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Symptoms of High Blood Sugar
High blood sugar (hyperglycemia) is most often seen in people who have diabetes that isn’t well controlled. The symptoms of high blood sugar can be mild, moderate, or severe.
Mild high blood sugar
If your blood sugar levels are consistently higher than your target range (usually 200 milligrams per deciliter (mg/dL) to 350 mg/dL in adults and 200 mg/dL to 240 mg/dL in children), you may have mild symptoms of high blood sugar. You may urinate more than usual if you are drinking plenty of liquids. Some people who have diabetes may not notice any symptoms when their blood sugar level is in this range. The main symptoms of high blood sugar are:
- Increased thirst.
- Increased urination.
- Weight loss.
- Increased appetite.
Young children are unable to recognize symptoms of high blood sugar. Parents need to do a home blood sugar test on their child whenever they suspect high blood sugar.
If you don’t drink enough liquids to replace the fluids lost from high blood sugar levels, you can become dehydrated. Young children can become dehydrated very quickly. Symptoms of dehydration include:
- A dry mouth and increased thirst.
- Warm, dry skin.
Moderate to severe high blood sugar
If your blood sugar levels are consistently high (usually above 350 mg/dL in adults and above 240 mg/dL in children), you may have moderate to severe symptoms of high blood sugar. These symptoms include:
- Blurred vision.
- Extreme thirst.
- Flushed, hot, dry skin.
- Restlessness, drowsiness, or difficulty waking up.
If your body produces little or no insulin (people with type 1 diabetes and some people with type 2 diabetes), you also may have:
- Rapid, deep breathing.
- A fast heart rate and a weak pulse.
- A strong, fruity breath odor.
- Loss of appetite, belly pain, and/or vomiting.
If your blood sugar levels continue to rise, you may become confused and lethargic. You also may become unconscious if your blood sugar levels are very high.
Causes, Risk Factors, Treatment & Prevention
What is a diabetic coma?
Diabetic coma is a life-threatening emergency that can happen to you if you have diabetes. In a diabetic coma, you’re unconscious and unable to respond to your environment. You’re either suffering from high blood glucose (hyperglycemia) or low blood glucose (hypoglycemia). You need immediate medical attention if you go into a diabetic coma.
Symptoms and Causes
What are the causes of diabetic coma?
Diabetic coma is mainly caused by an extremely high or low blood sugar level. One of these conditions is diabetic hyperosmolar syndrome. It happens in people with Type 2 diabetes. If you develop this condition:
- Your blood sugar could be as high as 600 mg/dL.
- Your urine won’t contain ketones usually.
- Your blood will be much thicker than normal.
Another condition is diabetic ketoacidosis, which is more common in people with Type 1 diabetes. Things to know about this condition include:
- It could happen with a blood sugar as low as 250 mg/dL or even lower in some cases.
- Your body uses fatty acids instead of glucose for fuel.
- Ketones develop in your urine and bloodstream.
What are the symptoms of diabetic coma?
The following symptoms are your body’s warning signs that your blood sugar (glucose) is too high or too low.
Whenever you have these symptoms, check your blood sugar. If it is too high or too low, treat it according to your healthcare provider’s instructions to prevent a diabetic coma. If you have had diabetes for a long time, you may fall into a coma without showing any of the symptoms.
Some symptoms of hyperglycemia (high blood glucose) are:
- Abdominal pain.
- Shortness of breath.
- Increased urination.
- Weak pulse.
Other symptoms of high blood sugar include:
- Walking unsteadily.
- Increased thirst.
- Rapid heart rate.
- Dry mouth.
- Fruity smell to your breath.
Low blood glucose (hypoglycemia) also has signs and symptoms. These include:
- Weakness and tiredness.
- Fast breathing.
- Shakiness, nervousness and/or anxiety.
- Confusion and problems communicating.
- Light-headedness, dizziness.
When blood sugar is too low, the brain doesn’t receive enough fuel. This can be caused by:
- Drinking too much alcohol.
- Eating too little.
- Exercising too much.
- Taking too much insulin.
What are the risk factors for diabetic coma?
While anyone who has diabetes is at risk for a diabetic coma, the causes depend on the type of diabetes:
- People with Type 1 diabetes have a greater chance of going into a diabetic coma as a result of diabetic ketoacidosis or hypoglycemia. This is because people with Type 1 diabetes always need insulin and have a wider range in their blood glucose levels than people with Type 2 diabetes.
