Record Your Numbers In A Log
Dont just check your numbers! Keep a log of your numbers.
Writing down your blood sugar levels can help you, and your doctor, identify trends in your fluctuations. Its especially helpful when you can also log your food intake and exercise routine alongside your blood sugar levels.
Logging your levels is a great way to understand your body and your blood sugar levels, and how things in your life influence you food, exercise, stress, sleep, medications, etc.
Brittle Type 1 Diabetes
Patients with especially type 1 diabetes are at the greatest risk of blood sugar fluctuations. That is because they are typically only on insulin and are subject to variability in the absorption we just discussed. They also miss another significant hormone that is glucagon. Glucagon is a counter-regulatory hormone that can prevent low blood sugar in healthy individuals and even most type II diabetic patients. In the absence of glucagon patients with type 1 diabetes are more prone to develop low blood sugars due to the deficiency of glucagon. Also if they are not counting carbohydrates very correctly or efficiently blood sugar fluctuations causing blood sugars to be up and down will be inevitable.For patients with brittle type 1 diabetes, I strongly recommend using a continuous glucose monitoring system such as Dexcom G6 or Freestyle libre 2. These devices help prevent low or high blood sugars by alerting the patient by predicting future high or low sugars.
Ahmet Ergin, MD, FACE, CDCES, ECNUEndocrinology
2260 Palm Beach Lakes Blvd. Ste 212 Unit #7
West Palm Beach, Florida
Signs & Symptoms Of Low Blood Sugar
Keeping blood glucose levels in a healthy range can be challenging.
When the amount of sugar in your blood has dropped below your target range , it is called low blood sugar .
If your blood sugar has dropped, you may feel:
- shaky, light-headed, nauseated
- an increase in heart rate
- sweaty, headachy
- numbness or tingling on your tongue or lips
Symptoms of very low blood sugar are more severe and can make you:
- confused and disoriented
- lose consciousness
Make sure you always wear your MedicAlert® identification and talk to your doctor or diabetes educator about prevention and emergency treatment for severe low blood sugar.
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Can Drinking Water Lower Blood Sugar Levels
If you experience a high blood sugar reading you should drink water as high blood sugar can make you dehydrated. Water doesnt directly lower blood sugar, but it can help dilute your blood which would temporarily fix your high blood sugar.
You should also avoid eating anything until your sugar level returns to an acceptable range. Contact your doctor if your blood sugar is above 400 mg/dL .
What Are The Signs & Symptoms Of Hypoglycemia
Mild hypoglycemia can cause such symptoms as:
Severe hypoglycemia can also cause these symptoms:
- not responding or waking up
Teach your child about the symptoms of low blood sugar and what to do. Even young kids who can’t describe their symptoms can learn to tell an adult when they don’t feel well. Help your child understand that they need treatment when they dont feel well. And explain how to find an adult who can help them.
Some people with diabetes can’t sense the early warning signs of low blood sugar. They may not recognize they need quick treatment. This can lead to more serious symptoms as blood sugar levels continue to fall. If you think your child cant sense what low blood sugar feels like, tell the diabetes care team.
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Continuous Glucose Monitoring System
The mean blood glucose level, standard deviation , mean amplitude of glycemic excursions , mean postprandial glucose excursion , percentage of time < 70mg/dl, percentage of time 140mg/dl, and percentage of time 200mg/dl were measured from the data recorded through continuous glucose monitoring using self-monitoring blood glucose device. MAGE, which was proposed by Service et al., represents fluctuations in blood glucose levels over a 24-hour period and was calculated from the daily variations in blood glucose level, which was measured continuously by CGM over a period of 2days. To assess postprandial glucose excursions from CGM data, MPPGE was calculated as the arithmetic mean of the differences between the postprandial peak glucose values and the corresponding preprandial glucose values for meals. Previous studies indicated that interstitial glucose concentrations measured by CGM correlate with venous blood glucose levels. CGM measurements represent glucose concentrations in the interstitial fluid, but since the introduction of the SMBG technique, the measured value is considered to represent blood glucose level.
What Should I Do If This Happens
People and their partners or roommates should learn to recognize the signs of nighttime hypoglycemia. Be prepared! Ask your doctor for an emergency glucagon kit. This kit contains a fast-acting medication that can be injected if the person cant be woken up. Store the kit in a bedside drawer for easy access.
DO NOT PUT ANYTHING INTO A PERSON’S MOUTH IF THEY ARE ASLEEP OR CANNOT SIT UP.
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If the person cannot be woken: If there is no emergency glucagon kit, call 911. If the person has a glucagon kit, the partner or roommate should follow the instructions to fill the syringe and inject the medicine. Once fully awake, he/she should eat a meal and check their blood glucose every few hours using a home test kit. After giving the injection, the persons doctor should be notified.
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If the person can be woken up and sit without support: They should be given a fast-acting glucose source. Good options include hard candy, fruit juice or glucose paste or tablets, which can be purchased at most pharmacies. Once the person is fully awake, they should eat a meal and check their blood glucose every few hours using a home test kit.
