When
you have
diabetes, you may have high blood sugar levels
(hyperglycemia) or low blood sugar levels (hypoglycemia)
from time to time. A cold, the flu, or other sudden illness can cause high
blood sugar levels. You will learn to recognize the symptoms and distinguish
between high and low blood sugar levels.
Insulin and some types of
diabetes medicines can cause low blood sugar levels.
Learn how to recognize and manage high and low blood sugar levels
to help you avoid levels that can lead to medical emergencies, such as
diabetic ketoacidosis or
dehydration from high blood sugar levels or
loss of consciousness from severe low blood sugar
levels. Most high or low blood sugar problems can be managed at home by
following your doctor's instructions.
Following your doctor's
instructions on the use of insulin or diabetes medicines, diet, and exercise
will help you avoid blood sugar problems.
Home blood sugar testing will help you determine
whether your blood sugar is within your
target range. If you have had very low blood sugar,
you may be tempted to let your sugar level run high so that you do not have
another low blood sugar problem. But it is most important that you keep your
blood sugar in your target range. You can do this by following your treatment
plan and checking your blood sugar regularly.
Children with
diabetes need their parents' help to keep their blood sugar levels in a target
range and to exercise safely. It is important for children to learn the
symptoms of both
high and
low blood sugar so they can tell others when they need help. There are many
support groups and diabetes education centers to help parents and children
understand about blood sugar, exercise, diet, and medicines.
Teens
especially may have a hard time keeping their blood sugar levels in control
because their bodies are growing and developing. Also, they want to be with
their friends and eat foods that may affect their blood sugar. Having diabetes
during the teenage years is not easy. But your teen is at an excellent age to
understand the disease and its treatment and to take over some of the
responsibilities of his or her care.
If your blood sugar level
reads too high or too low but you are feeling well, you may want to recheck
your sugar level or recalibrate your blood glucose meter. The problem may be
with either your blood sample or the machine.
High blood sugar (hyperglycemia)
High blood sugar occurs when the sugar (glucose) level in your blood
rises above normal. Eating too many calories, missing medicines (insulin or
pills), or having an infection or illness, injury, surgery, or emotional stress
can cause your blood sugar to rise.
High blood sugar usually
develops slowly over a period of hours to days. But missing a dose of insulin
can cause a rapid rise in blood sugar levels. Blood sugar levels just above
your target range may make you feel tired and thirsty. If your blood sugar
level stays higher than normal for weeks, your body will adjust to that level,
and you may not have as many
symptoms of high blood sugar.
Unless you
don't monitor your blood sugar regularly or you don't notice the symptoms of
high blood sugar, you usually will have time to treat high blood sugar so that
you can prevent high blood sugar emergencies. Three things can help you prevent
high blood sugar problems:
Test your blood sugar often, especially if you are sick or are
not following your normal routine. You can see when your blood sugar is above
your target range, even if you don't have symptoms of high blood sugar such as
increased thirst, increased urination, and fatigue. Then you can treat it
early, preventing an emergency.
Call your doctor if you have frequent high blood sugar levels
or if your blood sugar level is consistently staying above your target range.
Your medicine may need to be adjusted or changed.
Drink extra
water or non-caffeinated, non-sugared drinks so you will not be dehydrated. If
your blood sugar continues to rise, your kidneys will increase the amount of
urine produced, and you can become dehydrated.
Complications of high blood sugar can cause serious
problems, including coma and death. Over time, high blood sugar can damage your
eyes, heart, kidneys, blood vessels, and nerves.
Low blood sugar (hypoglycemia)
Low
blood sugar occurs when the sugar (glucose) level in your blood drops below
what your body needs. Not eating enough food or skipping meals, taking too much
medicine (insulin or pills), exercising more than usual, or taking certain
medicines that lower blood sugar can cause your blood
sugar to drop rapidly.
People who lose weight or develop kidney
problems may not need as much insulin or other medicines as they did before
they lost the weight or developed kidney problems. Their blood sugar may drop
too low. It is important to check your blood sugar often when your body goes
through changes.
If your blood sugar level drops just slightly below your target
range (mild low blood sugar), you may feel tired, anxious, weak, shaky, or
sweaty, and you may have a rapid heart rate. If you eat something that contains
sugar, these symptoms may last only a short time. If you have diabetes, you may
not always notice symptoms of mild low blood sugar. This is called
hypoglycemia unawareness. If your blood sugar is
well-controlled and does not change much during the day, you may have an
increased risk for hypoglycemic unawareness.
If your blood sugar level continues to drop (usually below 40
mg/dL), your behavior may change, and you may feel more irritable. You may
become too weak or confused to eat something with sugar to raise your blood
sugar level. Anytime your blood sugar drops below 50 mg/dL, you should act
whether you have symptoms or not.
