From the FDA Drug Label
Warn patients with diabetes that they may develop increased blood glucose levels following epinephrine administration.
- Increased blood glucose levels may occur in patients with diabetes following an anaphylactic reaction treated with epinephrine 1.
- The blood sugar is expected to increase in these patients.
From the Research
During an anaphylactic reaction, blood sugar levels typically decrease, a condition known as hypoglycemia, due to the release of histamine and other inflammatory mediators, which can be managed with epinephrine administration and glucose monitoring, especially in patients with diabetes 2.
Anaphylaxis and Blood Sugar Levels
The relationship between anaphylaxis and blood sugar levels is complex, involving the release of histamine and other inflammatory mediators that cause blood vessels to dilate and become leaky, leading to a drop in blood pressure and reduced blood flow to vital organs, including the liver, which plays a crucial role in maintaining normal blood glucose levels.
- The stress response during anaphylaxis stimulates insulin release, which further lowers blood glucose.
- In severe cases, this hypoglycemia can contribute to the symptoms of anaphylaxis, including confusion, weakness, and loss of consciousness.
Treatment and Management
Treatment for anaphylaxis focuses primarily on epinephrine administration, which not only counteracts the allergic response but also helps raise blood glucose by promoting glycogenolysis.
- Patients with diabetes who experience anaphylaxis should be particularly vigilant about monitoring their blood sugar levels during and after the reaction, as they may need additional glucose management 3.
- The use of corticosteroids in the management of anaphylaxis may also have an impact on blood sugar levels, although the evidence is limited and inconclusive 4.
Key Considerations
- Early administration of epinephrine is critical in the management of anaphylaxis, and patients should be educated on the proper use of epinephrine auto-injectors 5.
- Patients with a history of anaphylaxis should be monitored for potential biphasic reactions, which can occur hours after the initial reaction 6.
- The management of anaphylaxis should be individualized, taking into account the patient's medical history, the severity of the reaction, and the presence of any underlying conditions that may affect blood sugar levels 2.