Taking Control of Diabetes [part 2]

By Phoebe Chi, MD, MPH

In my previous posts, I discussed both the importance of knowing your Diabetes A-B-C’s as well as how to easily meal plan your way to health. In this post, I will focus on another essential skill that everyone with diabetes needs to have: how keep your blood sugars at an optimal level. By knowing what to watch for and knowing how to react, you can be empowered to truly take control of this condition. 

So let’s get started!


Where Should Your Sugars Be?

◊ Before meals

Between 80 and 130 mg/dL  (4.4 and 7.2 mmol/L) 

◊ 2 hours after meals

Less than 180 mg/dL  (10.0 mmol/L) 

– I –
Controlling Your Sugars with Healthy Habits

It is safe to say that the primary goal of diabetes management is to keep your blood glucose levels at a safe range. An important part of this is adjusting your everyday lifestyle habits. This is because many things that you do during the day can cause your blood sugar level to go up and down. By avoiding the following behaviors (or taking the right precautions when it’s unavoidable), you can prevent your blood sugars from dangerously fluctuating throughout the day.

◊ Things that affect your blood sugar level:

× Skipping meals
× Eating at irregular times
× Eating too little or too much food, especially carbohydrates
× Sudden changes in physical activity level
× Emotional stress
× Anytime your health changes (an infection, an illness, or surgery)
× Skipping medications or not taking them at the right time 

– II –
Symptoms to Watch For

Just as it is important to know your Diabetes A-B-C’s, I encourage every person with diabetes to know the signs and symptoms of hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar). Remember—always listen to your body; if something seems wrong, don’t ignore it.

◊ Symptoms of LOW blood sugar (hypoglycemia)

Shakiness or dizziness
Racing or pounding heartbeat
Confusion or irritability (or a sudden change in mood)
Tingling sensation in your fingertips or around your mouth

◊ Symptoms of HIGH blood sugar (hyperglycemia)

Extreme tiredness
Extreme thirst
Blurry vision or a change in vision
Increased hunger
Increased need to urinate or urinating a lot

Remember— your blood sugar level can be low or very high even in the absence of these symptoms. Therefore, the above list should be thought of as a list of warning signs telling you to act immediately and not as indicators of how well your diabetes is being controlled overall.

– III –
Checking Your Sugars

While we won’t focus on the nitty-gritty details of blood glucose monitoring (things such as how often you should check it and what particular method to use should be determined between you and your doctor), it is important to remember that there are certain circumstances where it is always wise to check your blood glucose level.

◊ Always check your blood sugar when:

You start a new diabetes medication
 Your medication dose gets changed
 You are sick (such as with the flu or an infection)
 You simply suspect that your sugar level may be too low or high

– IV –
Dealing with the Highs and Lows [of Blood Sugar]

So what should you do when you experience the above symptoms? If you do start having symptoms of either low or high blood sugars, follow the directions below (but if your doctor has already given you a personalized protocol for this situation, be sure to follow your doctor’s directions instead).

Low Blood Sugar (Hypoglycemia)

◊ What to do when you get symptoms of LOW blood sugar:

1 – Check your blood glucose level

2 – If it is lower than 70 mg/dl, or you are in a position where you cannot check it but are having symptoms, eat an emergency sugar food:

♦ 4 glucose tablets or one tube of glucose gel
♦ 1/2 cup (4 ounces) of fruit juice (not low-calorie or reduced sugar)
♦ 1/2 can (4 to 6 ounces) of regular soda
♦ 1 tablespoon of sugar, honey, or corn syrup
♦ A handful of raisins

3 – Wait 15 minutes and check your blood glucose again.

4 – If your glucose level is still low, eat or drink another emergency sugar food.

5 – Check your blood glucose again after another 15 minutes. Continue doing this until your blood glucose level and symptoms improve. 

6 – Once it improves, eat a snack (eg. half a sandwich or a serving of crackers)

High Blood Sugar (Hyperglycemia)

◊ What to do when experiencing symptoms of HIGH blood sugar:

1 – Check your blood glucose level

2 – If it is higher than 250 mg/dl (or if you cannot check it but you are having symptoms)  Drink a glass of water or sugar-free drink (to prevent dehydration)

–  [If you take insulin] Follow your doctor’s directions in taking extra insulin.

3 – Recheck your glucose level every 4 hours until it is below 180 mg/dl. 

Most of the time, going through these steps is enough to get your blood sugar back to a safe level. However, there are times where you may need professional medical help to get things under control. That is what I will cover now.

– V –
When to Seek Medical Help

 If you start experiencing the following symptoms or signs, call your doctor or 911 immediately:

If you start experiencing new symptoms or feel worse after following the above steps
♦ If you feel confused, disoriented, or get slurred speech
If you have a fever
If you are vomiting or have diarrhea
If you have not urinated in 8 hours
If your breath starts having a strong, fruity odor
If your breathing becomes rapid and deep
If you start to lose consciousness or have a seizure
If your blood sugar continues to be more than 300 mg/dL after 8 hours
If you continue to have blood sugar of less than 60 mg/dL after an hour


I hope this was helpful to you. Remember…the more you are in control of your sugars, the more control you have over your overall health. 

*The information in this post can be found in Being Empowered for a Healthy Heart: A personal guide to taking control of your health while living with chronic conditions, by Phoebe Chi, MD, MPH.


13 thoughts on “Taking Control of Diabetes [part 2]

Add yours

    1. There are many places that can get you the necessary prescription medicines for free or at least for a large discount. At most or all clinics, if the patient mentions it, we can sign them up for patient assistance (depending on their income). Some clinics—such as those that are considered “charity clinics” stock medications that they can give you straight away. My advice (if you have medical problems), is to look online for “charity clinics’ as they would have the best resources for that.

      As for low-cost foods, I’m sure others would have more knowledge about this than me, so I encourage you to ask around (you might even find the information you need through a little googling)

      I hope this was helpful. Take care. 🙂


  1. Thank you for the in-depth information. I have Diabetes 2 and am on a Mediterranean diet. I had never had to use insulin until I went into the hospital last November. I spent nine months and had six flap surgeries to close a coccyx wound open to the bone. I also had osteomyelitis and was on the antibiotic cubicin for six weeks.

    I’m assuming that the stress on my body is what caused my diabetes to get out of control. I wound up on Levemir and insulin shots. I just got home Friday and I have to start testing again as soon as I receive my glucometer. The problem is that there is a wound below the flap and I have to undergo another surgery next Wednesday.
    Is this why my diabetes is out of control? Will you tips above help me to stabilize it again even though I may have to stay in bed for a couple more months before I can get in my wheelchair again.

    Is it the stress in my body and, of course, the emotional weight of what I am going through?

    Thank you, Phoebe

    Liked by 1 person

    1. Hi Nancy,

      Yes–from what it sounds like, your body is going through a major stress response, which is causing your sugars to go up. Both physical stress (such as surgery or infection) and emotional stress can lead to this response. Because its effect on your sugars can be so significant, I am not surprised that you are needing insulin.

      I understand your situation is very difficult. As for what you can do to stabilize your sugars and minimize the time you are on insulin, the two main things would be to eat smaller, evenly-spaced meals and to do what you can to minimize the emotional stress you are feeling. Things like relaxation techniques and positive social support would be helpful.

      Here is a helpful article on the effect of stress on diabetes if you want to learn more:


      I hope this helped to answer your question. I’m always here if you have more. 🙂


      Liked by 1 person

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