Diabetes Self-Management Blog

Last month I was taken to the emergency room because my blood pressure dropped. It turned out I had gone low because of dehydration. I’m really embarrassed because I hadn’t realized how important hydration is.

It was scary. I could sit up, but only for about a minute. Then I’d have to lie down again. Couldn’t even think about standing (which is hard enough for me on a good day). I was in the ER for about 12 hours getting IV fluids before I was strong enough to go home. Lord knows what it will cost, and all because I didn’t drink enough.

I didn’t know I had a viral infection. They found that on a white blood count in the ER. But I did know I was eating lots of fiber, which absorbs water, and not drinking much. I just didn’t know I could get in so much physical trouble from a little dryness.

For people with diabetes, the risk of dehydration is greater, because higher than normal blood glucose depletes fluids. To get rid of the glucose, the kidneys will try to pass it out in the urine, but that takes water. So the higher your blood glucose, the more fluids you should drink, which is why thirst is one of the main symptoms of diabetes.

According to the British diabetes site diabetes.co.uk, other causative factors for dehydration include insufficient fluid intake, sweating because of hot weather or exercise, alcohol, diarrhea, or vomiting.

The symptoms of mild dehydration include thirst, headache, dry mouth and eyes, dizziness, fatigue, and dark-colored urine. Severe dehydration causes all those symptoms plus low blood pressure, sunken eyes, weak pulse and/or rapid heartbeat, confusion, and lethargy.

But many people, especially older people, don’t get these symptoms. It seems that thirst signals become weaker as we age. Diabetes may get people used to thirst so they don’t feel it as much.

If we aren’t drinking enough water, the kidneys still need water to eliminate excess glucose and other unwanted products. So they will raid the rest of the body for fluid to keep functioning. Gradually, our cells become dryer and dryer, which we might first notice in the eyes and mouth.

Since I’m now desperate to avoid dehydration, I have learned that your skin can tell you quickly if you’re hydrated. Pinch up some skin between your thumb and index finger, and then let it go. It should snap right back into place. If it goes a little slower, you are getting dehydrated. I’m doing the pinch test every hour or so now. If it doesn’t snap right back, I drink some water right away.

Preventing dehydration
This is definitely not rocket science. To keep from getting dry, drink more fluids. But what to drink? According to most experts, water is best.

James Pendergast of Diabetes Information Network says, “You can’t rely on your sense of thirst to keep yourself well hydrated. If you wait until you are thirsty to drink water, you’re waiting too long. You should consume water at regular intervals throughout the day even if you’re not thirsty at the moment.”

According to an article on Livestrong.com, drinking water with a little salt, or a sugar-free sports drink will help replace needed salts, which are often low when you’re dehydrated. Caffeine and sugar should be avoided.

David Mendosa at Mendosa.com says salt replacement is as important as fluid replacement. He recommends a commercial product called Ultima Replenisher that is sweetened with stevia and has no sugar, but a number of important electrolytes (salts) that tend to run low.

It’s just one more thing to think about with diabetes, but fortunately, it’s not a difficult one to keep on top of. I used to laugh at people saying drink 8 or 10 glasses of water a day, but not any more. “Drink up!” is my new motto.


  1. Another great topic David. I’m glad you’re feeling better.

    Before my metabolic syndrome got out of control requiring lots of meds, I used to be one of those people who drank 8-10 glasses of water. I enjoy the taste of water and consumed a lot, especially while eating. I literally get uncomfortable trying to eat without a liquid to “wash it down” with.

    Unfortunately as my meds increased, my susceptibility to nausea became severe. In simple terms, drinking more than a few sips of water makes me nauseated, and I find myself avoiding it. Ginger helps with the nausea if it gets too bad, but the last thing I want to do is add another pill to my regimen -Twelve prescriptions and six supplements.

    Any suggestions?

    Posted by Joe |
  2. Not to be a smart alec, but your blood glucose readings on the caveman machine should have been on the roof.

    Posted by jim snell |
  3. Joe, you asked for suggestions. Mine is to get off one or more of your meds. Perhaps just one is causing the nausea, or perhaps it is a combination. Either way, it’s a serious side effect that doctors should be willing to address.

    Jim, actually my glucose stayed in the normal range. But I don’t have diabetes.

    Posted by David Spero RN |
  4. David: I can see my comment was insufficient to prevent or at least not inviting confusion.

    My point was that there are caveman fingerprick glucose meters and their strip technology that read wildly off when body is dehydrated and that applieds to Diabetics and non - diabetics. Its a metering technology issue not a diabetes versus non diabetes issue.

    My apologies for the confusion and thank you for sharing.

    Posted by jim snell |

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