- People with Type 2 diabetes have a greater chance of going into a diabetic coma from diabetic hyperosmolar syndrome than from diabetic ketoacidosis or hypoglycemia.
Other risks that can lead to diabetic coma in anyone who has diabetes include:
- Insulin delivery problems.
- Poor diabetes management.
- Drinking alcohol.
- Skipping doses of insulin.
- Using illegal substances.
What are the complications of diabetic coma?
Complications of a diabetic coma include permanent brain damage and death.
Diagnosis and Tests
When is it necessary to call a doctor if you have diabetes?
Call a healthcare provider in the following situations:
- If you have diabetes and your blood sugar is 300 mg/dL or higher two times in a row for an unknown reason.
- If you have a low blood sugar (less than 70 mg/dL) that has not come up after three treatments, call your healthcare provider or 911.
- If you see a person with diabetes who appears confused, they may be having a low blood sugar episode. Left untreated, the low blood sugar could lead to a diabetic coma. If the person is still able to follow instructions, give him or her something to drink or eat and call for an ambulance or 911.
- If you see someone with diabetes become unresponsive, call 911.
If you do call 911, let the responders know that the person has diabetes if they’re not able to communicate. If you do have diabetes, you may want to wear a medical identification item like a bracelet or necklace.
When you are taken to a healthcare facility, providers will do a physical examination and take blood to determine levels of glucose, ketones and other substances.
Management and Treatment
How is diabetic coma treated?
If you go into a diabetic coma, you need treatment immediately. You’re at risk for brain damage or death if there is any delay in responding.
If your blood sugar is too high, you’ll receive:
- Intravenous fluids.
- Supplements of phosphate, sodium, and potassium.
If your blood sugar is too low, you will receive:
- Glucagon (a hormone to increase blood sugar).
- Intravenous fluids.
- 50% dextrose solution.
Can a diabetic coma be prevented?
You can help yourself prevent a diabetic coma by taking steps to keep your blood sugar in the target ranges. Meeting with a Certified Diabetes Educator (CDE) is an important part of understanding how to care for your diabetes. The CDE will help you be aware of symptoms for high and low blood sugar levels and how best to manage your condition.
It’s also important for your family, friends and coworkers to understand how to help you if you need help. Let them know about the symptoms of high and low blood sugar.
In terms of food and drink, here are some tips for preventing diabetic coma:
- Learn about foods that affect your blood sugar and the best meal plan for you.
- Don’t skip meals.
- Keep treatment for a low blood sugar with you at all times (example: four glucose tabs, a small juice box, or five Life Savers®).
- Avoid drinking too much alcohol.
- Ask your healthcare provider to prescribe a glucagon kit and teach a support person how to use it in case you ever have severe low blood sugar.
These are other recommendations to help you manage your blood glucose levels:
- Check and record blood sugar levels at the times recommended by your healthcare provider.
- Follow instructions for proper dosage and timing of medications and insulin.
- Learn how different types of exercise affect your blood sugar.
- Check your urine for ketones when blood sugar levels are high.
- Ask your healthcare provider when and how you should test for ketones.
- Check urine ketones when you have symptoms of diabetic ketoacidosis (DKA).
- Consider using a continuous glucose monitor that sends an alert if sugar levels are too low or too high.
- Learn how to manage stress.
- Wear a medical identification necklace or bracelet to alert first responders that you have diabetes.
Causes, Symptoms and Treatment Options
Medically reviewed by Drugs.com. Last updated on May 10, 2021.
What is Diabetic Ketoacidosis?
Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness.
To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don’t produce enough insulin and must inject it daily.
Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don’t have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or keto acids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations.
In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death.
Ketoacidosis is always accompanied by dehydration, which is caused by high levels of glucose in the blood. Glucose builds up in the blood if there is not enough insulin to move glucose into your cells. During an episode of ketoacidosis, it is common for blood sugar to rise to a level over 400 milligrams per deciliter. When blood sugar levels are so high, some sugar “overflows” into the urine. As sugar is carried away in the urine, water, salt and potassium are drawn into the urine with each sugar molecule, and your body loses large quantities of your fluid and electrolytes, which are minerals that play a crucial role in cell function. As this happens, you produce much more urine than normal. Eventually it may become impossible for you to drink enough fluids to keep up with amounts that you urinate. Vomiting caused by the blood’s acidity also contributes to fluid losses and dehydration.
