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.

Roberta Kleinman

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.
Roberta Kleinman

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