Part-2 of Shockingly Simple Ways to Control your Blood Sugar Levels

*Extra: Common Insulin Pen Errors.

Can a person with Diabetes experience hangover even without consuming a drop of alcohol?

To everyone’s surprise Diabetologists say “Yes!”

Someone once said that hangover is a headache and a terrible reminder to all the bad choices one made the previous night.

But wait! What has this got to with diabetes control? When it comes to alcohol and diabetes, people with diabetes can only afford a drink or two!

Well, let me tell you about something that shall surprise you! Have you ever wondered why your fasting blood sugars are always on the higher side?Perhaps you are having a sugar hangover!
Yes, you read that right. There is something that is called sugar hangover that tends to bog people with diabetes.Here are a few symptoms of a classic sugar hangover.

• Early morning brain fogginess.
• You are irritable for no reason.
• You are drowsy and lethargic.
• You feel dehydrated and nauseous.
• Feeling sleepy after breakfast.
• Having mood swings.
• Showing symptoms of allergies.

These symptoms look similar to those of an alcoholic hangover though you might not have touched a single drop ofany spirited beverage!

Too much sugar like alcohol affects your organs like kidney, blood vessels, and brain adversely and that’s the reason why you are having this sugar hangover.
For a person with diabetes this means dangerous diabetes complications.

The Science behind Sugar Hangover

In the parlance of diabetologists, two phenomena called the Dawn phenomenon, and Somogyi effect are the culprits causing fasting blood sugar to rise. This causes the sugar hangover.

The Dawn Phenomenon

This is a natural phenomenon. It occurs normally between 3: 00 AM and 8: 00 AM. During sleep, there is an increased surge of certain hormones and this causes high blood sugar.Increased hormonal activity makes the liver to dump glucose into the bloodstream. For non-diabetics, this mechanism allows them to ward off hunger pangs for some more time, but for diabetics this means high blood sugar.

Hormones that contribute to increased fasting blood sugar

• Amylin.
• Glucagon.
• Incretins.

In people with diabetes, these hormones go out of control. While sleeping the muscles of the body and the liver receive messages from the hormone glucagon to increase glucose in the blood as you are not eating. Since you are already diabetic, your insulin usage is not optimized or you do not have insulin. So, this glucose produced leads to bad diabetes control.

How to control high fasting blood sugar levels

• Talk to your diabetologist regarding measures to be taken. This is very important.
• Cut down/avoid on carbohydrates during dinner.
• Ask your doctor regarding medication/insulin dosage adjustment to manage fasting blood sugars.
• Self-monitor your blood sugar levels between the times of 2: 00 AM and 4: 00 AM. This will give you an idea of how your hormones behave.
• Also, test your blood sugar levels in the morning.
• Talk to your doctor about taking your diabetes medications close to your dinner time.
• Go for an early dinner perhaps around 8: 00 PM.
• Go for a walk after dinner.
• Add more cinnamon to your foods.
• Drink green tea.
• Talk to your doctor regarding chromium supplementation.
• Get the right diet for diabetes.

Somogyi Effect

This is also called rebound posthypoglycemic hyperglycemia. That means that when you are asleep, your blood sugar levels plummet and to compensate that, your body secretes more glucose. This then leads to high blood sugar.

How to avoid Somogyi Effect

• Eat a snack before bedtime.
• Talk to your doctor about reducing your nighttime diabetes medication or long-acting insulin.
• Do not exercise after your dinner.
• Though it might be difficult, test your blood sugar levels between 2: 00 AM and 4: 00 AM.

Now, let us take a detour and talk about error management!Error management is a major skill for people working on heavy machinery, but it does have great significance when it comes to diabetes control.

One great challenge for us is to figure out when we are susceptible to make wrong judgments.For pilots, it is critical to make the right judgment while making an emergency landing.
For a person with diabetes, it is important to make the right judgments when recognizing low blood sugar symptoms or high blood sugar symptoms.
It is also vital to know the errors that one commits with insulin injections and insulin pens.

False Positives and False Negatives

Error in judgments generally takes two directions – the false positives and the false negatives.

False Positive:

In the case of the false positives, you tend to have a false alarm. You tend to believe that a condition or a thing exists even though it doesn’t. In the case of diabetes, you may start to believe that you have high blood sugar, or low sugar level even though you do not have one.
This can be dangerous as you believe that you have a condition, but you do not have one. You take a precautionary measure, which might cause a side effect. If you believe you have high blood sugar and take some medicine, you might end up with hypoglycemia.

False Negative:

This is outright negligence. In the case of a false negative, you tend to believe that there is nothing wrong with you even though you have a condition. This can be very disastrous.
If you tend to believe that there is nothing wrong with you even though you have a case of say low blood sugar, you might end up with severe hypoglycemia, which might cause hospitalization.
So, what is the solution?
Do not rely on your judgment alone! Always monitor your blood sugar levels using a glucometer and pass on these values on a periodical basis with your care team!

*Common Insulin Pen Errors:

1. Dialing the dose back to zero instead of pushing the button to inject insulin.
How to avoid it – After the dose is dialed, the button needs to be pushed completely so that you hear a series of clicks. Hold the pen for at least ten seconds at the injection site.

2. Failing to hold the pen for ten seconds at the injection site.
What happens – Commonly, you might feel wetness at the site of the injection if you fail to hold the pen for ten seconds at the site. This is insulin. This leads to insufficient dosage.

3. Failing to agitate the pen.
What happens – In cases of mixed insulin, or short-acting insulin, the pen needs to be gently agitated in order to ensure even distribution of the insulin. If not, the dosage would be inaccurate.

4. Failing to prime the insulin pen:
Why prime – It’s important to push the first two units of insulin out into the airbefore injecting. This is to ensure smooth flow and accurate dosage. Failing to do so might lead to wrong dosage.

5. Leaving the insulin pen in the open after injecting.
What happens – By leaving the pen in the open after injecting leads to air entering the pen.This leads to inaccurate dosage. After injecting, hold the pen upright and tap it once or twice to remove air and then store it.

6. Finally, keep a note of the expiry date of the insulin pen!

Stay tuned for Part-3 to know how to control your HbA1c!

Also Read Part-1 : WARNING! By reading this you might know how to improve your blood sugar levels!