People with type 1 diabetes are at risk of diabetic ketoacidosis. If you have type 1 diabetes, ketoacidosis can occur because you have stopped taking your insulin injections or because your insulin dose is too low. It can be triggered by an infection or severe physical stress, such as an injury or surgery, because your body can need more insulin than usual during these stresses.
Ketoacidosis is less likely to occur in people with type 2 diabetes. In most people who have type 2 diabetes, blood insulin levels usually do not get low enough to signal the liver to make ketones.
In about 25% of children with diabetes, symptoms from ketoacidosis are the first sign that they have diabetes.
Symptoms of diabetic ketoacidosis include:
- Frequent urination
- Extreme thirst
- Dry mouth
- Cool skin
- Nausea and vomiting with or without abdominal pain
As blood ketone levels increase, the person’s breathing pattern may become slow and deep, and his or her breath can have a fruity odor. A person with ketoacidosis may seem to be tired or confused or may have trouble paying attention. Without prompt treatment in the first day of symptoms, the illness may cause low blood pressure, a loss of consciousness, coma or death.
If you have type 1 diabetes, it is important to measure your blood glucose levels at home using a machine called a glucometer. You also should have paper test strips that can detect ketones in the urine. If your blood glucose reading is above 300 milligrams per deciliter, you should test your urine for ketones. If the urine test strip reads “moderate” or “large,” it’s possible you have ketoacidosis.
People with diabetic ketoacidosis are always treated in a hospital. Your doctor will test your blood for levels of glucose, ketones, and electrolytes such as sodium and potassium. If you have been taking your insulin without missed doses, your doctor will want to determine if you have an infection.
Symptoms of diabetic ketoacidosis can develop over a period of a few hours, and treatment results in rapid recovery. Commonly, people who develop ketoacidosis will remain in the hospital for one to three days.
If you have type 1 diabetes, you usually can prevent diabetic ketoacidosis by following the insulin regimen and diet prescribed by your doctor and by testing your blood glucose regularly. If your body is stressed by an infection, ketoacidosis can develop within hours, and you may not be able to prevent it. It is important for you to check your blood sugar more frequently during an infection, so you can adjust your treatment. It is also important for you to recognize that vomiting and abdominal pain may be signs of ketoacidosis, so that you can get medical help quickly.
To help make sure that you receive proper emergency treatment for diabetic ketoacidosis if you are away from home, wear a medical identification necklace or bracelet that identifies you as a diabetic. This will help emergency personnel to recognize your problem quickly if you are among strangers and you are too sick to speak for yourself.
Diabetic ketoacidosis requires treatment in a hospital, often in the intensive care unit. You will receive a large volume of fluids intravenously (through a vein) and insulin to lower your blood sugar and to correct the acidosis. Your blood sugar and acid levels will be monitored frequently, and you will be given potassium supplements to restore your body’s supply of this essential mineral. Until your blood chemistry returns to normal, your vital signs (temperature, pulse, respirations, blood pressure) and urine output will be monitored closely. If an infection has triggered your episode of ketoacidosis, antibiotics or other medications will be used to treat the infection.
When To Call a Professional
If you have type 1 diabetes and feel unwell, check your blood sugar levels often. Also test your urine for ketones. Call your doctor if you have:
- Unexplained nausea and vomiting with or without abdominal pain,
- Moderate or high levels of urine ketones, or
- Your blood sugar is high and you can’t lower it by adjusting your insulin dose.
With prompt treatment, more than 95 percent of patients recover from diabetic ketoacidosis.
Learn more about Diabetic Ketoacidosis
IBM Watson Micromedex
Mayo Clinic Reference
National Institute of Diabetes and Digestive and Kidney Diseases
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
High and low: how to Reduce Blood Sugar Level Immediately
Is insulin enough to reduce blood sugar immediately? Insulin’s main function is to lower blood sugar levels, but does your insulin dosage do the job?
The simple answer is: yes, insulin does the job, especially for those with insulin-dependent diabetes. There are certainly alternative ways to lower blood sugar immediately, but that’s not exactly the goal when it comes to diabetes.
You don’t want to lower blood sugar rapidly, just for the sake of being rapid. If you reduce blood sugar too quickly, then you’ll end up having to deal with low blood sugar instead.
Diabetes management is more about finding balance and treating yourself in a controlled manner. So, while you might need to reduce blood sugar immediately in some situations, you can do it in a way where you’re still in control.
