Stress/Anxiety impacting blood sugar readings? A1C v OGTT?

[IrishClover]

TLDR: I have two questions please:

1) Can stress and anxiety cause higher blood sugar readings?
2) Is HBA1C as accurate as an OGTT? (I am scared to do an OGTT because of how stressed I get)

Some background, I am 5 weeks post partum, I had gestational diabetes and was put on 1,500mg of metaformin and 28u of insulatard (6 in the morning, 11 at lunch & nighttime).

I have extreme chronic anxiety and stress anyway, but it seriously ramped up with this diagnosis. I completely shut down and was struggling to cope. Finally I got some relief after I gave birth when my fasting and pre meals went back to normal as did some of my post meals, and was told to stop testing and come back for my 6 week OGTT. However, unfortunately I checked last week and some of my 2hr post meal readings have been high around the 7.8 mark and those meals had approx 60g of carbs so I’m freaking out I’m going to fail the OGTT now.

However, the diabetes team and mental health team I am under (due to extreme anxiety) have said it would be a better idea for me to get a HBA1C at 3 months pp rather than do the OGTT because it can be skewed by how stressed I am. To be absolutely truthful, I think about my blood sugars being high 24/7, as soon as I start eating I feel nauseous and by the time I’m going to check my bloods I’m hot/sweaty, hands slightly shaking and knots in my stomach - all of which the psychiatrist said are anxiety symptoms that can cause blood sugars to be higher. When pregnant I had a CGM (again pushed for this because I was so anxious) and I checked it probably over 100 times a day, and would be so stressed as I saw numbers climbing.

Sorry for being so long winded, but I just wanted to ask this community that actually has real life experience:

1)Does stress affect your blood sugars in real time i.e. when you go to take a reading? And over the long term if you’re stressed for a period of time?

2) Is a HBA1C as accurate as an OGTT? Is it ok to go for that instead of the OGTT?

Thanks in advance to anyone that can sit through reading all of the above and offer any wisdom!

**I am in therapy already for chronic anxiety, I know I need to address it and am working on it.

 

[EllieM]

Hi @IrishClover and welcome to the forums (I like your username by the way).

Stress certainly does push up levels, (as does illness, many medications and many other things). So I'd be inclined to agree with your team that an hba1c would be much more realistic than an OGTT. (Disclaimer I am not a doctor). I know from reading these forums that, in the UK at least, diabetes is normally diagnosed via hba1c rather than an OGTT.

Here's a study of what happened when some non diabetics wore cgms (continuous glucose monitors) for ten days.

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

www.ncbi.nlm.nih.gov

But I wouldn't regard 7.8 as particularly high (though I freely admit as a T1 I am probably not the best person to judge).

I'm going to address the elephant in the room, because you haven't mentioned your baby. I'm hoping he/she is fine and I apologise profusely for bringing the subject up if they aren't, but this factor is relevant to your state of mind and at the moment you sound like someone who has more issues with anxiety than diabetes (to me, who doesn't know your circumstances, and isn't a doctor).

Once more, welcome.

 

[jaywak]

TLDR: I have two questions please:

1) Can stress and anxiety cause higher blood sugar readings?
2) Is HBA1C as accurate as an OGTT? (I am scared to do an OGTT because of how stressed I get)

Some background, I am 5 weeks post partum, I had gestational diabetes and was put on 1,500mg of metaformin and 28u of insulatard (6 in the morning, 11 at lunch & nighttime).

I have extreme chronic anxiety and stress anyway, but it seriously ramped up with this diagnosis. I completely shut down and was struggling to cope. Finally I got some relief after I gave birth when my fasting and pre meals went back to normal as did some of my post meals, and was told to stop testing and come back for my 6 week OGTT. However, unfortunately I checked last week and some of my 2hr post meal readings have been high around the 7.8 mark and those meals had approx 60g of carbs so I’m freaking out I’m going to fail the OGTT now.

However, the diabetes team and mental health team I am under (due to extreme anxiety) have said it would be a better idea for me to get a HBA1C at 3 months pp rather than do the OGTT because it can be skewed by how stressed I am. To be absolutely truthful, I think about my blood sugars being high 24/7, as soon as I start eating I feel nauseous and by the time I’m going to check my bloods I’m hot/sweaty, hands slightly shaking and knots in my stomach - all of which the psychiatrist said are anxiety symptoms that can cause blood sugars to be higher. When pregnant I had a CGM (again pushed for this because I was so anxious) and I checked it probably over 100 times a day, and would be so stressed as I saw numbers climbing.

