What Is a Blood Sugar Roller Coaster?

A blood sugar roller coaster isn’t a medical term. But it describes a common experience for people who use insulin to treat diabetes.

A blood sugar roller coaster is when high blood sugar levels follow low ones, or vice versa. The experience can be exasperating and dangerous. Overtreatment, such as taking too much insulin or having too much sugar to correct blood sugar levels that are out of range, is a common cause, says Cara Schrager, RD, CDCES, a diabetes educator in Natick, Massachusetts.

Being on a blood sugar roller coaster can affect your energy, mood, and overall well-being, so learning how to avoid this phenomenon is key to feeling your best.

Every blood sugar roller coaster starts with a single high or low blood sugar level.

If you use insulin to treat diabetes, you have undoubtedly experienced many episodes of high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia). These out-of-range measurements, which can be uncomfortable and even dangerous, come with the territory.

Quick treatment of high and low blood sugar is key, most frequently by eating or drinking a source of sugar to raise your blood sugar level or by administering insulin or exercising to lower it. These blood sugar corrections are important for short- and long-term health. But if you’re not careful, your blood sugar can go from one extreme to the other.

Here’s one example of how that can happen, Schrager says:

• You start with a low blood sugar level.
• You overtreat your low blood sugar by eating too many carbohydrates.
• Your blood sugar rebounds and ends up too high.
• You take more insulin, potentially leading to another low.

Whether you start with low or high blood sugar, it’s the same phenomenon: one extreme blood sugar level followed by another, with the possibility of more to come.

It is important to treat low and high blood sugar levels, as low blood sugar in particular can have life-threatening consequences. Avoiding a roller coaster usually means avoiding overtreating out-of-range blood sugar values.

Hypoglycemia

When you are experiencing the symptoms of hypoglycemia, it can be difficult to avoid overtreatment. You may feel shaky, nervous, and completely ravenous, and it is tempting to overeat sweets or other sugary foods and beverages to fix your symptoms quickly. But consuming too many fast-acting carbohydrates at once, such as a full glass of orange juice, can cause rebound hyperglycemia, Schrager says.

It’s wise to carry portioned snacks of fast-acting carbohydrates, such as glucose tablets or jelly beans. This can help take the guesswork out of treatment and prevent you from reaching for a fattier snack, says Melissa Joy Dobbins, RDN, CDCES, a Chicago-area diabetes educator.

“If you’re not thinking clearly, you might have ice cream or a candy bar, which won’t raise blood sugar as quickly as it should,” she says.

Hyperglycemia

Patience is also important when handling corrections for high blood sugar levels. If your blood sugar remains high after eating a large meal, that doesn’t necessarily mean that the insulin you’ve already taken isn’t working properly.

Taking extra insulin when you already have a dose active in your body is called insulin stacking, and it can easily cause a roller coaster.

“An hour or two later, you can get a low that you try to treat — and then get a high,” Schrager says.

The symptoms of hypoglycemia and hyperglycemia make blood sugar swings more likely, as each condition can affect your mental state and your ability to think clearly. And overlapping symptoms may even make it difficult to guess which condition you’re experiencing: Always test your blood sugar to know exactly where your levels stand.

• Cold sweat
• Confusion
• Difficulty concentrating
• Extreme hunger
• Feeling restless, nervous, or anxious
• Headache
• Rapid pulse
• Shivering
• Weak feeling in the knees

If you have used insulin or other medications to treat type 1 or type 2 diabetes for a while, you might stop experiencing these hypoglycemia symptoms even if your blood sugar is too low, Dobbins says. This is called hypoglycemia unawareness, and it could lead to overtreatment.

• Blurred vision
• Confusion
• Dizziness
• Extreme thirst
• Fatigue
• Frequent urination
• Nausea and vomiting
• Shortness of breath

• Burnout
• Depression
• Feelings of distress and hopelessness

Preventing blood sugar roller coasters starts with reducing the frequency of high and low episodes while remaining prepared to treat the ones that inevitably occur. These tips may help:

• Check your blood sugar regularly. Talk to your doctor about when and how often to check your blood sugar; it’s typically several times per day.

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   A continuous glucose monitor can make it much easier to track your numbers and react to blood sugar changes.
• Carry insulin (if you take it) and hypo snacks. Set yourself up to react quickly and appropriately when your blood sugar moves out of range.
• Eat meals and snacks at regular times. Dobbins suggests this approach, which helps you regulate when and how you administer your medications, to avoid taking too much or too little.
• Consume a mixed meal. Foods that add protein, fiber, and fat to carbs will slow digestion and help blunt fluctuations in blood sugar, Dobbins says.
• Count your carbs. Dobbins recommends staying within your recommended carbohydrate intake. If you moderate your carb intake, you won’t need as much insulin for meals, potentially lowering the risk of hyperglycemia and hypoglycemia.

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• Take a light walk after meals. A 10-minute walk right after eating can reduce after-meal blood sugar levels.

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• Monitor your treatment plan. If you are struggling to manage your blood sugar, talk to your doctor about ways to improve stability. For example, if you have type 1 diabetes and extreme blood sugar variations, an insulin pump can deliver rapid-acting insulin continuously and sometimes automatically based on your blood sugar level.

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   If you have type 2 diabetes, your doctor can help you with medication changes that may reduce your hypoglycemia risk.

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• A blood sugar roller coaster refers to swings from high to low blood sugar levels, and vice versa, especially while taking insulin for diabetes.
• Taking too much, too little, or no insulin can lead to these blood sugar swings, as can factors such as stress and your diet and exercise habits.
• Blood sugar roller coasters can be frustrating and dangerous, affecting your quality of life and leading to serious health consequences.
• Frequent checks of your blood sugar levels, along with close collaboration with your healthcare team, are key to helping you manage your blood sugar effectively.