High Blood Sugar: Hidden Dangers
In the short term, high blood sugar levels can zap your energy, cause excessive thirst and urination, and blur your vision. High blood sugar levels can also lead to dehydration, dry and itchy skin, and infections. Minimizing the time spent above your target blood sugar range can help you feel your best and will help prevent complications and injury to your body.
Over time, high blood sugar affects many parts of the body. Chronic high blood sugar can start to cause noticeable changes, including:
- Memory problems
- Vision problems like blurriness, diabetic retinopathy, and blindness
- Gum disease that leads to tooth loss, which can make eating healthy foods difficult due to problems chewing
- Heart attack and stroke due to increased plaque build-up in the vessels and other vascular issues
- Kidney disease, which can lead to the need for dialysis or a kidney transplant
- Nerve damage that can cause decreased sensation in the feet and legs which increases the risk for wounds to turn into serious infections and even amputation
Nerve damage from high blood sugar can also cause a variety of symptoms including:
- Pain and tingling in the feet and hands
- Difficulty emptying your bladder
- Problems during the digestion process after eating, which can cause food to sit in the stomach too long and lead to nausea, vomiting, and erratic blood sugar levels
Checking your blood sugar frequently and taking immediate action when it is above range can reduce your risk of complications.
High Blood Sugar Causes
You may be thinking that hyperglycemia can happen just from eating a super-sugary food, but its not really as simple as that. Sure, eating a lot of sugar or carbs can elevate your blood sugar level, but thats typically when your pancreas kicks into gear and creates insulin to move that glucose into cells throughout the body.
But when someone has diabetes, this finely tuned system gets thrown out of whack. In type 2 diabeteswhich accounts for 90% to 95% of diabetes in adults, according to the CDCthe body either cant make enough insulin or cant utilize insulin well, according to the NIDDK. If someone has prediabetes, their blood glucose will be higher than normal but not quite in the type 2 diabetes range yet, per the NIDDK. And in type 1 diabetes, the body does not make insulin or makes very little.
In any case, the result is extra sugar hanging around the bloodstream, making you feel like total crap in the short term and putting your health at risk in the long term.
Strategies To Control Blood Sugar
There are steps you can take to control blood sugar every day.
Educate yourself The more you know about type 2 diabetes, the more confident youll feel about diabetes management. That feeling of self-efficacy is linked with better blood sugar control, taking medication as prescribed, and making lifestyle changes such as improving your diet and exercising, researchers reported in the Summer 2014 issue of Ethnicity & Disease.
Test your blood sugar on schedule When researchers followed adults with type 2 diabetes over the course of a year, they found that those who used a structured blood sugar testing approach throughout the day had better blood sugar control than those who did not, according to an October 2013 study published in Diabetes Care. Common times to test your blood sugar include when you first wake up, before and after meals and exercise, and at bedtime. Talk to your doctor about when and how often you should test.
Exercise Physical activity increases insulin sensitivity, which can help control blood sugar. Get at least 30 minutes of moderate exercise at least five days during the week. How to tell if your intensity level is moderate? You should be able to talk but not be out of breath or able to sing out loud, according to the ADA.
Because exercise can lower blood sugar, you should keep a source of fast-acting carbohydrate on hand in case you need to treat hypoglycemia. Test your blood sugar before and after exercise to make sure its in a safe range.
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Why Your Blood Sugar Level May Be High
Based on the ADA guidelines above, if your blood sugar is above 180 mg/dL two hours after a meal, it is considered above the normal range. What might cause your glucose or blood sugar to rise? Consider the following factors:
- Consuming more carbohydrates or a larger meal than usual
- Not taking enough insulin or oral diabetes medication based on carbohydrates or activity levels
- Reduced physical activity
- Side effects from medications like steroids or antipsychotics
Monitor Blood Sugar Levels Closely
High blood sugar levels often do not cause symptoms until they run well over 200 mg/dL. As such, it is essential for a person with diabetes to monitor their blood sugar several times a day. Doing so will mean that blood sugar levels never get that high.
A person with diabetes can use a home glucose monitor to check blood sugar levels. These are available for purchase online.
Recommendations for how frequently to check glucose levels during the day will vary from person to person. A doctor can make the best recommendations regarding blood sugar monitoring to a person with diabetes.
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What Is The Dawn Phenomenon
A rise in blood sugar level between approximately 3 A.M. and the time you get up is called the dawn phenomenon.