Find out how to stay in control, lower blood sugar, and get back to your normal lockdown routine of bread-baking and Tiger King-viewing!
When to Lower Blood Sugar
When blood sugar is too high, it is termed hyperglycemia. The World Health Organization recognises hyperglycemia as blood sugar that’s above 126 mg/dL or 7.0 mmol/L in a period before eating (fasting), or above 200 mg/dL or 11. 1 mmol/L two hours after eating.
When blood sugar is at this point, you should take steps to reduce those numbers. It goes without saying that testing blood sugar regularly is ideal, in order to know when you’re hyperglycemic.
You may also realise that you’re hyperglycemic if you’re experiencing some of the following symptoms:
- Frequent urination
- Increasingly thirsty
- Difficulty concentrating
- Blurred vision
Stay in control with Hedia Diabetes Assistant; get it for free from the App Store or Google Play!
According to the American Diabetes Association, when blood sugar levels start teetering towards 250 mg/dL or 13.9 mmol/L is when diabetic ketoacidosis can occur.
Ketoacidosis happens because of the body’s need for fuel. With high blood sugar, the body isn’t getting any fuel in the form of glucose. Instead, the body tries to burn fat for fuel, but this process leads to ketones – essentially acids – building up in the bloodstream.
Symptoms of ketoacidosis can include symptoms of hyperglycemia, along with:
- Vomiting or feeling nauseous
- Sweet-smelling breath
- Being short of breath
- Dry mouth
- Pain in the abdomen
To avoid the buildup of ketones (and to avoid a possible coma), it’s best to test for ketone levels to know what’s going on. There’s no uniform moment to check for ketones: the NHS suggests checking ketone levels from the moment you are hyperglycemic, if you can.
Meanwhile, diabetes.co.uk recommends checking for ketones if your blood sugar levels have been consistently above 13 mmol/L or 230 mg/dL.
You can easily keep track of this with Hedia, which gives an attention warning recommending you to check ketones if you have recorded blood sugar above 15 mmol/L or 270 mg/dL more than twice in six hours.
The higher the reading for blood ketone levels, the higher the likelihood of diabetic ketoacidosis. For the result of blood ketone test, the NHS gives the following numbers in mmol/L (if you happen to measure ketones in mg/dL, then you can use this converter):
0.6 mmol/L or under = healthy reading
0.6 – 1.5 mmol/L = slight risk of diabetic ketoacidosis; re-test in about two hours
1.6 – 2.9 mmol/L = at risk of diabetic ketoacidosis; contact your medical team as soon as possible
3.0 mmol/L = very high risk of diabetic ketoacidosis; seek help immediately
How to Reduce Blood Sugar Level Immediately: Insulin
The severity of the hyperglycemia determines how to act. In cases of insulin-dependent diabetes, most people will probably use rapid-acting insulin. The name is a giveaway: this is how to reduce blood sugar level immediately.
Hopefully, using insulin will allow you to get back to normal blood sugar levels before it gets too severe. This will also be the best way to be in control; you can lower your blood sugar with more accurate numbers.
This is where Hedia comes into play. Getting those numbers isn’t always so easy to figure out by yourself, especially not when dealing with the hassle of high blood sugar. Hedia can deal with that instead.
When using Hedia’s insulin calculator, all Hedia needs is: your blood sugar reading – this can even be added wirelessly and automatically with certain NFC or Blueetooth glucose meters; what you’ve eaten recently – this can be added swiftly with Hedia’s food database; whether you’ve exercised recently or are about to exercise; and if you’ve taken insulin in the last 4 hours. Have a go at the App Store or Google Play!
After taking insulin, keep testing blood sugar levels to see how your blood sugar decreases. Then, just continue with your day!
Other Steps for how to Reduce Blood Sugar Level Immediately
While insulin is what will mainly help, there are other methods that can be used in both severe and less so severe cases of hyperglycemia. Alternative methods are especially helpful for those with non-insulin-dependent diabetes.
In severe cases (when you’re at risk of diabetic ketoacidosis), it’s advisable for healthcare professionals to take care of you.
First, they will likely inject insulin to your veins (rather than the usual subcutaneous injection – into the layer of fat beneath the skin). In addition to this, they will rehydrate you with fluids, usually directly to your veins too. They will also give you nutrients at the same time, in the same manner.
