Sometimes your blood sugar may get too low or too high. When this happens, you may feel different. For example, if your blood sugar becomes too low, you may feel shaky, nauseous, tired, or feel your heart beating fast. If your blood sugar is too high, you may be very thirsty, have to urinate more than usual, and become very tired. However, sometimes people do not realize their blood sugar is low or high. If left untreated, both situations can be very dangerous and can result in more serious health problems. So, it is important to do the following:
Monitor your blood sugar level. Monitoring your blood sugar levels is important to help you and your doctor understand your diabetes and prevent complications. The amount of insulin you take, how much food you eat, and how physically active you are can all affect your blood sugar levels. The results of your blood sugar level will let you know if your blood sugar is too high or too low. You can test your blood sugar at home using:
• A blood sugar meter. A blood sugar meter, often called a glucometer, uses a small drop of blood obtained by pricking the fingertip. The blood sample is placed on a strip and inserted into the device which provides the result in less than a minute.
• A flash glucose monitor (FGM). A FGM is a small wearable device that uses a sensor placed on the back of the upper arm. A reader (a special device) is used to scan the sensor to obtain the glucose reading.
• A continuous glucose monitor (CGM). A CGM is a small medical device that continuously measures your blood glucose levels. It uses a tiny sensor inserted under your skin that wirelessly transmits the data to a handheld device, an app on your phone, or an insulin pump.
If you are manually checking your blood sugar levels or using a FGM, your doctor will instruct you on how often and when you should do your testing.
Know the signs of low blood sugar. Usually, blood sugar is TOO LOW if it is less than 70 (mg/dL). Clues of low blood sugar include: irritability, shaky hands, being tired, confusion, blurred vision, heart racing, sweating.
Educate friends and family about the signs of low blood sugar. When your blood sugar gets too low, you may be too confused to realize what is happening or remember what to do. It's important that friends and family know when you need help fixing low blood sugar.
If your blood sugar is less than 70 (mg/dL), or if you have signs of low blood sugar, take action!
If you are having symptoms of low blood sugar and your blood sugar level falls below 70 (mg/dL) follow the “15- 15” rule:
The rule is to consume 15 grams of carbohydrates and wait 15 minutes. After 15 minutes, recheck your blood sugar. If your blood sugar is still low (< 70 mg/dL), eat another 15 grams of carbohydrates and wait 15 minutes. Repeat the process until your blood sugar is above 70 mg/dL.
Examples of 15 grams of carbohydrates:
- 8 ounces of whole milk
- 6 ounces of regular soda (NOT diet soda)
- 5 ounces of orange juice
- 1 tablespoon of honey (NOT teaspoon, you want the big spoon)
- 5 to 6 Lifesavers (or any type of candy, NOT sugar-free candy)
- 3 glucose (sugar) tablets (available at any drug store/pharmacy)
- 1 tube of glucose gel
CONTACT your doctor if low blood sugar becomes a recurring event; the amount of insulin you take may need to be changed.
High blood sugar can also be very dangerous. It may take a long time for you to notice the signs of high blood sugar, or you may start to feel sick right away. High blood sugar can occur suddenly or it can have effects over time.
• Emergent or acute high blood sugar. If you have diabetes, there may be times when your blood sugar suddenly gets high. For example, if you get the flu or a stomach "bug" it may affect your blood sugar levels. If your blood sugar is too high it can lead to confusion, unconsciousness, and death.
• Long-Term effects of high blood sugar. If not treated with diet, exercise, and medicine, high blood sugar can lead to heart disease, kidney disease, worsening vision, blindness, loss of feeling in hands and feet, impaired healing of cuts and wounds, tingling and damaged nerves, change in bowel movements and constipation.
Know the signs of high blood sugar.
• Drowsy, sleepy, tired
• Flushed skin
• Fruit-like breath odor
• Frequent urination
• Dry mouth, dry skin
• Loss of appetite, stomachache, nausea, vomiting
• Trouble breathing (rapid and deep)
Your blood sugar level is too high if:
• Your fasting blood sugar level is above 130-140 mg/dL
• Your blood sugar is above 180 mg/dL 2 hours after a meal, and the proper insulin has been taken
Educate friends and family about the signs of high blood sugar. When your blood sugar gets too high, you may be too confused to realize what is happening or to remember what to do. It's important that friends and family know when you need help fixing high blood sugar.
If your blood sugar is greater than 130-140 (mg/dL), or if you have clues of high blood sugar, take action!
• Contact your doctor if your high blood sugar does not go down or if you have an illness (flu). Your doctor may need to adjust your insulin.
• Develop an action plan for high blood sugar. This includes knowing how much extra insulin to take based on the blood sugar number. Your doctor should give you instructions to follow if your blood sugar is too high.
IMPORTANT RESOURCE FROM THE AMERICAN DIABETES ASSOCIATION: DIABETES ALERTS
Download these free diabetes medical cards from the American Diabetes Association. Keep them with you so that they are available in case of emergency. This includes keeping them in your house, letting family and friends know where they are (or give a copy to them), keeping one in your wallet and/or in your car. Bring one with you when you travel. These cards are great for emergencies and will let others know you have diabetes and could be experiencing symptoms of very low or very high blood sugar.
