The physical side effects of high blood sugars are often talked about by our doctors, but what about the psychosocial and emotional side effects? Simply put, sometimes diabetes feels like its dominating our lives. If you’re living with diabetes, then you know that we can be doing everything right to manage our diabetes, yet it doesn’t always cooperate the way we’d like it to. And when that happens, it can leave us feeling out of control, exhausted, and emotionally depleted.
Today we’re talking about high blood sugars—what causes our blood sugars to go up and how to deal with it when it feels like we’re doing everything but they still won’t come down.
First off, let’s recap what it means to have diabetes: if you have diabetes, your body has an inability to manage its blood sugar, which results in having higher blood sugars. We say this because a lot of the time it feels like it’s our fault that we have high blood sugars, when in fact, it’s the very definition of having diabetes in the first place. The reality is, there are so many reasons why our blood sugars are high as a result of having diabetes that have nothing to do with what we did or didn’t do. We say this not to discourage you or make you feel defeated, but rather, to help you distinguish between the factors you do and don’t have control over. Once you understand what you do and don’t have control over, you can stop putting energy into trying to fix the things you can’t fix, and start working on the things you can.
Let’s break down some of factors that can cause and contribute to high blood sugars.
Food: The most obvious one, and the one you probably spend the most time thinking about is food. It’s the one that gets all the attention and while it does have a big influence on blood sugars, at the end of the day, it’s only one factor. Not every unexplained high is a result of food, but we can use food as a powerful tool for better diabetes control. Carbohydrates and protein will both cause your blood sugar to go up. High intakes of protein along with higher carbs can also have a greater effect on blood sugar than either protein or carbs alone. This is really important to keep in mind because if you find your blood sugar is higher after meals than you expected it to be based on the amount of carbs you ate, you might have to adjust your insulin dose to account for protein. That being said, do not make any adjustments to your insulin routine without consulting your health care provider first. When it comes to food, it often takes some trial and error to figure out which foods work with your body well and make you feel good, and which foods don’t. Test often. You might want to keep a log as well so you can see any patterns that develop.
Exercise: You’ve probably been told by your doctor to start exercising as a way to decrease your blood sugar, but you might not have been told that certain types of exercise can actually cause your blood sugars to go up. For instance, high intensity exercise like HIIT (high intensity interval training) or heavy weight lifting cause a release of stress hormones and increased circulating blood sugars to meet energy needs, which will cause blood sugars to rise. This temporary state of stress is actually a good kind of stress for your body, and in the long run it will improve your insulin sensitivity and help manage your diabetes overall. However, if your blood sugars are already running high prior to exercise, you might not want to engage in high intensity exercise because it will only cause your blood sugars to go that much higher. If your blood sugars get too high, you won’t be able to perform exercise very well and will probably feel not only physically exhausted but mentally frustrated. Instead, you can opt for lower intensity exercise such as going for a walk or one of our glucose lowering workouts in the GlucoseZone app.
Stress: There are certain kinds of stress that the human body was designed to deal with, like running from a predator, which caused the body to mobilize glucose stores for energy needs. The stress response in the body causes the hormones cortisol and epinephrine to raise blood glucose by mobilizing these glucose stores for energy. The release of the hormone norepinephrine inhibits insulin secretion resulting in a decrease of glucose disposal. The problem with this stress response is that today, we no longer have to deal with running from lions and tigers, yet our bodies experience this same response in reaction to the things we deal with every day like work, school, family, etc., and without finding ways to either minimize or manage stress, this leaves our blood sugars running higher than we’d like them to be. You might not be able to completely eliminate stress from your life, but the good news is that food and exercise can both be powerful tools for coping with stress, which will also help reduce high blood sugars. Try to find small ways to cope with stress such as meditating for five or ten minutes a day, yoga, listening to music, spending time laughing with friends, and other self-care activities you enjoy. Just like with exercise, sometimes a small amount can be extremely effective.
Now let’s talk about a few other causes of high blood sugars that you might be less familiar with.
The Somogyi effect (also known as the rebound effect): The Somogyi effect, named after the researcher who first described it, is the reaction by the body in response to a low blood sugar (hypoglycemia). This response is a protective mechanism to help the body avoid going too low. It does this by releasing the counterregulatory hormones glucagon and epinephrine, which cause the liver to convert stored glycogen into glucose thus raising blood sugar levels—sometimes too high. The Somogyi effect usually follows an episode of untreated nighttime hypoglycemia and could be the reason why you wake up with an unexpected and unexplained spike in your blood sugar.
The Morning Dawn Phenomenon: The morning dawn effect is a normal hormonal response in the body and also commonly occurs during sleep. The body makes less insulin and more glucagon during the night time hours, which incidentally, is one reason why people who work night shifts often struggle to maintain their blood sugars. Blood sugar levels in people without diabetes is maintained because the liver releases just enough sugar in response to the increase in glucagon, which signals the liver to break down glycogen into glucose, and insulin decreases. In people with diabetes, insulin is not present or not able to lower one’s blood sugar enough to counteract the increased glucagon and that causes blood sugar to go up too high.
Here’s a way to determine if you are experiencing one or both of these effects: Check your blood sugar at 3:00 a.m. If you are low at that time, then it is most likely the Somogyi effect. If not, it is more likely morning dawn effect.
Finally, medication: You could be experiencing high blood sugars because your oral medication or insulin doses are not prescribed properly. Keep records of your blood sugars and share them with your healthcare provider. Make sure that you are checking blood sugars when you are fasted and two hours after meals if you have type 1 and 2 diabetes and one hour after a meal if you have gestational diabetes.
Be sure to share with us your best ways of dealing with high blood sugars in the GlucoseZone live every Tuesday and Thursday at 6:30 p.m. EST.
By: Lauren Szalkiewicz and LaurieAnn Scher, MS, RD, CDE