Symptoms of blood sugar spike

Staying hydrated is important for everyone — especially considering that water makes up more than half of the human body!

“60 percent of our body is composed of water, 75 percent in our muscles, 85 percent in our brains, it’s like oil to a machine,” explained Dr. Roberta Lee at Medicine Daily.

But we don’t drink enough. According to recent research at the Institute of Medicine, 75 percent of Americans are perpetually dehydrated.

As people with diabetes, drinking enough water is especially crucial. Even a little dehydration during the day (which is easier than we realize) can impact our blood sugars.

This article will explain how dehydration affects blood sugar levels, how much water we should drink each day, who should limit their water intake, and what else you can drink if you don’t want to just drink plain water.

Table of Contents

How water impacts your diabetes

Quite simply, when you don’t drink enough water, the glucose in your bloodstream becomes more concentrated. And that leads to higher blood sugar levels. Both mild and severe dehydration can have a notable impact on your diabetes.

Even a mild level of dehydration — something you may not even feel — could easily leave your blood sugar levels 50 to 100 mg/dL higher than if you were drinking enough water.

If you’re consistently dehydrated on a daily basis, you might even be compensating with higher insulin levels than you’d need if your body was getting the water it needed.

More severe levels of dehydration, on the other hand, can drive blood sugars very high very quickly. For example, repeated vomiting from food poisoning or a stomach virus can lead to very sudden high blood sugar levels. But after an IV of fluids at the emergency room, you’ll likely see your blood sugar drop quickly towards normal levels without additional insulin.

It’s the simple issue of severe dehydration causing the glucose in your bloodstream to become extremely concentrated, and then quickly diluting it with plenty of fluids.

Almost every process in your body relies on water

Water actually does far more for our bodies than we realize. Water aids your digestion, lubricates joints, helps flush waste products and performs a host of other important tasks in your body. Not being properly hydrated will significantly reduce your physical capacity and brain function.

According to Harvard University, adequate water intake is vital for a variety of daily functions within our body:

  • carries nutrients and oxygen to cells throughout your body
  • flushes bacteria from your bladder
  • aids in the digestion of meals
  • prevents constipation
  • normalizes your blood pressure
  • maintains a stable heartbeat
  • cushions your joints
  • protects your organs and tissues from a variety of potential damage
  • regulates your body temperature
  • maintains your body’s electrolyte/sodium levels

Water has been pinpointed in many studies as an important part of losing weight, but researchers still aren’t clear how it’s accelerating your weight-loss efforts.

Theories behind water consumption and weight-loss include:

  • Drinking more water means you’re likely drinking less soda and other sugar-laden beverages
  • Drinking more water might boost your metabolism and cause you to burn more calories
  • Drinking more water might help reduce cravings for not-so-healthy foods
  • Drinking more water in place of diet soda may reduce insulin resistance

Regardless, it is clear in study after study that those who drink more water tend to lose more weight, in contrast, to study participants drinking less water.

Drinking enough water impacts so many aspects of our daily health. But how much water is enough?

How much water should people with diabetes drink each day?

There is no definitive rule for how much water you should drink, but there are guidelines we can follow.

The most important recommendation is that you should always have water available and drink whenever you feel thirsty. You don’t need to force yourself to drink water to reach some specific goal, but try to drink water continuously throughout the day.

Even if you don’t feel thirsty, you should try to take a few sips of water every hour to keep hydrated. The thirst reflex isn’t always perfect, especially for people with diabetes, so it’s better to proactively drink a little water than risk dehydration.

The average non-diabetic is advised to drink 8 glasses of water per day, so a person with diabetes should certainly take that to heart. While our insulin-producing friends need plenty of water, too, the consequences of mild dehydration in those of us with diabetes are more obvious in our blood sugar levels.

8 glasses of water per day add up to about 2 liters of water (67 ounces or just over half a gallon). It sounds like a lot — but you can make it feel more doable by choosing a medium-sized reusable beverage container and determining how many times per day you need to fill it to reach 2 liters.

If you’re exercising or battling the heat of summer, that number increases quickly.

