Think About What’s Going On
Irene Dunbar of Durham, NC, woke up one morning to discover that her blood sugar was at 119, which was high for her. “I had a cold and had had orange juice yesterday, and I normally do not drink orange juice,” Dunbar said, who also thought, “I better not do that.”
Sometimes, determining the cause of an elevated level may make you feel like a detective. But it’s important to ask yourself questions about potential causes, such as diet and exercise habits, changes in your treatment plan, or personal life adjustments. Determining the answers to these questions can help pinpoint what might be going wrong, according to MedlinePlus.
Its All About Balance Moderation And Consistency
The sugar high is all fun and games until the resulting sugar crash affects the quality of your day.
The term refers to the sudden drop in energy levels after consuming a large amount of carbohydrates. This can include pastas and pizza but is usually more common after eating simple carbohydrates, also known as simple sugars, such as desserts.
A sugar crash often causes undesired symptoms that can disrupt productivity and energy levels throughout the day.
Kelsey Herrick, senior dietitian at Sanford Health, suggests balance, moderation and consistency are the most effective ways to avoid these crashes. Herrick shares her knowledge on sugar crashes, how to avoid them and what to do if you get one.
Managing Your Diabetes Devices
If you are using an insulin pump, talk to your diabetes team about how to best manage hyperglycemia. In general, be sure to check your pump first. Make sure all parts are connected and working correctly. Check your bolus history and temporary basal rate. Also check your insulin to make sure it has not expired or gotten too warm.
If you use a CGM, try not to react to it too often. You might be tempted to give another dose of insulin too soon, before the first one finishes working, which is known as stacking insulin this can cause low blood sugar .
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Focus On Overall Diet Quality
Studies show that improving overall diet quality can help minimize cravings for sugary foods and enhance cravings for healthier foods.
For example, eating fewer foods high in added sugar like ice cream, cake, and cookies and increasing your intake of nutrient-dense foods like beans, vegetables, fish, and whole fruits may help reduce your reliance on added sugar and help you crave healthier foods.
Severe Low Blood Sugar
As your low blood sugar gets worse, you may experience more serious symptoms, including:
- Having difficulty walking or seeing clearly.
- Acting strange or feeling confused.
- Having seizures.
Severe low blood sugar is below 54 mg/dL. Blood sugar this low may make you faint . Often, youll need someone to help you treat severe low blood sugar.
People with diabetes may experience low blood sugar as often as once or twice a week, even when managing their blood sugar closely. Knowing how to identify and treat it is important for your health. Learn how to treat low blood sugar.
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Symptoms Of High Blood Sugar
Learning to recognize the symptoms of hyperglycemia can help you successfully manage your diabetes.
Some people with diabetes immediately feel the symptoms of high blood sugar. Others dont because their symptoms are mild or vague.
Symptoms of hyperglycemia typically begin when your blood glucose goes above per deciliter . Symptoms can worsen the longer its untreated.
Symptoms of a blood sugar spike may include:
- frequent urination
You’re Thirsty And Moody
Did you know that thirst is one of the signs of high blood sugar? If your body starts to dehydrate due to the increased blood glucose levels in your system, it’s going to signal for you to drink more water. This can mean feeling thirsty, even if you’ve just had a full bottle of water. Along with this sudden increased thirst, those who suffer from high blood sugar often feel grumpy or irritable.
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Causes Of Low Blood Sugar
There are many reasons why you may have low blood sugar, including:
- Taking too much insulin.
- Not eating enough carbs for how much insulin you take.
- Timing of when you take your insulin.
- The amount and timing of physical activity.
- Drinking alcohol.
- How much fat, protein, and fiber are in your meal.
- Hot and humid weather.
- Unexpected changes in your schedule.
- Spending time at a high altitude.
- Going through puberty.
Signs Of A High Blood Sugar Emergency
If high levels of blood sugar arent treated, you can develop a life-threatening complication called diabetic ketoacidosis . The conditionwhich is more common in type 1 diabetescan cause a build-up of ketone, a type of acid, in your blood.
Sometimes, DKA can be the first sign of diabetes for those who have not yet been diagnosed.
DKA can develop slowly at first, with its initial symptoms including:
- Muscle aches and stiffness
Left untreated DKA, can result in coma or death.
High blood sugar levels mixed with dehydration can also lead to hyperglycemic hyperosmolar state . HHS is more common among people with type 2 diabetes who have had an infection of some kind, such as pneumonia or a urinary tract infection.
HHS can present as extremely high blood sugars with fever, confusion, or weakness or paralysis on one side of the body. Immediate treatment is necessary to prevent serious consequences.