Sorry for being so long winded, but I just wanted to ask this community that actually has real life experience:

1)Does stress affect your blood sugars in real time i.e. when you go to take a reading? And over the long term if you’re stressed for a period of time?

2) Is a HBA1C as accurate as an OGTT? Is it ok to go for that instead of the OGTT?

Thanks in advance to anyone that can sit through reading all of the above and offer any wisdom!

**I am in therapy already for chronic anxiety, I know I need to address it and am working on it.

sorry to ask and I think I ought to know but what is an OGTT test ?

 

[gogobroom]

sorry to ask and I think I ought to know but what is an OGTT test ?

Oral Glucose Tolerance test - Basically a test to see how a dose of glucose effects your BS over a period of up to 2 hours.

 

[gogobroom]

TLDR: I have two questions please:

1) Can stress and anxiety cause higher blood sugar readings?
2) Is HBA1C as accurate as an OGTT? (I am scared to do an OGTT because of how stressed I get)

Some background, I am 5 weeks post partum, I had gestational diabetes and was put on 1,500mg of metaformin and 28u of insulatard (6 in the morning, 11 at lunch & nighttime).

I have extreme chronic anxiety and stress anyway, but it seriously ramped up with this diagnosis. I completely shut down and was struggling to cope. Finally I got some relief after I gave birth when my fasting and pre meals went back to normal as did some of my post meals, and was told to stop testing and come back for my 6 week OGTT. However, unfortunately I checked last week and some of my 2hr post meal readings have been high around the 7.8 mark and those meals had approx 60g of carbs so I’m freaking out I’m going to fail the OGTT now.

However, the diabetes team and mental health team I am under (due to extreme anxiety) have said it would be a better idea for me to get a HBA1C at 3 months pp rather than do the OGTT because it can be skewed by how stressed I am. To be absolutely truthful, I think about my blood sugars being high 24/7, as soon as I start eating I feel nauseous and by the time I’m going to check my bloods I’m hot/sweaty, hands slightly shaking and knots in my stomach - all of which the psychiatrist said are anxiety symptoms that can cause blood sugars to be higher. When pregnant I had a CGM (again pushed for this because I was so anxious) and I checked it probably over 100 times a day, and would be so stressed as I saw numbers climbing.

Sorry for being so long winded, but I just wanted to ask this community that actually has real life experience:

1)Does stress affect your blood sugars in real time i.e. when you go to take a reading? And over the long term if you’re stressed for a period of time?

2) Is a HBA1C as accurate as an OGTT? Is it ok to go for that instead of the OGTT?

Thanks in advance to anyone that can sit through reading all of the above and offer any wisdom!

**I am in therapy already for chronic anxiety, I know I need to address it and am working on it.

My understanding is that stress can have a effect on your blood sugars, especially if you are under serious stress - You are only 5 weeks PP so it is understandable that your stress levels are high and your body is recovering from a huge task over the last 9 months.

I would try not to stress about an OGTT (easier said than done) however it is not necessarily a pass or fail it is a metric that the docs can use to assist in your diagnosis and ensure that the treatment you are given is correct.

Personally I don't know if an OGTT is better than HbA1c in your situation however, they are testing different things, it is best to get tests done and get as much information as possible to ensure you are treated correctly.

 

[KennyA]

TLDR: I have two questions please:

1) Can stress and anxiety cause higher blood sugar readings?
2) Is HBA1C as accurate as an OGTT? (I am scared to do an OGTT because of how stressed I get)

Some background, I am 5 weeks post partum, I had gestational diabetes and was put on 1,500mg of metaformin and 28u of insulatard (6 in the morning, 11 at lunch & nighttime).

I have extreme chronic anxiety and stress anyway, but it seriously ramped up with this diagnosis. I completely shut down and was struggling to cope. Finally I got some relief after I gave birth when my fasting and pre meals went back to normal as did some of my post meals, and was told to stop testing and come back for my 6 week OGTT. However, unfortunately I checked last week and some of my 2hr post meal readings have been high around the 7.8 mark and those meals had approx 60g of carbs so I’m freaking out I’m going to fail the OGTT now.

