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MANAGING HIGHS AND LOWS OF BLOOD GLUCOSE LEVELS

 

Disclaimer - This content has been created for information purposes only, please consult your doctor before taking any decision on diabetes management. Although great care has been taken in compiling and checking the information, Johnson and Johnson Ltd., and its associates shall not be responsible, or in any way liable for any errors, omissions or inaccuracies in this publication whether arising from negligence or otherwise however, or for any consequence arising there from.

Hyperglycemia (high blood glucose level)

Hyperglycemia is blood glucose levels that rise above the Diabetes Safe Zone. The American Diabetes Association defines hyperglycemia as blood glucose levels over 130 mg/dL(7.2 mmol/L).

Detecting high blood glucose

If you are on insulin it is also important to watch out for high blood glucose (also known as hyperglycemia), which increases your risk of complications, such as heart attack. Self-monitoring of blood glucose (SMBG) is often the only sure way to detect hyperglycemia.

For most people, keep blood glucose levels-


Before meals One to two hours after meal
below 130 mg/dl (7.2mmol/L) below 180 mg/dl (10mmol/L)

Your own blood glucose targets need to be carefully individualized. Please check with your personal physician on what blood glucose target values are right for you and your condition.

Regular monitoring helps you spot patterns to try to avoid high and low blood glucose, reduce complications of diabetes, and help control your diabetes.

Spot high glucose results when you're on insulin

Let's look at situations that may cause high blood glucose and how planning ahead may help you prevent highs and lows.

Plan ahead and be prepared for high fasting results

If you have high fasting results, you may have:

  1. Missed your evening dose of insulin

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    Plan: Keep your insulin kit by your bedside and post reminder notes

  2. Used a new insulin or new dosage or your insulin needs to be adjusted

    how to reduce blood sugar

    Plan: Self-monitor before injecting. Follow up the next morning with a fasting blood glucose test.

  3. Experienced Dawn phenomenon or rebound hyperglycemia. Sometimes the liver releases too much glucose in the early morning hours when your blood glucose is at its lowest or when low blood glucose occurs in the middle of the night. Your doctor may need to adjust your insulin or other medications.

    Blood Sugar Levels

    Plan: If you wake up sweating and get a high result, add a 2 a.m. self-monitoring blood glucose test to help your doctor determine if you need an insulin adjustment.

If you have high blood glucose on other occasions:
  • Illness or stress
    Plan: Take care of health and see a doctor.
  • Eaten too much
    Plan: Self-monitor and adjust meal plans.

Hypoglycemia(low blood glucose level)

Hypoglycemia5 is blood glucose levels that fall into the low side of the Diabetes Danger Zone (less than 70 mg/dL (3.9 mmol/L).

Detecting low blood glucose

Taking insulin sometimes puts you at risk for hypoglycemia or low blood glucose. The American Diabetes Association defines hypoglycemia as blood glucose levels less than 70 mg/dL (3.9 mmol/L). If left untreated, hypoglycemia can result in unconsciousness or even a coma. Be extra careful and stay prepared.

Regular monitoring helps you spot patterns to try to avoid high and low blood glucose, reduce complications of diabetes, and help control your diabetes.

Be prepared for hypoglycemia
  • Self-monitor blood glucose. It's the only way to know for certain if your glucose is too low.
  • Self-monitor before you inject insulin. Insulin lowers your blood glucose level and you want to make sure your glucose doesn't fall too low overnight.
  • Learn to recognize the signs and symptoms. Common symptoms include feeling shaky, sweaty or dizzy; clumsiness; confusion; changes in mood.
  • Know how to bring your glucose back into the Diabetes Safe Zone. If you are hypoglycemic, follow your doctor's instructions. Record the event on a log sheet with the time, test result, and what you think caused it. Share these details with your doctor.
Confirm a plan with your doctor or talk about a general action plan, such as:

If your result is low, the 15 x 15 method can help.

  1. Eat 15 grams of sugar.
  2. Self-monitor blood glucose 15 minutes later.
  3. If your result is still low, repeat steps 1 and 2.

When you start injecting insulin ask your doctor what blood glucose targets are right for you and how to treat high or low blood glucose.

Have a plan for low blood glucose

Let's look at situations that may cause low blood glucose. In all cases, be sure to keep a record of your self-monitoring results to share with your doctor. Always carry hard candies or a snack in case of low blood glucose.

Low fasting results
  1. Using a new insulin OR a new dosage
    Plan: Be sure to self-monitor before injecting. Follow up the next morning with a fasting SMBG.
  2. Using too much insulin
    Plan: Inject only the amount of insulin your doctor instructed.
  3. Forgot to eat a scheduled snack the night before
    Plan: Keep a packaged snack on your bedside table.
  4. Drank alcohol the night before. Sometimes alcohol in the evening will cause a low result either before or after breakfast.
    Plan: When you drink alcohol, be sure to eat some carbohydrates too.
Low results during the day
  1. An unexpected energetic event (running for a bus or a long workday)
    Low Sugar Levels
    Plan: Be watchful of changes in your daily schedule.
  2. A new exercise routine
    Diabetes Levels
    Plan: Self-monitor blood glucose before exercise and 2 hours after to see how it affects your glucose. If the activity is long or intense, test during exercise.
  3. Missed or delayed meals
    Normal Blood Sugar Level
    Plan: Try eating small meals with mid-day snacks to keep your medication and glucose levels balanced. Avoid eating too much carbohydrate in a single meal because this may cause high glucose results.