High blood sugar is part of a life with diabetes, whether it’s type 1, type 2, LADA, gestational diabetes, even the more rare forms of the disease. But sometimes, hyperglycemia can seem unexplainable, persistent, and stubborn.
This article will outline the reasons why you may be experiencing high blood sugar, and what you can do about it.
What Exactly Happens When Blood Sugar Is High?
High blood sugar, by definition, is when there’s too much glucose in the blood and not enough insulin to help the cells digest it. That extra glucose floating around in the bloodstream is what brings about symptoms of frequent urination, fatigue, brain fog, headache, body ache. In severe cases, it can lead to diabetic ketoacidosis (DKA).
But even when you’ve done everything “right,” like counting carbohydrates and taking your medications, your blood sugar may rise and stay annoyingly (or dangerously) high. These are the top reasons why you may be experiencing unexplainable hyperglycemia.
Ever wonder why when you’re stressed about work or school your blood stays high? That’s because the release of natural hormones in your body, like adrenaline and cortisol, spike when you’re stressed, leading to insulin resistance, and in people with existing diabetes, high blood sugars. Whether you’re prepping for a big test, selling your home, hustling for that promotion at work, or fighting with your spouse, stress can send your blood sugars skyrocketing.
Dawn Phenomenon describes the high blood sugars and insulin resistance people experience in the morning, usually between 2 a.m. and 8 a.m.
The phenomenon is natural: late overnight, the body releases a surge of hormones in preparation for the new day. These hormones can trigger the liver to dump glucose into the bloodstream. In people with diabetes, the body cannot produce a healthy insulin response, and therefore blood glucose levels spike up.
Many people with diabetes require more insulin during those hours, maybe even twice as much, to counteract this age-old hormonal effect.
A different, less common (but more dangerous) phenomenon may also explain morning blood sugar highs: Somogyi effect.
When people with diabetes are under the weather (or fighting off an infection), their blood sugars tend to be much higher than normal, and they become much more insulin-resistant.
This can sometimes result in needing 75% (or more!) of your average daily insulin requirements. Make sure you’re staying hydrated, monitoring for ketones, and taking as much insulin as you need to keep your blood sugars in range.
If you cannot control your blood sugars during illness – especially if you’re having trouble eating or drinking – it’s very important to get in touch with your doctor.
You’re Eating Too Many Carbs
Let’s face it: carbohydrates spike blood sugar. It’s something that people with diabetes need to think about nearly every time they eat.
Test your blood sugar frequently to see how your own body responds to different foods. Some people may find that they can comfortably eat fresh fruit, but not added sugars or white rice. Some may find something completely different.
And if you use insulin before meals, you probably already know that carbohydrate counting can be an inexact science. The more carbs you eat, the more insulin you need to take, and the more difficult it is to deliver that perfectly dosed and perfectly timed pre-bolus.
Even a little carbohydrate restriction is likely to help reduce the frequency and intensity of blood sugar highs.
You’re Eating Hidden Carbs
Ever order a salad at a restaurant, thinking it will be a nice, low-carbohydrate option, only to experience debilitating high blood sugars for hours on end afterward? There are many deceiving foods that we think are low-carb, but are anything but.
Sugar and starches hide in many foods where you wouldn’t expect to find them, especially at restaurants and among the processed foods in the grocery store. Some examples of foods that seem “healthy” but can cause a blood sugar nightmare include:
- Salads with sweet dressings and croutons or other toppings (or salad in a bread bowl)
- Smoothies (especially fruit smoothies)
- Fruit juice
- Foods labeled “gluten-free”
- Flavored yogurts
- Fat-free ice cream
- Restaurant foods (especially due to extreme portion sizes)
“Healthy” does not necessarily mean “diabetes-friendly.” Fat-free products are often fortified with sugars and starches. And many gluten-free products have even more carbohydrates than their standard gluten counterparts.
If you’ve chosen a restaurant that can provide nutritional information, ask for it, so you’ll know exactly how many carbohydrates you’ll be consuming. Consider asking for salad dressings and sauces on the side.
Your Insulin Pump May Be Kinked
If you’re insulin-dependent, the first thing you should do at the sign of stubborn high blood sugar is to check to see if you have a kink in your insulin pump cannula. This can block the delivery of insulin, leading to a very frustrating day.
If you’re unsure, change your pump site! Make sure to call your insulin pump manufacturer to let them know of the issue, and they will usually mail you a replacement for free.
You’ve Injected Into Scar Tissue
If there’s no kink in the cannula, or if you’re using syringes to deliver multiple daily injections (MDI), you may have also just picked a “bad” site. When insulin is injected (either manually or with an insulin pump infusion set) into scar tissue, absorption suffers, resulting in unpredictable and high blood sugars.
Make sure to always rotate your sites as much as possible to avoid developing scar tissue and the inevitable high blood sugars they bring.
Your Medications Need Adjusting
Our bodies are constantly changing. It would be silly to expect the same insulin to carbohydrate ratio or insulin sensitivity factors or even the same number of milligrams of our oral diabetes medications for our entire lives.
Make sure you’re seeing your endocrinologist or diabetes doctor regularly; they can help refine your medication regimen.
You may be especially likely to require adjustments if you’ve recently lost or gained weight, have increased or decreased your activity levels, are going through a stressful life change, are pregnant, or planning on becoming pregnant, or haven’t been to the doctor for a while.
Your Medications Are Expired
Always check to make sure your medications aren’t expired! At room temperature, insulin will lose potency.
Oral medications can last much longer, but you still need to be cognizant of expiration dates and make sure you’re refilling your prescriptions regularly to avoid taking an expired (and potentially useless) dose.
What to Do When Your Blood Sugar Is High
High blood sugars can range from not-a-big-deal to a life-or-death emergency. Make sure to check your blood sugar often and monitor for any signs of diabetic ketoacidosis (DKA). If you have blood sugars that are over 250 md/dL for more than a few hours and you have moderate to high ketones, you will need to seek emergency medical care immediately. If you don’t have ketones, but want to feel better as soon as possible, try some of these tactics:
- Exercise – cardio (a walk, jog or even jumping jacks) can bring blood sugar down quickly
- Take a correction bolus of insulin
- Change your pump site
- Chug water
- Take a hot shower or bath
- Manage stress with a quick yoga sequence or meditation
- Test for ketones (if you have moderate or high ketones and your blood sugar has been high for several hours, call your doctor or go to the emergency room right away)
Understanding why you’re experiencing high blood sugars is one more way to improve your life with diabetes! Always work with your doctor before changing your oral medication and/or insulin therapy.
Have you ever experienced a mystery, stubborn high blood sugar? What helped you to get it down quickly? Share this post and comment below; we love hearing from our readers!