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Dr. Bill's Commentaries

Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

Elevated Blood Glucose Levels after Carpal Tunnel Hand Surgery   (July 27, 2012)

I just saw the following question:

I recently had carpal tunnel surgery on both hands at the beginning of June. It's now late July and my blood sugar levels are still in the 230s. I take Lantus twice a day. What can I do? I have a constant headache, jaw pain, teeth hurt; can this be making my level stay high? 

My reply:

Something doesn’t quite fit together here. As I understand it, you have had elevated blood glucose levels continuously since hand surgery that was done almost two months ago.

Surgery certainly can cause pain, and pain is a stressor that can raise blood sugar levels. Plus, after most surgical procedures, there’s decreased physical activity for a while, which also would contribute to high sugar levels. With that in mind, I think people with diabetes who are on insulin shots or pumps should be given explicit instructions on what target ranges to aim for post-operatively, and how to adjust their insulin to meet these targets.

Since you’re on insulin injections, it would be easy to adjust your insulin doses, either by raising the Lantus doses, or perhaps better still, adding premeal boluses of rapid-acting insulin (there are three brands, Humalog, Novolog, and Apidra: any one would work) to help bring your diabetes back under control. Speak to your physician or diabetes nurse educator about how to handle this.

That said, I wonder if your recent hand surgery is really to blame for your recent high blood sugar levels, or perhaps it’s something else. After carpal tunnel surgery, transient wrist pain would be expected, but as a non-surgeon, I simply don’t associate symptoms such as “constant headache, jaw pain, teeth hurt” with this type of surgery, especially after almost two months.

I’d suggest you visit either your personal physician or your hand surgeon to find out what is causing your present symptoms, as I suspect they may be separate from the surgery. And while your physicians are sorting out what’s wrong and treating that, you should also establish a target range for you to aim at for your glucose levels, and get advice on how to adjust your insulin doses to hit these targets.

Best wishes!

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