Hypoglycemia increases pain

Pain is increased by multiple mechanisms associated with blood sugar dysregulation. A study just published in the journal Pain demonstrates that hypoglycemia increases nerve sensitivity to pain. The authors state:

"Hypoglycemia is a physiological stress that leads to the release of stress hormones, such as catecholamines and glucocorticoids, and proinflammatory cytokines. These factors, in euglycemic animal models, are associated with stress-induced hyperalgesia. The primary aim of this study was to determine whether experimental hypoglycemia in humans would lead to a hyperalgesic state."

To determine the relative effects of normal versus low blood sugar on pain, a hypoglycemic state and normal blood sugar (euglycemic) state was induced in healthy study subjects by applying either a two 2-hour hypoglycemic hyperinsulinemic clamps or two 2-hour euglycemic (normal blood sugar) hyperinsulinemic clamps respectively on separate occasions. The day before and the day after both the euglycemic and hypoglycemic clamps their response to thermal and pain challenges was measured. Sensitivity to pain was significantly increased by hypoglycemia:

"In contrast to prior euglycemia exposure, prior hypoglycemia exposure resulted in enhanced pain sensitivity to hot and cold stimuli as well as enhanced temporal summation to repeated heat-pain stimuli. These findings suggest that prior exposure to hypoglycemia causes a state of enhanced pain sensitivity that is consistent with stress-induced hyperalgesia."

Blood glucose dysregulation, including both hypoglycemia and insulin resistance, has a profound and pervasive influence on human biological systems. Case management of pain must include the stabilization of blood glucose.