However, the diabetes team and mental health team I am under (due to extreme anxiety) have said it would be a better idea for me to get a HBA1C at 3 months pp rather than do the OGTT because it can be skewed by how stressed I am. To be absolutely truthful, I think about my blood sugars being high 24/7, as soon as I start eating I feel nauseous and by the time I’m going to check my bloods I’m hot/sweaty, hands slightly shaking and knots in my stomach - all of which the psychiatrist said are anxiety symptoms that can cause blood sugars to be higher. When pregnant I had a CGM (again pushed for this because I was so anxious) and I checked it probably over 100 times a day, and would be so stressed as I saw numbers climbing.

Sorry for being so long winded, but I just wanted to ask this community that actually has real life experience:

1)Does stress affect your blood sugars in real time i.e. when you go to take a reading? And over the long term if you’re stressed for a period of time?

2) Is a HBA1C as accurate as an OGTT? Is it ok to go for that instead of the OGTT?

Thanks in advance to anyone that can sit through reading all of the above and offer any wisdom!

**I am in therapy already for chronic anxiety, I know I need to address it and am working on it.

Yes, stress and adrenaline will affect BG. Just how much and in what circumstances varies from person to person. It's a completely normal reaction: your body assumes that the adrenaline means you're going to need energy and your liver will (in an effort to be helpful) dump glucose into your bloodstream.

HbA1c and OGTT are two separate tests and while they're both used in respect of diagnosis they (according to Bilous and Donnelly's Handbook of Diabetes) tend to be used for slightly different purposes. The A1c is probably the most common diagnostic test these days. It looks back about 8-12 weeks and estimates your blood glucose by counting the number of red blood cells that have had a glucose molecule attached. This is maybe why they were suggesting an OGTT - which checks your insulin response on the day. The fact that you've recently been pregnant might possibly give a misleading HbA1c - which just means the test would have to be repeated in a few weeks' time.

The OGTT uses a 75g dose of glucose and they would be looking for a level of less than 11.1mmol/l after 2 hours. If you're seeing readings at +2 hrs which are in the region of 7.8 after a 60g carb meal, that seems to me to be encouraging.

 

[MrsA2]

7.8 after a 60g carb meal is not very high.

I'm attaching my own example of stress affecting my bg.
I eat low carb and on this particular day had breakfast and a low carb lunch. Then about 4pm got a call to go help a relative in a nasty situation. I knew I probably wouldn't get anything to eat so decided to use it as a fasting opportunity.
From then on until I finally got home again 04:00 the next morning I had nothing other than water.
It was also a cold night and I was outside for some of it (temperature can affect bg too)
I was wearing a Libre at the time. You can see the times when the situation escalated and when it subsided just from my bg.

Please, please @IrishClover, get and accept all the help you can with your anxiety, if not for you, for your baby who will benefit so much from having a calm and happy parent. You deserve to enjoy motherhood and life xxx

 

[Lamont D]

Oral Glucose Tolerance test - Basically a test to see how a dose of glucose effects your BS over a period of up to 2 hours.

That is the standard test.
There is a diagnostic test using 75g of glucose for an extended oral glucose tolerance test. Which can be in duration for as long as five to six hours. Unless the test needs stopping for medical intervention.

And yes, stress can alter results.
However, the glucose testing by cgm or glucometer, should be viewed not only on that one instant but over time and if T2, around mealtimes.

Hba1c tests are the standard test for diabetic levels.
And circumstances dictate the results.

I don't think I've come across a really accurate system because of the nature of any patients body at that time!

 

[aylalake]

My BG is definitely affected adversely by stress. As an example of how even simple stress can affect me, I took apart a bird feeder to clean it out (one of those plastic tube types) and could NOT get it back together. While swearing at it, and battling on, my Libre alarm went off - 13.4!
After I calmed down, so did my BG, within about 15 minutes.

I also agree with others that 7.8 is not very high.

 

[VashtiB]

Hello and welcome @IrishClover

I'm sorry that you are suffering so much. I assume also that as with most new mothers you're also not getting a lot of sleep- particularly unbroken nights sleep. Lack of sleep is just another factor that can affect your blood sugar levels. It also affects your stress levels.

I also suffer from anxiety- not at your levels but I certainly find that it affects my levels.

My suggestions as a completely non medical person is to listen to your team and worry about an HbA1C test in 3 months. The HbA1C test is the test to diagnose whether someone has diabetes or not.

Until then focus on taking care of yourself. Your body has worked really hard to grow another person. Be kind to yourself. I'm glad you're in therapy. Take care of yourself and know that we will be here to offer support and advice if it's needed.

Welcome and take care.