When To See A Doctor
According to the University of Michigan, blood sugar levels of 300 mg/dL or more can be dangerous. They recommend calling a doctor if you have two readings in a row of 300 or more.
See your doctor if you have consistently high blood sugar levels. Symptoms of this include:
- increased thirst
- high levels of sugar in urine
Ask your doctor how often to check your blood sugar and about your ideal blood sugar levels.
If you dont currently see a doctor who specializes in diabetes, known as an endocrinologist, you can find one by searching the American Association of Clinical Endocrinologists website.
You can find a certified diabetes educator by visiting the American Diabetes Associations website and searching by zip code.
Summary
Talk to your doctor if you have consistently high blood sugar readings or symptoms of chronic hyperglycemia.
Checking your blood sugar and then treating hyperglycemia early will help prevent any complications.
Health problems can arise when someone has high blood sugar regularly and without treatment.
Examples of complications include:
- nerve damage, called diabetic neuropathy, that may affect sensations in the feet and hands
- diabetic retinopathy, or damage to the blood vessels in the eyes that affects vision
- increased risks for kidney problems
- increased risks for heart problems
Taking steps to keep your blood sugar at target levels can help to minimize the likelihood that these complications will occur.
What Is Diabetic Ketoacidosis
If you think you may have low blood sugar, check it even if you dont have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
- Fast, deep breathing.
- Nausea and vomiting.
- Stomach pain.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.
Moderate Versus Tight Glycemic Control
Glycemic goals within the hospital setting have changed in the last 14 years. The initial target of 80110 mg/dL was based on a 42% relative reduction in intensive care unit mortality in critically ill surgical patients . However, a meta-analysis of over 26 studies, including the largest, Normoglycemia in Intensive Care EvaluationSurvival Using Glucose Algorithm Regulation , showed increased rates of severe hypoglycemia and mortality in tightly versus moderately controlled cohorts . This evidence established new standards: initiate insulin therapy for persistent hyperglycemia greater than 180 mg/dL . Once insulin therapy is initiated, a glucose target of 140180 mg/dL is recommended for most critically ill patients . More stringent goals, such as 110140 mg/dL may be appropriate for select patients, such as cardiac surgery patients , and patients with acute ischemic cardiac or neurological events provided the targets can be achieved without significant hypoglycemia.
A glucose target between 140 and 180 mg/dL is recommended for most patients in noncritical care units . Patients with a prior history of successful tight glycemic control in the outpatient setting who are clinically stable may be maintained with a glucose target below 140 mg/dL . Conversely, higher glucose ranges may be acceptable in terminally ill patients, in patients with severe comorbidities, and in in-patient care settings where frequent glucose monitoring or close nursing supervision is not feasible.
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Fasting Blood Glucose Level Test Preparation
What should you do if your doctor orders a fasting blood sugar test? The preparation is the same as when you take a fasting test for cholesterol. First, be sure to find out if you need to schedule an appointment for your test . Ask your doctor what time is best to take it.
Then:
- Schedule your test if necessary
- Ask your doctor if you need to change any of the medications you take on the morning of the test
- If you normally drink coffee or have caffeine, ask your doctor if that is okay. It may not be, since it affects blood sugar levels
- Fast for at least 8 hours before your test. Usually, an overnight fast is most convenient
- You can drink water
How High Does Your Blood Sugar Have To Be For A Diabetic Coma
Your blood sugar has to be at least than 600mg/dl to have a risk of going into HONK. The average blood sugar in people with a diabetic coma is higher than 800mg/dl. It is not uncommon to see blood sugars higher than 1000mg/dl in a diabetic coma.
When your blood sugar gets this high, it means that the balancing act of drinking water and losing water in the urine has become unbalanced. Now you are losing more water than you are taking in. When this happens, it goes downhill fast.
As your blood sugars go higher, your blood becomes thick, like syrup. This draws water from your organs. The most significant effect happens on your brain. When the thick syrupy blood draws water from your brain, your brain shrinks. This triggers a series of symptoms that eventually lead to HONK.
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Why Is Dehydration The Key Issue In Honk
Many people think that you can go into a diabetic coma if you dont take care of your diabetes. However, that is only partially true. People who dont take care of their diabetes are at risk for HONK, but you only go into a diabetic coma if you are dehydrated. If you are diabetic and become very dehydrated, you can go into a diabetic coma from high blood sugar even when you take good care of diabetes.
