Topic OverviewDiabetes-related blood sugar levelsWhen you have diabetes, you may have high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) from time to time. A cold, the flu, or other sudden illness can cause high blood sugar levels. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. Insulin and some types of diabetes medicines can cause low blood sugar levels. Show
Learn how to recognize and manage high and low blood sugar levels to help you avoid levels that can lead to medical emergencies, such as diabetic ketoacidosis or dehydration from high blood sugar levels or loss of consciousness from severe low blood sugar levels. Most high or low blood sugar problems can be managed at home by following your doctor's instructions. You can help avoid blood sugar problems by following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise. Home blood sugar testing will help you determine whether your blood sugar is within your target range. If you have had very low blood sugar, you may be tempted to let your sugar level run high so that you do not have another low blood sugar problem. But it is most important that you keep your blood sugar in your target range. You can do this by following your treatment plan and checking your blood sugar regularly. Sometimes a pregnant woman can get diabetes during her pregnancy. This is called gestational diabetes. Blood sugar levels are checked regularly during the pregnancy to keep levels within a target range. Children who have diabetes need their parents' help to keep their blood sugar levels in a target range and to exercise safely. Be sure that children learn the symptoms of both high and low blood sugar so they can tell others when they need help. There are many support groups and diabetes education centres to help parents and children understand about blood sugar, exercise, diet, and medicines. Teens especially may have a hard time keeping their blood sugar levels in control because their bodies are growing and developing. Also, they want to be with their friends and eat foods that may affect their blood sugar. Having diabetes during the teenage years is not easy. But your teen is at an excellent age to understand the disease and its treatment and to take over some of the responsibilities of his or her care. If your blood sugar level reads too high or too low but you are feeling well, you may want to recheck your sugar level or recalibrate your blood glucose meter. The problem may be with either your blood sample or the machine. High blood sugar (hyperglycemia)High blood sugar occurs when the sugar (glucose) level in your blood rises above your target range. Eating too many calories, missing medicines (insulin or pills), or having an infection or illness, injury, surgery, or emotional stress can cause your blood sugar to rise. High blood sugar usually develops slowly over a period of hours to days. But missing a dose of insulin can cause a rapid rise in blood sugar levels. Blood sugar levels just above your target range may make you feel tired and thirsty. If your blood sugar level stays higher than your target range for weeks, your body will adjust to that level, and you may not have as many symptoms of high blood sugar. Unless you don't monitor your blood sugar regularly or you don't notice the symptoms of high blood sugar, you usually will have time to treat high blood sugar so that you can prevent high blood sugar emergencies. Three things can help you prevent high blood sugar problems:
Complications of high blood sugar can cause serious problems, including coma and death. Over time, high blood sugar can damage your eyes, heart, kidneys, blood vessels, and nerves. Low blood sugar (hypoglycemia)Low blood sugar occurs when the sugar (glucose) level in your blood drops below what your body needs. Not eating enough food or skipping meals, taking too much medicine (insulin or pills), exercising more than usual, or taking certain medicines that lower blood sugar can cause your blood sugar to drop rapidly. Do not drink alcohol if you have problems recognizing the early signs of low blood sugar. People who lose weight or develop kidney problems may not need as much insulin or other medicines as they did before they lost the weight or developed kidney problems. Their blood sugar may drop too low. Be sure to check your blood sugar often when your body goes through changes. When your blood sugar level drops below 4.0 millimoles per litre (mmol/L), you will usually have symptoms of low blood sugar. This can develop quickly, in 10 to 15 minutes.
You may have symptoms of low blood sugar if your blood sugar drops from a high level to a lower level. For example, if your blood sugar level has been higher than 17.0 mmol/L for a week or so and the level drops suddenly to 5.0 mmol/L, you may have symptoms of low blood sugar even though your blood sugar is in the target range. But if you have had diabetes for many years, you may not have symptoms of low blood sugar until your blood sugar level is very low. If your doctor thinks you have low blood sugar levels but you are not having symptoms, he or she may ask you to check your blood sugar more often. Your doctor may ask you to check your blood sugar in the middle of the night or to do a 3-day test using a continuous glucose monitor. Check Your SymptomsHow old are you? Less than 3 years Less than 3 years 3 years or older 3 years or older Are you male or female?
