Blood Sugar Swings and Management

Managing diabetes means being prepared for unexpected blood sugar changes. Certain foods and drinks are often to blame, but not always. Seemingly simple facts of everyday life can sometimes kick your sugar out of whack, too. As a T1D, some days it can seem that even though I am doing everything correctly, my blood glucose levels just do not agree.

Stress

When you're under stress, certain hormones send nutrients, including sugar, into the bloodstream to prepare your body for action. For people with diabetes, that stress response can equal a spike in blood sugar. It can also trigger poor eating habits, whether it's eating too little or eating too much.

Do you suspect stress raises your blood sugar?  Every time you check your sugar for the next 2 weeks, rate your stress on a scale from one to 10 and write down both your rating and your blood sugar. If you see a connection between the two, it's time to manage your stress.

To help with stress find some time that's just yours. Take a walk, ride a bike, or take regular breaks to unwind.

Tossing and Turning

Sleep disorders, lack of sleep, and interrupted sleep can raise blood sugars.  People with diabetes who have trouble falling asleep or who wake up in the night several times a week have higher fasting blood sugar than those who get a better night's sleep. If you have insomnia, get it treated.

Sick Days

Cold, flu, or any infection is a physical stress that can hike blood sugar just like mental stress. To top it off, the sugar and alcohol in some cold medicines can boost blood sugar, while the illness itself can kill your appetite and bring your levels down.

When you're sick, check your blood sugar every 2 to 4 hours, and test your blood or urine for ketones (substances that are made when the body breaks down fat for energy). Stay hydrated with lots of clear fluids and follow your usual meal plan and medications. If you can't keep food down, drink plenty of fluids, get 15 grams of carbohydrates every hour, and call your doctor.

Another helpful idea is to make every chance to prevent illness in the first place. Get vaccines for as many vaccine-preventable conditions as possible – COVID, flu, pneumonia, hepatitis B, shingles.

Medications for Other Conditions

Some medications for non-diabetes conditions can step up your sugar. For example, certain diuretics prescribed for high blood pressure cause you to lose potassium when you urinate, which in turn can raise blood sugar.  Antidepressants and antihistamines can cause weight gain and may spike blood sugar. Corticosteroids, such as prednisone and cortisone, treat inflammatory conditions including vasculitis, myositis, and rheumatoid arthritis -- but they can also raise blood sugar.

Make an appointment with our team at Palmetto Endocrinology to discuss all your medications to make sure they won't affect your levels.

Sugar-Free Foods

Many of these will raise your blood sugar levels. Why? They can still have plenty of carbs from starches. Check the total carbohydrates on the Nutrition Facts label before you dig in. You should also pay attention to sugar alcohols such as sorbitol and xylitol. They add sweetness with fewer carbs than sugar (sucrose), but they may still have enough to boost your levels.

Alcohol

Alcoholic drinks contain plenty of carbs, so at first they will raise your blood sugar. Hours after drinking, your blood sugar may drop. If you drink, it's best to do so with food, and check your blood sugar. The American Diabetes Association advises no more than one drink a day for a woman and two drinks for a man. One drink is 5 ounces of wine, 12 ounces of beer, or 1 1/2 ounces of liquor such as vodka or whiskey.

Heat

You'll be safer inside with the AC when it's hot outdoors. Heat makes your blood sugar harder to control. You should test it often and drink plenty of water to avoid dehydration. High temps can affect your medications, glucose meter, and test strips, too. Don't leave them in a hot car.

Caffeine

Your blood sugar can rise after you have coffee -- even black coffee with no calories -- thanks to the caffeine. The same goes for black tea, green tea, and energy drinks. Each person with diabetes reacts to foods and drinks differently, so it's best to keep track of your own responses. Ironically, other compounds in coffee may help prevent type 2 diabetes in healthy people.

We at Palmetto Endocrinology are committed to helping you achieve your blood sugar goals. Please call today for an appointment.

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.