Just because you went into a diabetic coma from high blood sugar doesnt mean you have poorly controlled diabetes. This is a simple fact that even many healthcare providers fail to understand. That is because we have been led to believe that bad things only happen to people with diabetes when they dont take care of themselves. It may be true regarding long-term consequences of diabetes, but its not true for a diabetic coma from high blood sugar. As I will explain shortly, it can happen to anyone with diabetes.
Why Do I Need To Know My Blood Sugar Numbers
Your blood sugar numbers show how well your diabetes is managed. And managing your diabetes means that you have less chance of having serious health problems, such as kidney disease and vision loss.
As you check your blood sugar, you can see what makes your numbers go up and down. For example, you may see that when you are stressed or eat certain foods, your numbers go up. And, you may see that when you take your medicine and are active, your numbers go down. This information lets you know what is working for you and what needs to change.
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Factors That Can Affect Blood Sugar Levels
If you have prediabetes or diabetes, you may have insulin resistance or an inability to produce insulin. This means your body has difficulty regulating blood sugar levels on its own.
Its a delicate balance to maintain, so the following list can help you familiarize yourself with factors that can cause your blood glucose levels to go up or down.
Diabetes Care In The Hospital
Recommendations
Both hyperglycemia and hypoglycemia are associated with adverse outcomes, including death . Therefore, hospital goals for the patient with diabetes include preventing both hyperglycemia and hypoglycemia, promoting the shortest safe hospital stay, and providing an effective transition out of the hospital that prevents complications and readmission.
High-quality hospital care requires both hospital care delivery standards, often assured by structured order sets, and quality assurance standards for process improvement.
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When To Call A Professional
If you have type 1 diabetes and feel unwell, check your blood sugar levels often. Also test your urine for ketones. Call your doctor if you have:
- Unexplained nausea and vomiting with or without abdominal pain,
- Moderate or high levels of urine ketones, or
- Your blood sugar is high and you can’t lower it by adjusting your insulin dose.
What Else Can I Do To Help Manage My Blood Sugar Levels
Eating a healthy diet with plenty of fruit and vegetables, maintaining a healthy weight, and getting regular physical activity can all help. Other tips include:
- Keep track of your blood sugar levels to see what makes them go up or down.
- Eat at regular times, and dont skip meals.
- Choose foods lower in calories, saturated fat, trans fat, sugar, and salt.
- Track your food, drink, and physical activity.
- Drink water instead of juice or soda.
- Limit alcoholic drinks.
- For a sweet treat, choose fruit.
- Control your food portions .
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How Do Carbs Affect Blood Sugar
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
How Do I Check My Blood Sugar
You use a blood glucose meter to check your blood sugar. This device uses a small drop of blood from your finger to measure your blood sugar level. You can get the meter and supplies in a drug store or by mail.
Read the directions that come with your meter to learn how to check your blood sugar. Your health care team also can show you how to use your meter. Write the date, time, and result of the test in your blood sugar record. Take your blood sugar record and meter to each visit and talk about your results with your health care team.
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What Is The Treatment Of Hbg
Insulin is the best treatment for HBG in the hospital. This is true even if you do not have diabetes or if you do not use insulin at home. Insulin injection is the most effective way to control blood sugar. Also, some diabetes pills can cause low blood sugar or other health problems while you are sick. For these reasons, you may have to stop taking your noninsulin diabetes medicines during your hospital stay.
Hospital patients with HBG should receive insulin shots under the skin . You should get basal insulin once or twice a day to keep blood sugar levels steady. Before meals, getting bolus insulin helps prevent blood sugar levels from going too high after eating. Besides mealtime insulin, some patients with HBG may need additional insulin injections. This constant treatment prevents HBG or, in some patients, a dangerous health problem called diabetic ketoacidosis .
For all patients with HBG, good nutrition is important to help control blood sugar. A dietitian should work with you to plan your meals. The point is to make sure you get enough calories and eat the right amount and types of sugars or carbohydrates. These include whole grains, fruits, vegetables, and low-fat milk.
Why Your Blood Sugar Level May Be Low
If blood sugar drops below 70 mg/dL, it is below normal levels. This can be caused by a variety of factors, such as:
- Not eating enough or missing a meal or snack
- Reducing the amount of carbohydrates you normally eat
- Alcohol consumption especially if youre drinking on an empty stomach
- Taking too much insulin or oral diabetes medication based on carbohydrates or activity levels
- Increased physical activity
- Side effects from medications
If you have diabetes, keep your blood glucose meter and sources of fast-acting glucose close by in case your blood sugar drops. This is especially important for people with hypoglycemia unawareness, which is a condition that causes symptoms of low blood sugar to go unnoticed.
