January 28, 2005
Aches and Pains, Complications
Question from Dunnellon, Florida, USA:
I am 46 years old and have been diabetic for 26 years. I have had several complications, including two heart attacks, diabetic mastopathy, and decreased kidney function. I also have had three shoulder surgeries, initially due to a torn rotator cuff. I just had surgery on my left wrist for carpal tunnel and need to have the right wrist done and another shoulder surgery, possibly a total shoulder replacement. I also had my esophagus rebuilt two years ago due to severe GERD and it didn’t work. I still have severe pain from that. I need to be in very tight control and I had been before I started having chronic pain. I am on an insulin pump and had extremely good results with it before all this started. I will only take pain medications at night so that I can get a few hours of sleep and then manage my pain with heat and ice therapy during the day. Is it possible for chronic pain to cause erratic glucose levels? I am at a total loss. I am weighing and measuring all my food and liquids and testing six to eight times a day and still cannot get consistent control. I have an excellent doctor who has been working very closely with me, but we just can’t get a handle on this. Any information would be appreciated SO much. I am really frustrated and scared at this point.
Answer:
Chronic pain can cause irregular blood sugar control. There is a physiologic response to the pain that may make your body more resistant to the insulin you take. However, you and your physician will have to wade through the body of evidence to see where this goes. Saying it is possible and proving it is so are very different issues. Like may people with diabetes, I anticipate you may have multiple reasons for less than optimal blood sugar control. Having a thorough evaluation by a consulting physician may be helpful. If you have not seen a pain specialist, you may consider this as well.
JTL
