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Have you experienced high blood glucose (blood sugar) spikes during or after a painful incident? Pain can have a strong effect on your blood glucose levels, which is important to understand when you’re living with type 2 diabetes.
Whether you experience acute pain (sudden pain that starts quickly) or chronic pain (pain that lasts for weeks or months), it’s important to understand how it can be related to your blood sugar. That way, you and your healthcare provider can figure out a plan to keep both your pain and your blood sugar levels under control.
Being in pain is stressful for your body. When you’re in pain, your brain starts sending out distress signals to the rest of your body. This includes messages to your adrenal glands. Your brain tells these glands to release chemicals like adrenaline, noradrenaline, and cortisol into your body.
These chemicals prepare your body to deal with whatever is causing the stress. They give you energy, make you more alert, and even increase your heart rate. They may also lower how sensitive you are to pain, to the point that you might not realize you’re in pain or understand how bad it is until that response wears off.
One of the ways these hormones help you face whatever is coming is by telling your liver to release glucose that it has stored. After all, your body may need this extra energy to flee or fight whatever has caused you pain. Because of this response, you can end up with high blood sugar levels when you’re in pain.
Acute pain and chronic pain may have different effects on your blood sugar. Acute pain is pain that starts suddenly, often after an injury, surgery, or illness. It may be mild or severe, but it usually improves as your body heals. Chronic pain is pain that lasts for months or longer, such as pain from diabetic neuropathy (diabetes-related nerve damage) or conditions like arthritis.
Acute pain can cause the glucose release mentioned above. It can also decrease your body’s sensitivity to the insulin that’s available. This can make it even harder for you to metabolize (process and use) the extra glucose in your bloodstream. All of this may mean that your diabetes treatment plan needs to be adjusted when you’re experiencing pain.
Chronic pain and diabetes management can be more complex. If the levels of the chemicals that your body releases under stress stay high for a long time, your body may continually release extra glucose. This can make it harder to manage your diabetes.
Sometimes, your body may not be able to keep levels of these substances consistently high. This can lead to significant fluctuations that happen quickly, all of which can affect your blood glucose.
One study looked at 60 older adults diagnosed with type 2 diabetes mellitus who experienced chronic pain. It found that their blood sugar levels fluctuated quite a bit. People who had worse pain experienced greater blood sugar fluctuations.
Thus, chronic pain might make diabetes harder to manage because it can be linked to shifting blood sugar levels, which may mean you need different strategies to stay in control of diabetes at different times.
The relationship between diabetes, blood sugar levels, and chronic pain may be even more complex than that. In fact, diabetes is often associated with chronic pain. We already noted above that diabetes can lead to diabetic neuropathy, a chronic pain condition.
Beyond that, researchers don’t entirely understand how diabetes and chronic pain interact. More research is needed to fully understand their relationship. That said, there is some helpful information available.
One study found that chronic pain seemed to be associated with changes in how the brain was able to use glucose. In fact, treatments that normalized the way the brain could use sugar also seemed to relieve pain. This could indicate that abnormal sugar usage in the brain leads to or worsens pain.
Since we know that pain can lead to changes in how the body uses glucose, it makes sense to ask whether these changes could also lead to more pain, creating a cycle that feeds on itself.
Whether your pain is acute or chronic, for the sake of diabetes management, it’s important to keep it under control. This can be complicated, as some pain medications can also affect blood sugar levels and make them harder to control, while others are associated with negative health consequences in people with diabetes.
Since diabetes can directly cause nerve pain, it’s important to know how you can safely manage it. If you’re not doing it already, working to manage your blood sugar is a key part of pain management for diabetic neuropathy. This can lower the risk of further nerve damage and help keep the blood vessels that serve your nerves as healthy as possible.
Safe treatments for nerve pain can include some medications and forms of physical therapy.
Sometimes, doctors will prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to people living with diabetes. These include over-the-counter medications like ibuprofen and naproxen, as well as some that are only available with a prescription.
However, these medications may be more likely to lead to heart failure in people with diabetes than they are in others. In one large European study, people with type 2 diabetes were 43 percent more likely to end up in the hospital with heart failure (when the heart isn’t pumping as well as it should) within four weeks of being prescribed an NSAID.
While this kind of result was more likely to happen in people who didn’t have controlled diabetes, it’s something to talk about with your doctor before you take these medications.
Opioids are strong medicines used to treat moderate to severe pain. However, prescribing opioids for people living with diabetes can be especially complex.
For one thing, some research suggests people with diabetes may be more likely than others to continue using opioids for an extended period — such as after surgery — even if they were only meant for short-term pain.
On top of that, opioids can affect blood sugar levels in unpredictable ways. They typically raise blood glucose, but in some people with diabetes, they may cause it to drop. This variability adds another layer of complexity when managing diabetes alongside pain.
The takeaway: More research is needed to understand how opioids affect people with diabetes and how to manage pain safely and effectively.
Fortunately, there are a lot of options when it comes to pain relief. Doctors who are pain-relief specialists should know which ones of these may help you based on the type of pain you experience, as well as which ones are safe for you as someone living with diabetes.
Some options to discuss with a healthcare provider include:
Many of these options have little direct effect on blood sugar, but surgery and changes in your activity level, including exercise, can affect your glucose levels, so it’s important to talk with a medical professional about what is safest for you.
If you’re experiencing acute or chronic pain, or if you have something scheduled like a surgery where you know ahead of time that you’ll need pain relief, talk to your doctor about the best approach for you. Because managing pain is an important part of helping keep your blood sugar more stable, your doctor can help you choose pain-relief options that are safe and effective for your situation.
On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.
How have you experienced the relationship between pain and blood sugar levels? Let others know in the comments below.
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