Need help navigating life with diabetes? You can always Ask D'Mine!

Welcome again to our weekly Q&A column, hosted by veteran type 1 and diabetes author  in New Mexico. This week, Wil is answering a somewhat unusual question related to sexual activity... Read on for details.

{Got your own questions? Email us at [email protected] } 

 

Christopher, type 1 from California, writes: Hello, how you doing? I’m a diabetic, been for 34 years. I take shots, 4x a day, and now I’m getting way too many low blood readings—like 25-100. Around May this year I went to see my new girlfriend for the first time, and later we had sex. I didn’t have any STDs before that, and she said she was STD-ree. But since then I’ve been getting low blood sugar readings. My question is: Can being exposed to an STD affect your diabetes?

[email protected] D’Mine answers: I’m doing great, thank you for asking -- although you seem to be doing better, you lucky dog, you! Well, except for the whole thing with the lows and the possible sexually transmitted disease (STD).

We’ll talk about the wisdom of having unprotected sex with someone you’ve just met in person for the first time, who says she’s STD-free, in a moment, but first let’s deal with the biology. Can STDs cause lows?

As a rule, most infections cause blood sugar to go the other way: To go up. In fact, various infections, including STDs, commonly end up leading to incidental findings of diabetes, meaning some poor sod went to the doctor to be treated for a case of the and then discovered he or she also had diabetes! The sugar bump from some infections causes a gradual increase over time, while other types of bugs trigger a rapid spike upward that is stubborn to respond to corrections.

But just to be sure I didn’t overlook anything, I did some research for you. My first stop was, ironically, down under. No, I wasn’t doing field research, get your mind out of the gutter! I’m talking about Australia.

In Australia, where they are delightfully more frank in their discussions of sex, drugs, and diabetes than we are here in the more prudish US of A. STDs aren’t even called STDs. Nope, the Aussies call them STIs, which stands for Sexually Transmittable Infections. As a self-appointed Guardian of the Language, I actually like this label better, as the words carry a connotation of something that can happen to you, which our STD really doesn’t do (transmittable vs. transmitted).

As an ex-public health worker, I can tell you that word choice matters for prevention!

Anyway, the party crowd down under confirmed my first instinct. The Aussie National Diabetes Services that STIs, including chlamydia, genital warts, gonorrhea, hepatitis A and B, and herpes can all raise blood sugar.

Of course, there are more than 20 types of SDT/STIs between the sheets, so I guess some really rare type might cause lows in some people, but if so, I couldn’t find any reports of it.

As a side note though, I guess I should scare the piss out of everyone this morning by pointing out that HIV/AIDs patients commonly have diabetes-like blood sugars (which might be caused by the treatments as opposed to the virus) but that A1C tests don’t work for them. Here, check out , showing that HIV patients with A1Cs in the 6.7% range were actually clocking average blood sugars in the 162 range (which should have given A1Cs of 7.3%).

OK, that’s not huge, but still, what the eff?

Researchers concluded it was due to a combination of the increased size of red blood cells seen in some HIV positive people and the use of the medication , but the nuts and bolts of it all mystified them.

Still, even though the A1C is underestimating the average glucose level in these cases, the HIV isn’t causing low blood sugars. 

Bottom line, even if you did get a STD from your new squeeze, it isn’t the cause of your new lows. So to answer your question of which STDs can affect your diabetes, the answer is: All of them. But none of them causes the problem you are having. 

Now, I have a question for you: Are you sure the lows started after “first contact"? The reason I ask is that, while it doesn’t seem possible that a STD can cause a low, the reverse isn’t true. It’s very easy to catch a STD from a low blood sugar, ‘cause when we are low, we tend to make bad decisions. Like having unprotected sex with someone you don’t know well. 

Just sayin'… 

Anyway, if you’re worried about a STD, you should go get checked. There’s no need for shame about that. Really, it’s being a good citizen, as wellas being the right thing for your health and your diabetes. It’s important because we D-folk are much more likely to get STDs compared to sugar-normals, and thanks to our crappy immune systems, we are likely to have a harder time fighting them off. Probably our meter kits should come complete with condoms, along with the lancets. Hmmm… Maybe that’s what that little zipper pouch in the case is for!       

As to your low sugar issues, as I think we can safely rule out a STD as the cause. You need to look at all the usual suspects to find what is causing your lows:

Any change in your activity levels? i.e. Are you moving more?

What about your eating? Are you eating less?

Any changes in your other medications? Anything, say like a statin, reduced or dropped? Statins tend to raise blood sugar, so if you reduce or drop one, your insulin would need to be reduced to compensate. 

What about stress? Is your stress level lower now that you have a girlfriend in close orbit?

Although I’m guessing no on that last one. At least not for you. Because, going out on a thin limb here, I’m detecting some trust issues. You had sex with this lady, then something happened with your diabetes, and your first thought was that you caught a STD from her. Of course, that’s not totally irrational, given that our STD stats that about 25% of the population is sleeping with a STD, but the fact that it was your first thought tells you something about your attitude toward the relationship, and her.

So that’s something you need to think about. 

But please, not when you are having a low.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.