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Diabetes and Polyphagia (Excessive Hunger)


One of the most challenging aspects of living with diabetes is that it can make you extra hungry for the one thing that affects your blood sugar the most: food. More specifically, sugary food.

This condition is called Polyphagia and is essentially “excessive hunger.” It’s very common in people with diabetes.

In this article, we’ll look at several causes of polyphagia in people with diabetes, and what you can do to manage and reduce it.

What is polyphagia?

Polyphagia is the medical term for “excessive hunger” and it’s one of the three well-established signs of diabetes that all start with the letter “p”.

  • Polydipsia: an increase in thirst
  • Polyuria: an increase in your need to urinate
  • Polyphagia: an increase in your appetite

While non-diabetics can certainly experience ongoing polyphagia, it is especially common in people with diabetes because both high and low blood sugar levels can have a significant impact on your appetite.

What causes polyphagia?

Pinpointing the exact cause of your polyphagia as a person with diabetes might be tricky, because while the diabetes-related causes are few, the non-diabetes related causes are many!

Let’s take a closer look.

Cause of polyphagia related to diabetes

Next, we’ll dig more deeply into these 3 common causes of excessive hunger.

Why hyperglycemia (high blood sugar) causes excessive hunger

Hyperglycemia is “high blood sugar” and while anything over 140 mg/dL is considered “higher than normal,” the side-effect of hunger starts when your blood sugar is crossing that 250 mg/dL line. The longer it stays about 250 mg/dL, the stronger those cravings will become.

This cause of polyphagia is especially troublesome because the more you eat, the higher your blood sugar becomes, and then, the stronger your excessive hunger becomes, too.

High blood sugar levels directly increase your craving for food, and in particular, sugar, because your body relies on that second-by-second delivery of glucose in order to function. 

When there isn’t enough insulin present to actually make use of and transport that glucose to your brain and other cells throughout the body, your brain cues its signal for hunger.

And again, it’s a vicious cycle because the more you eat, the higher your blood sugar becomes, the more intense your craving for sugar becomes.

Solution

Truly, the solution here is to work with your healthcare team on reducing your blood sugar levels.

There are a variety of treatment plans to accomplish this depending on your ability to avoid indulging those high-sugar cravings, if you’ve been diagnosed with any type of diabetes yet, what medications you’re currently taking, and what medications could help that you haven’t tried.

For many, resisting that urge to eat when your blood sugars are persistently over 200 mg/dL or 250 mg/dL is very difficult. Your brain is begging you for more food.

Most likely, you’ll need to consider some combination of insulin and other non-insulin diabetes medications to get your blood sugar back into a healthy range. Don’t wait! While it can be scary to start a new medication, it’s critical to not only regulating your appetite but also to preventing longterm damage in your eyes, fingers, toes, kidneys — you name it!

Plus, you’ll feel better! 

Why hypoglycemia (low blood sugar) causes excessive hunger

Hypoglycemia (low blood sugar) is a very common part of real-life with diabetes if you’re taking insulin or another diabetes drug that can potentially cause low blood sugars. (Many non-insulin medications cannot cause low blood sugar even if they work by lowering your blood sugar.)

Quite simply, the intense craving and hunger for sugar — and food in general — is your brain saying, “Hey! Save me! Help me!”

For most, this craving for sugar starts when your blood sugar dips below the 80 to 70 mg/dL range.

Your brain relies on a second-by-second delivery of glucose in order to function. While many other systems in your body prefer glucose as their energy source, the brain absolutely needs glucose.

You can also experience that sudden hunger when your blood sugar is dropping rapidly but is still at 90 or 100 mg/dL when you check it. Those cravings for food and sugar can still kick-in because of how quickly your blood sugar is dropping.

Solution

First and foremost, you’ll need to treat the low blood sugar with fast-acting carbohydrates. But the average low blood sugar only needs between 5 to 10 grams of carbohydrate in order to come back up to a healthy level.

Some low blood sugars occur from an overdose of insulin, and these can require a significantly large serving of carbohydrates.

Learning how to not over-eat during a low blood sugar takes time. You can easily develop a habit of letting yourself eat whatever you want, and this becomes a vicious cycle that usually triggers a blood sugar roller coaster as well as long-term weight-gain, exhaustion, and frustration. 

The first step is to be prepared with fast-acting carbohydrates to treat low blood sugars. Instead of eating a meal when you’re low, or using a low blood sugar as an excuse to eat cake, use certain foods as though they are “medicine,” and you are medicating the low with that food.

For example, I often use gummy Life-Savers because they contain 3 to 4 grams of carbohydrate per gummy, they don’t melt or freeze, and I can store them easily in my nightstand, my car, my purse, etc.

The second step is to work with your healthcare team to adjust your insulin and medication doses that are causing these recurring low blood sugars. Some lows are just flukes and aspects of juggling the many factors that affect our blood sugar. But if you’re experiencing severe lows regularly, your insulin doses likely need some fine-tuning.

Why hyperthyroid (overactive thyroid) causes excessive hunger

Hyperthyroid (overactive thyroid) is when your thyroid gland begins producing far more thyroid hormones than it’s supposed to, explains the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Hyperthyroid is also referred to as “Grave’s Disease.”

Thyroid conditions are common in people with diabetes, so it’s important you have your thyroid levels tested once a year or if you suspect any of the typical symptoms

Your thyroid is located on the front of your neck, and you’ve likely had a doctor feel this part of your throat during a diabetes check-up. When a person develops hyper- or hypothyroid, the gland is often noticeably swollen.

The hormones produced by your thyroid are responsible for how your body uses energy and every part of your body relies heavily on a balanced production of these hormones.

Hyperthyroidism can affect your heart, bones, muscles, menstruation, fertility, safety for both mother and baby during pregnancy, your body weight, and of course, your appetite.

An overproduction of thyroid hormones will make you hungry! Period. And during the months prior to your diagnosis, you’ll likely experience a gradual weight-gain as your appetite gradually increases more and more. 

Solution

The first step is to have your thyroid levels tested with a blood draw at your doctor’s office or phlebotomy lab.

If your results do show an overproduction of thyroid hormones, you’ll likely need to start an “anti-thyroid” medication that helps regulate the production of these hormones.

There are several options, and much like insulin, they’ll need to be titrated gradually with your healthcare team to find the right dose for you. 

Other causes of polyphagia unrelated to diabetes

If none of the diabetes-related causes of excessive hunger apply to you, there are certainly other causes to consider.

  • Eating disorders: bulimia, anorexia
  • Exercise addiction
  • PMS (pre-menstrual syndrome)
  • Medications: steroids, antidepressants, etc.
  • General anxiety
  • Stress
  • Lack of sleep
  • Kleine-Levin Syndrome
  • Prader-Willi Syndrome
  • Marijuana 

If you suspect any of these factors may be contributing to your polyphagia, talk to your healthcare team about getting the support you need to manage or treat these issues. 

Polyphagia isn’t the same as binge eating!

While both conditions can involve overeating, it’s important to stress that polyphagia isn’t the same as binge eating.

Binge eating is defined as episodes of uncontrolled eating which may or may not be associated with an actual feeling of hunger. Binge eating is also typically characterized by loss of control during a binge episode and feelings of guilt after an episode.

Polyphagia simply means that you are excessively physically hungry. It doesn’t necessarily involve a mental or emotional craving for food.

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