For many people, having a headache is, unfortunately, a fact of life. Headaches are extremely common, and the World Health Organization (WHO) states that almost half of adults are estimated to have a headache over the course of a year. There are many different types of headaches, ranging from migraines to tension headaches to cluster headaches — and even “ice cream” headaches that result from eating or drinking something that is extremely cold. Headaches can also occur due to sinus infections, high blood pressure, and medications. Given all of the possible causes of headaches, it’s not surprising that so many people suffer from them.
What’s causing your headaches?
If you have diabetes and you find that a pounding head is more than just a passing nuisance, it’s time to sort out possible causes. Some of the likely culprits may be directly related to your diabetes. Let’s take a look at five ways diabetes causes headaches.
Hyperglycemia, or high blood glucose, is typically defined as a blood glucose level above 180 mg/dl. Causes of hyperglycemia include:
• Not taking (or not taking enough) diabetes medicine, including insulin, non-insulin injectables, and diabetes pills
• Eating more carbohydrate than usual
• Not being physically active
• Illness, injury, or surgery
• Getting too much or too little sleep
• Certain medicines, such as corticosteroids
Depending on high how your blood sugar is, you may or may not have symptoms. However, typical symptoms of high blood sugar include:
• Increased thirst
• Having to urinate often
• Blurred vision
What can you do?
If you have a headache, either by itself or combined with other typical symptoms of hyperglycemia, check your blood glucose. You may find that the higher your blood glucose, the worse the headache. Drinking water to lessen the chance of dehydration is important, and depending on how high your blood sugar is or if you have ketones in your urine, doing some physical activity can help to lower your blood sugar level. To lessen the frequency of hyperglycemia, follow your diabetes treatment plan as closely as possible. Talk with your health-care provider if your blood sugars are still high despite taking your medicines as directed, as you may need a change in your dose or an additional medicine.
On the opposite end of the spectrum is hypoglycemia, or low blood glucose. A blood glucose below 70 mg/dl is considered to be “low” for most people. Symptoms of low blood glucose tend to come on more quickly than symptoms of highs. These include:
What can you do?
If you get headaches when you’re low, you probably will have other symptoms of hypoglycemia, as well. Again, the best course of action is to check your blood glucose. No meter handy? To be on the safe side, eat or drink 15 grams of carbohydrate, such as 4 glucose tablets, a pouch of glucose gel, 4 ounces of juice, or 6 ounces of regular soda (avoid reaching for a candy bar, peanut butter, or anything that contains fat). Once your blood sugar comes back up to a safe level, your headache should gradually subside.
According to the American Diabetes Association, 2 in 3 people with diabetes have high blood pressure or take medication to lower blood pressure. For most people with diabetes, the blood pressure goal is less than 140/80 mmHg (your goal may be lower, so it’s wise to check with your doctor). Most people who have high blood pressure don’t have symptoms; however, if your blood pressure is high and stays high over a period of time, you may have headaches.
What can you do?
Uncontrolled blood pressure can cause serious problems including stroke, heart attack, and kidney disease. You can get and keep your blood pressure at your target by doing the following:
• Staying physically active
• Losing weight
• Stopping smoking
• Limiting alcohol
• Cutting back on sodium
• Eating fruits and vegetables
• Taking medicine to lower blood pressure
In addition, ask the medical assistant what your blood pressure is at every doctor’s visit. Talk with your doctor about using a home blood pressure monitor to keep tabs on how your blood pressure treatment plan is working.
4. Sleep apnea
Sleep apnea is a common and serious condition that can occur when the upper airway becomes blocked repeatedly during sleep. People who have Type 2 diabetes have a higher risk of sleep apnea compared to people without diabetes; it’s also more common in people who are overweight or obese and who have heart disease. And men are two to three times more likely to have sleep apnea than women. Common signs and symptoms include:
• Stopping breathing for periods of time during sleep
• Gasping for air
• Dry mouth
• Daytime sleepiness
• Morning headaches
Untreated sleep apnea can do more than cause headaches — your risk of high blood pressure, high blood sugars, heart attack, stroke, and liver problems increase, as well.
What can you do?
First things first — if you or your partner suspect that you may have sleep apnea, talk with your doctor. Your doctor may refer you to a sleep specialist or a center for a sleep study. A sleep study can detect your breathing patterns, and will monitor your blood oxygen levels, as well as brain and heart activity during sleep. If you’re diagnosed with sleep apnea, you may need to wear a mouthpiece or use a CPAP machine while you’re sleeping. Lifestyle measures, such as weight loss, healthy eating, physical activity, and stopping smoking can also help control or treat sleep apnea.
5. Food and eating habits
Despite the constant recommendations to eat healthfully when you have diabetes, it’s not necessarily easy to change your eating habits. No one is perfect! But when it comes to your food choices or how and when you eat, it’s worthwhile to focus on a) trying to get into an eating routine and b) making healthful food decisions most of the time. You’ll reap a host of benefits by doing so, including more stable blood glucose levels, reaching and staying at a healthy weight, a lower risk of chronic conditions such as heart disease, and, yes, fewer headaches. What and how you eat (or don’t eat) can be directly responsible for headaches, especially migraines. Typical “triggers” for migraines include:
• Too much or too little caffeine
• Alcohol, especially red wine, whiskey, Scotch, and champagne
• Aged cheeses (blue cheese, brie, cheddar)
• Nitrates and nitrites, found in cold cuts, hot dogs, sausage, and bacon
• Monosodium glutamate (MSG)
• Dark chocolate
• Chili peppers
• Foods or drinks containing aspartame, a nonnutritive sweetener
• Citrus fruits
Other culprits: skipping or delaying meals, and not drinking enough fluids.
What can you do?
Consuming the foods listed above doesn’t necessarily mean that they’ll trigger a migraine; you’ll need to pay close attention to how certain foods or beverages affect you. In fact, it’s worthwhile to keep a diary of things that might bring on headaches. And as much as possible, aim to eat regularly. If you can’t eat a full meal at your usual mealtime, eat something, such as an energy bar, a piece of fruit and a handful of nuts, or a container of Greek yogurt, for example. If your headaches persist despite making dietary changes, you might benefit from medicines, such as beta blockers, antidepressants, antiseizure medicines, or a class of drugs called triptans.
Of course, there are apps for that…
In many cases, the cause of your headaches can be easily explained by factors such as changes in blood glucose levels, lack of quality sleep, or missing your morning coffee. But headaches that continue despite making lifestyle changes should always be brought to the attention of your doctor. He or she may refer you to a headache specialist. You can also keep tabs on your headaches by using an app. App suggestions include:
Want to learn more about the relationship between diabetes and headaches? Read “Diabetes and Headaches: Soothing That Aching Head.”