Psychoglycemia: When your Blood Glucose Drives you Crazy

Posted by beverly on Thu, 10/16/2014 - 14:43 in

- Beverly S. Adler, PhD, CDE
Clinical Psychologist and Certified Diabetes Educator

Sometimes blood sugar can drive you crazy. Dr. Beverly Adler, PhD, CDE, talks about hypoglycemia and hyperglycemia, and how frustrating being on the blood sugar roller coaster can be. Read on to learn tips for handling what she’s dubbed as “psychoglycemia.”

Understanding Hypoglycemia (Low Blood Glucose)

The American Diabetes Association recommends a target range for your blood glucose level to be between 70 mg/dL to 130 mg/dL. When your blood glucose level falls below 70 mg/dL, most people start to feel some symptoms of hypoglycemia. Common symptoms can include shakiness, nervousness or anxiety, sweating, chills and clamminess, fast heartbeat, hunger, nausea, tingling or numbness in the lips or tongue, headaches, and weakness or fatigue. It's important to treat a low quickly - so your blood glucose doesn't go even lower.

To treat a hypoglycemic reaction, you need to eat or drink 15-20 grams of sugar or simple carbohydrates. Wait 15 minutes for your blood glucose to rise and then check your blood glucose level again. If your number is still too low, then repeat eating/drinking 15-20 grams of sugar.

Understanding Hyperglycemia (High Blood Glucose)

The word hyperglycemia comes from the Greek words:

"Hyper-" = high + "glykys" = sweet + "haima" = blood, meaning high blood glucose.

Several factors can contribute to hyperglycemia in people with diabetes, including not using enough insulin or oral diabetes medication, not injecting insulin properly or using expired insulin, not following your diabetes eating plan, being inactive, having an illness or infection, using certain medications like steroids, being injured or having surgery, and experiencing emotional stress.

Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated – above 200 mg/dL. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Other symptoms that can occur are headaches, tiredness, blurred vision, hunger, and trouble thinking or concentrating.

Insulin is the treatment of choice for people with type 1 diabetes and some people with type 2 diabetes who also take insulin. Taking an extra dose of rapid-acting insulin can be used to help temporarily correct a high blood glucose level. However, if your blood glucose is above 240 mg/dL, check your urine for ketones. Drinking water helps to replace the fluids you've lost through excessive urination, as well as helps dilute the excess glucose in your blood.

"Psychoglycemia"

When your blood glucose levels fluctuate from too low to too high (and vice versa), then you're on the blood glucose roller coaster. This roller coaster is the low, then high, then low again blood glucose cycle that can occur when you have diabetes. The consequence of over-treating a low is a high blood glucose, which then requires a correction dose of insulin. But taking too much rapid-acting insulin, in your crazy attempt to get your blood glucose back down, can lead to another low...and thus, more food. That feeling of frustration trying to stabilize your roller coaster blood glucose is what I call "psychoglycemia" - when your blood glucose drives you crazy!

Ending the Blood Glucose Roller Coaster

Overeating, under-eating and significantly changing your level of physical activity can put you at risk for glucose fluctuations. Learning to spot and act on the warning signs of glucose highs and lows can help you get off the blood glucose roller coaster and keep your glucose levels - and your mood - as stable as possible.

Check your blood glucose! Don't guess! Most people overestimate or underestimate their blood glucose levels. Careful monitoring is the only way to make sure that your blood glucose levels remain within your target range.

The good news is that you can break the cycle of blood glucose rebounds and get off the roller coaster.  Treat your low blood glucose with 15-20 grams of sugar or simple carbohydrates. Then WAIT to check your blood glucose in 15 minutes. The temptation is to eat and eat and eat until your hypoglycemic symptoms stop. But the trick to avoiding the blood glucose roller coaster is to treat your lows effectively without over-treating them.

When you minimize the glucose spikes after eating, you end the hyperglycemia/hypoglycemia roller coaster. And you end the feeling that your blood glucose is driving you crazy.

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NOTE:  Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.