If your blood sugar level drops
very low (usually below 20 mg/dL), you may lose
consciousness or have a
seizure. If you have symptoms of severe low blood
sugar, you need medical care immediately.
You may have symptoms of low blood sugar if your blood
sugar drops from a high level to a lower level. For example, if your blood
sugar level has been higher than 300 mg/dL for a week or so and the level drops
suddenly to 100 mg/dL, you may have symptoms of low blood sugar even though
your blood sugar is in the normal range. But if you have had diabetes for many
years, you may not have symptoms of low blood sugar until your blood sugar
level is very low.
If your doctor thinks you have low blood sugar
levels but you are not having symptoms, he or she may ask you to check your
blood sugar more often. Your doctor may ask you to check your blood sugar in
the middle of the night or to use a 3-day continuous glucose monitor
test.
Review the Emergencies and Check Your Symptoms
sections to determine if and when you need to see a doctor.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Actionsets are designed to help people take an active role in managing a health condition.
A person is losing
consciousness or becoming sleepy or lethargic and is
not able to swallow water without choking or coughing, preventing him or her
from following the appropriate guidelines for low blood sugar levels.
Note:
If a person becomes sleepy or lethargic but is able to
swallow water without choking or coughing, check his or her blood sugar. If the
person has a blood sugar level less than 60
mg/dL, follow the appropriate guidelines for
emergency care for low blood sugar.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
If you think your blood sugar level may be
high or low, do a
home blood sugar test-do not wait until you have
symptoms.
If your doctor has given you specific instructions to
follow for high or low blood sugar levels, be sure to follow those
instructions. Be sure to follow your treatment plan if you get the flu, a cold,
or have surgery.
If you are pregnant and have diabetes, follow your
doctor's instructions for high or low blood sugar levels.
Do you have symptoms of mild to moderate high blood sugar (symptoms of high blood sugar), and your symptoms are increasing after taking
steps to lower your blood sugar level?
Is your blood sugar level high after you test your blood twice and your
usual plan for lowering your blood sugar is not working, but you do not have
symptoms of high blood sugar?
Is your blood sugar level high and continues to rise after you have taken
steps to lower your blood sugar level, but you do not have symptoms of high
blood sugar?
Have
you had low blood sugar levels without any symptoms?
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
Other Symptoms to Watch For
The information in this topic is specific to
diabetes-related high and low blood sugar levels. The following symptoms may
affect your blood sugar levels:
A person is losing
consciousness or becoming sleepy or lethargic and is
not able to swallow water without choking or coughing, preventing him or her
from following the appropriate guidelines for low blood sugar levels.
Note:
If a person becomes sleepy or lethargic but is able to
swallow water without choking or coughing, check his or her blood sugar. If the
person has a blood sugar level less than 60
mg/dL, follow the appropriate guidelines for
emergency care for low blood sugar.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
If you think your blood sugar level may be
high or low, do a
home blood sugar test-do not wait until you have
symptoms.
If your doctor has given you specific instructions to
follow for high or low blood sugar levels, be sure to follow those
instructions. Be sure to follow your treatment plan if you get the flu, a cold,
or have surgery.
If you are pregnant and have diabetes, follow your
doctor's instructions for high or low blood sugar levels.
Do you have symptoms of mild to moderate high blood sugar (symptoms of high blood sugar), and your symptoms are increasing after taking
steps to lower your blood sugar level?
Is your blood sugar level high after you test your blood twice and your
usual plan for lowering your blood sugar is not working, but you do not have
symptoms of high blood sugar?
Is your blood sugar level high and continues to rise after you have taken
steps to lower your blood sugar level, but you do not have symptoms of high
blood sugar?
Have
you had low blood sugar levels without any symptoms?
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
Other Symptoms to Watch For
The information in this topic is specific to
diabetes-related high and low blood sugar levels. The following symptoms may
affect your blood sugar levels:
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
When you have diabetes, whether it is
type 1 diabetes,
type 2 diabetes, or
gestational diabetes, one of the most important skills
you will learn is how to manage your blood sugar level. Following your doctor's
instructions on the use of
insulin or diabetes medicines, diet, and exercise will
help you avoid blood sugar problems. You will learn to recognize the symptoms
and distinguish between high and low blood sugar levels. It may be difficult
for a parent of a young child to distinguish the
difference between high and low blood sugar symptoms in a child.
Learn the symptoms of high and low blood sugar
levels.
Once you have learned to recognize high or low blood sugar
levels, you can take the appropriate steps to bring your blood sugar level back
your
target blood sugar levels.
People who
keep their blood sugar levels under control with diet, exercise, or oral
diabetes medicines are less likely to have problems with high or low blood
sugar levels.
Learn how to deal with high blood sugar levels
Be
sure to know how fast your insulin medicine will work to bring your blood sugar
down. Some insulins work very fast while regular insulin takes a little longer
to bring the sugar level down. Knowing how fast your insulin works will keep
you from using too much too quickly.
