Diabetes does not often cause headaches, but headaches that occur with diabetes can sometimes indicate problems with blood sugar levels, including low or high blood sugar.

When a person has diabetes, their body is unable to use the hormone insulin to manage blood sugar levels effectively.

Over time, periods of continuously high or low blood sugar can lead to serious and life threatening complications, such as heart disease and kidney failure.

Recognizing headaches due to poor blood sugar control can be a first step to preventing more severe health problems.

This article examines the link between diabetes and headaches and what to do about it.

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Not everyone with diabetes will experience headaches. However, those with a recent diagnosis of diabetes sometimes experience them while establishing the best way to manage their blood sugar levels.

People who have had diabetes for some time might also notice headaches due to changes in blood sugar levels.

A headache can signify hyperglycemia when blood sugar levels are too high. They can also occur with hypoglycemia when blood sugar levels are too low.

These headaches might stem from changing levels of hormones, such as epinephrine and norepinephrine. These hormones can constrict the blood vessels in the brain and cause discomfort.

Some scientists have suggested a link between migraine and type 2 diabetes, as both involve the vascular system and the transmission of nerve impulses, and people with diabetes seem more likely to have migraine than those without.

A 2018 population study that looked at data for over 44,000 people concluded that other issues that people commonly experience with diabetes, such as neck and back pain and some mental health issues, could account for the higher rates of migraine.

In 2020, however, researchers tested blood samples from 31 people with migraine. They found evidence that plasma glucose levels were higher during spontaneous migraine attacks than between attacks, suggesting a possible link.

Learn more about diabetes and headaches here.

Doctors consider blood sugar levels lower than 70 milligrams per deciliter (mg/dl) to be an indicator of hypoglycemia. This is a serious condition, as glucose is the primary fuel source for many cells in the body, including brain cells.

Symptoms of hypoglycemia usually develop suddenly and can be much more obvious than the symptoms of hyperglycemia.

In addition to headaches, some of the symptoms of low blood sugar include:

  • anxiety
  • blurred vision
  • chills
  • confusion
  • dizziness
  • weakness
  • hunger
  • irritability
  • lightheadedness
  • nausea
  • racing heart
  • seizures
  • shakiness
  • sweating
  • tiredness
  • loss of consciousness

Hypoglycemia can occur in people with diabetes if they take too much insulin, exercise more than usual, or do not eat enough carbohydrates.

Following a treatment plan for diabetes can help prevent headaches and more serious compilations due to hypoglycemia.

What are the signs of low blood sugar?

Hyperglycemia results from too much glucose circulating in the blood. In type 1 diabetes, a lack of insulin production causes spikes in blood sugar. In type 2 diabetes, the body cannot use insulin correctly.

Additional risk factors include:

  • a poor diet, high in sugars and fats
  • a sedentary lifestyle
  • stress, which releases the hormone cortisol that increases blood sugar levels

Symptoms of hyperglycemia are often slow to appear. However, a headache may be an early symptom of hyperglycemia.

Other symptoms include:

  • blurred vision
  • confusion
  • dehydration
  • excessive thirst
  • fatigue
  • hunger
  • increased urination
  • slow healing wounds

Hyperglycemia is a serious condition that requires rapid management, as high glucose levels can damage the blood vessels and nerves. They can also damage the pancreas, resulting in lower insulin production.

Without glucose absorption into cells, the body burns fat instead. This process may lead to a buildup of ketones, waste products that develops when the body burns fat for energy.

A buildup of ketones can cause diabetic ketoacidosis, which can lead to coma and even death.

A person can manage hyperglycemia with dietary changes and medications. Keeping blood sugar levels under control will reduce the risk of headaches from diabetes.

What should blood glucose levels be?

Over-the-counter (OTC) pain relief, including acetaminophen and ibuprofen, can help relieve headaches. People who experience migraine headaches should ask their doctor about suitable treatment options.

If a person notices that headaches occur when their blood sugar levels are either high or low, they should speak with their healthcare team. They may need to adjust their treatment plan.

People with kidney damage should avoid taking ibuprofen or aspirin for pain relief unless their doctor suggests it. Kidney damage is a complication of diabetes, so people with diabetes should ask a doctor which pain relief drug is safe for them to use.

People with diabetes should seek medical advice before making changes to their diet, exercise routine, or medication. Following a doctor’s guidance can help prevent fluctuations in blood sugar levels, making headaches less likely.

Treating headaches from hypoglycemia

The first step in treating a hypoglycemia-induced headache is confirming that the pain is due to low blood glucose. A blood glucose test can check this.

Taking a blood glucose test is especially important for people with diabetes who wake up with a headache in the morning, as it can be a sign of nocturnal hypoglycemia.

The American Diabetes Association(ADA) recommends that people with low blood sugar consume 15 grams of simple carbohydrates or glucose before rechecking levels after 15 minutes.

Once blood sugar returns to the target range, symptoms, including headache pain, should reduce.

Treating headaches from hyperglycemia

To relieve a headache from high blood glucose levels, a person can:

  • exercise
  • drink fluids to increase hydration
  • take insulin or other medications as agreed with their doctor

A person with type 1 diabetes should check their blood sugar levels and do a urine test to measure ketone levels, especially if glucose testing shows blood sugar levels are 240 mg/dl or above.

People with ketones in their urine should not exercise and seek emergency medical help. Exercising at this time could unintentionally increase blood sugar levels.

Other ways to prevent hyperglycemia headaches are by:

  • maintaining a moderate weight
  • following a nutritious and balanced diet
  • taking any medications as the doctor recommends

What are some natural remedies for headaches?

People with diabetes who experience frequent headaches should seek medical advice, as they may need to adjust their treatment plan.

The person should seek medical help if:

  • A headache is severe or getting worse, and pain relief does not help.
  • Headaches occur frequently.
  • There is severe throbbing pain at the front or side of the head, which could indicate a migraine or cluster headache.
  • They experience other symptoms, such as a fever, nausea, vomiting, or sensitivity to light and sound.

They should go to the emergency room if:

  • Headaches occur within 5 days after a head injury.
  • The pain is extreme.
  • There are vision changes, such as blurred vision.
  • The person has difficulty walking, speaking, or remembering things.

The International Classification of Headache Disorders classifies headaches as either primary or secondary.

  • Primary headaches: These do not relate to another medical condition. Examples of primary headaches include migraine and tension headaches.
  • Secondary headaches: Underlying medical conditions or health issues cause these headaches. They include the type of headache that people with diabetes can experience.

Other causes of secondary headaches include:

The pain of either primary or secondary headaches can vary in severity and duration. Some people may not experience headaches often, while others might have a headache several days each week.

Other symptoms may occur, depending on the type of headache a person experiences. For example, migraine might also lead to nausea and increased sensitivity to sound or light.

Diabetes headaches tend to cause moderate to severe levels of pain. A severe headache significantly affects a person’s ability to resume usual function in everyday life.

Headaches can happen for many reasons, and diabetes may play a role.

OTC pain relief can often improve symptoms, but people with migraine may need prescription treatment.

If a person with diabetes has frequent headaches, they may wish to check their blood sugar levels each time to see if there is a pattern.

Anyone experiencing frequent headaches due to hyperglycemia or hypoglycemia should speak with their healthcare team. They may need to adjust their treatment to regulate blood sugar more effectively.

If headaches are severe or persist despite keeping blood sugar levels optimum, a person should seek further advice from their doctor. There may be another reason for a headache.