Hyperosmolar Hyperglycemic Nonketotic Syndrome : A Complication Of Severe Hyperglycemia In Type 2 Diabetes
In people with type 2 diabetes, extreme hyperglycemia can lead to a very rare but serious condition called hyperosmolar hyperglycemic nonketotic syndrome, or HHNS). HHNS is most likely to occur when you’re sick particularly if you aren’t able to drink enough fluids or keep fluids down. It happens most often in elderly people and, like ketoacidosis, can result in a coma.
Normal Blood Sugar Ranges In Healthy Non
For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal. Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.
Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:
- Fasting blood sugar : under 100 mg/dL
- 1 hour after a meal: 90 to 130 mg/dL
- 2 hours after a meal: 90 to 110 mg/dL
- 5 or more hours after eating: 70 to 90 mg/dL
What If Your Morning Blood Sugar Level Is High
Due to certain hormonal changes, it is quite natural to have a relatively higher blood sugar levels in the morning. If you do not have diabetes, your body will produce enough insulin to bring your blood sugar back to normal again. It may not happen though if you have diabetes.
Your blood glucose levels may stay elevated because of insulin resistance, which refers to a condition in which your body’s fat cells and muscles fail to use insulin effectively. The condition also affects the function of your liver and changes the way it processes and releases sugar, especially at night.
The situation is different when you have type-2 diabetes because the liver starts releasing more glucose than is needed into your blood. It means that your hormones are causing your blood sugar to go up and your liver is also making things worse by releasing more sugar into your system. This leads to a spike in blood sugar levels that stay elevated unless you pay attention to your diet and exercise. You may also have to take medications to manage your blood sugar better.
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How Can You Control Your Morning Blood Sugar Levels
Still, if you want to try and control your morning fasting blood sugar level, you should stick to following habits
- Do some moderate-intensity exercise or a brisk walk in the evening
- Have your last meal of the day before 7:30 pm
- Avoid grains in dinner
- Mix 2 tsp of Apple cider vinegar with 20 tsp of water and drink it
- Consume at least 50% greens, including raw and cooked in your dinner
- Climb stairs after dinner
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.
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Fasting Plasma Glucose Test
A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.
The NICE guidelines regard a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes.
Low Blood Sugar Symptoms
Hypoglycemia happens when blood glucose levels drop too low. Low blood sugar can be caused by many things including the two different types of diabetes, certain medications, alcohol, endocrine disorders, eating disorders, pregnancy , and disorders of the liver, kidneys, or heart.
Here are some of the most common symptoms that someone with low blood sugar might experience:
- Tingling lips
If your blood sugar is low you might start to feel some of the first signs of hypoglycemia like dizziness, lightheadedness, or sweating. The only way to know for sure if your blood sugar is low is to test it with a glucose meter or other glucose monitoring device.
If you dont have access to these tools and start to feel the symptoms of low blood sugar, consume 15 grams of carbs or take a quick dissolve glucose tablet to raise your blood sugar levels and avoid further symptoms, according to the American Diabetes Association . Once your blood sugar is back in its target range, you can have a snack or meal to make sure it doesnt drop again.
Here are some other lifestyle and medicinal treatments that can help treat hypoglycemia:
- Eat a healthy diet full of whole foods that are minimally processed.
- Take prediabetes or diabetes medications as recommended by your healthcare provider.
- Use a glucagon kit in emergencies. Glucagon is a hormone that raises blood sugar levels quickly.
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What Is The Normal Range For Blood Sugar Levels And What Blood Sugar Level Constitutes A True Emergency
Dr. Horton answers the question: ‘Normal Range For Blood Sugar Levels?’
— Question:What is the normal range for blood sugar levels, and what blood sugar level constitutes a true emergency?
Answer:Now, in a normal individual we measure blood sugar under different circumstances. What we call fasting blood sugar or blood glucose levels is usually done six to eight hours after the last meal. So it’s most commonly done before breakfast in the morning and the normal range there is 70 to 100 milligrams per deciliter.
Now when you eat a meal, blood sugar generally rises and in a normal individual it usually does not get above a 135 to 140 milligrams per deciliter. So there is a fairly narrow range of blood sugar throughout the entire day.
