Blood Sugar Swings – Part 2

By Roberta Kleinman|2023-09-26T09:30:09-04:00Updated: June 11th, 2014|Diabetes Management, Newsletters|16 Comments

Today, we will continue with reasons why blood sugars may vary from day to day – even though you are eating the same foods in the same quantities at the same time. As stated before, food has a huge impact on blood sugar control, but it is far from the only reason.

This article is part two in a series on Blood Sugar Swings. To catch up, please read part one.

  1. Dehydration – When you are dehydrated your blood sugars can be elevated, since the fluid in your system is now more concentrated. The reverse is also true. Having elevated blood sugars can increase your risk of dehydration since the body is pulling fluid to compensate for the extra sugar. Summer heat and humidity can increase your risk of dehydration as well. Although it is possible to over hydrate, it is uncommon. If you are on fluid restrictions due to cardiac issues – including heart failure – you should monitor fluids according to your physician’s instructions. Otherwise, enjoy beverages such as regular water, sparkling water, seltzer water, zero calorie flavored water, unsweetened ice tea or diet soda. Sipping water can help get an isolated elevated blood sugar down.
  2. Steroids – Every week a patient will inform me they received a shot for knee, shoulder or back pain and their blood sugars have increased significantly. Cortisone or prednisone injections can be a life saver for people with acute or chronic pain, but these shots often raise blood sugars. Remember to tell all physicians about your diabetes, since each discipline may focus on one specific problem without addressing the whole person. Many times joint pain can be treated with injections which do not contain steroids. People with chronic lung issues like COPD are often treated with steroids which may cause elevated sugars. You always need to address the risk / benefit profile with your health care provider before taking a new medication or treatment.
  3. OTC medication (cough and cold syrups and nasal decongestants) – Learn to read labels on medications just as you read food labels. These products often contain high amounts of sugar for flavor. There are now specific diabetes / hypertension products which often are sugar free.
  4. Birth control pills and anti depressants – Again, some of these products can elevate blood sugars, but never stop taking them without consulting your doctor. If you do notice a problem your doctor may be able to suggest an alternative. Skipping these medications or stopping them abruptly can have a negative impact on your health.
  5. Dawn Phenomenon – The body can release hormones including cortisol, epinephrine, glucagon and growth hormones (or counter regulatory hormones) between the early morning hours to get you ready for the day. This happens to everyone. These hormones can cause you to have elevated numbers when you wake up if you have diabetes since you do not have enough insulin. Talk to your physician about testing blood sugars at that time to see if you can establish a pattern and then treat accordingly. Some ways to help this is to exercise late in the day, talk about medication changes with your physician, and limit evening carbohydrates. Also, eating breakfast will help turn off the liver from producing more glucose.
  6. Menstrual cycles – Many women experience elevated blood sugars prior to their periods. The pre-menstrual time can cause decreased insulin sensitivity and increase blood sugars. Try more exercise which can decrease cramping and insulin resistance.
  7. Time zone changes – When traveling this summer make sure you check with your health care provider especially if you are on insulin. You may require more or less insulin depending if you are traveling to the east or west. They will help you find a new schedule quickly.
  8. Too much caffeine – Drinking large amounts of caffeine may have an impact on your blood pressure and blood sugars. A recent study done at Duke University “showed that 500mg of caffeine can raise blood sugars by 7.5%.” Always look at nutrition labels because caffeine may be hidden. Remember – tea has caffeine, unless it is herbal and caffeine free.
  9. Intense exercise – Doing short bursts of intense exercise or an anaerobic type such as soccer, hockey or sprinting can often raise blood sugars. The reason is the hormones (epinephrine, norepinephrine, cortisol, growth hormone and glucagon) cause the liver to pour out glucose when the muscles can’t get enough glucose due to lack of insulin. Most times moderate exercise will do the trick to lower blood sugars.
  10. Skip hand washing – When testing blood sugars always start with hand washing with soap, and forget the alcohol which dries out your skin. Any residue from hand lotions, skin products or vitamins can have an affect on your blood sugars. Also touching or handling sweet foods, fruits like mangos or beverages can give you inaccurate results.
  11. Testing too close to meal time – Recommendations for testing after a meal are usually at the 2 hour postprandial mark. Testing earlier than 2 hours can give you extremely high results which do nothing but aggravate you.
  12. Somogyi Effect – When low blood sugar or hypoglycemia is not treated in the middle of the night it rebounds and causes high blood sugars. It was named after Dr. Somogyi who discovered this phenomenon. The body responds by releasing stress hormones which causes increases of glucose pouring from the liver. These stress hormones can circulate for hours and increase insulin resistance. Eating a bedtime snack with sufficient protein can help prevent this problem.