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Treatment For Blood Sugar Level Fluctuations / Brittle Diabetes
Controlling your blood sugar levels is the primary way to manage the condition. It requires careful management and regular monitoring of the blood sugar levels and treating the conditions such as kidney diseases, pancreas diseases, thyroid and adrenal diseases that are causing fluctuation. Based on the cause, diet and lifestyle modifications with that medication or surgical intervention will help if treating the brittle diabetes.
Blood sugar level fluctuations can lead to neurological disorders, thyroid diseases, kidney diseases and obesity. Managing it at early stage can prevent future complications and diabetic coma.
It is to be noted that people have persistent and unexplained hypoglycaemia should consultdiabetologistfor further evaluation.
What To Do When Blood Sugar Readings Vary
Have you ever double-checked your blood glucose level immediately after an initial reading, only to find completely different numbers? Although it may be impossible for these measurements to be perfect, taking steps to ensure they are as accurate as possible is important for effective diabetes control. Below are a few steps you can take to get the most accurate reading the first time around.
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Symptoms Of Fluctuating Sugar Levels
These are some common symptoms that may indicate fluctuation in blood sugar levels. The symptoms of high blood sugar levels:
- Increased thirst
- Irritability – feelings of anger or frustration
The symptoms of low blood sugar levels:
- Involuntary trembling hands or tremors
- Severe headaches
- Changes in vision, such as double vision or blurred vision
- Sometimes loss of consciousness & even coma
How Can Parents Help
Nearly every child with diabetes will have an episode of mild hypoglycemia at times. Rarely, an episode will be a serious emergency. You can help make this less likely, and be ready if it does happen. Here are some tips:
- Follow your childs diabetes care plan. This is the best way to keep their sugars in a healthy range. The plan will guide you on the timing of:
- blood sugar checks
If you have questions about how to prevent or treat hypoglycemia, or about the diabetes care plan, call your child’s diabetes health care team.
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How To Control Fluctuating Blood Sugar Levels
Diet and lifestyle modifications can help in maintaining blood sugar levels and control fluctuating blood sugar levels. Diet is one of the main reason which can be regulated properly to maintain blood sugar levels. It has 3 macro nutrients carbohydrates fats and proteins, carbohydrates plays a major role in regulating blood sugars.
Carbohydrates are 2 types, 1. Simple carbohydrates 2. Complex carbohydrates
Simple carbohydrates are sucrose, fructose, lactose & Galactose found in fruits and milk products and give immediate energy bursts. Simple carbohydrates are also seen in junk foods, cold drinks, chocolate & sweets. These are processed and refined sugars without minerals and vitamins, leading to high sugars.
Complex carbohydrates contain more than one sugar found in vegetables, whole grains, beans and peas. They contain minerals, vitamins and fibre. People with diabetes should increase complex carbohydrates in the diet.
Carbohydrate estimation should be done with the help of dietician or diabetes educator.
Other techniques to manage blood sugar fluctuation or variation by adequate sleep, decrease stress levels, reduce weight, medications to be taken regularly to be discussed with your doctor, reducing intake of caffeine.
Insulin dependent patients need to be educated about site rotation, technique of insulin administration. Improper technique, no proper site rotation can cause sugar fluctuation.
What Happens To Blood Sugar While You Sleep
Itâs tied to whether the hormone insulin, which removes glucose from the blood, is working the way itâs supposed to. Blood sugar levels surge while youâre sleeping, usually around 4 to 8 a.m. for someone with a normal sleep schedule. In a healthy person, insulin can handle the surge by telling muscle, fat, and liver cells to absorb the glucose from the blood, which keeps your levels stable.
For people who have diabetes or who are likely to get it, insulin canât do that job very well, so blood sugar levels will rise higher.
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When Are Blood Pressure Fluctuates Within Minutes Desirable
Contrary to the popular belief, blood pressure fluctuations have very little to do with the heart health, but rather with biochemical and mechanical processes that guard the blood flow. There are several feedback sensors located in the kidneys, the adrenals, arteries, as well as the brain that work continuously to ensure that blood pressure is matching the body needs. These sensors are responsible for regulating blood flow by either managing the heart rate or by changing blood vessel tone. Either way, there will be changes to BP.
The effort to regulate BP perfectly minute to minute is of great importance to the body. It takes less than 5 minutes for brain cells to die if they are deprived of oxygen. Thus, if you detect blood pressure fluctuations within minutes, unless your sensors malfunctioned, its likely that your need for oxygen changed.
Let me give you an example. Have you seen people running, playing tennis or wresting? They were all huffing and puffing. But their gasping for air wasnt due to a suddenly developed breathing disorder. It was due to the body sensors demanding more oxygen.1
Gym is the place where BP frequently gets out of control. Weight lifters may go into a temporary hypertension while increasing their systolic number by 100 mmHg or more. But such gym-induced blood pressure spike has nothing to do with risk for hypertension. It is how the body delivers oxygen.