The liver is expected to launch just enough glucose to replace what is being used, and insulin works as the messenger to inform the liver how much is enough. However if theres insufficient insulin , or if theres sufficient insulin however it can not communicate its message to the liver , the liver starts to release glucose much too quickly. In addition, levels of hormones such as cortisol begin to increase in the morning hours, which can contribute to altered insulin level of sensitivity.
Mayo Clinic doctor Maria Collazo-Clavell, MD, says prevent carbohydrates at bedtime. She likewise says an insulin pump can assist a lot. You can program it in advance to increase your insulin when the dawn phenomenon starts to begin. You might need to inspect a few middle-of-the-night levels to find out when the phenomenon begins for you, or if you are going too low.
The outcome? Blood glucose levels increase. This is why blood sugar levels can increase in between the time you go to sleep and the time you awaken.
Random Plasma Glucose Test
Random blood sugar testing is used in people who have symptoms of diabetes. A random blood sugar test can be done at any time of day. The test looks at blood sugar without considering your last meal.
No matter when you last ate, a random blood sugar test of 200 mg/dL or above suggests that you have diabetes. This is particularly true if you already have symptoms of diabetes.
Your doctor will go over your results with you. Heres what your test results could mean:
- random blood sugar of 200 mg/dL or more = diabetes
- random blood sugar level between 140 and 199 mg/dL = prediabetes
- random blood sugar less than 140 mg/dL = normal
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Are The Test Results Ever Wrong
Initially, your test results may vary. For instance, a blood sugar test may show that you have diabetes but an A1C test may show that you dont. The reverse can also be true.
How does this happen? It could mean that youre in an early stage of diabetes, and your blood sugar levels may not be high enough to show on every test.
The A1C test can be wrong in some people of African, Mediterranean, or Southeast Asian heritage. The test can be too low in people with anemia or heavy bleeding, and too high in people with iron deficiency anemia. Dont worry your doctor will repeat the tests before making a diagnosis.
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.
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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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Selecting An Insulin Infusion Protocol
Numerous insulin infusion protocols have been published. However, head-to-head comparisons are rare, and efficacy and safety are difficult to determine because of differing patient populations, glycemic targets, metrics for evaluation, and definitions of hypoglycemia used in the various protocols., Selecting a validated protocol allows for more rapid implementation but does not eliminate the need for ongoing safety and effectiveness monitoring and continuous quality improvement.
Some paper protocols are table-based, whereas others require mathematical calculations. The level of clinical judgment and physician oversight also varies among the available protocols. Computerized protocols allow for more complex mathematical calculations and can provide alerts or alarms to remind staff members to check patients’ blood glucose level and adjust infusion rates.
Several studies comparing computerized and paper-based protocols have found improved protocol adherence, improved glycemic control, and less hypoglycemia with computerized protocols. It is worth noting that evaluations of computerized glucose control programs have used glycemic targets that are tighter than currently recommended, and although the percentages of blood glucose readings within the target range were higher than with paper protocols, they still were not optimal in most studies. It is not clear how computerized glucose control programs compare to paper-based protocols when currently recommended targets are used.
Time Your Bolus Insulin Properly
For people who take rapid-acting insulin at mealtimes, the timing of the bolus can have a huge impact on after-meal blood glucose levels. Boluses given too late to match the entry of glucose from dietary carbohydrates into the bloodstream can produce significant blood glucose spikes soon after eating. A properly timed bolus, on the other hand, can result in excellent after-meal control.
Unless you have gastroparesis , it is best to give bolus insulin doses before eating. How long before? It depends mainly on what you are eating and on your pre-meal blood glucose level.
Figuring out the pre-meal blood glucose part is fairly straightforward: the higher your blood glucose, the earlier the bolus should be given. If your pre-meal blood glucose is well above your target, it is best to give the bolus and then wait at least 30 minutes before eating. Near your target blood glucose? Wait 15 minutes. Below target? Either take the bolus and eat right away, or take the bolus after eating to manage high blood glucose.
Does earlier bolusing make a difference? Absolutely. Research has shown that simply giving mealtime boluses before eating rather than after eating can reduce the post-meal spike by about 45 mg/dl.
