As a nurse, I rarely work a shift where I do not have at least one diabetic patient to care for. And when I check their blood sugar levels, it’s not unusual for that patient to be surprised when I tell them their numbers are high. They say “But I hardly ate any carbs today!” or “My levels are never this high at home.” And then I explain there are some things other that carbs that can raise blood sugar levels.
Your body reacts to stress by increasing hormone production. When hormone levels increase, your blood sugar levels rise. Whether you’re dealing with an emotionally stressful situation or your body is under the physical stress of an ailment, expect your blood sugar levels to be higher than normal and adjust insulin doses properly.
Infections raise blood sugar levels in the same way stress does. And the reverse is also true: high blood sugar levels increase a diabetic’s risk for developing infection. A 2010 study published by the JAMA Archives of Surgery found high blood sugar levels after surgery was the “most important risk factor for surgical site infection in general.” The exact correlation between infections and blood sugar levels is not completely understood. However, this fact shows the importance of frequent blood sugar monitoring especially during illness.
When you hear the word steroids, don’t assume sports enhancing drugs. I’m referring to corticosteroid medications like Prednisone which reduce inflammation caused by ailments like asthma and severe psoriasis. Excess glucose is stored within the liver. When you take corticosteroids, they stimulate the liver cells to release more glucose into blood stream. Corticosteroids also prevent insulin from moving sugar out of your blood stream and into your cells. In fact, long term use of corticosteroids has been known to cause type 2 diabetes in some people. Your health care provider can address any concerns you may have regarding these medications.
Certain antibiotics can cause blood sugar levels to swing too high or too low. A 2013 study published by Clinical Infectious Diseases determined oral antibiotics classified as fluoroquinolones (like Levaquin and Cipro) could cause severe blood sugar swings. As a result, the Food and Drug administration now requires proper labeling of these medications to reflect the findings of this study. If you are diabetic and you are currently taking one of these types of antibiotics, speak with your primary care provider. You may need to monitor your blood sugar levels more frequently or be prescribed an alternative treatment.
University of Illinois, Diabetes Life Lines, February/March 2005
McKay LI, Cidlowski JA. Physiologic and Pharmacologic Effects of Corticosteroids. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: http://www.ncbi.nlm.nih.gov/books/NBK13780/
Hsu-Wen Chou, Jiun-Ling Wang, Chia-Hsuin Chang, Jen-Jyh Lee, Wen-Yi Shau, and Mei-Shu Lai
Risk of Severe Dysglycemia Among Diabetic Patients Receiving Levofloxacin, Ciprofloxacin, or Moxifloxacin in Taiwan, Clinical Infectious Diseases 2013
Diabetes.org, Living With Diabetes: Stress, last updated July 15, 2013