Hopefully this will give you some ideas as to why you blood sugars are not in proper range. Try to be a detective but always check with your health care provider if you do not find the answer quickly!

NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.

About the Author: Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia. She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past. She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups. More about Nurse Robbie


  1. ADW Customer June 12, 2014 at 12:07 pm - Reply

    Just wanted to say how much I appreciate the
    information that Roberta sends me regularly. The articles are easy to
    understand, complete and very informative. Thanks Roberta and ADW for having
    this service for us.

    • Nurse Robbie June 13, 2014 at 9:30 am - Reply

      Thank you for your positive feedback! ADW is very interested
      in helping you stay healthy and avoid future diabetes complications. Feel free to post any questions and keep learning.
      Best of luck!
      Nurse Robbie

  2. ADW Guest Post June 12, 2014 at 12:05 pm - Reply

    what if I drink coffee all day? Will that keep me hydrated?

    • Nurse Robbie June 13, 2014 at 9:35 am - Reply

      Thanks for your question. Coffee causes dehydration and you usually can tell since it also increases urination. It is generally recommended to only drink 2 cups of regular coffee and up to 2 cups of decaf daily. The studies now show coffee may be beneficial to people with diabetes but each day the study results change. You need to check with your own physician to see what they recommend for you, especially if you have heart issues. Also consider the cup size. Use a coffee cup not a massive mug. Too much caffeine may cause an irregular heart beat in some individuals. You should stick to water, sparkling water, or crystal light for better hydration. Remember we are in the summer months and the heat and humidity will cause you to dehydrate faster even without an abundance of caffeine. Hope this helps and best of luck!

  3. Guest Post June 12, 2014 at 12:04 pm - Reply

    Hi. Since I only had
    A1C of 6.5 which has risen to 6.8 do I need do pin prick tests yet? Doctors
    never told me that I should.

    • Nurse Robbie June 13, 2014 at 9:45 am - Reply

      Thanks for your question. The answer is an emphatic YES. You
      should be testing one time a day varying the time and document in a log book or spread sheet. Another way to test is testing
      2 times one day and skipping the next day. Your A1C is rising and you and your doctor should try to figure out why this is happening. An A1C is an average of your fasting blood sugars combined with after eating or post prandial numbers. You will get information by either testing on one day pre and 2 hours post the
      same meal or by testing one day fasting and the next day 2 hours after a meal. You should also occasionally test to see what happens when you exercise, when you are sick, or when you have a change in your medications. The A1C is a 3 month average but you are missing the daily information which can give
      you more answers to why your levels are creeping up. Your A1C should not exceed 7% to help reduce your risk of diabetes complications. Use the information to make life style changes and improved choices. I hope this helps you and best of luck!

  4. ceara_red June 11, 2014 at 10:17 pm - Reply

    very little of what you say is applicable to me, as i am one of the 15%…you know, the ones you, for the most part, ignore.

    but it’s not just you.

    it’s pretty much everyone these days, even the people at my pump company…the CGM makes me want to pull every strand of hair out of my head…INDIVIDUALLY.

    i am frustrated, burnt out and ready for this whole mess to be over…after 35+ years, i think i’m entitled to feel that way, right?

