Sepsis can lead to hypoglycemia, or low blood sugar levels. This may occur due to the shock that sepsis can place on the body. When it occurs, it can result in a poor prognosis and higher risk to the person.

Sepsis is a life threatening reaction to an infection.

It often occurs as an extreme immune response to an infection in the lungs, urinary tract, skin, gastrointestinal tract, or other body areas. The condition is responsible for about 1 in 3 deaths in hospital settings.

Hypoglycemia occurs when sugar in the bloodstream dips lower than 70 milligrams per deciliter of blood (mg/dL). It often occurs in metabolic conditions such as diabetes, but sepsis can trigger low blood sugar levels. When sepsis causes hypoglycemia, it can worsen a person’s overall chances of recovery.

This article reviews the connection between sepsis and hypoglycemia.

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Sepsis can sometimes lead to hypoglycemia, causing a person to have a worse prognosis.

A 2022 review of people with sepsis in a hospital in Japan noted that almost five times as many of these individuals had hyperglycemia, which refers to high blood sugar levels, as hypoglycemia.

However, the review further notes that when hypoglycemia does occur, it increases a person’s risk of:

  • mortality
  • severe acidosis
  • significantly higher blood lactate level

A 2021 systematic review and meta-analysis also notes that blood glucose levels may help indicate disease severity in those with sepsis. It suggested that those with hypoglycemia likely have poorer outcomes.

Sepsis often causes hyperglycemia, where a person’s blood sugar levels rise to unsafe levels. In response, doctors may take drastic steps to control the rising blood sugar levels.

According to a 2021 systematic review, when doctors over-treat high blood sugar levels, they may inadvertently trigger hypoglycemia. The review also states that treating hyperglycemia may not improve outcomes but instead put a person at higher risk of their blood sugar levels dropping too low.

Sepsis can also interfere with ordinary sugar or glycemic controls, which can lead to spontaneous hypoglycemia. The exact rate of spontaneous hypoglycemia is unknown, but it strongly correlates with sepsis severity.

Possible causes may include:

  • lack of the hormones cortisol and adrenaline
  • alteration in glucose metabolism
  • increase in glucose consumption in certain tissues

Sepsis can cause changes to how the body controls blood sugar levels due to acute stress associated with sepsis. Often, sepsis can lead to insulin resistance.

Insulin resistance is when cells do not respond appropriately to the hormone insulin, which plays a vital role in regulating blood sugar levels. When this occurs, it can cause hyperglycemia.

According to a 2020 analysis, the presence of hyperglycemia can indicate a severe case of sepsis that increases the risk of poorer outcomes in people who are not living with diabetes.

The analysis suggests that people living with diabetes or pre-existing hyperglycemia may have a better outcome from sepsis than those who develop hyperglycemia due to sepsis.

Starting treatment as early as possible can offer the best outcome. Treatment often involves a combination of therapies that may include:

  • treating the underlying infection with antibiotics
  • giving intravenous fluids
  • taking medications to help with blood pressure and prevent blood clots
  • removing the source of infection, for example, a catheter or damaged tissue
  • providing nutrients
  • having surgery to remove an organ or dead tissue
  • breathing support
  • having dialysis if the kidneys become damaged

Sepsis occurs due to the body reacting to an infection. Several different infections can cause sepsis.

Sepsis is often due to viral, fungal, or bacterial infections in the lung, urinary tract, skin, or gastrointestinal tract. Bacterial infections from Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa are most likely to cause sepsis.

Sepsis can lead to several serious complications, including tissue damage, organ failure, and death. Quick recognition and treatment of sepsis can help improve a person’s chances of survival and limit the risk of other complications.

Some possible complications include:

  • changes to the immune system’s function
  • kidney damage or failure
  • need to amputate a limb
  • problems with memory or concentration

About 50% of people will develop post-sepsis syndrome. This syndrome can cause several symptoms including:

  • depression or mood swings
  • lack of energy
  • difficulty falling asleep or staying asleep
  • low appetite
  • shortness of breath or difficulty breathing
  • loss of self-esteem
  • swelling in the arms or legs
  • hallucinations
  • disabling muscle or joint pain
  • panic attacks, flashbacks, or nightmares

Sepsis can alter a person’s blood glucose levels. While it is more common for a person to develop hyperglycemia, sepsis can cause hypoglycemia directly or be due to over-treating hyperglycemia.

Blood sugar level changes often indicate a worsening case of sepsis. Early treatment can help restore blood glucose levels and prevent complications.