Avoid strong blood sugar fluctuations | Diabetes Guide

            

. 3 Diseases

Also, a thyroid malfunction that produces too little or too much thyroid hormone may affect blood glucose levels. Therefore it makes sense to have the TSH value in the blood measured once a year by the doctor. This reveals whether the small organ in the neck works normally. In rare cases, a Cushing syndrome is behind the puzzling sugar fluctuations. Then there is too much cortisone in the blood and drives up the sugar. The reason is usually the regular intake of a cortisone drug, sometimes an overproduction of cortisone by the adrenal glands. Important: If you need cortisone because of an illness, such as rheumatism, you must not stop it or reduce the dose without talking to the doctor.

. 4 Gewebsverhärtungen

In diabetic patients who inject insulin, tissue hardening under the skin is one of the most common causes of fluctuating blood glucose levels. They arise when injecting insulin again and again in the same place. Then it does not get evenly into the blood. Diabetologist Kröger inspects the injection sites once a quarter for all insulin patients and advises them to check them regularly for changes. To prevent it, you should change the puncture site and the needle for each injection.

. 5 Hormones

Adolescence is a troubled time, as far as diabetes is concerned. This is not only because adolescents often neglect their diabetes at this stage. But also on hormones that counteract insulin. For example, this can cause the sugar to rise sharply in the morning hours. In this case, it can make sense to switch from the pen to the pump. Bellies can set their device to deliver more insulin early in the morning. In some women, the values ​​vary mainly on the days before the period, which is probably also due to hormones. This can be changed only with a flexible adjustment of the insulin dose.

. 6 Insulin or drugs

Sometimes the diabetes medications are to blame when the sugar roller coaster drives. For example, tablets from the group of sulfonylureas are more likely to cause hypoglycaemia than other diabetes medicines. People who take a sulphonylurea drug and often have too low levels should talk to the doctor about switching to tablets that do not increase the risk of low blood sugar.

If you inject normal insulin with food and then always have too high values, switching to a fast-acting analog insulin might help. "Sometimes it's enough to wait a few minutes after insulin administration before you start eating," says diabetic Kröger. Under no circumstances should one make the mistake of injecting insulin again, because of a higher value after eating. Because the insulin injected before eating is also still in the blood, it can lead to hypoglycaemia.

If the morning values ​​are always too high, you should temporarily check your blood sugar at night, for example, between two and four o'clock. Anyone carrying a system for continuous sugar measurement (CGM or FGM) will be able to track down nocturnal sugar derailments. Sometimes you have a hypo in your sleep, without realizing it. Then the body releases blood sugar-raising hormones – with the result that the value is increased afterwards. If the blood sugar rises from about four o'clock in the morning, it may also mean that the dose of the insulin sprayed on the previous evening or the diabetes tablets is no longer sufficient at this time.

In any case, it is advisable to check the dose of the drug or insulin taken in the evening with the doctor. Those who inject conventional delay insulin (NPH insulin) at night and have consistently high morning values ​​can benefit from the switch to a long-acting analog insulin. Sometimes it is enough to inject the NPH insulin later (about 11 pm). For the effect to last as long as possible: Always inject NPH insulin into the thigh.

. 7 Movement

Physical activity improves insulin action and lowers blood sugar. In itself a good thing. But anyone who injects insulin or takes a sulphonylurea drug and does not adjust the dose beforehand risks hypoglycaemia. Because many hours after strenuous exercise more sugar is channeled into the muscles, it can also come to "late" hypoglycemia. Therefore, it is particularly important to control sugar more often after intense exercise and go to bed at a slightly higher rate to prevent nocturnal sugar lows.

Strong fluctuations: checklist for sugar detectives

What is behind fluctuating values? The checklist helps to find out.

• Values ​​that are too low due to tablets? Sulfonylurea preparations increase the risk of hypoglycaemia by eating little carbohydrates or by omitting meals.
• Insulin spatter error? If you always inject in the same spot, it will change to cause insulin to enter the blood unevenly.
• Carbohydrates correctly estimated? Those who inject insulin and misjudge their carbohydrate content have too high or too low values.
• Need Refreshment? Perhaps a targeted training helps to improve diabetes management in everyday life and to prevent fluctuations. Talk to your doctor about it!
• Guilty thyroid? Thyroid dysfunction is more common in diabetes and can confound sugar levels.
• Diabetes Diary: Document your values ​​and anything that could influence them – this helps to get to the bottom of fluctuations.