Eating balanced meals and snacks at regular times throughout the day is a big part of maintaining normal blood glucose levels. Check out our article on meal planning for diabetes to better understand the three macronutrients where calories come from and which have the biggest effect on blood sugar.
Meal Planning for Diabetes: How to Optimize Your Diet >
Everyone will respond differently to certain factors, which is why its important to have individualized target glucose levels. To help you reach your target blood glucose goals, work with your healthcare provider to discuss modifications to your diet, physical activity, or medications, and alert them of other factors like a recent illness or stressful event.
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What Are The Causes Of High Blood Sugar
Insulin is a hormone made by the pancreas. It helps in moving glucose from the digested food to the cells to be used as energy. High blood sugar can occur if the body does not have enough insulin. There are various conditions that affect the insulin function, thus resulting in high blood sugar. Some of the causes that contribute to high and even dangerous levels of blood sugar include the following,
- If a diabetic person misses taking the diabetes medication.
- Overeating, especially the food rich in carbohydrates.
- Lack of exercise or physical activity
- Infection or certain illnesses that cause the blood sugar to rise quickly.
- Intake of Certain medications such as steroids that affect sugar levels.
- Excessive and prolonged stress
Guide To Hospital Stays
If you experience some difficulties managing your diabetes or other health conditions, or you have an accident, you may need to go to the emergency department for assistance or be admitted to the hospital. If this happens, it can help to know what to expect and what questions to ask the health-care team you meet to ensure you are well cared for. It is also important to know what your rights and responsibilities are in these situations.
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A Few Final Notes On Keeping Blood Sugar Stable
Taking an active, intentional approach to your blood sugar levels is crucial to your quality of life and overall health, ONeill says. Avoiding too-high or too-low blood sugar levels will help you avoid adverse symptoms and health complications, and staying within your target range can enable you to feel your best and do whatever you want to do in life, she says.
Test your blood sugar regularly, listen to your body, and dont ever hesitate to reach out to your doctor.
Additional reporting by Karen Appold.
What Causes High Blood Sugar Levels In The Morning
Commonly known reasons why your blood sugar may be high in the morning include high-carb bedtime snacks and not enough diabetes medications.
Yet two lesser-known reasons may be causing your morning blood sugar woes: the dawn phenomenon and the Somogyi effect. These causes of high morning blood sugar levels are a result of body changes and reactions that happen while you are sleeping.
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Other Reasons To Call A Doctor
Sometimes people with diabetes can become overwhelmed and have a hard time coping with the disease. This is very common, especially in teens. If you find that you feel sad all the time, want to eat or sleep a lot or not at all, or you’re thinking about suicide, your doctor can be a resource for you if you don’t feel comfortable talking to a parent or teacher. He or she may refer you to a counselor, therapist, or other mental health professional who can help you understand more about why you feel the way you do and help you figure out ways to feel better.
How Can High Blood Sugar Levels In The Morning Be Controlled
Once you and your doctor determine how your blood sugar levels are behaving at night, he or she can advise you about the changes you need to make to better control them. Options that your doctor may discuss depend on the cause of the morning high blood sugars.
For dawn phenomenon:
- Changing the timing or type of your diabetes medications
- Eating a lighter breakfast
- Increasing your morning dose of diabetes medication
- If you take insulin, switching to an insulin pump and programming it to release additional insulin in the morning
For Somogyi effect:
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How Is It Determined If The Dawn Phenomenon Or Somogyi Effect Is Causing The High Blood Sugar Levels
Your doctor will likely ask you to check your blood sugar levels between 2 a.m. and 3 a.m. for several nights in a row. If your blood sugar is consistently low during this time, the Somogyi effect is suspected. If the blood sugar is normal during this time period, the dawn phenomenon is more likely to be the cause.
Some additional clues that the Somogyi effect may be the cause include nightmares, restless sleep and overnight sweating as these are all signs of low blood sugar levels.
Normal And Diabetic Blood Sugar Ranges
For the majority of healthy individuals, normal blood sugar levels are as follows:
- Between 4.0 to 5.4 mmol/L when fasting
- Up to 7.8 mmol/L 2 hours after eating
For people with diabetes, blood sugar level targets are as follows:
- Before meals : 4 to 7 mmol/L for people with type 1 or type 2 diabetes
- After meals : under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes
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