QUESTION:
Can stress or anxiety lower your blood glucose level?
Stress and anxiety more commonly raise blood glucose, but individual responses can vary. Stress hormones such as adrenaline and cortisol can cause the liver to release more glucose into the bloodstream. In some people with diabetes, however, stressful situations may also be associated with lower glucose because of changes in food intake, activity, medication timing, or other factors.
When you feel threatened, anxious or under pressure, your body activates its stress response. Hormones such as adrenaline and cortisol help prepare the body for action by making more energy available.
One result can be an increase in blood glucose. This is why emotional stress, illness, pain, poor sleep or other stressful events may contribute to higher readings in some people.
The American Diabetes Association also recognizes acute stress as one of the factors that can affect glucose concentrations.
Yes, but usually not because stress hormones directly lower glucose. Anxiety may reduce appetite, delay meals, cause nausea, or change physical activity. If you use insulin or medicines that can cause hypoglycemia, these changes may contribute to a lower reading.
That is why I would look at the whole situation rather than assuming that anxiety alone caused the glucose drop.
If you notice that your glucose changes during stressful periods, record the
If you are unsure whether a reading is within your usual treatment range, our blood glucose target guide explains common treatment targets, while the fasting blood sugar guide explains how morning readings are interpreted.
Important: If you have repeated low glucose readings, especially below 70 mg/dL (3.9 mmol/L), review them with your healthcare professional. Recurrent hypoglycemia should not simply be attributed to stress or anxiety.
In practice, I would expect stress to raise glucose more often than lower it. If your glucose falls during anxiety, I would also look at whether you have eaten less, exercised more, or taken insulin or another glucose-lowering medicine around that time.
Answer by: Dr. Albana Greca Sejdini, MD, MMedSc, Family Physician, IDF Fellow
This information is for general education and does not replace individual medical evaluation, diagnosis or treatment.
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by Mutale Chiluba
(Copperbelt, Zambia)
QUESTION:
I'm a new patient diagnosed with diabetes two weeks ago. I had a blood sugar of about 8 mmol/L a month ago, but later it rose to about 25 mmol/L. I was admitted to hospital for 5 days and it dropped to about 14 mmol/L. Since then, my sugar has been fluctuating between 13 and 18 mmol/L.
What should I do if my blood sugar is not dropping below 13 mmol/L?
Blood glucose of 13–18 mmol/L (234–324 mg/dL) is still high, especially if it is happening repeatedly. Because you were recently diagnosed and previously reached about 25 mmol/L (450 mg/dL), I would not simply wait for the readings to come down on their own. Your diabetes treatment should be reviewed promptly by your healthcare team.
For many nonpregnant adults with diabetes, common treatment targets are around 80–130 mg/dL (4.4–7.2 mmol/L) before meals and below 180 mg/dL (10.0 mmol/L) after meals, although individual targets can differ.
So glucose repeatedly between 13 and 18 mmol/L remains above the usual target range. A previous level of 25 mmol/L is markedly elevated and deserves careful follow-up.
Our blood glucose target guide explains common treatment ranges, while the after-meal blood sugar guide can help you interpret readings taken after food.
Stress can raise blood glucose, but it would be unsafe to assume that stress alone explains values this high. Infection, illness, missed or inadequate medication, dehydration, steroid medicines, changes in food intake, or the type of diabetes can also affect glucose.
An HbA1c test can help show your average glucose exposure over roughly the previous 2–3 months, but your current readings still need attention now.
Because your readings remain high after a recent hospital admission, I would contact your diabetes clinician promptly and review your medication, glucose pattern, food intake, hydration and any symptoms.
Do not increase, reduce or stop diabetes medicine or insulin unless you have been given an individualized plan.
Seek urgent medical care if you have vomiting, abdominal pain, difficulty breathing, severe weakness, dehydration, confusion, inability to keep fluids down, or glucose and ketones that are not improving. These can be warning signs of a hyperglycemic emergency.
If you are at risk for diabetic ketoacidosis, your care team may advise checking blood or urine ketones when glucose is high, especially during illness. The ADA advises ketone monitoring in at-risk people when symptoms or significant hyperglycemia are present.
Do not perform vigorous exercise if glucose is very high and ketones are present, because exercise may make the situation worse.
A healthy eating pattern can support diabetes management, but there is no need to rely on large amounts of cereals, fruit, or any single food to lower glucose.
I also would not recommend herbs or supplements as a substitute for proper diabetes treatment. Persistent glucose in this range needs medical review, not an herbal remedy.
In your situation, the important point is that the glucose has improved from 25 mmol/L, but 13–18 mmol/L is still too high to simply ignore. I would want to know whether these readings are fasting or after meals, what treatment you were given after discharge, and whether you have symptoms or ketones.
Answer by: Dr. Albana Greca Sejdini, MD, MMedSc, Family Physician, IDF Fellow
This information is for general education and does not replace individual medical evaluation, diagnosis or treatment.
Click here to post comments or follow up
Ask the Doctor now? Simply click here to return to Contribute to All About Beating Diabetes.