“But even a healthy person’s water needs will vary,” adds Harvard, “especially if you’re losing water through sweat because you’re exercising, or because you’re outside on a hot day.”

Harvard research says the general rule of thumb for healthy individuals on a hot day or during exercise is to drink two to three cup per hour to compensate for water lost through sweating.

Who should limit their water intake?

“It’s possible to take in too much water,” explains Harvard research.

Certain health conditions can mean that too much water is actually taxing on your body. These conditions and medications mean you should talk to your doctor about the right amount of daily water for your body:

  • Kidney disease or other kidney conditions
  • Thyroid disease
  • Liver issues
  • Heart conditions
  • Medications that cause water retention
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Some antidepressants
  • Opiate pain medications

Good alternatives to plain water

Most sugar-free non-calorie beverages are good alternatives to plain water. This includes:

  • Flavored or infused water
  • Sparkling water
  • Unsweetened tea
  • Diet soda (in limited amounts)

Coffee in small amounts is also hydrating, as the diuretic effect of coffee (making you urinate more) is less than the amount of liquid you drink.

A note on diet soda

Some research studies point to a link between insulin resistance, weight gain, and frequent consumption of diet soda.

As one study from the United Kingdom concluded, “Replacement of with water after the main meal in women who were regular users of may cause further weight reduction during a 12-month weight maintenance program. It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period.”

However, other studies have not found the same effects of diet soda so it’s probably safe to consume diet soda in limited amounts.

Suggested next posts:

  • Coffee and Diabetes: How Coffee Affect Blood Sugar
  • Diabetes and Polyphagia (Excessive Hunger)

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Causes of Low Blood Sugar

So what causes the blood sugar level to be low? Interestingly, this can happen when you eat either too much or too little.

Eating Too Little

Our body converts the foods we eat into glucose for energy.

If you’re not eating enough due to dieting or other reasons, you’ll not have sufficient blood sugar to sustain your body.

Since up to 50% of women are dieting at any given time, low blood sugar is much more common than many people think.

Side Note: World Health Organization (WHO) establishes that starvation begins under 2,100 calories a day, and USDA standards indicate 2,500 calories as the daily minimum that an adolescent or adult woman needs to get the minimum amount of life-sustaining nutrients.

Eating Too Much

You can also get low blood sugar when you eat too much.

This often happens when you eat foods with a high glycemic index that are turned into sugar quickly, such as soda, candies, pastries, white breads, etc.

When there’s a lot of sugar in the blood stream, insulin works extra hard to pump it from the blood into the cells, and stores it as fat.

If you regularly overeat, your insulin will get exhausted and become less effective, leading to either high or low sugar levels in the blood stream.

How to Balance Blood Sugar

If I could sum up my learning on life, health and happiness in one word, it would be “balance.”

And balancing blood sugar is one of the most fundamental aspects because it sets us up biochemically to balance the rest of our lives.

So to harmonize our menstrual cycles and to ensure our physical as well as mental and emotional well-being, it’s extremely important that we keep our blood sugar stable on a daily basis.

Here are some suggestions:

1. Have a Protein-rich Breakfast

Eat a substantial (at least 25% of the day’s food intake), protein-rich breakfast within 90 minutes of waking.

2. Eat 3 Meals a Day

Eat at least 3 solid meals a day.

3. Eat Every 4 Hours

Don’t skip a meal and don’t let more than 4 hours go by without food.

4. Choose Low Glycemic

Eat more nutrient-dense foods with a lower glycemic index.

Avoid or minimize the intake of junk foods that give you empty calories without adequate nutrients.

5. Balance

Balance carbs with healthy fats, protein and fiber (veggies). They will make you feel full and satisfied, reducing the chances of overeating.

6. Take Supplements

The B vitamins, vitamin C, and the mineral chromium are crucial for keeping blood sugar level stable and preventing carbohydrate cravings.

Take a wholesome multi-vitamin supplement and 200mg of Chromium 3 times a day to replenish these vital nutrients in your body.

7. Take Omega-3

Omega-3 fatty acids can help raise your metabolism, promote fat-burning, and support your insulin function to keep your blood sugar stable.

