In Diabetes, sugar levels never remain the same, fluctuating throughout the day. Few patients experience extreme fluctuations within a day. It’s like a stock market or roller coaster kind of behaviour. Dr Somnath Gupta, Consultant Physician & Diabetologist, Yashoda Hospitals, Hyderabad, says that these fluctuating blood sugar levels occur because of multiple factors [explained and unexplained causes].
A Few Factors That Can Cause This Include:
- Emotional or Physical Stress
- Sleep disturbances
- Medications like steroids, sedatives and diuretics
- Energy drinks
- Physical strain
- Long travels
- Quality and quantity of diet
- Co-morbidities like chronic Kidney disease and chronic liver disease
Some Of The Risk Factors That Come Along With It Are:
Early onset of microvascular and macrovascular complications like:
- Diabetic neuropathy
- CVA and stroke
- Easy fatigue
- Lack of energy
- Anger and depression
- Visual disturbances
- Sleep disturbances
- Increased frequency of urine
- Extreme hunger
- Involuntary movements of hands and legs
- Dryness of skin
- Excessive Sweating
- Fluctuating blood sugar levels occur when there is an overdose of diabetes medications. For example, if a patient is on insulin, administrating insulin at the same site can cause hypertrophy of Lipohyde hypertrophy and dystrophy of the tissues, leading to high glycaemic variability. Similarly, using improper insulin administration techniques can cause high blood glucose fluctuation.
- We usually monitor glycosylated haemoglobin (HVAC), FBS & PLBS, and if it is under control, we think he is out of danger and will not have any complications. But studies say that even after maintaining Hbac FBS and PUBS, if the patient has high glycaemic variability and time in range is out of control, and he will land Into microvascular and macrovascular complications.
It Can Be Prevented Through:
- Dietary and lifestyle modification will help in controlling fluctuating blood sugars
- Adequate sleep
- Reducing weight or maintaining proper weight
- Decreasing stress levels
- Reduced intake of tea and coffee
- Reduced alcohol intake
- Proper medications
- Regularly check-ups with primary care physician
- Encourage taking complex carbohydrates and limiting the intake of simple carbohydrates.
- Carbohydrate intake estimation to be done (consult with a dietician)
- Insulin-dependent patients need to be educated about Insulin site rotation and administration technique, as improper insulin administration can also cause high glycaemic variability.
- Chronic liver and kidney disease problems must be treated accordingly to reduce fluctuation.
- Daily physical activity 30-45 min/day. Six days a week helps in stimulating insulin and controlling blood sugar levels.
- Blood and urinary tract infections can also cause blood glucose fluctuations. But, again, treating infections empirically and based on culture and sensitivity will help control fluctuations.
The continuous glucose monitoring system is the most Innovative method available to diagnose significantly fluctuating blood sugar or high glycaemic variability. It has a small sensor which is attached to the body. This sensor helps monitor glucose levels from 5 to 14 days, which helps calculate glycaemic variability and time in range.
Regular monitoring of glucose levels, dietary and lifestyle modifications reducing stress levels, adequate sleep, good physical activity, regular follow-ups with dietician and diabetologist. It will help achieve and maintain glucose levels, prevent diabetic complications, and avoid high glucose excursions. Home