Did you pass out completely (lose consciousness)? If you are answering for someone else: Is the person unconscious now? (If you are answering this question for yourself, say no.) Are you back to your normal level of alertness? After passing out, it's normal to feel a little confused, weak, or light-headed when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do. Yes Has returned to normal after loss of consciousness No Has returned to normal after loss of consciousness Did the loss of consciousness occur during the past 24 hours? Yes Loss of consciousness in past 24 hours No Loss of consciousness in past 24 hours Do you have a plan for dealing with low blood sugar? If you haven't used your plan or don't have one, take steps to get your blood sugar back up. Yes Has plan for managing low blood sugar No Has plan for managing low blood sugar Are your symptoms: It may take up to 30 minutes after you eat a quick-sugar food before you can tell how it is affecting your blood sugar. Getting worse? Symptoms are getting worse Staying the same (not worse or better)? Symptoms are the same Getting better? Symptoms are getting better Are you concerned that you are having episodes of low blood sugar more often than in the past? Yes Increased episodes of low blood sugar No Increased episodes of low blood sugar Are the symptoms severe, moderate, or mild? Severe Severe dehydration Moderate Moderate dehydration Are you having trouble drinking enough to replace the fluids you've lost? Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids. Yes Unable to maintain fluid intake No Able to maintain fluid intake Has there been a decrease in how alert or aware you are or how well you can think and respond? Yes Decreased level of consciousness No Decreased level of consciousness Do you have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness Is your blood sugar high? If you are an adult, is your blood sugar >34 mmol/L? If you are younger than 18, is your blood sugar >14 mmol/L? Be sure to double-check a high blood sugar. If it's not higher than the number given for your age group but you're worried about it anyway, answer yes. Yes Blood sugar over 34 mmol/L No Blood sugar over 34 mmol/L Yes Symptoms of diabetic ketoacidosis No Symptoms of diabetic ketoacidosis Does your urine contain a moderate to large amount of ketones? Ketones are a sign that your blood sugar is getting out of control. There is a urine test for ketones that you can do at home. Yes Moderate to large amount of ketones in urine No, or you haven't tested your urine Less than moderate amount of ketones in urine (or has not tested urine) Yes Symptoms of infection Do you have a plan for dealing with high blood sugar? Yes Has plan for managing blood sugar No Has plan for managing blood sugar Is the plan helping get your blood sugar under control? Yes Plan is helping get blood sugar under control No Plan is helping get blood sugar under control Are you concerned that you are having episodes of high blood sugar more often than in the past? Yes Increased episodes of high blood sugar No Increased episodes of high blood sugar Have you been sick with anything worse than a cold for more than 2 days? Yes Sick for more than 2 days No Sick for more than 2 days Are you concerned about how to keep your blood sugar in the target range? Yes Concerns about managing blood sugar No Concerns about managing blood sugar Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Symptoms of serious illness may include:
Symptoms of serious illness in a baby may include the following:
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For example:
Severe dehydration means:
Moderate dehydration means:
Mild dehydration means:
Severe dehydration means:
Moderate dehydration means:
Mild dehydration means:
Early symptoms of low blood sugar may include:
If blood sugar continues to drop, you may start to have more severe symptoms. You can test for ketones at home using special tablets or test strips. Ketones are substances made by the body when it burns fat instead of sugar. They are a sign that your blood sugar is out of control. To do the urine test:
Some home blood sugar meters can also measure blood ketones. You use the same finger-prick method that you use to measure blood sugar. Symptoms of infection may include:
Symptoms of diabetic ketoacidosis may include:
Here is what you can do to treat low blood sugar. If at any point during these steps you think you are getting worse, seek care immediately.
Seek Care TodayBased on your answers, you may need care soon. The problem probably will not get better without medical care.
Call 911 NowBased on your answers, you need emergency care. Call 911 or other emergency services now. Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.
Make an AppointmentBased on your answers, the problem may not improve without medical care.
