Diabetic Hyperphagia: Causes, Symptoms, Treatments

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Hyperphagia, sometimes called polyphagia, refers to excessive feelings of hunger, which are not relieved by eating. People who have diabetes often experience hyperphagia due to problems with insulin.

Eating in kitchen late at night

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Symptoms

While everyone has cravings from time to time, and certainly everyone feels hungry, the experience of hyperphagia is separate from normal hunger cues.

People with diabetic hyperphagia may experience:

  • Feelings of hunger, despite eating regularly or snacking often
  • Overeating
  • Intense food cravings
  • Weight gain
  • Weight loss
  • Fatigue
  • High blood sugar
  • Low blood sugar
  • Other symptoms of diabetes, such as excessive thirst and/or frequent urination
  • Digestive problems such as diarrhea, nausea, and heartburn

Diabetic hyperphagia is not the same thing as binge eating. With binge eating, a person eats an excessive amount of food, even if they are not hungry, and there is an emotional component. With diabetic hyperphagia, a person feels constantly hungry whether or not they eat or how much they eat.

Diabetic hyperphagia does not have to have a mental or emotional component, it can simply be the physical sensation of hunger.

Constant Cravings

People with diabetic hyperphagia usually crave sugary foods, This is true with both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) because in both cases, the body cells are not getting the sugar they need.

Causes

Hyperphagia can occur in people with all types of diabetes, including type 1, type 2, and gestational diabetes.

In people with diabetes, hyperphagia is usually related to problems with insulin and blood sugar levels.

Hyperglycemia (High Blood Sugar)

Insulin is needed to help blood glucose enter cells, where it is used by the body for purposes such as energy.

People with diabetes either:

  • Cannot make any insulin (usually, type 1 diabetes)
  • Do not make enough insulin
  • Do not use insulin efficiently (insulin resistance)

If left untreated, blood glucose cannot enter body cells effectively and is not used by the body, but stays in the bloodstream creating high blood sugar.

Because the cells are not receiving the energy they need, the body continues to send signals for more food. While adequate food is being eaten, the body cells are starving.

This creates a vicious cycle in which the high blood sugar causes problems with insulin, and the problems with insulin cause feelings of hunger encouraging excessive eating, which in turn raises blood sugar.

Hypoglycemia (Low Blood Sugar)

Hypoglycemia can occur in people who are not diabetic and people who are diabetic.

Unlike hyperglycemia in which there is too much glucose in the bloodstream, hypoglycemia results from too much insulin in the bloodstream and too little glucose.

For people who are diabetic, this can happen when there isn't a balance between blood glucose and insulin, often as a result of taking medications to control blood sugar or taking insulin.

Episodes of hypoglycemia often occur at night and may lead to night-time food cravings.

Hypoglycemia Emergency

Hypoglycemia can lead to a medical emergency if blood glucose levels drop too low. People with diabetes often keep high carbohydrate foods and drinks handy, such as glucose pills or juice, to raise their blood glucose quickly if it drops too low.

Hypothalmic Lesions

Tumors or damage to the hypothalamus region of the brain are associated with the development of hyperphagia, obesity, and insulin resistance.

These are risk factors for a number of health conditions, including diabetes.

Diagnosis

It may be difficult at first to distinguish hyperphagia from simple food cravings. While eating may or may not provide temporary relief, the cravings and constant hunger will repeatedly return.

Hallmark Hyperphagia Symptpm

The hallmark of hyperphagia is that it is not relieved by eating.

If someone is experiencing signs of hyperphagia, they should consult with a healthcare provider. Because hyperphagia can be caused by a number of different conditions, some of which are serious or life-threatening, it is important to find the underlying cause of hyperphagia.

Diabetes may be suspected if hyperphagia is accompanied by other symptoms such as:

  • High blood glucose
  • Excessive thirst
  • Frequent urination
  • Blurry vision
  • Fatigue
  • Cuts, wounds, or infections that are slow to heal
  • Headaches
  • Difficulty concentrating
  • Weight loss

Diabetes usually develops over time rather than suddenly:

  • Type 1 diabetes can come on slowly or suddenly and can reach the level of a medical emergency if symptoms go unnoticed, which will result in a diagnosis.
  • Type 2 diabetes can go undetected for years and is often discovered during testing or treatment for another condition.

To determine the cause of hyperphagia, a healthcare professional may:

  • Do a physical examination
  • Ask about symptoms, including symptoms of other conditions associated with hyperphagia, and the duration of symptoms
  • Discuss the family history and medical history
  • Discuss personal history including diet and lifestyle practices
  • Requisition lab tests such as blood work or urine tests
  • Run a glucose tolerance test
  • Order imaging such as a CAT scan or MRI

Treatment

The most effective treatment for hyperphagia is to treat its underlying cause. In the case of diabetic hyperphagia, managing the diabetes will also manage the hyperphagia.

Controlling Diabetes

The treatment approach for diabetes depends largely on the type of diabetes.

While type 1 diabetes is a lifelong autoimmune disorder, resulting in the inability to produce insulin, type 2 diabetes is much more common, can often be managed through lifestyle changes, and for some people goes away with treatment.

Type 1 diabetes almost always requires careful blood sugar monitoring and the administration of insulin. Monitoring can be done using at-home devices.

Insulin is either injected or delivered through a pump that is affixed to the skin. This is usually performed by the person with diabetes, or a guardian if the person is a child.

Type 2 diabetes may or may not require medication such as insulin or oral diabetes medication.

Both type 1 and type 2 diabetes require lifestyle habits such as:

  • Healthy eating
  • Exercise
  • Good sleep habits
  • Stress management
  • Blood sugar monitoring
  • Monitoring for signs of complications, which may include seeing specialists such as an eye doctor or foot doctor

Managing Hunger

While it is most important to control diabetes, there are some things to try that may help manage hunger with diabetic hyperphagia:

  • Check your blood sugar. If it is low, eat quick sugar carbohydrates to bring it up
  • Eat high fiber, low carbohydrate foods
  • Drink plenty of water
  • Eat a high-protein breakfast
  • Eat without distractions such as the TV
  • Keep food interesting with a variety of tastes, herbs, and spices
  • Exercise through a craving
  • Distract yourself while having a craving—go on a walk, take a shower, do an activity you enjoy
  • Manage your stress levels and watch for signs of mental health struggles such as depression or anxiety, which can lead to emotional eating
  • Allow small tastes of the foods you are craving
  • Keep healthy snacks easily accessible

Other Treatment Options

Medications such as liraglutide are being investigated as possible treatments for hypothalamic hyperphagia, but more research is needed.

A Word From Verywell

If you suspect you are experiencing insatiable hunger and frequent cravings, hyperphagia may be to blame.

Because hyperphagia can indicate a serious health risk such as diabetes, it's important to speak with a healthcare provider if you are experiencing signs of hyperphagia.

With measures to keep blood sugar at healthy levels, diabetic hyperphagia can be managed.

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