Yes, stress can significantly impact blood sugar levels, particularly in emergency situations. When a person experiences stress, the body releases stress hormones like cortisol and adrenaline. These hormones can trigger the liver to release glucose into the bloodstream, leading to elevated blood sugar levels. In emergency contexts, such as bringing a patient to the hospital, the combination of physical exertion, emotional stress, and potential changes in routine (like skipping meals) can further contribute to this increase. For individuals with diabetes or those at risk, this rise in blood sugar can be especially pronounced.

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Vedantam D, Poman DS, Motwani L, Asif N, Patel A, Anne KK. Stress-Induced Hyperglycemia: Consequences and Management. Cureus. 2022 Jul 10;14(7):e26714. doi: 10.7759/cureus.26714. PMID: 35959169; PMCID: PMC9360912.

[Abstract

Hyperglycemia during stress is a common occurrence seen in patients admitted to the hospital. It is defined as a blood glucose level above 180mg/dl in patients without pre-existing diabetes. Stress-induced hyperglycemia (SIH) occurs due to an illness that leads to insulin resistance and decreased insulin secretion. Such a mechanism causes elevated blood glucose and produces a complex state to manage with external insulin. This article compiles various studies to explain the development and consequences of SIH in the critically ill that ultimately lead to an increase in mortality while also discussing the dire impact of SIH on certain acute illnesses like myocardial infarction and ischemic stroke. It also evaluates multiple studies to understand the management of SIH with insulin and proper nutritional therapy in the hospitalized patients admitted to the Intensive care unit (ICU) alongside the non-critical care unit. While emphasizing the diverse effects of improper control of SIH in the hospital, this article elucidates and discusses the importance of formulating a discharge plan due to an increased risk of type 2 diabetes in the recovered.

Conclusions

SIH is a condition that develops in patients undergoing any form of medical stress. An interplay between various cytokines and hormones leads to a state of insulin resistance and increased glucose production. Evidence states that patients suffering from SIH usually have poor outcomes in the hospital. The degree of blood glucose elevations and SHR are used as prognostic indicators. Intravenous insulin infusion is the modality of treatment for the critically ill. Appropriate targets must be set based on the patients’ illness, and routine monitoring has significantly improved outcomes. While increased in-hospital mortality is evident from the studies so far, an increase in morbidity is also seen. The risk of developing type 2 diabetes after recovery is high; hence, a dedicated follow-up by healthcare professionals is necessary. Annual blood work to check HbA1c and blood glucose levels is recommended. Moreover, a target blood glucose range needs to be individualized for each patient in the hospital and at home. However, fixed guidelines to manage SIH are yet to be studied in detail. We have highlighted the guidelines that are widely practiced along with the common obstacles like hypoglycemia which can be overcome by timely measurements of blood glucose and appropriate modifications of the insulin dose. Finally, we feel that the SIH needs more in-depth research studies to construct a more organized and direct approach to diagnosing and managing such a condition.]