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You probably know that unmanaged diabetes can cause symptoms like extreme thirst or frequent urination (the irony). But headaches? It’s a thing, and it sucks.

Turns out, it’s not unusual for diabetes to trigger severe head pain. But, it’s usually a sign that your blood sugar levels are out of whack — and that you might need to make some adjustments to your diabetes management plan.

Here’s a look at the connection between diabetes and headaches, the easy ways to find relief, plus how to keep the problem from coming back.

When you’re not staying on top of your diabetes, it can cause your blood sugar to drop too low or climb too high. Both of these problems are triggers for headaches. Having a headache itself isn’t harmful, but it could be a sign that your blood sugar isn’t where it should be.

How exactly do blood sugar levels lead to head pain, though? Let’s take a closer look at the culprits.

Low blood sugar, or hypoglycemia, happens when your blood glucose levels drop below where they need to be. It can happen if you skip a meal or if you inject too much insulin.

It’s also possible for your blood glucose to dip if you eat something with too many carbs, since the sudden spike in blood sugar can lead to an unhealthy drop after the body tries to compensate.

Usually hypoglycemia-related headaches come on quickly as your blood sugar takes a nosedive. Basically, the brain needs a steady supply of glucose to function. If you don’t have enough glucose in your bloodstream to give the brain what it needs, you can end up with a throbbing headache.

High blood sugar, or hyperglycemia, may occur when your blood glucose levels get (drumroll) too high — usually at least over 180 mg/dL or 10 mmol/L.

If you have diabetes and are insulin-resistant or aren’t producing or injecting enough insulin, the glucose from your food can’t be absorbed by your cells for energy. That causes the glucose to build up in your bloodstream, which then leads to high blood sugar.

Unlike low blood sugar headaches, high blood sugar headaches tend to develop slowly over a few days or weeks. As your blood glucose levels continue to rise, you might notice that your headache gets worse and worse.

If you’re being plagued with frequent headaches, try keeping a journal. Track when and what you eat as well as your headache symptoms. This can help you piece together what’s causing the problem and how to fix it.

Oh, and of course, keep your healthcare provider of choice in the loop.

Both hypo- and hyperglycemia can trigger headaches and migraines. They can be super painful, with a throbbing or pulsing sensation on in your head. You might also feel weak, nauseous, and sensitive to light or sound.

Diabetes-related headaches can cause other symptoms too, depending on whether your blood sugar is too low or too high.

  • Low blood sugar headaches can leave you feeling faint, shaky, nauseous, or sweaty.
  • High blood sugar headaches may be accompanied by feeling super thirsty or having to pee more than usual, fatigue, or blurred vision.

First up, when you notice that throbbing pain coming on, start by checking your levels. The American Diabetes Association recommends aiming for these targets:

  • Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals
  • Less than 180 mg/dL (10.0 mmol/L) 2 hours after meals

If your blood sugar is below the target range, try having 15 to 20 grams of fast-acting carbs like glucose tablets or gel, juice, regular soda, or sugary candy.

If you don’t start to feel any better within 15 minutes, have another 15 to 20 grams of fast-acting carbs. This can help bring your blood sugar back up and start to ease your headache. After, have a healthy meal or snack to keep your levels stable.

If your blood sugar is above the target range, you may need to adjust your insulin levels or take a supplement of short-acting insulin.

Getting more insulin can help your cells absorb some of the excess glucose in your bloodstream, bringing your blood sugar levels back down and helping your headache go away. In addition, you can also try some of these other sugar-balancing activities.

As you work to get that blood sugar back to normal, you can also take an OTC pain reliever like ibuprofen or acetaminophen. The meds may help your head feel better a little faster.

If your headache is mild or moderate and you aren’t experiencing any other serious symptoms, it’s fine to treat the problem at home. But if you start showing signs of severe low or high blood sugar — like confusion, trouble breathing, vomiting, fever, seizures, or loss of consciousness — seek medical attention right away.

Say it with us: Extreme blood sugar swings can be life-threatening. No bueno.

Got that nasty headache to go away? Great. Now you just need to keep it from coming back. Here’s how to make that happen:

Manage your blood sugar

In general, you should aim to keep your blood sugar between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals and below 180 mg/dL (10.0 mmol/L) 2 hours after meals.

You might have to check your levels frequently, up to several times a day. If it seems like your blood sugar is consistently going above or below your target range, talk with your doctor. You might need to make changes to your diet or adjust your insulin levels.

Eat right

No ifs, ands, or buts. Food plays a major role in hyper- or hypoglycemia. Fill your plate with foods that can help control your blood sugar, like fatty fish, leafy green veggies, Greek yogurt, and eggs.

If low blood sugar is a recurring problem for you, try having smaller, more frequent mini-meals instead of three bigger ones.

Tend to wake up with a low blood sugar headache? Having a high-fiber snack before bed can help (think a medium pear with cottage cheese, a slice of Ezekiel toast with nut butter, a rice cake, or some roasted chickpeas).

Drink that water

Dehydration is a top cause of headaches in general, so making sure that you’re drinking enough is just common sense. Eight cups of water daily is a good rule of thumb, but if that’s not quite enough to quench your thirst, have more.

Eating water-rich fruits and veggies like cucumber, spinach, watermelon, or berries can help too. Just make sure any fruit you consume fits within your target carb range.

Identify potential triggers and steer clear

Things like alcohol, coffee, chocolate, and aged cheese can cause headaches for some. If you’ve taken steps to get your blood sugar under control but head pain is still a problem, try keeping a journal of your symptoms along with the foods you consumed before the discomfort started. If you can pinpoint the problem, the next step is to eat less of it!

tl;dr

  • Both low and high blood sugar can trigger severe headaches in people with diabetes, but there are ways to cope.
  • Managing your blood glucose levels is the best way to get rid of the pain — and keep it from coming back.
  • Keep your healthcare provider in the loop. They can help you manage your headaches and your diabetes (duhhh).