Self-monitoring of blood glucose (SMBG) methods have made it possible for most people with diabetes to check their blood glucose (sugar) levels regularly. Before SMBG became available, many people with diabetes were unable to control their blood glucose levels and regularly experienced brittle diabetes when blood glucose levels unpredictably swing between high and low levels. People with type 1 diabetes may be at a greater risk of having swings in their blood sugar levels than those with type 2 diabetes.
Since SMBG has become so common, most people with diabetes do not experience brittle diabetes. However, individuals who have intense reactions to stress, medications and food still may experience brittle diabetes. Even with regular eating and insulin schedules, some individuals still may have uncontrollable blood swings from one day to the next.
You may find it difficult to determine why these extreme changes in your blood glucose levels are occurring. Like every puzzle, there are several pieces you may need to fit together before you get a clear picture of why this is happening. According to the American Diabetes Association, many factors may cause such dramatic changes in blood glucose levels, including stress hormones, food absorption and the insulin absorption.
If you’re experiencing uncontrollable swings in your blood glucose levels, and you’re confused about why this is happening, ask yourself the following:
Do you allow enough time for your insulin to begin working before you start eating?
Are you measuring your insulin dose correctly? If a single dose is too large, insulin action times may differ from day to day.
Do you rotate your injection sites regularly? Rotating your injection sites regularly keeps your skin healthy and may help insulin absorption. Also, consider using the abdomen as your injections site because it may provide the most consistent insulin absorption rate.
Each time you inject insulin, do you inject it at the same depth? “Intramuscular (in the muscle) injections are absorbed more rapidly than subcutaneous (beneath the skin) injections.”
Do you inject insulin into muscles that get a lot of use? If you inject insulin into a muscle that gets a lot of use, quicker insulin absorption may occur.
What are the temperatures of your home and workplace? Warm temperatures speed up insulin absorption, and cold temperatures slow down insulin absorption.
Do you smoke? Smoking tobacco slows down insulin absorption.
Do you experience hypoglycemia (low blood sugar) frequently? If so, your liver releases glucose as a natural defense, which may interfere with your insulin’s job.
Do you experience long periods of hyperglycemia (high blood sugar)? If so, you may become dehydrated. As a result, it may be more difficult for your body to absorb insulin.
Do you have neuropathy (nerve damage)? Neuropathy may cause diarrhea or slow down the digestion of food, affecting your blood glucose levels.
Since many factors affect your blood sugar levels and insulin absorption, the answers to these questions may help you avoid brittle diabetes unpredictable blood glucose swings.