Include omega-3 rich foods such as fish, eggs, nuts and seeds in your diet, or take a fish oil or flaxseed oil supplement.

8. Add L-glutamin

L-glutamin is an amino acid that’s proven effective in stopping cravings for sweets, starches and alcohol almost instantly.

It helps balance the brain chemistry (and hence reduces your need to depend on your limited willpower).

Consider taking 1 capsule of L-glutamin supplement 1 to 3 times a day, preferably between meals.

9. Support the Adrenals

Support your adrenal function to restore your overall hormone balance.

Get adequate rest, keep your stress level manageable, and build up your adrenal reserve with natural remedies.

These tips are simple enough to implement. The key is to make them part of your daily routine – something you do day in and day out without having to think about it.

Remember, when you take care of your blood sugar, it’ll take care of you!

I hope you find this article helpful. And as always, I’d love to hear your thoughts, experiences and feedback!

Note: If you have any underlying health condition, please check with your doctor before taking any dietary or herbal supplements as they may interfere with your medication.

Image source

The cause of fluctuating blood sugar levels in diabetics

The small electrode is only allowed to just brush against the surface of the cell so it must be controlled extremely carefully under the microscope. Tiny, tiny steps. Only 0.1 of a micron at a time. When the electrode finally makes contact the surface of the cell bends inwards. Then – quite suddenly – the electrode fuses with the cell and measurement can begin.

This technique allows us to register extremely small flows of current through the cell’s ion channels, says Patrik Rorsman, Professor of Diabetic Medicine at the University of Oxford in England and newly appointed to an ‘Excellent Researcher’ position at the Sahlgrenska Academy.

The method he uses is called patch-clamp. Thanks to the technique he has managed to develop basic knowledge of how the body regulates sugar levels in the blood. It is a delicate tightrope act that is first and foremost controlled by the hormones insulin and glucagon. Insulin ensures that the levels fall while glucagon makes them rise. But the fact that Patrik Rorsman entered research at all, and that he has devoted himself to studying the behavior of these particular hormones is due to pure chance. Let’s tell the story from the beginning.

A bad conscience opens up new possibilities

When researchers Bert Sakmann and Erwin Neher successfully measured small currents passing through individual cells in 1982, the news spread fast in the cellular biology world. It was quickly realized that this was a major breakthrough. For example, it was suddenly possible to measure the currents that cause nerve signals to be transmitted in our bodies. Young researchers from around the world wanted to visit the laboratory in Germany and join in the gold-digging. But few of them were able to pass the eye of the needle. Patrik Rorsman, on the other hand, slipped in as if on the proverbial banana skin:

– Sakmann was supposed to hold a lecture in Stockholm but forgot all about it. I had nothing to do with the lecture but he must have felt that he owed Sweden something. He said: “I suppose that Swede can come then.”

And Patrik Rorsman was given the chance to test his wings at Sakmann’s laboratory and learn the new technique, which quite soon earned Sakmann and his colleague a Nobel prize. Patrik Rorsman was supposed to measure currents in pulsating heart muscle cells. But personally he was more interested in diabetes as a disease. One day, when his lab supervisor was away, he took the opportunity to isolate the production of insulin-producing cells, called beta-cells, from the islets of Langerhans in the pancreas. Sakmann happened to pass by. He looked at the cells under the microscope and observed that they appeared to be brown in color. They would be very suitable for patch-clamp measurement.

– This was on Friday evening and we decided to do it on the Saturday. When we met the next day he recorded the cells and found extremely high levels of activity in them, says Patrick Rorsman.

A stream of ions causes insulin to be secreted

Insulin secretion, a fundamental process in the body, proved to depend on the fact that ions flow through the walls of the cell, the cell membrane. When the beta-cells break down glucose, this triggers a chain of reactions that causes the number of positively charged potassium ions to increase inside the cells. A current is formed across the cell’s membrane which causes channels for another kind of ions, calcium ions, to open up in the membrane. When calcium ions pour out of the cells, the current that Patrik Rorsman and Bert Sakmann were able to measure was created. The current causes the cell to release insulin into the bloodstream.

