Insulin Safety Center

What Can Go Wrong?

Sometimes your blood sugar may get too low or too high. If your blood sugar becomes too low it can be very dangerous.

To Prevent Dangerous Low Blood Sugar, Here Are Some Important Tips:

Self-monitor your blood sugar level. Monitoring your blood sugar levels is important to understanding your diabetes and preventing complications. The results of your blood sugar level can detect if your blood sugar is too high or too low. It can also help you and your doctor understand how insulin, physical activity, and the foods you eat impact your blood sugar. 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 for the results.
A Flash Glucose Monitor (FGM). A FGM is a small wearable device that uses a sensor placed on the back of the upper arm and a reader that scans 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.

Make sure you know the clues for 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.

Make sure friends and family also know the clues for low blood sugar. When your blood sugar gets too low, you may be too confused to 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 clues of low blood sugar (see above), take action!

Follow the "Rule of 15"

If you experience the above symptoms and your blood sugar falls below 70 (mg/dL) follow the “15- 15” rule:

The rule is to consume 15 grams of carbohydrates and wait 15 minutes. After the 15 minutes recheck your glucose. If your blood sugar is still low (< 70 mg/dL), consume another 15 grams of carbohydrates. Repeat the process until your blood sugar is above 70 mg/dL.

Examples of 15 grams of Carbohydrates:

- 8 ounces of whole milk
- ½ Can of regular soda (NOT diet soda)
- A glass of orange juice
- 1 Tablespoon of honey (NOT teaspoon, you want the big spoon)
- 5 to 6 Lifesaver (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 as your insulin dosage may need to be readjusted.

High blood sugar

High blood sugar can be very dangerous also. It may take a long time for you to notice the bad effects of high blood sugar, or you may start to feel sick right away.

Effects of high blood sugar

Emergency or acute high blood sugar: If not treated with diet, exercise, and medicine, high blood sugar can lead to "diabetic coma" 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.

To prevent dangerous high blood sugar, check your blood sugar often. Watch out for clues of high blood sugar such as:

High blood sugar clues include:          
• 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)          
• Increased blood sugar level

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.

Make sure friends and family also know the clues for high blood sugar. When your blood sugar gets too high, you may be too confused 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 (see above), take action!

Take action:

• CONTACT your doctor if high blood sugar becomes a recurring event as your insulin dosage may need to be readjusted.

• Develop an action plan for high blood sugar. This includes knowing how much extra insulin to take based on the blood sugar number.

IMPORTANT RESOURCE FROM THE AMERICAN DIABETES ASSOCIATION: DIABETES ALERTS
Download these free diabetes medical cards from the American Diabetes Association. Keep them with you or your vehicle so that they are available in case of emergency. The wallet or identification cards notify others you are diabetic and could be experiencing symptoms of very low or very high blood glucose.