Type 2 diabetes and dizziness
People with diabetes may experience dizziness, either as a symptom of the condition or as a result of dehydration or certain medications. A doctor can help determine the cause and how to manage or treat it.
Diabetes can cause low or high blood sugar, which can make people feel dizzy or lightheaded. High blood sugar can also lead to dehydration, as the body removes excess glucose from the blood through the urine, taking extra water with it.
Certain medications, including those that lower blood sugar, can also cause dizziness.
In this article, we look at the possible causes of dizziness in type 2 diabetes, other symptoms to be aware of, treatment options, and when to see a doctor.
Low blood sugar, or hypoglycemia, can occur in a person with diabetes. Low blood sugar levels, or low glucose levels, are those that fall below the healthy range.
According to the American Diabetes Association (ADA), low blood sugar levels are usually below 70 milligrams per deciliter (mg/dl), although this may be different for each individual.
Research suggests that 11–44%Trusted Source of people with diabetes experience dizziness as a symptom of low blood sugar.
Other signs of low blood sugar can include:
- shakiness
- feeling nervous or anxious
- sweating, chills, or clamminess
- irritability
- confusion
- increased heartbeat
- feeling lightheaded
- hunger
- nausea
High blood sugar, or hyperglycemia, can also cause dizziness. In people with type 2 diabetes, the body may not be able to use insulin effectively enough to control blood sugar, leading to hyperglycemia.
According to research from the United Kingdom, in people using insulin to treat diabetes, about 27% and 22% reported feeling lightheaded or dizzy, respectively, as a result of high blood sugar.
Other symptoms of high blood sugar include:
- high levels of sugar in the urine
- frequent urination
- feeling more thirsty than usual
People with diabetes have a higher risk of dehydration due to high blood sugar levels. High blood sugar causes the kidneys to remove excess glucose from the blood through urine.
As the kidneys filter glucose out of the blood, they also remove water. This increased urination means that people with high blood sugar can become dehydrated more easily.
Dehydration can cause dizziness. Other symptoms of dehydration include:
Certain drugs can cause dizziness, including diabetes medications that lower blood sugar.
Other medications that may cause dizziness include:
- diuretics
- SGLT2 inhibitors
- certain antibiotics, such as ciprofloxacin, erythromycin, and gentamicin
- antifungals, such as amphotericin B and fluconazole
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- statins
- neuropathic pain relief medication, such as amitriptyline, duloxetine, and pregabalin
A person can discuss medication changes with a doctor. They should not stop taking medications or change their dosages unless the doctor instructs them to do so.
It is important that people seek treatment for dizziness resulting from type 2 diabetes. Severe dizziness may affect everyday tasks and quality of life, and it can lead to falls.
Without treatment, some causes of dizziness may progress to serious complications. In severe cases, uncontrolled blood sugar levels may lead to a loss of consciousness or ketoacidosis, which requires emergency medical care.
Severe dehydration can also lead to life threatening complications without treatment.
By following a treatment plan, people can learn how to control the symptoms of type 2 diabetes, maintain healthy blood sugar levels, and prevent dehydration and dizziness.
Anyone experiencing regular dizziness should contact a doctor. They may wish to consider keeping track of when they feel dizzy to help a doctor identify any patterns.
The doctor may carry out a physical examination and assess any other symptoms. They may check blood sugar levels and review the person’s medications to determine the cause of the dizziness.
Treating or managing the underlying causes of dizziness in type 2 diabetes may help resolve dizziness.
Monitoring blood sugar
Monitoring blood sugar can help people maintain levels within a healthy range. People can use a device called a blood glucose monitor, which measures blood glucose levels in a pinprick of blood from the fingertip.
Low blood sugar: The 15:15 rule
Doctors may recommend that people with low blood sugar follow the 15:15 rule. The ADA explains that a person can take 15 grams (g) of carbohydrates and then check their blood sugar levels 15 minutes afterward. If blood sugar is still low, they should take another 15 g.
People can repeat this until their levels are within a normal range. Examples of carbohydrates that can raise low blood sugar efficiently include:
- glucose tablets or glucose gel, which a person should take according to the instructions on the label
- a half cup of juice or non-diet soda
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, such as jelly beans or gumdrops
It is important to avoid using complex carbohydrates to treat low blood sugar in an emergency, as these can slow down the time it takes for the body to absorb glucose. The same applies to carbohydrates with fat, such as chocolate.
Once blood sugar levels have returned to a healthy level, a person can eat a healthy snack to prevent their levels from dropping again.
Carbohydrate levels may vary for each individual, and children will need less than 15 g to treat low blood sugar. People can discuss a specific treatment strategy for low blood sugar with a doctor.
Low blood sugar: Glucagon
In severe cases of low blood sugar, when the 15:15 approach is insufficient, people may need glucagon. Glucagon is a hormone that the pancreas produces to release stored glucose. A person can speak with their doctor to check whether they require prescription glucagon.
High blood sugar: Diet and exercise advice
People with high blood sugar may be able to lower their levels through exercise and eating a nutritious, well-balanced diet with smaller portions.
If a person’s blood sugar level is higher than 240 mg/dl, it may not be safe for them to exercise because ketones may be present in the urine. Ketones are waste products that the body creates when it uses fats as fuel instead of glucose.
Exercising with ketones in the urine may cause blood sugar levels to increase even further. A buildup of ketones can also lead to a life threatening condition called ketoacidosis.
A doctor can offer advice on a safe treatment plan for lowering blood sugar.
High blood sugar: Hydration
Managing high blood sugar may also help treat dehydration. Drinking plenty of water throughout the day can help the body stay well-hydrated. For more severe cases of dehydration, people may need to replenish their electrolytes.
It is best to avoid sugary drinks or fruit juices, as these could increase blood sugar levels.
Medications
If medications are causing dizziness, a doctor may be able to alter the dosage or suggest an alternative. It is important that people do not stop taking any medication without speaking with a doctor.
Other symptoms of type 2 diabetes
Type 2 diabetes can cause low or high blood sugar and dehydration, all of which can cause people to feel dizzy or lightheaded. Certain medications, including those for diabetes, may also cause dizziness.
Anyone with type 2 diabetes who experiences frequent or severe dizziness should discuss this symptom with a doctor. Dizziness could be a sign of uncontrolled blood sugar or dehydration, both of which can cause severe complications without treatment.
Depending on the underlying cause, a doctor may suggest changing to an alternative medication or taking steps to manage blood sugar or avoid dehydration.