Patrik Rorsman was soon able to show that two diabetes drugs, tolbutamide and diazoxide, influence the potassium ion channels. No-one had understood before why these substances affect insulin secretion. The knowledge that the patch-clamp technique can provide such basic knowledge whetted his appetite. Patrik Rorsman decided to abandon his dreams of being a doctor and become a researcher instead.

Glucagon contributes to blood sugar fluctuations in diabetics

He soon also began to study insulin’s counterpart in the body – glucagon, which is also secreted by the pancreas but from alpha-cells.

– The alpha-cells were more difficult to study since there are so few of them. But we have learned with time, he goes on.

For the past ten years he has been working at the University of Oxford with a focus on glucagon. Patch-clamp measurements show that alpha-cells react in the wrong way in diabetics. In healthy people, glucagon is secreted when blood sugar levels are too low. Glucagon ensures that the liver manufactures enough sugar but in diabetics glucagon is not secreted and blood sugar falls to levels that are dangerously low. On the other hand, the alpha cells secrete glucagon when blood sugar levels are high and then the hormone instead contributes to increase the amount of blood sugar. This makes blood sugar levels fluctuate and become difficult to control.

“Being appointed a Wallenberg Scholar means that I can do things that might seem a little crazy. There’s too much bread and butter in research today. People make research too short-term because they have nothing to report. But that’s not the way forward. Being a Wallenberg Scholar means having freer hands to try projects that involve greater risk.”

As a newly appointed Wallenberg Scholar Patrik Rorsman will be moving home to Sweden, to the University of Gothenburg. He will be continuing to seek knowledge related to diabetes as a disease but he will also finally be able to chatter away in Gothenburgese again. He’s really looking forward to that.

Text Ann Fernholm
Translation Semantix
Photo Magnus Bergström

Published: 2013

Blood Sugar Swings

Patients frequently want to know “what causes my blood sugars to go up and down even though I am doing the same things every day.” Patients will eat similar foods in the same quantities daily and hope their blood sugars will stay at the same level. Although eating does have a huge impact on blood sugars, there are other causes as well. Let’s look at some of the other possible reasons why your blood sugars may vary from day to day.

Illness or physical stress

Having a urinary tract, lung, or skin infection, as well as the flu or gum disease can make your blood sugars fluctuate. Often patients do not realize there is an underlying infection until their blood sugars soar. If you see your blood glucose numbers climbing for no apparent reason you should take your temperature and check with your physician to rule out possible infection. Chronic unrelieved pain or fibromyalgia may also cause blood sugar changes. Find ways to resolve these issues by researching physical therapy, chiropractic medicine, acupuncture, yoga, pain relievers or any other alternative ways to achieve pain relief. Lack of sleep or poor quality of sleep can result in chronic stress and insulin resistance, which will raise blood sugars.

Medication

Medications can have an effect on blood sugar variations from day to day. Patients who skip their daily diabetes medicines will have blood sugar fluctuations. Starting new medications can cause changes. Remember, it may take new medications between 4-8 weeks to show improved and consistent blood sugar control. Existing medicine dosages that are increased or decreased will have an impact on sugars. Certain patients do not take medications as prescribed. For example Glipizide (an oral sulfonylurea) needs to be taken 30 minutes prior to a meal. This gives it time to enter your system and squeeze the insulin from the pancreas; otherwise you may not get adequate results.

Some patients may know about proper timing of medication but do not follow protocol. They are often in a rush to eat and move on with the day; they take all their pills at the same time. Know if your medication needs to be taken with food or not. You should know the difference between the types of insulin and the timing. If you take rapid acting insulin (Novolog / Humalog), you should eat within 15 minutes or you may suffer from hypoglycemia. Taking rapid insulin an hour after a meal may cause an initial jump in blood sugars (due to the food) followed by a rebound low. Site rotation and rotation of insulin injections can also be the reason for blood sugar swings.

