The Mysterious High Blood Sugar

August 18, 2014By 1 Comment

images11It creeps up on you out of no where.  You haven’t done a damn thing to deserve it… no missed boluses, no sneaking of the Mike and Ike’s just for kicks, and no sign of a stressful situation anywhere that could be cause for an instant spike in blood sugar.  It comes on with a wave of sometimes nausea, a massive headache that feels like you’ve been in a car accident.  Sometimes the thirst is instant and completely  unquenchable.  Other times your patience is shot and your yearning for a pillow and a dark room is stronger than any urge you’ve ever had.  But you have to work, take care of the kids, finish your errands, or even get up in front of a room full of people and give a presentation.  You have to be nice, be coherent, be intelligent, and on your toes.  It’s life with a side of crap.  An unexpected high blood sugar.

Not that the above makes it any easier when it’s a high blood sugar that is your fault or your environment (a cookie for breakfast and a missed dose of insulin, or unavoidable stress.)  But when you physically cannot explain to yourself (in the process of talking it through with your Diabetes person in your head) how in the hell you went from days of glorious blood sugars, maybe even months, and feel like you are finally on the path to good control after maybe a horrendous few months of work stress, holidays being over, or family drama, or limited time for your own health… your sucked back down once more into the abyss of mysterious high blood sugars.

For me, it has taken well over a year after having my baby to finally start to pay full undivided attention again to correcting, deciphering the cause, and preventing as many high blood sugars as I can.  There is never a perfect day and never a perfect calculation of ‘what if’s’ when it comes to insulin and high blood sugar management.  However, for any seasoned diabetic who has been managing this disease for decades we know exactly, usually, what the culprit is of our high blood sugars.

The most common reasons for a high blood sugar are as follows:

  • Miscalculation of carbs or missed bolus (on accident or on purpose to try to avoid a low before exercise for example)
  • Stress and/or illness:  See my blog about diabetes and stress to explain this one in more detail
  • Lack of exercise:  If you are someone who works out regularly or does light aerobic activity regularly and all of a sudden stops (maybe due to injury or life in general), you can see a spike in blood sugars that are used to having that extra muscle around to use insulin more effectively.
  • Mechanical issue: potential issue with pump tubing or infusion set, or maybe even a bad vial of insulin.
  • Alcohol: It can really mess with your blood sugars when consumed in larger amounts (which is never recommended!)
  • Sudden change in hormones due to pregnancy or menstrual cycle.  Tip: Many women I know with diabetes have two settings on their pump, one for the week before their period and one for during…this really helps with blood sugar control during this fluctuating time.

After months of very frustrating, no-budge high blood sugars when I had been doing everything right (wearing my CGM, checking frequently, exercising, continually increasing my insulin settings, and not over-doing it on sweets, etc…)  I finally, and randomly discovered what was causing my high blood sugars.  I had been on the birth control pill for years before planning my pregnancy, and then after the birth of my daughter, I went right back on the pill, only a different brand then I had been on before because I was still nursing.  After I was done nursing, my doctor switched my pill again.  Now, we all know that hormones like estrogen in particular can cause crazy things with blood sugars and moods!  However, I was on a low dose of hormones in my particular pill, and it was a progesterone only pill, so I never gave it a second thought.  When I recently, about a month ago, went off the pill and on an IUD, it was like the sun finally came out.  My blood sugars were almost instantly better, and in fact I had low blood sugars every day and every night for weeks until I finally felt like I could lower all my basal rates a bit.  So for me (and this was just for ME personally) that just must have been what it was.

It’s amazing how little attention is given to the other medications we are on, as people living with a chronic disease, and how those medications may be effecting us.  I am not an OBGYN so I can’t give the explanation as to why the change in birth control made all the difference for me.  Was it a coincidence?  Was it because I had also started working out more intensely in the last couple of months?  Was it because I had been working on controlling my stress?  It probably was a combination of all of the above but it really got me thinking about how little we and our doctors pay attention to the medications we are on and how they affect our blood sugars.

First, PLEASE do not go and change ANY of your medications because of my personal revelation.  ALWAYS speak to your doctor about anything you question that may be causing your blood sugars to be erratic.  Second, don’t assume it’s a medication that you are on that is indeed causing any high blood sugars.  Take a look at my list above first to see if you have ruled out the most common reasons for high blood sugars. 

I would recommend writing down all the medications you are taking currently, including anything over the counter, and bringing it to your next Endo appt.  Endo’s are usually pretty good at identifying medications that may be contributing to your high blood sugars.  Medications such as antidepressants and anti-anxiety medications may indeed cause high blood sugars, but often times it’s due to their causing increased appetite and food intake that can be the real culprit and not the medication itself, while other times it is indeed in part to the medication itself.  Your doctor will know best.  Anything containing hormones like birth control, are sometimes necessary to keep as part of your daily medical regimen, so talk to your Endo about adjusting your insulin needs to correspond with what the medication is doing to your blood sugar, or about possibly switching to another brand or dose.  Your doctor may be able to figure out that taking the medication at a different time during the day can help with blood sugar control.  Medications such as steroids used short-term for such acute issues like pneumonia can definitely cause high blood sugars, but it usually is temporary and your doctor can help you with your insulin management during those times.

Overall, I wanted to write this blog just in case anyone else was feeling like they were in a high blood sugar rut, doing all the work of trying to fix it without seeing any good results.  It’s just more food for thought that you should talk to your doctor about.

Remember…I am NOT A DOCTOR, just a very extroverted dietitian who like to give it to you straight up and without sugar-coating it…pun intended.

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  1. Elizabeth says:

    So many factors to consider. Amazing the effect life changes or simple adjustments in medication can have. You have to be a detective!

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