.
I have a few questions I would like to ask you:
1.
Can blood glucose levels be affected and rise above normal during a serious illness?
2.
Since I was anxious and had not eaten all day while hospitalized, could this also impact my blood glucose levels? (Does anxiety cause elevated blood glucose?)
3.
Given that my kidneys are still recovering (the edema and fluid accumulation have improved), will maintaining a bland diet (low in oil, sugar, salt, and protein) help bring my blood glucose back below 100 mg/dL?
4.
My parents, grandparents, aunts, and uncles do not have a history of diabetes, but my grandmother does (she has type 2 diabetes, not congenital).
How significant is the hereditary risk for diabetes in this context?
Thank you for your answers!

Niming, 20~29 year old female. Ask Date: 2016/12/03

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Anonymous:
1.
Conditions such as illness, infection, stress, pregnancy, irregular lifestyle, and the use of certain medications can lead to elevated blood glucose levels or significant fluctuations.
2.
If anxiety is severe, it can indeed cause an increase in blood glucose levels; however, it is important to consult your treating physician to determine if there are other factors contributing to the elevated blood glucose at that time.
3.
Blood glucose control primarily involves diet, exercise, and medication adjustments.
By effectively managing these three key principles, blood glucose levels can certainly be controlled.
However, your existing kidney condition may also affect blood glucose variations.
4.
If there is a family history of diabetes among direct relatives, the likelihood of developing diabetes is higher; however, with proper attention and prevention, it is not inevitable.
5.
Below are some basic diabetes education materials for your reference:
(1) According to the American Diabetes Association's diagnostic criteria for diabetes:
a.
Fasting plasma glucose level ≥ 126 mg/dl after fasting for 8 hours or more.
b.
2-hour plasma glucose level ≥ 200 mg/dl during an oral glucose tolerance test.
c.
HbA1c (glycated hemoglobin) ≥ 6.5% (must be confirmed with a method that meets the international certification standards NGSP and DCCT, and there should be no disproportionate hyperglycemia).
The above a, b, and c conditions must be confirmed on two separate occasions.
d.
Clinical symptoms of diabetes (such as excessive thirst, frequent urination, increased appetite, and weight loss) with any plasma glucose level ≥ 200 mg/dl (this can be confirmed with just one test).
(2) If fasting blood glucose is abnormal (between 100-125 mg/dl), the risk of diabetes increases.
(3) Risk factors for developing diabetes include a family history of diabetes, gestational diabetes, obesity, hypertension, hyperlipidemia, lack of physical activity, overeating, alcohol abuse, use of certain medications, poor lifestyle choices, and excessive stress; please be mindful of these.
6.
It is strongly recommended that you discuss these matters thoroughly with your treating physician; it is not advisable to rely on online Q&A for conclusions or decisions.

Reply Date: 2016/12/03

More Info

Hello! Thank you for your questions regarding the impact of severe illness on blood sugar levels. Let's break down your concerns one by one.

1. Does severe illness affect blood sugar levels?
Yes, severe illness can significantly impact blood sugar levels. When the body is under stress due to illness, it releases stress hormones such as cortisol and adrenaline. These hormones are part of the body's "fight or flight" response and can lead to increased blood sugar levels. This is particularly true in cases of acute illness, infection, or injury, where the body's metabolic demands change. In your case, the acute kidney failure and associated complications likely contributed to the elevated blood sugar readings you observed.

2. Does anxiety and fasting affect blood sugar levels?
Absolutely. Anxiety can lead to increased blood sugar levels due to the release of stress hormones. When you are anxious, your body may perceive it as a stressor, which can trigger the release of glucose into the bloodstream. Additionally, fasting can also affect blood sugar levels. While fasting typically lowers blood sugar, the stress of being in a hospital environment and the anxiety associated with your condition can counteract this effect, leading to higher readings. Therefore, both your emotional state and the fasting period could have contributed to the fluctuations in your blood sugar levels.

3. Can a low-sodium, low-sugar, low-protein diet help lower blood sugar?
Yes, adopting a healthier diet can help manage blood sugar levels. A diet low in sugar and refined carbohydrates can prevent spikes in blood sugar. Additionally, reducing sodium and protein intake is beneficial for kidney recovery, especially if you are experiencing kidney issues. Eating a balanced diet rich in whole grains, vegetables, and lean proteins can help stabilize blood sugar levels. However, it's essential to ensure that you are still getting adequate nutrition, so consulting with a dietitian may be beneficial to create a meal plan that meets your needs while supporting your kidney health and blood sugar management.

4. What is the hereditary risk of diabetes in your family?
Family history can play a role in the risk of developing type 2 diabetes. While having a family member with diabetes increases your risk, it does not guarantee that you will develop the condition. The risk is influenced by a combination of genetic factors and lifestyle choices, such as diet and physical activity. Since your immediate family members do not have a history of diabetes, your risk may be lower, but it is still essential to monitor your blood sugar levels, especially given your recent health issues.

In summary, your elevated blood sugar levels during your illness can be attributed to the stress of the situation, anxiety, and potential fasting effects. Maintaining a healthy diet and managing stress are crucial steps in stabilizing your blood sugar levels. Additionally, monitoring your blood sugar regularly and discussing any concerns with your healthcare provider will help you manage your health effectively. If you have further questions or need more personalized advice, please consult with your healthcare provider or a registered dietitian.

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