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We have a six year old daughter with Type 1 Diabetes who is losing her first baby tooth. Over the last three days the tooth has become very loose and is ready to come out. When she attempts to move the tooth blood appears. During this same time period her sugar levels have run higher than normal. Is there a relationship between these two events?

Yes, you're right: there would be a relationship between any stressful event, especially if it causes pain, and temporary elevations of blood sugar level.

Usually, when thinking of what causes blood sugar to fluctuate, most of us would know to include

  1. food (usually raises blood sugar, but water alone, or alcoholic beverages, usually lowers the blood sugar);
  2. activity (usually lowers the blood sugar, but may raise the blood sugar if the pre-exercise blood sugar level were very high); and
  3. insulin or diabetes pills (which should always lower the blood sugar level).

It's not discussed much, but whenever we think of the reasons for changing blood sugar levels, we should also include STRESS, such as pain, or emotional stress, or viral or other infectious illnesses, and just about every medical disorder, including surgery and pregnancy, and even treatment with some medications (see an earlier question about steroid medications).

Therefore, it should be recognized that "stress" is a factor in blood sugar control; it usually raises blood sugar.

So, the complete list of what factors influence blood sugar should be:

  1. food;
  2. activity;
  3. insulin or diabetes pills; and
  4. stress.

It would not be surprising that your daughter would have higher blood sugar levels while teething.


If the stress were expected to last more than a few hours, it might be worth adjusting insulin doses to keep the sugar down; however, remember that when the stress subsides, the insulin dose will need to be readjusted!

Original posting 5 Jan 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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