'White coat' hyperglycemia
C. K. Lardinois
Department of Medicine, Ioannis A. Lougaris Veterans Affairs Medical Center, Reno.
A visit to a physician's office may provoke an increase in blood pressure.
Stress is also a well-known glycemic aggravation, and managing diabetes
with ongoing stress is often difficult. Two patients with diabetes mellitus
in whom anxiety and stress contributed to transient hyperglycemia that
impacted adversely on their diabetes management are presented. "White coat"
hyperglycemia should be suspected when the clinical glucose levels are
higher than the glucose levels measured by the patient at home and the
clinical glycohemoglobin levels. The recognition of white coat
hyperglycemia is especially important with the recent findings that
intensive therapy effectively delays the onset and slows the progression of
diabetic complications in patients with insulin-dependent diabetes
mellitus. Failure to appreciate white coat hyperglycemia will increase the
risk of hypoglycemic episodes, some of which may be severe and life
threatening.