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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.
What To Think About When Your Blood Sugar Is High
High blood sugar can harm you. If your blood sugar is high, you need to know how to bring it down. If you have diabetes, here are some questions to ask yourself when your blood sugar is high:
- Are you eating right?
- Are you eating too much?
- Have you been following your diabetes meal plan?
- Did you have a meal or a snack with a lot of carbohydrates, starches, or simple sugars?
Are you taking your diabetes medicines correctly?
- Has your doctor changed your medicines?
- If you take insulin, have you been taking the correct dose? Is the insulin expired? Or has it been stored in a hot or cold place?
- Are you afraid of having low blood sugar? Is that causing you to eat too much or take too little insulin or other diabetes medicine?
- Have you injected insulin into a scar or overused area? Have you been rotating sites? Was the injection into a lump or numb spot under the skin?
What else has changed?
To prevent high blood sugar, you will need to:
- Follow your meal plan
- Take your diabetes medicines as instructed
You and your doctor will:
- Set a target goal for your blood sugar levels for different times during the day. This helps you manage your blood sugar.
If your blood sugar is higher than your goals over 3 days and you don’t know why, check your urine for ketones. Then call your health care provider.
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You’re Feeling Anxious And Irritable
This typically shows up as a result of changes in hormone levels within your body which the extra glucose in your body can cause.
Low serotonin levels are often responsible for feelings like this, so if you notice yourself becoming more emotional than usual, it could also mean something is wrong with your insulin balance even though it’s not always easy to tell what these changes will lead to at first because they happen gradually over time.
People who have diabetes tend to experience mood disorders such as depression and anxiety much more frequently than those who do not and other mental health issues, including memory loss and further cognitive declines.
Symptoms Of Low Blood Sugar
How you react to low blood sugar may not be the same as how someone else with low blood sugar reacts. Its important to know your signs. Common symptoms may include:
If youve had low blood sugar without feeling or noticing symptoms , you may need to check your blood sugar more often to see if its low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.
You may not have any symptoms when your blood sugar is low . If you dont have symptoms, it will be harder to treat your low blood sugar early. This increases your risk of having severe lows and can be dangerous. This is more likely to happen if you:
- Have had diabetes for more than 5-10 years.
- Frequently have low blood sugar.
- Take certain medicines, such as beta blockers for high blood pressure.
If you meet one or more of the above and you have hypoglycemia unawareness, you may need to check your blood sugar more often to see if its low. This is very important to do before driving or being physically active.
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How Do You Feel When You Are Diabetic
Frequent urination, increased thirst, feeling weary and hungry, eyesight issues, poor wound healing, and yeast infections are some of the early signs and symptoms. If you aren’t checking your blood sugar levels regularly, you could be at risk for serious complications such as blindness or amputation.
Diabetes can affect your physical health in many ways, including causing wounds to heal slower, increasing your risk of developing heart disease, and causing certain organs to fail. Emotional effects include anxiety, depression, and a decreased sense of well-being. In fact, research shows that people with diabetes have higher rates of anxiety and depression than those who don’t have the disease.
Psychological effects include anxiety, depression, and a decreased sense of well-being.
Physical effects include damage to nerves, kidneys, lungs, blood vessels, eyes, and skin. Diabetic nerve damage may lead to pain, sensitivity to heat and cold, and loss of feeling in the feet. Kidney damage may cause excess urine to flow into the bladder , decrease in kidney function , or require surgery .
Is Hyperglycaemia Serious
The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you’re likely to experience hyperglycaemia at some point.
It’s important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated.
Occasional mild episodes aren’t usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods.
Very high blood sugar levels can cause life-threatening complications, such as:
- diabetic ketoacidosis a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma this tends to affect people with type 1 diabetes
- hyperosmolar hyperglycaemic state severe dehydration caused by the body trying to get rid of excess sugar this tends to affect people with type 2 diabetes
Regularly having high blood sugar levels for long periods of time can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.
If you experience hyperglycaemia regularly, speak to your doctor or diabetes care team. You may need to change your treatment or lifestyle to keep your blood sugar levels within a healthy range.
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About High Blood Sugar
High glucose levels occur when the body doesn’t have enough insulin or can’t properly use the insulin it has to shuttle glucose from the bloodstream to the bodys muscles, organs, and tissues for fuel, ONeill says. As a result, the amount of sugar in the blood builds up.