Now in our diabetic patients we see both low blood sugar levels that we call hypoglycemia, or elevated blood sugars, hyperglycemia. Now, if the blood sugar drops below about 60 or 65 milligrams per deciliter, people will generally get symptoms, which are some shakiness, feeling of hunger, maybe a little racing of the heart and they will usually be trenchant or if they eat something, it goes away right away. But if blood sugar drops below 50 and can get down as low as 40 or 30 or even 20, then there is a progressive loss of mental function and eventually unconsciousness and seizures. And of course that is very dangerous and a medical emergency.
Do You Have To Fast For An A1c Blood Test
Unlike the fasting plasma glucose and the OGTT tests, there is no need to fast before having the A1C test. If A1C test results indicate a person has or might have diabetes, a healthcare provider might suggest one of these tests to confirm the results. Another test, the random plasma glucose test, which does not require fasting, can also be used. If the results are borderline or if the results of the different tests do not match, a doctor might suggest repeating the test in several weeks or months.
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Achieving Normal Fasting Glucose Level
The very first thing is to watch out the figures lower than 70 mg/dl. In case you’ve been experiencing more than two episodes of low figures then you should consult your doctor.
The most probable cause include medicine you are taking and diet you’re following. And that should be corrected to keep glucose level under control.
Trying to achieve normal fasting glucose level means you must work hard on it and never surrender.
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How Can I Treat High Blood Sugar
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
- Be more active. Regular exercise can help keep your blood sugar levels on track. Important: dont exercise if ketones are present in your urine. This can make your blood sugar go even higher.
- Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
- Follow your diabetes meal plan. Ask your doctor or dietitian for help if youre having trouble sticking to it.
- Check your blood sugar as directed by your doctor. Check more often if youre sick or if youre concerned about high or low blood sugar.
- Talk to your doctor about adjusting how much insulin you take and what types of insulin to use.
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Can You Have High A1c And Not Be Diabetic
According to one 2009 study, 3.8% of people without a history of diabetes have an elevated A1C level . This group is more likely to have other risk factors for Type 2 diabetes and cardiovascular disease. Researchers found that the following groups were more likely to have an elevated A1C without having a diagnosis of diabetes:
- Higher C-reactive protein levels
A high A1C result might signal that there is a problem. Even a modest increase in your blood sugar, above normal levels, can increase your risk of heart disease, even when you dont have full-blown diabetes, says Dr. Bellatoni. A physician can review test results and talk to patients about risk factors and lifestyle changes to improve blood sugar levels.
A Warning Of Developing Type 2 Diabetes
Impaired fasting glycaemia is sometimes called pre-diabetes. This is when blood glucose levels in the body are raised, but are not high enough to mean that the person has diabetes. IFG means that the body isnt able to use glucose as efficiently as it should. This is because a layer of fat around the cells of the body, prevents insulin doing its job and taking the glucose into the cells of the body where its needed for energy. This situation is reversible by losing weight and hence the fat around the cells disappears. If you dont lose weight however, is it unlikely that you wont eventually develop Type 2 Diabetes.
IFG has no symptoms and can often go undiagnosed for years. Although there are no symptoms, many people diagnosed with IFG are overweight. Nine out of 10 people with IFG have high blood pressure, raised cholesterol levels or a family history of the condition.
IFG can lead to the development of type 2 diabetes. People with IFG are five to 15 times more likely to develop type 2 diabetes than people with normal glucose levels. However, this isnt inevitable. You can take steps to reduce the chances of this happening. People with IFG also have a slightly increased risk of heart disease and stroke.
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The 411 On A1c: Normal A1c Levels And 15 Ways To Lower High A1c
The hemoglobin A1C test is the closest thing to a diabetes scorecard you can find. Whether someone has had diabetes mellitus for years or if they have just been diagnosed, they have probably heard about this test. Unlike blood sugar meters people use at home, the A1C measures an average blood sugar level over the past several months by analyzing how many of a patients hemoglobin cells have glucose attached to them. The test results keep track of how well a person is managing his or her diabetes.
Fasting & Elevated Blood Glucose
Type 2 diabetes for 20+ years. Started keto with intermittent fasting in January 2019. Why would my fasting blood glucose numbers during my 18-24-hour fast be elevated, then come down to normal ranges after eating?
