Help! Why do I have fluctuating blood sugar levels?
Blood sugar levels affect your quality of life. Keeping your blood glucose level in your target range improves your energy and mood, and may prevent or delay long-term, serious health problems, such as heart disease, vision loss, and kidney disease. The American Diabetes Association (ADA) recommends a range of healthy glucose levels for non-pregnant adults with diabetes: Before a meal – 70 to 130 mg/dl (3.9 to 7.2 mmol/L), and after a meal – less than 180 mg/dl (10 mmol/L).
You may experience blood sugar fluctuations for a variety of reasons. Let’s take a look at what causes blood sugar swings and what you can do about it.
Why does blood sugar fluctuate?
Hyperglycemia, hypoglycemia, and other factors can lead to blood sugar fluctuations.
What is hyperglycemia?
Hyperglycemia means your blood sugar is too high, which happens when your body can’t use insulin properly or you have too little insulin. There are a number of reasons you may have high blood sugar if you’re living with diabetes.
Factors you can influence
- What you eat
- Not drinking enough water
- Drinks such as coffee, energy drinks, alcohol, and tea
- Artificial sweeteners
- Too many unhealthy carbohydrates
- Insufficient doses of your glucose-lowering medication
- Medications like antidepressants, steroids, and diuretics
- The amount of and type of exercise you do
Factors beyond your control
- Physical or emotional stress
- Sleep disturbances
- Infections like the common cold, injury, or surgery
- Travel to another time zone
- Extreme weather
- For women – hormonal fluctuations during periods and menopause
What is hypoglycemia?
According to the Mayo Clinic, a fasting blood sugar of 70 mg/dL (3.9 mmol/L) or below can indicate hypoglycemia (low blood sugar). However, you should determine your target ranges in consultation with your doctor – your numbers may be different.
Here are some factors that can lead to low blood sugar if you’re living with diabetes:
Issues with your insulin
- Too few carbs in light of your insulin
- When you take your insulin
- Too much insulin
What you eat and drink
- The kind of exercise you do and when you do it
- Drinking alcohol
- The amount of fat, protein, and fiber in what you eat
- Scheduling changes that you didn’t expect
- Very humid and hot weather
- High altitude
Check out the CDC’s article about low blood sugar if you’d like to learn more.
What are the symptoms of fluctuating blood sugar?
Symptoms of Hyperglycemia
Here are some symptoms of – follow up if need be!
- Frequent urination
- Feeling very thirsty
- Unintended weight loss
- Frequent bladder infections, skin infections, and thrush
- Feeling very hungry or tired
Symptoms of Hypoglycemia
Here are some symptoms of – don’t wait!
- Feeling shaky and trembling
- Feeling anxious or nervous
- Chills, clamminess, and sweating
- Impatience or irritability
- Feeling confused
- Racing heartbeat
- Feeling dizzy or lightheaded
- Lack of normal skin color (pallor)
- Lack of strength or energy
- Blurred/impaired vision
- Numbness or tingling or in your lips, tongue, or cheeks
- Clumsiness or coordination problems
- Nightmares or broken sleep
- Loss of consciousness
Brittle diabetes: Extreme blood sugar fluctuations
It’s important to know about a condition called brittle diabetes, which is characterized by extreme and frequent blood sugar fluctuations. Also known as labile diabetes or unstable diabetes, this condition usually occurs in people living with type 1 diabetes. It’s rare – only about 3 of every 1,000 people with insulin-dependent diabetes are affected. It’s not clear why, but it seems to occur more often in women in their twenties and thirties. If you suspect that you may have brittle diabetes, talk to your doctor about treatment options.
How can you manage blood sugar swings?
There are steps you can take to keep your numbers in range. Here are some suggestions for getting your blood sugar under control. With time and practice, you’ll learn what works best for you.
Don’t guess – test!
Self-monitoring of blood sugar levels is an important part of managing your diabetes, reducing the probability of long-term health complications, and preventing blood sugar fluctuations. Testing your blood sugar will immediately provide feedback on your body’s response to physical activity, diet, medication, stress, illness, and more. Testing will indicate how well your body is doing with insulin production and how well your basal, or background (long-acting) insulin, is working, if relevant.
