Stress hyperglycemia is when a person without diabetes has high blood sugar levels of over 180mg/dl due to stress. Hormones and inflammation cause blood sugars to rise to similar levels that doctors see in diabetes.

Stress hyperglycemia is a name for blood glucose levels above 180mg/dl in people without an existing diagnosis of diabetes. It commonly affects people who are critically ill in the hospital.

In hospitals, a doctor uses insulin infusions to manage glucose levels and prevent further complications, which could be life threatening.

This article explores how stress on the body changes blood sugar levels and the symptoms it may cause. It discusses stress hyperglycemia in the context of people in the hospital and how to manage everyday stress to keep blood sugar steady.

stress hyperglycemia in emergency settingShare on Pinterest
ER Productions Limited/Getty Images

The stress response occurs when the sympathetic nervous system is activated. Areas of the brain are responsible for processing fear, arousal, and emotional stimuli. This can cause a cascade of hormonal and physiological responses.

The adrenal glands at the top of the kidneys release hormones such as cortisol and catecholamines, which increase blood sugar levels.

Commonly known as the fight or flight response, the stress response is an evolutionary mechanism to protect the body from danger or harm. By increasing blood sugar, the body has fuel to use immediately to run or take whatever physical or mental actions are needed.

However, in everyday life, an overactive stress response can be harmful.

Experts note that ongoing stress can increase the risk of insulin resistance and lead to high blood sugar levels in the body. This can contribute to the development of type 2 diabetes.

In daily life, people with a diagnosis of type 2 diabetes may benefit from stress management techniques, as these may also help manage glucose levels.

Stress hyperglycemia is a short-term rise in blood sugar that occurs due to illness, physical stress, or psychological stress. It is common in a hospital setting and resolves when the stressful condition is no longer present.

A doctor will diagnose stress hyperglycemia when blood glucose exceeds 180mg/dl in people without diabetes. Experts note that at least 50% of critically ill people experience it within the first 48 hours of admission to a critical care unit.

Some research suggests that known risk factors for diabetes — such as a higher body mass index (BMI) or a family history of diabetes — may increase the risk of stress hyperglycemia.

According to a 2021 review, scientists initially considered stress hyperglycemia a normal protective response to keep the body in balance. However, research has since indicated that it can lead to adverse outcomes and complications.

For example:

In a hospital setting, doctors will monitor physiological signs of stress in the body in order to manage symptoms. In people with stress hyperglycemia, this may help prevent further complications or death.

In an everyday setting, the following are signs of stress:

  • trouble sleeping
  • feeling unwell more and getting sick more than usual
  • digestive problems
  • headaches
  • feeling sad
  • feeling angry or irritable
  • using substances such as drugs or alcohol more than usual

Ways of managing stress levels include:

  • regular exercise and physical activity
  • relaxing activities, such as deep breathing or meditation
  • using an app to help relax the muscles
  • take measures to get enough sleep, such as having a regular sleep routine
  • limiting caffeine intake
  • prioritizing tasks, such as deciding what to do now and what to do another day
  • asking family or friends for support

If someone has stress symptoms they feel they cannot manage, or if they are thinking of harming themselves, they can speak with a doctor, who will be able to help.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

Was this helpful?

People with diabetes can talk with their doctor or dietitian to learn how to better manage their blood glucose levels. In addition, they may need to monitor their blood sugar using tests.

The following tips from the American Heart Association and the Centers for Disease Control and Prevention (CDC) may help people with and without diabetes to manage their blood sugar levels:

  • Eat a varied diet rich in vegetables, whole grains, beans, nuts, and lean protein foods.
  • Avoid processed foods, refined carbohydrates, and sugary foods and drinks.
  • If able, be physically active and exercise regularly.
  • Manage weight, if possible.
  • Drink water rather than sweetened juices or sodas.
  • Limit alcoholic drinks.
  • Eat at regular times and avoid skipping meals.

Stress hyperglycemia refers to high blood sugar levels in people who do not have a diagnosis of diabetes. It commonly affects people who are critically ill in the hospital.

Doctors will take measures to manage glucose levels to prevent potentially life threatening complications. However, a person who experiences stress hyperglycemia may have a higher risk of developing diabetes after recovery.

Everyday stress affects the body and can raise blood sugar levels. However, people can manage this with a healthy diet, lifestyle changes, and professional help if they need it.