Patients may repeatedly stick the same spot either because they think it will hurt less (callus formation) or because they are unaware of the need to rotate within a site. After several injections in one quadrant a patient may develop hard lumps, indentations or thick skin. This can prevent proper insulin absorption and result in poor blood sugar management. Changing the site selection from day to day may result in blood sugar variations. Insulin is best absorbed in the abdomen because it is quick and consistent. Using alternative sites including the arm, leg and buttock will possibly cause swings due to absorption rates. When using an insulin pen you should always remove the used needle after your shot and only replace it with a new one at the time of the next injection; otherwise the insulin in the pen could leak and be ruined; this will cause variations in sugar readings. Most insulins only last for 28 days, so expired insulin can cause blood sugar variations.

If your prescription calls for a medication to be taken twice a day, you should not skip a dose or you will have blood sugar fluctuations. Set a timer or place it on the table if you have trouble remembering your second dose. Always check tubing, tape and site placement when using an insulin pump. Make sure you are getting adequate insulin from your pump to prevent blood sugar fluctuations.

Stress

Mental stress can cause blood sugar variations. Try to avoid it, learn to say no, meditate, count to 10, exercise, find a hobby, volunteer, see a therapist or make a list on how to reduce stress. Everyone has stress, but learning how to handle and cope with it will help you improve your blood sugars and keep them steady.

Change in portion sizes or total carbohydrates

If you are following a portion control eating plan and you suddenly change it for a celebration, night out, holiday party or trip you may notice fluctuations in your sugar. If you skip, delay a meal or delete carbohydrates completely you will have variations in your sugar which could be dangerous. Never skip meals.

Sugar free soda or drink intake

Diabetes Care published a small study stating that “too much diet soda can increase blood sugars even though it is sugar free.” Sugar free soda is extremely sweet and one theory is “it causes you to crave more sweets which may increase weight and blood sugars.” Check with your physician and use sugar free products in moderation.

These are just a few reasons why your blood sugars vary from day to day. It can be frustrating but if you know what causes blood sugar changes you can make a difference!

Stay informed!

Tags: bloodpressure, denver, diabetes, newwestphysicians

How to Recognize and Manage a Blood Sugar Spike

Blood sugar levels fluctuate all day long. When you eat food, particularly those foods that are high in carbohydrates like bread, potatoes, or pasta, your blood sugar will immediately begin to rise.

If your blood sugar is consistently high, you need to talk to your doctor about improving your diabetes management. Blood sugar rises when:

  • you’re not taking enough insulin
  • your insulin isn’t lasting as long as you think it is
  • you’re not taking your oral diabetes medication
  • your medication dosage needs adjusting
  • you’re using expired insulin
  • you’re not following your nutritional plan
  • you have an illness or infection
  • you’re using certain medications, like steroids
  • you’re under physical stress, such as an injury or surgery
  • you’re under emotional stress, such as trouble at work or home or with money problems

If your blood sugar is usually well-controlled, but you’re experiencing unexplained blood sugar spikes, there might be a more acute cause.

Try keeping a record of all the food and drinks you consume. Check your blood sugar levels according to your doctor’s recommendations.

It’s common to record your blood sugar reading first thing in the morning, before you’ve eaten, and then again two hours after eating. Even a few days of recorded information can help you and your doctor discover what’s causing your blood sugar spikes.

Common culprits include:

  • Carbohydrates. Carbs are the most common problem. Carbs get broken down into glucose very quickly. If you take insulin, talk to your doctor about your insulin-to-carb ratio.
  • Fruits.Fresh fruits are healthy, but they do contain a type of sugar called fructose that raises blood sugar. However, fresh fruits are a better choice than juice, jellies, or jams.
  • Fatty foods. Fatty foods can cause what’s known as the “pizza effect.” Taking pizza as an example, carbohydrates in the dough and sauce will raise your blood sugar immediately, but the fat and protein won’t affect your sugars until hours later.
  • Juice, soda, electrolyte drinks, and sugary coffee drinks.These all affect your sugars, so don’t forget to count the carbs in your drinks.
  • Alcohol. Alcohol raises blood sugar immediately, especially when mixed with juice or soda. But it can also cause low blood sugars several hours later.
  • Lack of regular physical activity. Daily physical activity helps insulin work more effectively.Talk to your doctor about adjusting your medication to fit your workout schedule.
  • Over-treating low blood sugars. Over-treating is very common. Talk to your doctor about what to do when your blood glucose level drops so that you can avoid huge swings in blood glucose levels.

