Appendicitis can cause high blood sugar, a phenomenon known as stress-induced hyperglycemia. Appendicitis is an acute inflammation and infection of the small, finger-shaped pouch attached to the large intestine. The body interprets this severe infection as a major physical threat, triggering a powerful defense mechanism that includes a dramatic shift in metabolism. This temporary elevation of glucose levels is a physiological response, which can complicate a patient’s clinical picture and treatment.
Appendicitis and Systemic Inflammation
Appendicitis typically begins when the appendix becomes blocked, often by hardened stool, leading to swelling, increased pressure, and bacterial overgrowth. This obstruction quickly causes inflammation and infection within the appendix wall. As the condition progresses, the infection can become severe, moving from a local issue to one that affects the entire body.
The localized infection triggers the immune system to launch a massive, body-wide response known as systemic inflammation. This response is characterized by the release of signaling molecules called pro-inflammatory cytokines, which circulate throughout the bloodstream. This inflammatory cascade acts as the primary trigger for metabolic changes, causing the body to shift its priorities to mobilizing energy stores and setting the stage for elevated glucose levels.
How the Body’s Stress Response Elevates Glucose
The high blood sugar observed in acute appendicitis is a direct result of the body’s physiological stress response, designed to provide immediate fuel for survival. This response involves activating the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis, which rapidly increase the amount of glucose circulating in the blood.
A cascade of counter-regulatory hormones is released for energy mobilization, including adrenaline, cortisol, and glucagon. Adrenaline and glucagon primarily act on the liver, stimulating glycogenolysis (the breakdown of stored glycogen into glucose) and gluconeogenesis (the creation of new glucose from non-carbohydrate sources).
Simultaneously, cortisol and other stress hormones induce temporary insulin resistance in peripheral tissues, such as muscle and fat cells. This makes the body’s cells less responsive to insulin, reducing glucose uptake.
The combination of increased glucose production by the liver and reduced uptake by the body leads to a rapid rise in blood sugar levels. This metabolic shift ensures that immune cells and the brain have an abundant glucose supply to support the fight against infection.
Monitoring and Resolution Post-Treatment
Recognizing stress-induced hyperglycemia is important for managing acute appendicitis, as elevated glucose levels can increase the risk of complications, such as surgical site infections. Blood glucose is routinely monitored in patients with acute abdominal pain, regardless of prior diabetes diagnosis. Levels are often measured preoperatively to assess inflammatory stress and guide immediate management.
Once the infected appendix is successfully treated, typically through surgical removal (appendectomy), systemic inflammation subsides. As the infection clears and acute stress diminishes, the release of counter-regulatory hormones rapidly decreases. This allows the body’s normal mechanisms for glucose regulation to regain control.
For patients without pre-existing diabetes, the hyperglycemia is generally transient, returning toward a normal range within 24 to 48 hours following the procedure. However, this episode can unmask previously undiagnosed or pre-diabetic states, requiring follow-up testing after recovery. A persistently high blood sugar level post-treatment signals the patient may need ongoing management for a chronic condition.