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Blood Sugar Level 218 Mg/dl
Blood sugar 218 mg/dl and blood sugar 312 mg/dl .Please suggest line of medication to be taken. It is not advisable to seek medications without meeting a doctor in person. A lot of factors need to be considered before deciding on the choice of diabetes medicines. Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The internet is not a doctor and neither are you. Chat with a real doctor about your health. My sugar level is 230 in fasting , how can i control my sugar level, kindly give me advice as soon as pos … Read More I am a diabetic for close to 17 years. My blood sugar levels are normally between 180 and 240(both fastin … Read More What’s the normal fasting blood sugar. My HB1AC was 5.2 fasting blood sugar 104Mean plasma glucose … Read More My fasting blood sugar level came out to be 87mg/dl and my mothers fasting blood sugar level is 98.97. I … Read More He was going on feeling hungry on that particular day, so I felt like checking his sugar level, we have a … Read MoreContinue reading > >
Preventing High Blood Sugars
Everyone with diabetes experiences high blood sugars sometimes there are simply too many variables in the human body out of your control to prevent them altogether.
That being said, there are a few guidelines we can all follow to minimize the frequency of high blood sugars:
- Avoid full-sugar beverages including soda, juice, coffee drinks, iced tea, etc.
- Choose your carbohydrates carefully starchy carbs from pasta, candy, bread, desserts, etc. will spike your blood sugar the most
- Take your medications as prescribed and contact your healthcare team if you miss a dose to determine if you can take it late
- Exercise daily even a 20-minute walk makes a big difference on a daily basis
- Drink plenty of water to prevent dehydration
And of course, if youre experiencing high blood sugars are a daily basis and youre unsure of the cause, talk to your healthcare team about making adjustments in your diabetes management regimen. A slight increase in your medications can have a big impact!
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Keeping Your Levels In Range
If you have diabetes, keeping your blood glucose within normal range after a high-carbohydrate meal can be difficult. The type of carbohydrates you choose can make a difference in your blood sugar. Complex carbohydrates, which must be broken down into simple sugars before your body can absorb them, slow the absorption process and help stabilize your blood sugars. The glycemic index defines carbohydrates by their absorption rate. Carbohydrates with a low glycemic index, less than 45, cause a slow steady rise in blood glucose. Whole grains such as oats, wheat, barley, brown rice and lesser known grains such as quinoa help keep your levels within range. Foods high in fiber, such as whole grains, fruits and vegetables, also slow digestion and help stabilize blood glucose after meals. Exercise can also help slow digestion and stabilize peaks in glucose.
How Does The Screening Work
Your doctor will ask you to take a test called the oral glucose tolerance test. Heres what happens:
When youre screened early, if that screening is normal, you should get screened again around 24 to 28 weeks when insulin resistance from the placental hormones is at its peak, he says.
The placenta is the organ that connects you to your baby to nourish it as it grows. Some hormones that the placenta makes work against the action of the insulin your body makes. As the placenta grows, so does this insulin resistance. In some people, this change is enough to cause the blood sugar level to be increased as it is in people with diabetes.
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Beware Of Low Blood Sugars
Remember, above all else, its very easy to over-treat a high blood sugar and wind up low. Then youll be tempted to binge-eat and wind up high again. This blood sugar roller coaster is exhausting and dangerous, too.
Frequently finding yourself on the blood sugar roller coaster means your approach to taking insulin and/or how you treat low blood sugars isnt working and needs some fine-tuning. Work with your healthcare team to reduce and prevent these wild swings to ensure your overall safety and quality of life!
Who Should Be Treated
One important question that remains unanswered is whether the threshold for treating high blood sugar in pregnancy should be lowered and if so, by how much.
“Because there was a continuous relationship that was even seen in women with glucose levels considered near normal, this study isn’t very helpful for trying to pinpoint where the cutoff should be,” Coustan says.
In an editorial accompanying the study, diabetes researchers Jeffrey Ecker, MD, and Michael Greene, MD, of Harvard Medical School, conclude that the current evidence does not support lowering the threshold for gestational diabetes diagnosis and treatment.
While women in the HAPO trial with higher blood sugar levels also had higher rates of delivering high birth-weight babies, they also gave birth to fewer babies who were small for their gestational age.
Continued
And while C-section rates increased with increasing blood sugar in the HAPO study, the increase was modest. Treatment to lower blood sugar levels was found to have no impact on C-section deliveries in a similar study of pregnant women with high-normal blood sugar.
“Until trials show clinical benefits for expanding the diagnostic criteria for ‘gestational diabetes,’ we would not favor any change,” Ecker and Greene write.
Next month, an internationally representative group of diabetes, pregnancy, and public health experts will meet in Pasadena, Calif., to make their own assessment.
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