When you have type 1 diabetes, it’s easy to assume that every issue, from a leg cramp to a bloody nose, is somehow related to your diagnosis. However, nosebleeds aren’t typically a symptom of diabetes, and bleeding from the nose doesn’t seem to be more common among people with diabetes.

Nonetheless, members of myT1Dteam have said they’ve noticed more bloody noses (also called epistaxis) since getting diabetes or starting diabetes medication. Is it all in their heads? Here are some of the possible reasons why you may be dealing with frequent nosebleeds.

What Causes Nosebleeds?

Nosebleeds can happen to anyone. Around 60 percent of people experience at least one nosebleed in their lifetime. In 10 percent of these cases, medical treatment is required. Bloody noses happen when the tissue that lines the inside of your nose becomes injured and breaks, releasing blood from the small blood vessels in the nasal cavity.

Various risk factors can cause a nosebleed. Two of the most common causes are dry air and nose-picking. Other possible causes include:

• Allergies
• Bleeding disorders
• Blood thinners or anticoagulants, like warfarin (Coumadin)
• Foreign objects in the nose
• A cold
• Nasal sprays that dry out the nose
• Nasal polyps (painless growths inside the nose or sinuses)
• Nose trauma
• Chronic kidney disease
• Recreational drug use
• Sinus infection

Members of myT1Dteam have shared that they experienced nosebleeds from health conditions they have aside from diabetes.

“Have any of you with rheumatoid arthritis and diabetes experienced nosebleeds?” asked one member. “I get nosebleeds so bad that they last for an hour. I am trying to get some understanding of what can cause a nosebleed as severe as mine. I don’t know if inflammation can cause it.”

“I used to have a lot of nosebleeds due to my high blood pressure (hypertension),” shared another member. “Now that my blood pressure is normal, I’m fine.”

Another member described nosebleeds related to allergy nose spray. “I have been very weak from severe nosebleeds. My red blood count cell is low from it. I am very weak and dizzy. I saw an ear, nose, and throat doctor, and this is caused by a nose spray mometasone (Nasonex). My septum is almost completely gone,” they explained.

If you suspect your bloody noses are caused by an uncontrolled health condition or a treatment you’re using, ask your health care provider for more details. They can help you sort out the information you hear from other people or read online to figure out what’s true for your situation.

Do Diabetes Medications Cause Nosebleeds?

Only one diabetes drug has been linked to nosebleeds, but it’s typically only for people with type 2 diabetes. Metformin is an oral medication that helps regulate blood sugar levels. Since it doesn’t affect insulin production, most people with type 1 diabetes aren’t prescribed this medication. Occasionally, metformin is used in type 1 diabetes to limit how big a dose of insulin a person needs to take.

Severe bleeding episodes are a very rare side effect for people who take large doses of metformin. This effect is most likely to impact people who are over 50 years of age.

How To Prevent Nosebleeds

Bloody noses are a nuisance that always seems to strike at the worst times. If you’ve just put on a new white shirt or are dozing off for a good night’s sleep, a bloody nose can be the last thing you want.

You can take certain steps to help lower your risk factors for nosebleeds if they’re a common problem for you. Some tips you can try include:

• Avoid heavy lifting — Lifting heavy objects may spike blood pressure and trigger a nosebleed.
• Blow your nose gently — Blowing your nose too roughly can do damage and reopen scabs in the nose.
• Don’t stick anything in your nose — This includes your finger. Picking your nose irritates delicate tissues inside your nostrils and often leads to nosebleeds.
• Keep your nasal passages moist — Use a saline nasal spray or humidifier to prevent dryness in the nose.

Caring for a Bloody Nose

Nosebleeds aren’t usually serious and typically resolve on their own. However, there are some steps you can take to help stop the bleeding. It’s a good idea to learn these methods and to share them with children who are managing type 1 diabetes so they’ll be prepared.

• Sit up straight and stay upright. It is important that the blood flows out of the nose and not back into the throat. If blood gets down into the throat or stomach, it could cause choking.
• Pinch your nose (on the sides, not the bridge) to put pressure on the blood vessels, which will help reduce blood flow. Pinch just above the nostrils and breathe through your mouth instead.
• Use a tissue for gently blowing out any clots in the nose. This could make pinching or icing your nose more comfortable. Avoid intense nose blowing, which could make the bleeding worse.
• Ice your nose to constrict the blood vessels, which in turn can help stop the bleeding. If your nose has been bleeding for more than 15 minutes, see if applying ice or a cold pack makes a difference.

When To Call the Doctor

Sometimes, nosebleeds are serious and require medical attention. One member of myT1Dteam shared that heavy nosebleeds run in their family. “The nosebleeds I was having really scared me,” they said. “My father had them, and they had to cauterize some of the vessels in his nose.”

If your nosebleed isn’t stopping after using the above tips or was caused by a serious injury, you should seek medical help. It’s also good to contact your doctor if you have numbness or pressure in your face along with nosebleeds.

Although bloody noses aren’t directly caused by diabetes, it’s a good idea to discuss any sudden changes, like increased frequency of nosebleeds, with your health care provider. Nosebleeds may be a sign of another underlying health problem that needs to be addressed. Your doctor can also provide tips on how to keep this issue under control.

Talk With Others Who Understand

On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, members come together to ask questions, give advice, and share their stories with those who understand life with type 1 diabetes.

Do you notice more frequent bloody noses with diabetes? Have you ever experienced a severe or life-threatening nosebleed? Share your experience below, or start a conversation by posting on your Activities page.