    • Nurse Robbie June 26, 2014 at 5:46 pm - Reply

      I do understand your frustration since type 1 is sometime ignored. Please let me know if there are any questions or topics you want more information on and I will do my best to provide you with the information you are looking for. Also, check out some Type 1 diabetes articles at You will find information which may be more applicable to you and your specific needs. I hope you may consider talking to a professional about your present frustrations since stress and anxiety can increase blood sugars as well.
      Best of luck & Health!
      Nurse Robbie

  5. VeggieNut June 11, 2014 at 5:24 pm - Reply

    Diet sodas are not a healthy choice and while if used in moderation they might not do too much damage, diet sodas tend to be habit forming to the point that people just reach for one without even thinking about it. If you are going to drink something, it would be in your best interest to drink to your health. Green tea which contains health promoting antioxidants like catechins is a much better choice especially if it’s unsweetened. Homemade green drink is another very healthy option. Veggies like kale, spinach, Swiss chard, turnip greens, romaine lettuce, cucumbers and such can easily be grown organically your own home garden. I pick mine fresh, wash it and blenderize with purified water. This makes a cool refreshing drink that contains healthy anti-oxidants like lutein and zeaxanthin which are important for eye health. What you allow into your body can be a major weapon in winning the war on diabetes.

    • Nurse Robbie June 26, 2014 at 5:51 pm - Reply

      Hi VeggieNut,
      I do agree with you and do not believe that diet soda is a healthy choice but for people with diabetes who crave sweet drinks it is an option in moderation over regular- loaded with sugar soda. I too have read the current research on diet soda and weight gain. Since diet soda is extremely sweet from the artificial sweeteners it can sometimes increase sweet cravings-habit forming – which can lead to overeating. I realize that it is full of chemicals but many people with diabetes will not take the time to prepare those yummy sounding green drinks that you prepare. I would love for our readers to focus on healthy choices as much as possible but people need several options. Thanks for your excellent input and stay healthy.
      Nurse Robbie

  6. Ann Dunlap June 11, 2014 at 3:40 pm - Reply

    Thank you. That answers a lot of questions. And I have cut back on my coffee now..

    • Nurse Robbie June 26, 2014 at 5:49 pm - Reply

      Hi Ann,
      We are always glad that we can be of help and give you suggestions on how to take better care of your diabetes. You should have good results by cutting back on your coffee intake and remember to stay hydrated especially during the hot summer months.

  7. Gerald June 11, 2014 at 3:23 pm - Reply

    Thanks for the information. I am a type 1 diabetic. Although I work out pretty well late at night, I have long had problems with high blood sugar levels. It seems that my insulin never works correctly and I always have to increase my insulin to bring my blood sugar levels down. This list has given me a couple of possibilities why. I am currently finishing a Ph.D. program and I also have Attention Deficit Hyperactivity Disorder. So to compete with my peers requires longer hours on the keyboard for me – 10-16 hours a day, 7 days a week. The long hours of sitting I think have been bad for me. I also drink lots of coffee while sitting, so I might consider switching to decaf sooner and see if these things help me.

    • Nurse Robbie June 26, 2014 at 5:50 pm - Reply

      Hi Gerald,
      So glad the information was helpful to you. I give you a lot of credit since you have a full schedule but you still make time to learn how to care for your diabetes and better control. If you continue having elevated blood sugars please check with your physician to see what else may be causing the problem. Remember that elevated blood sugars can eventually lead to complications . Good luck and keep learning!
      Nurse Robbie

  8. Dan Garcia June 11, 2014 at 3:08 pm - Reply

    Extremely interesting, since I was diagnosed in 2005, I have only learned about half of the issues you speak of in your post. Thanks for the helpful information.

    • Nurse Robbie June 26, 2014 at 5:52 pm - Reply

      Hi Dan,
      We are glad you were able to take away some helpful points from our newsletter. Learning about diabetes is a process and hopefully you will be receiving more tips in the future to keep you on track with your diabetes control. Best of luck,
      Nurse Robbie

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