One of the challenges of managing diabetes is maintaining consistent blood sugar (glucose) levels. Even with diligence, some situations can cause high blood sugar, or hyperglycemia, while others can bring on low blood sugar, or hypoglycemia.
After all, it’s not just carbohydrate intake that influences the amount of glucose coursing through your bloodstream when you have type 2 diabetes. Emotional stress and certain medications can increase your blood sugar levels, and a boost in activity can cause it to drop, says Megan O’Neill, CDCES, a medical science liaison for diabetes care at Abbott healthcare company in Monterey, California. Sometimes, people experience a spike in their blood sugar early in the morning due to the “dawn phenomenon,” a temporary surge of hormones that occurs as the body prepares to wake, according to the Cleveland Clinic.
“For people with diabetes, managing blood glucose levels is especially important,” O’Neill says. “Levels that are too low or high can result incomplications that affect your kidneys, heart, and vision, reduce your quality of life, require expensive interventions, or even be fatal.”
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The more prepared you are to spot the signs of both high and low levels, the better able you’ll be to quickly and easily bring them back within a desired range and stay healthy.
What’s the right range for you? The answer is slightly different for everyone, and your doctor can help you pinpoint yours. The American Diabetes Association (ADA)generally recommends trying to stay within these blood sugar targets:
- Between 80 and 130 milligrams per deciliter (mg/dL) before meals
- Less than 180 mg/dL two hours after meals
The first step to staying in these ranges, and course-correcting high and low blood sugar levels along the way, is to monitor yourblood sugar levels with a glucose meter.
Clinical guidelines recommend that anyone taking insulin test their glucose at least four times per day and as many as 12 times per day. Those who are pregnant or have difficulty maintaining healthy blood sugar levels also need to test their blood sugar more often. Factors that increase the ideal testing frequency include the type of insulin, past levels of glucose control, and symptoms, O’Neill says. Some people with diabetes can benefit from continuous glucose monitoring, a device that allows you to get readings without finger pricks every five minutes, she says.
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About High Blood Sugar (Hyperglycemia)
High glucose levels occur when the body doesn’t have enough insulin or can’t properly use the insulin it has to shuttle glucose from the bloodstream to the body’s muscles, organs, and tissues for fuel, O’Neill says. As a result, the amount of sugar in the blood builds up.
Hyperglycemia typically happens when you consume more carbohydrates or bigger portions of food than usual, if you don’t take enough insulin or other diabetes medication as prescribed, and if you decrease your levels of physical activity, she says. Heightened stress levels can also increase blood sugar levels. Non-diabetes-related medications that are known to raise blood sugar levels include steroids, beta blockers, birth control pills, and many mental health medications, she explains.
Signs of high blood sugar include frequent urination, fatigue, dry or itchy skin, feeling thirsty, more frequent infections, and eating more food but not gaining as much weight as usual, says Athena Philis-Tsimikas, MD, the corporate vice president for the Scripps Whittier Diabetes Institute in La Jolla, California.
High blood sugar levels can cause these symptoms through various mechanisms, according to the Mayo Clinic. For example, high blood sugar levels damage blood vessels and nerves throughout the body. They can also deprive organs of energy and can cause fluid to accumulate in the eyes. And in an attempt to get your blood sugar to a healthier level, your body will often increase urine output.
A blood sugar reading above 180 milligrams per deciliter (mg/dL) is considered above normal and can bring on these symptoms, although it’s possible to have high blood sugar without any symptoms, Dr. Philis-Tsimikas says.
A reading above 300 mg/dL can be dangerous, according to the University of Michigan, which recommends immediately informing your doctor if you have two or more readings of 300 mg/dL in a row. In severe cases, very high blood sugar levels (well above 300 mg/dL) can result in coma. If you experience mental confusion, nausea, or dizziness, proceed to the emergency room.
Ways to treat high blood sugar include:
- Take your medications as directed. Missing doses or taking insulin or other diabetes-managing medications at incorrect times can lead to large fluctuations in blood sugar levels up or down, O’Neill says. Apps such as Medisafe, which is free to download on the App Store and on Google Play, can help you stay on top of your medication regimen. The top-rated app allows you to plug your meds into your calendar and set reminders so you never miss a dose.
- Eat carbohydrates in moderation. TheADA recommends an individualized carb count for everyone with diabetes. Higher intakes can result in hyperglycemia and lower intakes in hypoglycemia. Count carbs by using an app such as the Carb Manager keto diet app, which is top rated and free to download on the App Store and Google Play. It’s not just for those on the ketogenic diet; with the free version, you can record food, track your carb and calorie intake, monitor weight loss, and log workouts.
- Exercise regularly with your doctor’s guidance.Exercise can lower blood sugar in the short term by using glucose for fuel. It can also help you manage your blood sugar over the long term by increasing insulin health, O’Neill says. Plenty of exercise apps and free online resources exist; work with your CDCES to come up with an individualized exercise plan.
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