Are Your Blood Sugar Readings Accurate?

If you have type 2 diabetes, testing blood sugar levels regularly — and understanding what the numbers on each reading mean — can help you monitor blood sugar and better manage the condition. These numbers are important because blood sugar test results can help you figure out how your diet, exercise, and medications might be affecting your diabetes.

When you master blood sugar readings, you’ll be on your way to better blood sugar control and, ultimately, better results on your A1C test, the blood test your doctor orders to track blood sugar control over time. Maintaining good blood sugar control over a long period, such as a decade, could significantly reduce your risk of diabetes complications like heart attack and stroke.

Understanding Blood Sugar Fluctuations

Even with highly effective modern technologies such as digital glucose meters, people with diabetes still worry about testing accuracy. Although you want to get the best results for each skin prick, when you’re new to blood sugar testing it can be confusing to watch those results change throughout the day.

“It’s helpful to understand that blood sugar changes minute by minute,” says certified diabetes educator Karen A. Chalmers, MS, RD, CDE, diabetes services program manager in the section of endocrinology, diabetes and nutrition at Boston Medical Center in Massachusetts.

For example, a person might test before coming to a medical appointment and then be surprised to find that his or her blood sugar is higher or lower by the time the doctor tests it. At first, this can lead to self-doubt and asking yourself, “Am I testing right?” or confusion about whether your meter and testing strips are accurate or not.

“Blood sugar is like a wave in the ocean — it’s constantly in motion,” Chalmers says. That’s why you’ll likely gain more information by looking at your tests over the course of an entire day or week to find a pattern rather than focus on individual test results.

Still, there’s a lot you can do to make sure that when you monitor your blood sugar you’re getting the most accurate and useful daily results, and ultimately lower A1C results in the long run.

Know When to Test

Your diabetes team will likely make recommendations for when you should be testing your blood sugar as you get started. For example, you might be told to test when you wake up in the morning, before meals, one to two hours after meals, and before bed. If you exercise, you might also test before and after a workout to see how your body responds to it. Depending on the medications you take, including insulin, you might have additional or fewer times to test.

To achieve blood sugar control, always make sure you keep a log of the times you test and your results. If you’re not sure why you have been told to test at certain times or why you are getting the results you get, talk to your diabetes team.

Additionally, if the cost of test strips throughout the month is difficult for you to afford, make a plan with your diabetes team to get the most out of the testing you are able to do. The cost of this maintenance may actually help you save money in the long run: A July 2012 article in the Journal of Diabetes Science and Technology reviewed studies of blood sugar testing at home and found evidence to suggest that because testing helps people maintain better blood sugar control, ultimately it can lead to lower diabetes care costs over a lifetime.

Know How to Test

Once you’re accustomed to testing, you’ll become more confident in your readings. Use these tips to help with the learning curve:

Set reminders for testing. If you tend to forget to test, use reminders to help yourself get in the habit. Leave your testing kit and record book out where you’ll easily see them, such as on the kitchen table, or set a reminder on your phone or computer for the appropriate times. You can also ask a loved one to remind you. Find a system that works best for you.

Know your testing tools. If you’re not sure how to use your glucose meter and test strips, ask a nurse or diabetes educator to show you how. Pay attention to details such as calibration codes for your meter if necessary. Newer meters may be easier for you to use. Even if you’ve been testing for awhile, it’s sometimes helpful to try testing in front of a health professional to make sure you’re doing it right.

Care for the meter and strips. Keep all of your supplies clean and stored in a cool, dry place. Always have extra batteries available for your meter.

Take your meter to the doctor. Bring your meter with you to appointments so you and your doctor can compare notes.

Stay sharp. A dull lancet will mean painful skin pricks and possibly poor results. Change out lancets frequently and don’t share your meter with anyone else.

