HBA1C and Stress

[Daphne917]

I’ve just had the results of my annual blood test and my hba1c is now 42 ie pre-diabetic despite being in the normal range since 2013. I was surprised at this as I have been eating low carb (ish) as usual and when I have tested my morning blood sugars have been between 5.4 and 6.00. However I have been under a lot of stress lately with my husband, who has Parkinson’s Disease, being in hospital for 13 weeks with heart failure, followed by 3 infections (one bordering on Sepsis) and the Parkinson’s team over prescribing his Parkinson’s medication which resulted in him having a GCS of 8 when normally it should be over 15. He has also narrowly avoided 2 visits to ICU. He is still in hospital and now has Covid.

Whilst I am concerned that my hba1c is beginning to rise I am assuming it may be down to stress but wondering if it is or if I need to rethink my carb intake which is currently approx 130 per day depending on what I can be bothered to eat when I get back from the hospital etc. Am I correct in this assumption?

 

[KennyA]

Hi, you seem to have been through the mill recently.

I don't think there's any doubt that stress - ie high levels of adrenaline and cortisol - stimulates the liver to increase blood glucose levels. It's described in the standard reference books - eg Bilous and Donnelly. The CGM graph attached shows one day where the wearer didn't eat anything but had the news that her son was in a car crash, then visited him in hospital, then had to call at the police station. The peaks in BG from around 2pm are fairly clear.

I've never seen any work on HbA1c results that show that overall higher stress levels lead to higher HbA1cs, but it seems logical that sustained higher blood glucose levels (whether the glucose comes from food or from an over-active liver) would increasingly glycate haemoglobin in the same way.