Managing High and Low Blood Sugar With Diabetes
Here’s how to prevent hypoglycemia and hyperglycemia.
If you have diabetes, you know that keeping your blood sugar within a healthy range is important. You may also know that your blood sugar levels may rise (hyperglycemia) or fall (hypoglycemia), depending on what you eat, your physical activity levels, your medication doses, and other factors, such as whether you’re sick with a cold or other infection. The key to keeping blood sugar under control is to be able to identify symptoms of low and high blood sugar, and have a plan of action to get your levels stable again.
What Is Low Blood Sugar and What Are the Symptoms?
Low blood sugar, or hypoglycemia, is when your blood glucose measures less than 70 mg/dL. This can happen if you don’t eat enough or wait too long between meals, exercise without eating, take too much medicine (insulin or certain diabetes pills), or drink too much alcohol.
Symptoms of low blood sugar can vary from person to person, but some early signs may be:
- feeling excessively hungry
- sweating a lot
- feeling anxious or worried
- heart palpitations
- tremors
How Should You Treat Low Blood Sugar?
If you have low blood sugar, the first thing you should do is look for something sweet to drink, like orange juice. “It’s the fastest way to get sugar into your system,” says Sandra Arévalo, RDN, CDE.
Fast-acting carbohydrate sources (15 g):
- 3 to 4 glucose tablets
- milk (8 oz) or juice (4 oz)
- a spoonful of sugar or honey (1 Tbsp)
- a couple spoonfuls of raisins (2 Tbsp)
- 6 to 8 hard candies
Follow the 15/15 Rule for Low Blood Sugar
A good way to make sure you blood sugar has returned to a healthy level without going too high is to apply the 15/15 rule, or eating 15 grams of carbs and checking your blood sugar after 15 minutes. If your blood glucose is 51 to 70 mg/dL, eat 10 to 15 grams of a fast-acting carbohydrate. If it’s less than 50 mg/dL, eat 20 to 30 grams.
What Is High Blood Sugar and What Are the Symptoms?
High blood sugar (hyperglycemia) is when your blood sugar exceeds 160 to 250 mg/dL, or your individual blood glucose target. This can happen if you didn’t give yourself enough insulin (type 1) or your body isn’t using it properly (type 2). Hyperglycemia can also occur if you ate too much, are stressed or sick, or if you experienced the dawn phenomenon (a surge of hormones that the body produces daily around 4:00 a.m.).
Symptoms of high blood sugar also vary, and some people may actually not feel any symptoms of hyperglycemia. Common signs may include:
- increased thirst
- frequent urination
- dry, itchy skin
- weight loss
- fatigue
- blurry vision
- headache
- feeling nauseous or faint
How Is High Blood Sugar Treated?
A great way to remedy high blood sugar is to exercise. However, if your blood glucose exceeds 240 mg/dL, you should check your urine first for ketones. If ketones are present, don’t exercise—doing so may actually cause your blood sugar go higher.
You can also treat your high blood sugar with insulin, if you take it. It’s also important to stay hydrated and watch your diet to make sure you’re not eating too many carbohydrates.
How Should You Prevent High and Low Blood Sugar?
The best way to keep your levels under control is to practice good diabetes management and check your blood sugar regularly. It’s also important to know the early symptoms so you can stop hyperglycemia or hypoglycemia in its tracks and, importantly, prevent it from getting worse.
Dr. Sood is a board-certified endocrinologist in private practice in New York City and an assistant professor at Hofstra School of Medicine.
Sonal ChaudhryDr. Chaudhry is an endocrinologist at NYU Langone Health in New York City.
Sandra ArevaloSandra Arevalo is a spokesperson for the American Association of Diabetes Educators and Academy of Nutrition and Dietetics and director of nutrition services and community outreach at South Bronx Health Center.
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The main goal is to stabilize the blood
glucose levels, the blood sugar levels,
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to get them as close to normal as possible
without creating low blood sugars.
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And then also to lower their risk of
complications from high blood sugars.
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Hypoglycemia is when your blood glucose
measures less than 70 mg per deciliter.
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Symptoms of hypoglycemia may be anxiety,
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palpitations, tremors,
feeling excessively hungry or sweaty.
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Those are some earlier
symptoms of low blood sugar.
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I try not to be afraid of lows.
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And trust me, I have had some scary
ones in my house at night all by
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myself.
First thing that you have to do when
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you have hypoglycemia,
is to look for something to drink.
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And I am saying drink because it is
fastest way to get sugar into your
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system.
There are different ways to treat low
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blood sugar, so
the 15-gram glucose tablets.
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Also 4 oz of juice or 8 oz of milk.
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If you have access to a tablespoon of
honey or sugar, that'll work as well,
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or a couple of tablespoons of raisins.
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The 15 minute rule is what helps you
treat hypoglycemic events correctly.
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You wait 15 minutes,
then you check your blood sugars again.
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If they are already on the rise,
wait a little bit,
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check in another 15 minutes.
Hyperglycemia is when your blood
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sugar exceeds 200 to 250.
The symptoms of high blood sugar vary
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a lot, as a matter of fact, there
are people who don't even feel a thing.
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People usually feel very tired,
very thirsty, they have to go to
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the bathroom a lot, they might start
having blurry vision, itching in the skin.
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It's like the skin
starts getting very dry.
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If the sugars are very, very high they
kind of start losing weight as well.
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Eating a lot,
is like this uncontrollable hunger.
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So high blood sugar,
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if you take insulin,
can treated with insulin.
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If you don't take insulin, you wanna
make sure that you stay hydrated,
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that you take your diabetic
medication as you should.
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That you perhaps eat fewer carbs,
or sugars, and may exercise.
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Where I continue to be challenged, and
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where I continue to work is how can I
make those decisions ahead of time so
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that I don't get to a high blood sugar or
a low blood sugars.
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