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Lifestyle factors driving sugar level highs and lows

Living a balanced lifestyle with a healthy diet and regular exercise is a key part of diabetes management. But do you sometimes feel puzzled when you’re doing all the right things, yet your sugar level still swings? Get a better understanding of the unexpected lifestyle factors that could be influencing your sugar levels so you can speak to your doctor or nurse on how to adjust your treatment to suit your lifestyle.  Smart insulin pens can help you keep accurate records of the time of injection, size and amount of insulin you have dosed in a day. You can also track the lifestyle factors mentioned in this article. When you combine these sets of data, it can help you to get more from your consultation, the next time you visit your doctor or nurse.

Lifestyle and sugar level behaviour – everyone’s different

Your sugar levels are affected by a wide range of lifestyle factors. What you eat and drink, your level of activity, how much you sleep, how much stress you experience, the medication you take, and whether you’ve been ill recently, all influence your sugar levels. Some factors are more obvious than others, such as eating regularly and being mindful of the type and amount of carbohydrates you eat, but other lesser known factors could have unexpected effects. They may be more difficult to spot because their effect on sugar levels may differ from person to person; and may also vary from day to day for the same person.

The factors to consider

The “big three” that are arguably the most important for diabetes management, are diet, physical activity and diabetes medication. These have a direct impact on sugar levels for all people with diabetes – and are crucial to consider in any diabetes treatment discussions for people with types 1, 1.5* or type 2 diabetes.

Beyond the big three, there is a long list of other factors that can influence how your sugar behaves. Below we are uncovering some of the more surprising aspects of our everyday lives that can take your sugar levels high or low.

1. The spike from your coffee

When it comes to diet you may already be more careful to avoid anything that would send your sugar soaring – but did you know that caffeine and artificial sweeteners could cause a spike in sugar levels? You wake up feeling groggy, so you reach for the coffee pot (black, no sugar) or have a sugar-free soda to kick-start your day and help you wake up. No matter which one you choose, you don’t think twice about this morning ritual since there’s no sugar involved and therefore little to no carbs. But suddenly you are experiencing a sugar spike. What a lot of people do not know is that some people with diabetes experience spikes in their sugar levels when they have caffeine or artificial sweeteners.

A great way to shed light on these mysterious spikes, is to keep track of your sugar and insulin levels, as well as keeping a record of what you eat and drink. In this way you’ll see if there is a link between the spike in your sugar level and your morning wake-up routine. These data can also help your doctor or nurse advise you on how to best manage your sugar levels. If your levels spike when you drink coffee or sugar-free soda, they might suggest you take a small dose of insulin before you have it.

Going forward, if you continue tracking your sugar level and insulin, you’ll notice the impact of this dose on your sugar levels.

2. Dehydration drives up your sugar levels

Exercise along with diet, are the two major tools used in diabetes management. Regular activity helps your body regulate sugar levels. The more active you are, the more sensitive your cells become to insulin – which makes the insulin work better in managing sugar levels.

Sugar levels can fluctuate during exercise depending on the type, intensity, and the duration of the exercise.

If you exercise regularly, you may have come to know how to predict its effect on your sugar levels. However, what you may not realise while you are sweating it out on the treadmill, is that dehydration can increase your sugar levels. Also being dehydrated makes you tired and feel drained. Next you hit the gym, make sure you stay hydrated by keeping a bottle of water with you. How much water you need per day will differ from other people, so it is best to discuss it with your
doctor or nurse.

3. Good sleep for stable sugar levels

Life can be hectic. The demands of work, being there for friends and family, and the need for exercise and relaxation can take up a lot of your time. It’s no wonder that making adequate time for sleep often gets left out.

Loss of sleep leads to your body using insulin less efficiently. Fasting sugar levels4  have been found to be higher in those who sleep for less than 6 hours a night compared to those who sleep 7-8 hours per night.

Fasting sugar levels have been found to be higher in those who sleep for less than 6 hours per night compared to those who sleep 7-8 hours per night.

