For most people, blood glucose levels that stay higher than 140 mg/dL (before meals) are too high. Talk with your health care team about the glucose range that is best for you. Eating too much food, being less active than usual, or taking too little diabetes medicine are some common reasons for high blood glucose (or hyperglycemia). Your blood glucose can also go up when you’re sick or under stress. Over time, high blood glucose can damage body organs. For this reason, many people with diabetes try to keep their blood glucose in balance as much as they can.

Some people with type 2 diabetes may not feel the signs of high blood glucose until their blood glucose is higher than 300. People with blood glucose higher than 300 are more likely to have dehydration. Dehydration can become a serious problem if not treated right away. Your blood glucose is more likely to go up when you’re sick—for example, when you have the flu or an infection. You’ll need to take special care of yourself during these times. 

Signs of High Blood Glucose

Some common signs of high blood glucose are having a dry mouth, being thirsty, and urinating often. Other signs include feeling tired, having blurred vision, and losing weight without trying. If your glucose is very high, you may have stomach pain, feel sick to your stomach, or even throw up. This is an emergency and you need to go to the hospital right away.

If you have any signs that your blood glucose is high, check your blood. In your logbook or on your record sheet, write down your glucose reading and the time you did the test. If your glucose is high, think about what could have caused it to go up. If you think you know of something, write this down beside your glucose reading.

Preventing High Blood Glucose

Keep a balance

Try to stay with your food and activity plan as much as you can. Drink water. Take your diabetes medicine about the same time each day. Work with your health care team to set goals for weight, blood glucose level, and activity.

Test your blood glucose

Keep track of your blood glucose and go over your records often. You’ll learn how certain foods or activities affect your glucose. Show your records to your health care team. Ask how you can change your food, activity, and medicine to avoid or treat high blood glucose. Ask when you should call for help.

Taking Care of Yourself When You’re Sick

Keep Taking Medicine

Be sure to keep taking your diabetes pills or insulin. Don’t stop taking them even if you can’t eat. Your health care provider may even advise you to take more insulin during sickness.

Keep Eating

Try to eat the same amount of fruits and breads as usual. If you can, eat your regular diet. If you’re having trouble doing this, use carbohydrate choices or servings: eat enough soft foods or drink enough liquids to take the place of the fruits and breads you usually eat.

Drink Liquids

Drink extra liquids. Try to drink at least 1/2 cup (4 ounces) to 3/4 cup (6 ounces) every half-hour to hour, even if you have to do this in small sips. These liquids should not have calories. Water, diet soda pop, or tea without sugar are good choices.

Check for Changes

• Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
• Check your temperature every morning and evening. A fever may be a sign of infection.
• Every 4 to 6 hours, check how you’re breathing and decide how alert you feel. Having trouble breathing, feeling more sleepy than usual, or not thinking clearly can be danger signs.

Call for Help

Ask your health care provider when you should call. During your sick times, you may need to call every day for advice. You should call your health care provider or go to an emergency room if any of the following happens:

• You feel too sick to eat normally and for more than 6 hours can’t keep food or liquids down.
• You have severe diarrhea (loose bowel movement).
• You lose 5 pounds or more without trying to.
• Your temperature is over 101°F.
• Your blood glucose level is lower than 60 mg/dL or stays over 300 mg/dL.
• You’re having trouble breathing.
• You feel sleepy or can’t think clearly.

In general, a blood glucose reading lower than 70 mg/dL is too low. If you take insulin or diabetes pills, you can have low blood glucose (also called hypoglycemia). Low blood glucose is usually caused by eating less or later than usual, being more active than usual, or taking too much diabetes medicine. Drinking beer, wine, or liquor may also cause low blood glucose or make it worse.

Low blood glucose happens more often when you’re trying to keep your glucose level near normal. This is no reason to stop trying to control your diabetes. It just means you have to watch more carefully for low levels. Talk this over with your health care team.

Signs of Low Blood Glucose

Some possible signs of low blood glucose are feeling nervous, shaky, or sweaty. Sometimes people just feel tired.

The signs may be mild at first. But a low glucose level can quickly drop much lower if you don’t treat it. When your glucose level is very low, you may get confused, pass out, or have seizures.

If you have any signs that your glucose may be low, test it right away. If it’s less than 60 to 70 mg/dL, you need to treat it right away. 

Treating Low Blood Glucose

If you feel like your blood glucose is getting too low but you can’t test it right then, play it safe go ahead and treat it. Eat 10 to 15 grams of carbohydrate right away.