Hyperglycemia typically happens when you consume more carbohydrates or bigger portions of food than usual if you don’t take enough insulin or other diabetes medication as prescribed and if you decrease your levels of physical activity, she says. Heightened stress levels can also increase blood sugar levels. Non-diabetes-related medications that are known to raise blood sugar levels include steroids, beta-blockers, birth control pills, and many mental health medications, she explains.
Signs of high blood sugar include frequent urination, fatigue, dry or itchy skin, feeling thirsty, more frequent infections, and eating more food but not gaining as much weight as usual, says Athena Philis-Tsimikas, MD, the corporate vice president for the Scripps Whittier Diabetes Institute in La Jolla, California.
High blood sugar levels can cause these symptoms through various mechanisms, according to the Mayo Clinic. For example, high blood sugar levels damage blood vessels and nerves throughout the body. They can also deprive organs of energy and can cause fluid to accumulate in the eyes. And in an attempt to get your blood sugar to a healthier level, your body will often increase urine output.
How Do I Treat Hyperglycemia
You can often lower your blood glucose level by exercising. However, if your blood glucose is above 240 mg/dl, check your urine for ketones. If you have ketones, do not exercise.
Exercising when ketones are present may make your blood glucose level go even higher. You’ll need to work with your doctor to find the safest way for you to lower your blood glucose level.
Cutting down on the amount of food you eat might also help. Work with your dietitian to make changes in your meal plan. If exercise and changes in your diet don’t work, your doctor may change the amount of your medication or insulin or possibly the timing of when you take it.
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How Is Hyperglycemia Diagnosed
If you have diabetes and notice a sudden change in your blood sugar levels during your home monitoring, you should alert your doctor of your symptoms. The increase in blood sugar may affect your treatment plan.
Regardless of whether you have diabetes, if you begin experiencing any symptoms of hyperglycemia, you should speak to your doctor. Before going to your appointment, you should note what symptoms youre experiencing. You should also consider these questions:
- Has your diet changed?
- Have you had enough water to drink?
- Are you under a lot of stress?
- Were you just in the hospital for surgery?
- Were you involved in an accident?
Once at your doctors appointment, your doctor will discuss all of your concerns. Theyll perform a brief physical exam and discuss your family history. Your doctor will also discuss your target blood sugar level.
If youre age 59 or younger, a safe blood sugar range is generally between 80 and 120 milligrams per deciliter . This is also the projected range for people who dont have any underlying medical conditions.
People who are age 60 or older and those who have other medical conditions or concerns may have levels between 100 and 140 mg/dL.
Your doctor may conduct an A1C test to determine what your average blood sugar level has been in recent months. This is done by measuring the amount of blood sugar attached to the oxygen-carrying protein hemoglobin in your red blood cells.
You Have Bad Breath And Dry Mouth
An unusual smell when you breathe in through your mouth might indicate that something is wrong with the way glucose moves throughout your system. This can cause a buildup in ketone levels within your blood, giving off an unpleasant odor, much like nail polish remover or acetone.
Sometimes people mistake this for regular bad breath, but if it happens frequently and seems to have no other cause, it could be a sign that your insulin balance is out of whack, so make sure to see a doctor as soon as possible if you notice this happening.
Gum disease is also a frequent problem for people with diabetes, so if you notice that your gums are inflamed or swollen, it might be a sign that blood sugar is starting to rise. The dry mouth associated with this problem can lead to the development of cavities and other dental issues, so make sure you’re drinking enough water throughout the day as well as brushing after meals if necessary.
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When To See A Dermatologist
Diabetes can cause many other skin problems. Most skin problems are harmless, but even a minor one can become serious in people who have diabetes. A board-certified dermatologist can recognize skin problems due to diabetes and help you manage them.
Are all dermatologists board certified?
No. See what it takes to become board certified.
ImagesImage 1: Image Courtesy of Clark C. Otley, MD. All Rights Reserved
Images 3, 7, 8, 9: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Image 2 from DermNetNZ
Some images used with permission of Journal of the American Academy of Dermatology
Images 5, 6 and 10: Getty Images
ReferencesCohen Sabban, EN. Cutaneous manifestations of diabetes mellitus from A to Z. Focus session presented at: 74th Annual Meeting of the American Academy of Dermatology March 4-8, 2016 Washington D.C.
Duff M, Demidova O, et al. Cutaneous manifestations of diabetes mellitus. Clinical Diabetes. 2015 33:40-8.
Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:1461-70.
McKinley-Grant L, Warnick M, et al. Cutaneous manifestations of systemic disease. In: Kelly AP and Taylor S. Dermatology for Skin of Color. . The McGraw-Hill Companies, Inc. China, 2009:481-4.