It’s normal to have a sugar level surge in the morning5 to supply the body with energy for the day. However, if you have diabetes your body won’t release insulin to match this rise, causing your sugar level to spike.

If you are tracking your sleep patterns, sugar level and insulin dosing, you and your diabetes care team can assess whether you need to eat a snack, avoid carbs before going to bed, take your medication before bed instead of in the morning, or to simply go to bed earlier.

4. Stress can spike your sugar level

Life can be stressful at times. What you may not realise is that stress, in a variety of forms, even sunburn, can also impact your sugar levels. When you are stressed or you have an infection such as a cold, your body will send out hormones and sugars to prepare for a stress response or to fight off the infection. When you have diabetes, any stressful situation can lead to a spike in your sugar level.

Any stressful situation can lead to a spike in your sugar level.

Keeping track of it all

It would be impossible to measure and control all the factors that can impact your sugar level. Keeping a close eye on your sugar levels alone throughout the day can be challenging enough along with all other things happening. Luckily, technology is continuing to make the task of tracking easier. Continuous glucose monitors (CGM) and Flash monitors can keep track of glucose developments, and an array of mobile applications have made it easier to log and track factors such as diet, exercise or sleep.

At Novo Nordisk we have contributed to these developments by making it easier to track your insulin injections. Our smart insulin pens automatically keep track of your insulin doses by time, amount and type of insulin dosed per day. The information is stored in the pen (up to 800 doses!) and can be uploaded to a dedicated or partner mobile application where it can be explored in the context of sugar level data, exercise or diet logs, to name a few.

In diabetes management, information can be empowering. The challenge we face is making the collection of relevant data simple and manageable in the everyday lives of people with diabetes. With smart insulin pens we are hoping to make insulin tracking easier. You can read more about smart insulin pens here.

Read also our article on why it is important to track: Why Track.

* Type 1.5 is also known as latent autoimmune diabetes (LADA), where the body gradually loses its ability to produce insulin. It is a slow-developing type 1 diabetes that occurs in adults. It is best to speak with your healthcare professional to find out what type you are.9

References
  1. Lane J, Surwit R, Barkauskas C, et al. Caffeine impairs glucose metabolism in Type 2 Diabetes.     Diabetes Care 2004;27(8):2047-2048.
  2. Pepino M, Wice B, Tiemann C, et al. Sucralose affects glycemic and hormonal responses to an     oral glucose load. Diabetes Care 2013;36:2530-2535.
  3. Schaeffer J. Fueled by Technology — Athletes Achieve Top Performance With Diabetes     Management Tools. Today’s Dietitian 2010;12(8):22.
  4. Rafalson L, Donahue R, Stranges S, et al. Short sleep duration is associated with the     development of impaired fasting glucose: the Western New York Health Study. Ann Epidemiol     2010;20(12):883-889.
  5. American Diabetes Association. The Diabetes Advisor. Factors affecting blood glucose. [online]     [cited 2020 Feb 26] Available from: URL: https://professional.diabetes.org/sites/    professional.diabetes.org/files/media/15_advisor_factors-blood-glucose_eng_final_lo-res.pdf.
  6. WebMD. Diabetes. Somogyi Effects and Dawn Phenomenon. [online] [cited 2020 Feb 26]     Available from: URL: https://www.webmd.com/diabetes/dawn-phenomenon-or-somogyi-    effect#1.
  7. Collins S. WebMD. 4 Surprising Reasons for Blood Sugar Swings. [online] [cited     2020 Feb 26] Available from: URL: https://www.webmd.com/diabetes/features/surprising-    blood-sugar-swings#1.
  8. WebMD. Diabetes and Colds. [online] [cited 2020 Feb 26] Available from: URL: https://    www.webmd.com/diabetes/guide/diabetes-colds#1.
  9. Mayo Clinic. Types of diabetes.(online) (cited 2010 Feb 26). Available from: URL: https://    www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/types-of-diabetes.

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