Because
you have diabetes and can have low blood sugar levels, you need to keep some
type of food with you at all times that can quickly raise your blood sugar
level. These should be quick-sugar foods (about 15 to 20 grams of carbohydrate) that puts glucose into your bloodstream in about 5
minutes. Any quick-sugar food on this list will raise your blood sugar about 30
milligrams per deciliter (mg/dL) in about 15 to 20 minutes. Be sure to check
your blood sugar level again 15 minutes after eating a quick-sugar
(carbohydrate) food to make sure your level is getting back to your target
range. When your blood sugar gets to 70 mg/dL or higher, you can eat your normal meals and snacks.
Quick-sugar foods
Food
Amount
Table sugar
1 tablespoon
Fruit juice or regular soda
pop
½ cup
Fat-free milk
1 cup
Honey or corn syrup
1 tablespoon
Jam
2 tablespoons
Raisins
2 tablespoons
Gumdrops
7 small
Life Savers candy
8 pieces
Hard candy
3 pieces
Glucose tablets
3 tablets
Glucose gel
½ tube
It is important to know that sugar foods like a candy
bar or ice cream do not help raise low blood sugar levels quickly because these
foods also have fat and protein. So the body cannot use the sugar
(carbohydrate) in these foods quickly to raise the blood sugar level.
Since low blood sugar levels can quickly become a medical
emergency, it is important to wear medical identification, such as a
medical alert bracelet, to let people know you have diabetes so they can get
help for you.
If you have severe symptoms of low blood sugar,
someone else may need to give you a
shot of glucagon. If this occurs, be sure to call your doctor immediately to let
him or her know this has happened.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to
evaluate your symptoms if any of the following occur during home
treatment:
Although high blood sugar (hyperglycemia)
and low blood sugar (hypoglycemia) have very different symptoms and treatments,
they are both caused by blood sugar and insulin imbalances. The steps you take
to control your blood sugar level will help prevent both high and low blood
sugar levels.
Be sure to have identification, such as a
medical alert bracelet, with you at all times that says you have diabetes. This
will help other people take steps to care for you if you are not able tell them
about your medical condition.
You can take steps to prevent high
and low blood sugar emergencies.
Follow your treatment plan.
Monitor
your blood sugar levels regularly to detect early
changes before an emergency develops. Treat your symptoms of high or low blood
sugar quickly to prevent more problems.
Control your stress.
Limit
how much alcohol you drink.
Monitoring and controlling blood sugar levels
Use
home blood sugar tests to determine whether your blood
sugar is in your
target range. Work with your doctor to set your
individual treatment goals. If you can consistently maintain this level of
control, you will have very few blood sugar level emergencies.
Control stress
No matter how skilled you are at
monitoring and controlling your blood sugar levels, you are still at risk for
high or low blood sugar levels that are brought on by stressful situations.
Stress can affect your body's blood sugar levels in two ways:
It changes the way your body uses
insulin, which is mostly a problem for people with
type 2 diabetes.
It can cause you to
change the way you take care of yourself, a problem for all people with
diabetes.
Stress can be both mental and physical. Some examples of
stress include an illness, a bad day at work, and a tough problem at home. When
you are under stress, your blood sugar levels change. For more information, see
the topic
Stress Management.
You can keep your
blood sugar levels under control when you exercise, so that you do not become
too hungry or make your blood sugar level drop. There are two ways to keep your
blood sugar levels under control:
At the meal before your planned exercise,
you can take less insulin, OR
Before you
exercise, eat some carbohydrate.
Keep a
quick-sugar food with you during exercise in case your
blood sugar level drops low.
Vaccinations
Your doctor may recommend that you
get vaccinations, such as a
flu(What is a PDF document?)
shot
or
pneumonia(What is a PDF document?)
shot, to prevent you from those illnesses.
Other places to get help
The American Diabetes
Association has a lot of information on diabetes and can link you to support
groups. For more information, call 1-800-DIABETES (1-800-342-2383) or see the
organization's Web site: www.diabetes.org/home.
You can help your doctor
treat your condition by being prepared to answer the following
questions:
What steps did you take to correct your high or
low blood sugar level? Did they help?
Have you had signs of another
illness?
Have you made any recent changes in your diet, exercise,
or medicines?
What other prescription and nonprescription medicines
do you take?
Have you recently had increased emotional or physical
stress?
Have you noticed situations that trigger or may cause your
high or low blood sugar problem?
Have you noticed any patterns,
such as time of day, when your high or low blood sugar problem
occurs?
Have you used a high blood sugar card? If so, be sure to
bring it when you see your doctor. See an example of a
high blood sugar card(What is a PDF document?)
.
Be sure to take your daily blood sugar (glucose) monitoring
logbook to your appointment. If you have specific records of your blood sugar
problems, be sure to take those records.
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