Use up-to-date strips. Test strips have expiration dates. Note the date on your calendar so that you’ll never use expired strips.

Use the right test strips. Test strips can look a lot alike, but they don’t all work for every meter. Get the kind or brand recommended for your specific device.

Clean your hands. Washing your hands immediately before testing will remove any dirt and debris as well as sugars from foods (such as fruit) that you might have eaten or touched. A soak in warm, soapy water can also make it easier to get a blood sample because it brings blood to the skin surface.

Get a sufficient sample. “Getting a big enough drop of blood is important,” Chalmers says. Your meter will let you know if you didn’t, but you want to make each prick and test strip count.

Know when results might not be accurate. Over time, you’ll get to know your diabetes and how your body feels. While the majority of blood test results will be accurate, there may be times when your gut tells you that the numbers you’re seeing can’t possibly be correct. You can always retest after double-checking that your meter settings are right and your testing procedure were correct. However, based on how you feel, if you suspect that your blood sugar might be very high or going very low, call your doctor for advice or go to the emergency room.

By testing your blood sugar accurately at regular intervals, you’ll learn how diabetes is affecting your body, improve your A1C test numbers, and help yourself stay healthier over time.

What Is Brittle Diabetes?

Balancing your blood sugar levels is the primary way to manage this condition. Tools that can help you do this include:

Subcutaneous insulin pump

The main goal for people with brittle diabetes is to better match the amount of insulin they get to how much they need at a given time. That’s where the subcutaneous insulin pump comes in. It’s the most effective tool for controlling brittle diabetes.

You carry this small pump in your belt or pocket. The pump is attached to a narrow plastic tube that is connected to a needle. You insert the needle under your skin. You wear the system 24 hours a day, and it continuously pumps insulin into your body. It helps keep your insulin levels steady, which in turn helps keep your glucose levels on a more even keel.

Continuous glucose monitoring

Typical diabetes management involves regular testing of your blood to check your glucose levels, often several times each day. With brittle diabetes, that may not be often enough to keep your glucose levels under control.

With continuous glucose monitoring (CGM), a sensor is placed under your skin. This sensor constantly detects glucose levels in your tissues and can alert you when these levels get too high or too low. This allows you to treat your blood sugar issues right away.

If you think a CGM system might work well for you, talk to your doctor to find out more.

Other treatment options

Brittle diabetes often responds positively to careful management. However, some people with the condition still have severe blood sugar fluctuations despite treatment. In rare cases, these people may need a pancreas transplant.

Your pancreas releases insulin in response to glucose in your bloodstream. The insulin instructs your body’s cells to take glucose from your blood so the cells can use it for energy.

If your pancreas doesn’t function correctly, your body won’t be able to process glucose properly. A study published in the journal Diabetes Care showed that pancreas transplants have high success rates in managing brittle diabetes.

Other treatments are in development. For instance, an artificial pancreas is currently in clinical trials in a collaborative project between the Harvard School of Applied Engineering and the University of Virginia. An artificial pancreas is a medical system that makes it unnecessary for you to manually manage your glucose monitoring and insulin injection. In 2016, the Food and Drug Administration (FDA) approved a “hybrid closed-loop system” artificial pancreas that tests your glucose level every five minutes, 24 hours a day, automatically supplying you insulin as needed.

Living with diabetes or prediabetes requires constant monitoring and vigilance when it comes to your blood glucose levels. For someone with diabetes, a level that is too high or too low could result in adverse reactions like dizziness, irritability, weakness, increased thirst or hunger, and exhaustion. While many are aware that certain foods can impact their blood sugar, there are other factors that may be just as detrimental to maintaining a normal glucose concentration in your blood. Continue reading to learn how environmental factors may be influencing your blood sugar levels, as well as how to properly test your blood sugar, and what to do if you have high or low blood sugar.

Factors that influence blood sugar

Foods high in starches, sugars, and caffeine have all been associated with raised blood sugar levels, but did you know that similar effects can be caused by factors not related to food intake?

Below are some of the most common causes of blood sugar fluctuations that are not linked to food.

