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August 3, 2020

Hyperglycemia and DKA, Stress

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Question from Nashville, Tennessee, USA:

I have successfully controlled my diabetes for 68 years. However, lately, I have been experiencing elevated blood sugars. Could it be related to the stress of a current surge in COVID-19 or have I used my injection site too many times? I take two or three units of Lantus in the morning and Humalog for carbohydrates I am consuming.

Answer:

From: George Grunberger, MD, FACP, FACE

Strange indeed but, in general, I’d answer that stress of ANY kind (sleep deprivation, anxiety, etc.) can lead to the release of stress hormones which act against insulin’s effect. Thus, if stress cannot be relieved or controlled, patients often have to increase their insulin dose to maintain glucose control. This is usually long-acting insulin (i.e., Lantus). But, you need to talk to your endocrinologist about specific advice.