This treatment gives some clues as to how to reduce blood sugar level immediately in less severe cases:
1) Stay hydrated; drink water. Since being thirsty is a symptom of hyperglycemia/high blood glucose, you’ll probably want to be drinking plenty of water anyway. This helps with flushing out excess glucose.
2) Stay nourished. This is less straightforward, since eating food can often lead to even higher levels of blood glucose. But because you’ll be drinking a great deal of water (and urinating a great deal), you’ll also be flushing out nutrients at the same time.
So, it’s worth considering eating something nourishing after you’ve lowered your blood sugar. Or, if you want to keep up your nutrients during hyperglycemia, consider drinking fluids without carbs and with electrolytes.
Protein can also help stabilise blood sugar levels. If you’re hyperglycemic, you’ll want to eat something protein-rich but without carbs. For one example, meat like turkey or chicken will usually have no carbs.
Find out more nutritional info on specific food items with our food database. Meanwhile, get advice from our Nutrition Consultant with Food and Diabetes!
3) Exercise (with caution). Does exercise lower blood sugar? Yes, as long as it’s aerobic exercise. Exercise that gets your heart-rate up over a longer period – for instance, a 15 minute jog – will increase insulin sensitivity, and lower blood sugar.
Be aware, though, that intense exercise will begin the body’s burning of fat. As we know, burning fat produces ketones – not ideal when trying to avoid ketoacidosis.
To avoid this, make sure your blood sugar is not above 250 mg/dL or 13.9 mmol/L; above this would be too dangerous for exercise. And do check ketone levels if exercising.
4) Relax. Perhaps the least relaxing thing is someone telling you to relax when you’re not relaxed. But relaxing does help! The combination of stress and diabetes can lead to high blood sugar. So, take a moment to breathe.
In Control of Blood Sugar
There you have it, you cool cats and kittens, that’s how to reduce blood sugar level immediately. Insulin is specifically designed to lower blood sugar; that is what will do the trick.
If you’re insulin-dependent, then insulin is the best medicine. Don’t fret, take insulin, be prepared to check ketones and then crack on with the day.
And in other cases, the four alternative methods to lower blood sugar will also help. Otherwise, bear them in mind, because they are still good tips for avoiding high blood sugar in the first place!
Make Hedia a part of your routine by downloading it from the App Store or Google Play!
Related post: 8 Signs and Symptoms of Diabetes
What to Do if Blood Sugar Is Over 400
Blood sugar over 400 mg/dL could mean you’re at risk of the potentially fatal diabetic ketoacidosis.
Image Credit: Charday Penn/iStock/GettyImages
If you have diabetes, it’s very important to keep your blood sugar, or glucose, levels within a healthy range.
Here’s why: If your glucose levels dip too low, you can experience symptoms of hypoglycemia, which include shakiness, a rapid heartbeat and lightheadedness. And, if your blood sugar levels swing too high (called hyperglycemia), you could experience not just long-term health complications, but short-term problems like diabetic ketoacidosis (DKA), a serious condition that could possibly be fatal.
Find out what happens when your blood sugar levels are too high, as well as potential outcomes when they rise above 400 milligrams per deciliter (mg/dL).
What Are the Symptoms of High Blood Sugar?
In general, the American Diabetes Association (ADA) recommends shooting for a blood sugar level of 80 to 130 mg/dL before a meal and a level of less than 180 mg/dL after a meal. Still, because people’s target blood glucose levels can vary, it’s best to work with your doctor or health care provider to determine the right numbers for you.
Read more: What Are Normal Blood Sugar Levels and What Happens If They’re High?
If your blood sugar levels are too high, you can experience symptoms like frequent urination and increased thirst. Left untreated, hyperglycemia can develop into diabetic ketoacidosis, which occurs when your body is no longer able to use insulin to break down glucose for energy.
Without insulin, your body begins to break down fats, triggering the production of chemicals called ketones, according to the ADA. Your body can’t harbor too many ketones, so it tries to flush them out of the body through the urine — but because the body can’t always eliminate them all, they can continue to build up, causing diabetic ketoacidosis.
How Do I Know if I’m at Risk?
Testing your urine with a urine test strip will reveal the presence of ketones in your urine — high levels of these chemicals are a potential signal of diabetic ketoacidosis. Your doctor will tell you when you should perform the test, but the ADA says that, in general, you may want to check your urine for ketones when your blood sugar levels hit more than 240 mg/dL.