Even if you recognize when your glucose is high or low, it doesn’t always accurately reflect your true blood glucose levels. If you don’t test to confirm your levels, you can lead to a misjudgment in treatment.
We have a guide for you for how to accurately measure your blood sugar at home – you can see it here. Keep testing and learn your patterns, and always talk to your diabetes care team before deciding to change treatment. Make sure you test with a meter that has been cleared by the FDA like the Dario blood glucose meter – but be aware that different meters may give you different results.
Make sure you test frequently. Here are some reasons your numbers might not be in range at different points in the day.
Testing blood sugar first thing in the morning
As a rule, fasting blood glucose is taken first thing in the morning, before eating or drinking anything except water. If you use basal, or background (long-acting) insulin, this reading will give you an indication of how it’s working. If you do not use insulin, it will indicate how well you’re doing with insulin production. Your healthcare team can analyze this test over time to determine if you need to make changes in medications or lifestyle.
Possible reasons you may have a high fasting blood glucose level sugar include:
• The dawn phenomenon – release of certain hormones at night can cause your liver to release glucose into your blood stream
• The Somogyi effect, or the “rebound effect” – following an episode of hypoglycemia at night, your body may react by releasing hormones that prompt your liver to convert glycogen into glucose
• Health factors such as stress, illness, or injury
Possible reasons you may have a low fasting blood glucose level include:
- Exercise that you don’t usually do• Intensive exercise before going to sleep, especially for insulin users
• High doses of basal insulin
• Certain medications, such as antibiotics (check with your healthcare provider or pharmacist)
Testing blood sugar after meals: What you should know
Testing after a meal will give you important information about how a given meal affects your blood sugar. Glucose levels reach a peak around 1-2 hours after the beginning of a meal, which is why the timing of your test is so important. According to the American Diabetes Association, a good post-meal blood glucose level target is 180 mg/dL or below. You can work with your health care provider on personalized goals.
There are several reasons your post-meal blood glucose level may be higher than your target, including:
• Your insulin dose was not enough to cover your meal (if relevant)
• You had too many carbohydrates or too much protein
• Your current medication regime may not be effective for keeping your blood glucose level in range
• Health factors such as stress or illness
Eating right means choosing the right food and the right portion sizes. If your daily nutrition includes fruits and vegetables, lean meats, and plant-based sources of protein like beans, lentils nuts, minimal added sugar and processed foods (food that undergoes special processes by adding chemicals, sugar, salt, or various flavor extracts) – you are eating right.
Count your carbs
Carb counting is a useful tool for planning meals and for keeping blood sugar levels within a healthy range. Most adults living with diabetes aim for about 45 – 60 grams of carbs per meal and 15 – 20 grams of carbs per snack. Knowing the amount of carbs per serving and logging your meals will help you keep your blood sugar level in range.
Skip the sugar
The reality is that most of us have more than the recommended daily nutritional value of sugar. The World Health Organization recommends that added sugars should make up no more than 5% of the calorie intake we get from food and drink each day.
Try these tips:
• Skip sugary drinks
• Sugar from natural sources like honey or fruit should be consumed in a controlled manner according to a dietitian’s recommendation
• Minimize your intake of fast food and processed foods, which often contain addictive sugar supplements
• Choose healthier snacks like unsweetened yogurt, unsalted nuts, seeds, fruits, and vegetables
• Try using less sugar when you cook or bake
The craving for sweet food is one of the main reasons people find it difficult to manage their blood sugar. There are many ways to prevent cravings for something sweet. Try drinking water before meals, increasing your protein intake, eating proper meals, and practicing mindfulness.
You may find that initially, giving up sweet treats is rough going. Stay the course! Once your palate adjusts and your body gets used to foods with less sugar, you may not even miss your old favorites.
Ready to manage your fluctuating blood sugar levels?
Now you know why blood sugar fluctuates and what to do about it. With some time and effort, you should be able to manage those blood sugar fluctuations and get your levels in range. You got this!
The articles provided on this website are for informational purposes only. In addition, it is written for a generic audience and not a specific case; therefore, this information should not be used for diagnostic or medical treatment. This site does not attempt to replace the patient-physician relationship and fully recommends the reader to seek out the best care from his/her physician and/or diabetes educator.