Changes In Diet Patterns Or Food Content Can Cause Blood Sugar Fluctuations
Changes in Diet can fluctuate blood sugar.
All other people know that high carbohydrate content in the food will spike blood sugars. However, not everybody is aware of the glycemic index. The Glycemic index is an indicator of how fast the blood sugar will spike with the same amount of carbohydrates. For example at 30 g of carbohydrates in apple have a much lower glycemic index and 30 g of carbohydrates in the breakfast cereal. Blood sugar may spike twice or 3 times faster with the breakfast cereal compared to apple with the same amount of carbohydrates.
Another point that You have to be aware of is the fat content in the food. Anytime you eat carbohydrates with high animal fat content your blood sugars may spike much higher and the spike may come delayed many hours after a high fat, high carb meal.
On the contrary, if you eat very healthy and eat very little carbs the medications you have been taking for your regular diet may be too much especially if you are on sulfonylureas or short-acting insulins.
In summary, to prevent blood sugars go up and down or fluctuate too much you have to pay attention to the glycemic index and fat content in your diet in addition to paying attention to carbohydrates.
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Variability In Carbohydrate Consumption And Incorrect Nutritional Labels Can Cause Blood Sugar Fluctuations
Unfortunately, regulatory agencies do not always disclose certain facts. One of the facts is that nutrition facts can also have a certain degree of certainty which is allowed by regulatory agencies and by law. This Uncertainty can be again up to 20%. If you are counting carbs or trying to count carbs, knowing that even nutrition facts are not 100% accurate will make it extremely difficult to stay on track and prevent fluctuations. This means that 100 g that is reported on the nutrition label can actually be 120 g of carbohydrates. Of course, given the variability in the insulin absorption and variability in the nutrition facts will put you at a significant risk for blood sugars to go up and down or fluctuate significantly. This is even more of a problem for patients with type 1 diabetes.
What Can You Do
To keep your blood sugar in balance, try to get at least 7 hours of sleep each night.
If you work at night or have rotating shifts: Try to maintain regular meal and sleep times, even on your days off, if you can. And get some exercise during your breaks, like short walks or stretches.
If youâre concerned about your blood sugar: Getting a good nightâs sleep on a regular basis will go a long way toward helping your body use insulin efficiently. Along with getting enough sleep, avoid eating late at night, and try to get some exercise after dinner, like going for a walk.
If you have diabetes: If your blood sugar is often too high in the morning, talk to your doctor. You may need to do some extra blood sugar testing or use a continuous glucose monitor to figure out whatâs going on, which will determine how you should handle it. Your doctor may suggest a tweak to your diabetes medicines or your exercise routine.
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Insufficient Sleep Can Throw Blood Sugar Out Of Whack
Restless nights hurt more than your mood and energy they may also spell trouble for your blood sugar. A review published in December 2015 in Diabetes Therapy concluded that a lack of sleep may hinder glucose control and insulin sensitivity in people with type 2 diabetes.
“Sleep is restorative,” Bonsignore says. “Not getting enough sleep is a form of chronic stress on the body, and anytime you have added stress, you’re going to have higher blood sugar levels.”
Unfortunately, people with type 2 diabetes commonly report troubles sleeping, McDermott says. Those with high body-mass indexes are at particular risk for sleep apnea, in which breathing frequently starts and stops during sleep.
To improve your sleep quality and duration, work to get into a consistent sleep routine where you go to bed and wake at the same time every day. Your goal: Nab seven to nine hours of sleep per night, per recommendations from the National Sleep Foundation. If you continue to have sleep troubles or suspect you have sleep apnea , reach out to a sleep medicine specialist for support, Bonsignore says.
Keeping Track Of Blood Sugar Levels
Knowing when to call the doctor or seek emergency care is essential. Severe blood sugar spikes can lead to advanced health problems.
Anyone experiencing hyperglycemia symptoms should immediately check their blood sugar levels. They should contact the doctor if the reading is above 180 milligrams per deciliter within 2 hours of eating a meal.
It may also help to record blood sugar levels in a journal and look for patterns, such as blood sugar spikes occurring every morning. If this happens, it might be time to check with the doctor about adjusting the dosage of insulin. If blood sugar levels are consistently high after meals, a doctor may advise a person to take insulin during meal times.
A person should also be sure to bring this journal to medical appointments. The doctor can review the results and recommend any necessary adjustments to the management plan.
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Is Fluctuating Blood Sugar Dangerous
Definitely yes. Fluctuating blood Sugar has Roller Coaster effect on Patient of Diabetes Both
- Microvascular i.e. Diabetic Nephropathy, Retinopathy & Neuropathy as well
- Macro vascular complication i.e. Cerebrovascular disease, Cardiovascular disease and Peripheral vascular disease appears early & tend to be more severe in diabetic patient with fluctuating blood sugars.