August 18, 2004
Hyperglycemia and DKA
Question from Bozeman, Montana, USA:
I recently broke my ankle, am on crutches and in a cast. Ever since this happened, I have had to increase my basal rates and have been having trouble getting my blood sugars under control. I feel that I am very, very, very insulin resistant. Wouldn’t the added trouble of using crutches help keep my blood sugar lower? It is not; it is the opposite. Would that be because I am recovering and have lost a lot of muscle? I had surgery about four years ago to have a cyst removed from one of my ovaries. My sugars were out of control then also. The doctors could not understand why. Is this just how my body reacts to stress and recovery?
Answer:
Your blood sugars are primarily affected by your insulin dose, activity, and diet. If you have an intercurrent illness, that can also increase insulin requirements as stress hormones counteract the affect of insulin. In your case, you are exercising less and those big muscles are not utilizing the glucose they usually do. In addition, you have had the illnesses. This would only seem correct that your blood sugars would respond this way.
JTL
