How does stress hyperglycemia differ from chronic diabetes?

• A. It occurs during acute illness with elevated counterregulatory hormones and is usually transient; HbA1c may be normal or mildly elevated
• B. It is autoimmune in nature like type 1 diabetes
• C. It causes permanent beta-cell loss
• D. It is identical to chronic diabetes

Answer: (D)

Stress hyperglycemia is a temporary rise in blood glucose that occurs during acute illness or physiological stress. It happens because counterregulatory hormones (like glucagon, cortisol, catecholamines) and inflammatory signals surge, increasing glucose production by the liver and reducing insulin action. Because this is tied to the acute event, the hyperglycemia usually resolves once the illness improves. HbA1c, which reflects average glucose over the past 2–3 months, may remain normal or only be mildly elevated if there wasn’t long-standing hyperglycemia before the stress. Chronic diabetes, on the other hand, is a persistent condition caused by ongoing beta-cell dysfunction and/or insulin resistance, often with autoimmune destruction in type 1 or long-standing metabolic impairment in type 2, leading to sustained hyperglycemia and higher HbA1c that persists beyond acute episodes. So the key distinction is transient glucose elevation during acute illness with possibly normal or only mildly elevated HbA1c, versus long-term, persistent diabetes.