Cold and flu. An illness like the common cold or flu can cause a spike in blood sugar as your body works to fight the invading ailment. Ensure you stay hydrated, and notify your doctor if you are experiencing vomiting or diarrhea lasting more than two hours, or if you have been sick for more than two days and showing no signs of recovery.

Stress. Especially common for those with type 2 diabetes, stress can cause your body to release hormones that raise your blood sugar. Combat this external influence by learning relaxation techniques and trying to reduce stress in your life wherever possible.

Steroids and water pills. Corticosteroids used to treat a variety of conditions like rashes, asthma, and arthritis can raise your blood sugar levels and, in some cases, trigger diabetes for certain individuals. Similarly, diuretics – commonly referred to as water pills – are meant to help those with high blood pressure, but can also raise blood glucose levels. In contrast, medications like antidepressants have been found to either raise or lower blood sugar levels, meaning you should be mindful about which medications you are taking.

Decongestants. Cold medicines that help relieve your stuffy nose often contain pseudoephedrine or phenylephrine that can cause a spike in blood sugar levels. Some cold medications also contain sugar and/or alcohol in small quantities, so it is best to avoid these brands.

Chores. Completing the household chores like mowing the lawn or cleaning up may actually lower your blood sugar, providing a benefit for those with diabetes who have trouble managing their glucose levels.

Sleep. Sleep can cause your blood sugar to dip dangerously low, especially in diabetics who take insulin. In contrast, some may experience spikes in their blood sugar when they first wake up, even before eating, due to hormone fluctuations or drops in insulin levels that occur during sleep. Check your blood sugar before bed and first thing in the morning to monitor whether you are affected by either of these trends so you may take corrective action.

Exercise. While some moderate exercise may help you lower your blood glucose levels, working out too hard may result in a blood sugar spike while exercising, followed by a drop that can last for up to 24 hours afterwards. Take care when exercising and consult your doctor and/or a personal trainer to help you create a fitness regimen that will keep your blood sugar level in a safe range.

Heat. Heat makes it more difficult to control your blood sugar, so it is important to stay cool during periods of excessive heat. Ensure you are well hydrated and test your blood glucose levels regularly to keep an eye on your sugar and adapt to your changing needs as necessary.

How to test your blood sugar

Testing your blood sugar is a relatively simple procedure that you can perform almost anywhere, provided you carry your glucose meter with you. To test your blood sugar, begin by washing your hands thoroughly and inserting a new test strip into the meter. Prick the side or tip of your finger with the attached lancing device, and apply the edge of the strip to the drop of blood that appears. Wait for your meter to test your blood, then review your reading on the screen. The recommended level before a meal is approximately 80-130mg/dL, and less than 180mg/dL one to two hours following the beginning of a meal. These numbers are guidelines, but do not reflect the individual needs of every patient.

What to do if your blood sugar is too high or too low

If you have tested your blood sugar and it is outside your recommended range, the following methods can help you regulate your levels.

Low blood sugar. If your blood sugar is too low, you may feel weak, hungry, sweaty, and drowsy. In severe cases, you may also lose consciousness or have a seizure. To combat low blood sugar, consume 15 grams of a fast-acting carbohydrate such as glucose tablets, sugar water, juice or soda, candies, or honey. Wait 10 to 15 minutes, then check your blood sugar again. If it is still too low, consume another 15 grams of fast-acting carbohydrates, and if you plan on being active, eat a small snack like cheese and crackers or half of a sandwich. Be sure to wait 45 to 60 minutes before driving.

High blood sugar. High blood sugar may cause you to feel thirsty and tired, and prompt you to urinate more often. Your doctor will have outlined a treatment plan for managing high blood sugar levels that may include a meal plan, activity regimen, as well as some medications and/or insulin. If you are experiencing persistent high blood sugar while following this treatment plan, contact your doctor, as certain aspects may need to be adjusted.

Your blood sugar may fluctuate due to a variety of factors – aside from the foods you eat. If you have diabetes or are at risk of developing the condition, it is important that you monitor your blood glucose levels and are aware of any factors that may raise or lower your blood sugar.

Related: Diabetes diet: Healthy snacks for managing diabetes

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