Home TreatmentManage your blood sugar levelWhen you have diabetes, whether it is type 1 diabetes, type 2 diabetes, or gestational diabetes, one of the most important skills you will learn is how to manage your blood sugar level. Following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise will help you avoid blood sugar problems. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. It may be hard for a parent of a young child to distinguish the difference between high and low blood sugar symptoms in a child. When you have learned to recognize high or low blood sugar levels, you can take the appropriate steps to bring your blood sugar level back to your target blood sugar levels. People who keep their blood sugar levels under control with diet, exercise, or oral diabetes medicines are less likely to have problems with high or low blood sugar levels. Do not drink alcohol if you have problems recognizing the early signs of low blood sugar. Learn how to deal with high blood sugar levelsBe sure to know the steps for dealing with high blood sugar and how fast your insulin medicine will work to bring your blood sugar down. Some insulins work very fast while regular insulin takes a little longer to bring the sugar level down. Knowing how fast your insulin works will keep you from using too much too quickly. Learn how to deal with low blood sugar levelsBecause you have diabetes and can have low blood sugar levels, you need to keep some glucose or sucrose tablets or solution or quick-sugar food with you at all times. These can quickly raise your blood sugar level. Be sure to check your blood sugar level 15 minutes after eating a quick-sugar (carbohydrate) food to make sure your level is getting back to your target range. If you continue to have low blood sugar, take another 15 grams of carbohydrate. When your blood sugar gets to 4.0 mmol/L or higher, you can eat your normal meals and snacks. Eat a small snack if your next meal or snack is more than one hour away. Quick sugar foods to help raise blood sugarfootnote 1
It is important to know that sugar foods like a candy bar or ice cream do not help raise low blood sugar levels quickly, because these foods also have fat and protein. So the body can't use the sugar (carbohydrate) in these foods quickly to raise the blood sugar level. You can get low blood sugar from using too much insulin or from other medicines you take. Parents need to help their child learn to treat a low blood sugar level. Pregnant women who have gestational diabetes also need to know how to deal with a low blood sugar level. Since low blood sugar levels can quickly become a medical emergency, be sure to wear medical identification, such as a medical alert bracelet, to let people know you have diabetes so they can get help for you. If you have severe symptoms of low blood sugar, someone else may need to give you a shot of glucagon. If this occurs, be sure to call your doctor immediately to let him or her know this has happened. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home treatment:
PreventionTake steps to control your blood sugar levelAlthough high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) have very different symptoms and treatments, they are both caused by blood sugar and insulin imbalances. The steps you take to control your blood sugar level will help prevent both high and low blood sugar levels. Be sure to have identification that says you have diabetes, such as a medical alert bracelet, with you at all times. This will help other people take steps to care for you if you are not able tell them about your medical condition. You can take steps to prevent high and low blood sugar emergencies.
Monitoring and controlling blood sugar levelsUse home blood sugar tests to determine whether your blood sugar is in your target range. Work with your doctor to set your individual treatment goals. If you can consistently maintain this level of control, you will have very few blood sugar level emergencies. Parents can help their child learn how to prevent low blood sugar levels and high blood sugar levels. Control stressNo matter how skilled you are at monitoring and controlling your blood sugar levels, you are still at risk for high or low blood sugar levels that are brought on by stressful situations. Stress can affect your body's blood sugar levels in two ways:
Stress can be both mental and physical. Some examples of stress include an illness, a bad day at work, and a tough problem at home. When you are under stress, your blood sugar levels change. For more information, see the topic Stress Management. Blood sugar levels and exerciseYou can keep your blood sugar levels under control when you exercise, so that you do not become too hungry or make your blood sugar level drop. There are two ways to keep your blood sugar levels under control:
Keep a quick-sugar food with you during exercise in case your blood sugar level drops low. VaccinationsYour doctor may recommend that you get vaccinations, such as a flu vaccine or pneumococcal vaccine, to prevent you from those illnesses. Other places to get helpDiabetes Canada has a lot of information on diabetes and can link you to support groups. For more information, call 1-800-BANTING (1-800-226-8464) or see the organization's website: www.diabetes.ca. Preparing For Your AppointmentQuestions to prepare for doctor appointmentYou can help your doctor treat your condition by being prepared to answer the following questions:
Be sure to take your daily blood sugar (glucose) monitoring logbook to your appointment. If you have specific records of your high and low blood sugar problems, be sure to take those records. Parents will also need to keep records of their child's high or low blood sugar problems to share with their child's doctor. References
CreditsAdaptation Date: 4/28/2022 Adapted By: HealthLink BC Adaptation Reviewed By: HealthLink BC Do Diabetics have high blood sugar?Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes.
Do Type 2 diabetics have high or low blood sugar?Type 2 diabetes is a condition that involves high blood glucose or blood sugar. The pancreas makes insulin, a hormone that enables cells to take glucose from the bloodstream for energy. In type 2 diabetes, the cells do not respond normally to insulin, called insulin resistance.
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