Blood Sugar Levels: Anxiety's Impact on Health

Blood sugar issues?

Hello Doctor: I have anxiety issues, and according to my psychiatrist, I have what is known as panic disorder, which often causes chest pain, hyperventilation, and difficulty breathing.
Yesterday, I experienced sudden, unbearable chest pain and felt like I couldn't get enough air, leading to hyperventilation and numbness in my hands and feet, which resulted in me being taken to the emergency room (I suspect this was triggered by my panic disorder).
Upon arrival at the ER, the doctor conducted some assessments and ordered blood tests.
The overall results were normal, but I was informed that my blood sugar was 194, which is elevated (this was about two hours after dinner).
The ER doctor thought this might not be accurate and, considering my young age, did not express much concern.
However, I am very worried because about six months ago, my comprehensive health check showed a fasting blood sugar of 95, which is normal.
I would like to ask the doctor if my blood sugar of 194 (non-fasting) requires further testing, or if it is a normal phenomenon due to my anxiety and panic.
Is it possible for anxiety and panic to cause such a high spike in blood sugar? Additionally, I have a sweet tooth, drink sugary beverages, and have slightly above-average body fat, but my limbs are still slim, although I do have a small belly (neither of my parents has diabetes, but my grandfather does).
I am genuinely worried and would appreciate your guidance.
Thank you, Doctor!

Xiao Z, 20~29 year old female. Ask Date: 2017/05/16

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding your anxiety issue, based on your description, it seems to be "hyperventilation syndrome," which refers to excessive breathing that leads to the removal of carbon dioxide, causing numbness in the hands and feet.
You can try breathing into a paper bag to increase the carbon dioxide levels in your body, which should help alleviate the symptoms.
As for the blood sugar issue, we typically do not diagnose diabetes based on a single blood sugar value.
It is recommended to measure fasting blood sugar levels multiple times; if they are consistently normal, the likelihood of diabetes is indeed low.
Thank you for your question.

Reply Date: 2017/05/16

More Info

Anxiety and panic disorders can significantly impact various aspects of health, including blood sugar levels. In your case, the elevated blood sugar reading of 194 mg/dL, taken two hours after a meal, raises some concerns, but it is essential to consider the context in which this reading was obtained.

Firstly, it is well-documented that stress, anxiety, and panic attacks can lead to temporary spikes in blood sugar levels. This phenomenon occurs because stress triggers the release of hormones such as cortisol and adrenaline (epinephrine). These hormones prepare the body for a "fight or flight" response, which includes increasing glucose production in the liver and reducing insulin sensitivity. As a result, even in individuals without diabetes, stress can lead to elevated blood sugar levels.

In your situation, the acute stress from experiencing chest pain and difficulty breathing likely contributed to the spike in your blood sugar. It is not uncommon for individuals experiencing panic attacks to have elevated blood sugar levels due to the physiological responses to stress. However, it is crucial to differentiate between a temporary spike due to acute stress and a consistent pattern of elevated blood sugar that may indicate a more chronic issue, such as prediabetes or diabetes.

Given your previous fasting blood sugar level of 95 mg/dL, which is within the normal range, the sudden increase to 194 mg/dL should be interpreted cautiously. It is essential to monitor your blood sugar levels over time to determine if this reading is an isolated incident or part of a more concerning trend. Regular monitoring, especially if you experience ongoing anxiety and panic attacks, can provide valuable insights into how your body responds to stress and your overall metabolic health.

Additionally, your lifestyle choices, such as a preference for sweet foods and sugary drinks, can also contribute to elevated blood sugar levels. While occasional indulgence is normal, consistently high sugar intake can lead to insulin resistance over time, increasing the risk of developing type 2 diabetes, especially if combined with other risk factors like family history and body composition.

To address your concerns, I recommend the following steps:
1. Regular Monitoring: Keep track of your blood sugar levels, both fasting and postprandial (after meals). This will help you and your healthcare provider identify patterns and determine if further testing is necessary.

2. Consult a Healthcare Provider: Given your elevated blood sugar reading and history of anxiety, it would be wise to discuss your situation with a healthcare provider. They may recommend additional tests, such as an HbA1c test, which provides an average blood sugar level over the past three months, to assess your overall glucose control.

3. Manage Anxiety: Since anxiety can impact your physical health, consider seeking support for managing your anxiety and panic symptoms. Therapy, medication, or lifestyle changes such as mindfulness, meditation, and regular physical activity can be beneficial.

4. Dietary Changes: Reducing your intake of sugary foods and beverages can help stabilize your blood sugar levels. Focus on a balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables.

5. Physical Activity: Incorporating regular exercise into your routine can improve insulin sensitivity and help regulate blood sugar levels. Even moderate activities like walking can be effective.

In summary, while anxiety and panic can lead to temporary spikes in blood sugar, it is essential to monitor your levels and consult with a healthcare provider to rule out any underlying conditions. By addressing both your mental health and lifestyle factors, you can work towards achieving better overall health and well-being.

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