Check your blood glucose again in 15 minutes. Eat another 10 to 15 grams of carbohydrate every 15 minutes until your blood glucose is above 70 mg/dL.

Tell family members, close friends, teachers, and people at work that you have diabetes. Tell them how to know when your blood glucose is low. Show them what to do if you can’t treat yourself. Someone will need to give you fruit juice, soda pop (not diet), or sugar.

If you can’t swallow, someone will need to give you a shot of glucagon and call for help. Glucagon is a prescription medicine that raises the blood glucose and is injected like insulin. If you take insulin, you should have a glucagon kit handy. Teach family members, roommates, and friends when and how to use it.

Waiting to treat low blood glucose is not safe. You may be in danger of passing out. If you get confused, pass out, or have a seizure, you need emergency help. Don’t try to drive yourself to get help. Be prepared for an emergency.

There’s good news for people with diabetes.

Studies show that keeping your blood glucose (also called blood sugar) close to normal helps prevent or delay some diabetes problems. Through careful control, many problems such as eye disease, kidney disease, heart disease, nerve damage, and serious foot problems can be prevented or slowed. People who have type 1 diabetes as well as people who have type 2 diabetes can benefit by keeping their blood glucose levels closer to normal.

Keeping a Balance

As the turtle makes steady progress, so too must those with diabetes continue to maintain healthy lifestyles and stick to daily routines that involve regular exercise, good nutrition, glucose monitoring, and regular visits to health care providers. To keep your glucose at a healthy level, you need to keep a balance between three important things:

• What you eat and drink.
• How much physical activity you do.
• What diabetes medicine you take (if your doctor has prescribed diabetes pills or insulin).

A Few Things About Food

Here are some tips for making healthy eating choices:

1. Eat regular meals. Ask your health care team to help you choose a meal plan. Your dietitian may suggest you eat three meals and a snack or two every day at about the same times. Eating every 4 to 5 hours can help control blood sugar.

2. Eat a variety of foods. Choose a variety of foods to eat so that your body gets the nutrition it

3. Eat less fat. Avoid fried foods. Foods that are baked, broiled, grilled, boiled, or steamed are

more healthy to eat. Eat meats that have little fat. When you eat dairy products (cheese, milk, yogurt, and others), choose those that have little or no fat or cream.

4. Eat less sugar. You may find that eating less sugar helps you control your blood glucose level.

Here are some things you can do to eat less sugar:

• Eat more high-fiber foods, like vegetables, dried beans, fruit, and whole grain breads and cereals.
• Drink water and other drinks that have no added sugar.
• Eat fewer foods that have extra sugar, such as cookies, cakes, pastries, candy, brownies, and sugared breakfast cereals.
• Talk with your health care team about ways to sweeten food and drinks without using sugar.

5. Eat less salt. Eating less salt may help control your blood pressure. Here are some ways to eat

less salt:

• Use less salt when you prepare foods.
• Cut down on processed foods, such as foods you buy in cans and jars, pickled foods, lunch meats (“cold cuts”), and snack foods, such as chips.
• Taste your food first before adding salt. You may not need to add any.
• Use herbs and spices instead of salt to flavor your food.

6. A word about drinking alcohol: Alcohol can cause health problems, especially for people with diabetes. It adds calories and doesn’t give your body any nutrition. Drinking alcohol may cause dangerous reactions with medicines you take. Your blood glucose can go down too low if you drink beer, wine, or liquor on an empty stomach. If you want to include a drink in your food plan once in a while, ask your health care team how to do so safely.

A Few Things About Physical Activity

1. It’s important to be active. Physical activity has many benefits. It can help you control your blood glucose and your weight. Physical activity can help prevent heart and blood flow problems. Many people say they feel better when they get regular exercise.
2. Start with a little. If you haven’t been doing any physical activity, talk to your health care team before you begin. Walking, working in the yard, and dancing are good ways to start. As you become stronger, you can add a few extra minutes to your physical activity. If you feel pain, slow down or stop and wait until it goes away. If the pain comes back, talk with your health care team right away.
3. Do some physical activity every day. It’s better to walk 10 or 20 minutes each day than one hour once a week.
4. Choose an activity you enjoy. Do an activity you really like. The more fun it is, the more likely you will do it each day. It’s also good to exercise with a family member or friend.

If you’re already active now, but want to become more active, talk to your health care team about a

safe exercise plan.