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.