Fasting can definitely raise blood glucose. This is due to the effect of insulin falling and the rising counter-regulatory hormones including increased sympathetic tone, noradrenaline, cortisol and growth hormone, in addition to glucagon. These all have the effect of pushing glucose from liver storage into the blood. This is normal. If you are not eating, you want to use some stored glucose. The question is this if you are not eating, and your blood glucose went up, where did that glucose come from? It can only have come from your own body . So, its a natural phenomenon, and the fasting now allows your body to use some of the glucose for energy.
Dr. Jason Fung
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Does Blood Sugar Level Change With Age
Many factors changes with age and even sometimes co-morbidities gets added. To adopt with these certain conditions, optimum levels of different substances in blood also changes. So the same goes for the blood sugar. It has been confirmed by different studies that fasting blood sugar level increases with age considering different factors like obesity.
But, now the question comes, how much increment will be considered as normal? Obviously not random! It has a specific level but the increment varies depending on various conditions.
It is said that the ideal level of blood sugar increases with the passing of decade through your adult years due to benign physiological changes which decrease the glucose tolerance.
Basically, if you are quite healthy then, 2mg per 100 ml rise is considered as normal through the advancing years. But this issue is seen to bewilder both clinicians and investigations alike.
However, this small extent is only for fasting. Besides this, you may notice that your postprandial sugar levels are also escalating. Be conscious! Because it must not increase more than 4mg per 100ml. Again, sugar level may elevate up to 8 to 13mg per 100 ml per decade following a glucose challenge.
The above-mentioned levels are for those who are comparatively healthy and are not suffering from any other disease apart from diabetes.
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.
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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Recommended Blood Sugar Targets
For people with type 1 diabetes, the American Diabetes Association recommends that blood sugar targets be based on a personâs needs and goals. Talk to your doctor and diabetes educator about these goals. A general guideline is:
Before meals, your blood sugar should be:
- From 90 to 130 mg/dL for adults
- From 90 to 130 mg/dL for children, 13 to 19 years old
- From 90 to 180 mg/dL for children, 6 to 12 years old
- From 100 to 180 mg/dL for children under 6 years old
After meals , your blood sugar should be:
- Less than 180 mg/dL for adults
At bedtime, your blood sugar should be:
- From 90 to 150 mg/dL for adults
- From 90 to 150 mg/dL for children, 13 to 19 years old
- From 100 to 180 mg/dL for children, 6 to 12 years old
- From 110 to 200 mg/dL for children under 6 years old
For people with type 2 diabetes, the American Diabetes Association also recommends that blood sugar targets be individualized. Talk to your doctor and diabetes educator about your goals.
In general, before meals, your blood sugar should be:
- From 70 to 130 mg/dL for adults
After meals , your blood sugar should be:
- Less than 180 mg/dL for adults
What Is Fasting Blood Sugar
As the name suggests, fasting blood sugar is the amount of sugar present in your blood after fasting . During these fasting hours, you cannot eat or drink anything except water. The normal range of fasting blood sugar levels varies from 70-100mg/dl. If your blood sugar level is more than this then you may have diabetes.
Fasting sugar is preferred by doctors as it is a reliable number compared to non-fasting sugar levels. After eating different types of food, our blood sugar level fluctuates differently. So, doctors, may not get a correct picture of your blood sugar level. Your doctor may also ask for fasting sugar levels to calculate your insulin resistance.
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Still Frustrated With Your Blood Sugar And A1c Results
Your blood sugars and your insulin or medication needs never stay in one place. If you gain weight or lose weight, your insulin and medication needs will change. If you become more active or less active, your needs will change. If you make drastic or even small changes to your nutrition, your needs will change!
Working with your diabetes healthcare team, and diabetes coaches who can teach you how to make changes in your overall diabetes management plan are essential. Diabetes is a lifelong learning process.
Take a deep breath and be patient. If you dont like what youre seeing on your glucose meter, dont get madget studying! Take good notes and work with your team to make changes to reach your goals.
Read more about improving your A1c in DiabetesStrongs guide, How to Lower Your A1c.
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