Other symptoms of diabetic ketoacidosis include nausea, difficulty breathing, an altered mental state and a fruity odor on the breath.
“In our clinic, if a person has blood sugar levels of over 300 mg/dL, we will check for urine ketones,” says Susan Spratt, MD, an endocrinologist and associate professor of medicine at Duke University School of Medicine. “If their blood sugar levels are over 300 mg/dL — and certainly over 400 mg/dL — we’re concerned that they may be going into diabetic ketoacidosis.”
If your urine test reveals that ketones are present, call your doctor, who can give you further instructions. You may need to go to the emergency room to seek treatment right away. The ADA says that if you have ketones present in the body, you shouldn’t exercise. In this case, exercise can cause your blood sugar levels to spike even higher.
If your blood sugar levels are over 400 mg/dL, you could also be at risk for dehydration, says Dr. Spratt. During treatment, your doctors will give you insulin to stabilize your blood sugar levels and replace any fluids you might have lost through urination or vomiting, according to the U.S. National Library of Medicine.
Read more: What Is a Healthy Blood Sugar Reading in the Morning?
Diabetes Numbers Warnings and Precautions
If your blood sugar reading is over 400 mg/dL, there is a chance that you have a false reading — particularly if you aren’t experiencing any symptoms. For example, if there were food particles on your fingers or you used outdated or improperly stored test strips, you might have gotten an inaccurate reading.
If you re-test your levels and your blood sugar is indeed above 400 mg/dL, follow the advice your doctor has given you — whether that includes taking extra insulin or drinking more water — and contact him or her for further treatment advice.
If you have symptoms of diabetic ketoacidosis, you may need to seek immediate medical attention. Without treatment, diabetic ketoacidosis can lead to a diabetic coma and death. Diabetes statistics show the condition was the seventh leading cause of death in the U.S. in 2017, according to the ADA, so it’s important to receive the right medical care right away.
High Blood Sugar at Night: Causes, Symptoms, and Prevention
By Eliza Skoler
Why do your blood sugar levels increase at night, and what you can do to prevent this? Learn strategies for managing high blood sugar levels overnight and in the morning, including healthy bedtime snacks.
For National Sleep Awareness week, we are focusing on how to regulate overnight blood glucose (sugar) levels. With the many factors that can affect your glucose levels, nighttime can be a challenge. Some people with diabetes experience high overnight levels while others fear or experience a glucose drop during sleep. Trying to keep glucose levels stable overnight will help you get more sleep and feel better – and a good night’s sleep will aid your diabetes management the next day. While this article focuses on overnight highs, you can learn more about preparing for and preventing hypoglycemia (low blood sugar) here.
Here are some tips and strategies for how people living with diabetes can get better sleep at night and avoid high blood sugar levels.
Click to jump down:
Symptoms of High Blood Sugar at Night
Is It Safe to Sleep with High Blood Sugar?
Why Does Blood Sugar Go Up at Night?
What is the Dawn Phenomenon?
How to Stabilize Your Blood Sugar Overnight
Great Bedtime Snacks for People Living with Diabetes
What Should Your Blood Sugar be When You Wake Up?
How to Lower Morning Blood Sugar
Symptoms of High Blood Sugar at Night
If your blood sugar is high at night you may experience symptoms of hyperglycemia. Hyperglycemia, or “high glucose,” is not defined by one specific glucose level. While many people with diabetes aim to keep blood sugar levels below 180 mg/dl during the day, some people aim for the lower range of 120 or 140 mg/dl at night, when they are not eating.
At night, symptoms of hyperglycemia include:
Other symptoms of hyperglycemia that you may experience during the day or night include:
Is It Safe to Sleep with High Blood Sugar?
Glucose levels that are occasionally a little high at night generally don’t pose serious, immediate health concerns. Most people with diabetes cannot avoid some high glucose levels. However, frequent or long-term highs – particularly extremely high levels (above 250 mg/dl) – can be dangerous. It is important for people with diabetes to reduce high blood sugar as much as possible for two key reasons:
Frequent hyperglycemia can lead to major health complications caused by damage to blood vessels and nerves, which can affect your eyes, heart, kidneys, and other organs. This occurs when glucose levels are too high over a long period of time.
Very high glucose levels can be a sign of diabetic ketoacidosis (DKA, or high levels of ketones in your blood indicating that there is not enough insulin in your body). This occurs mainly in people with type 1 diabetes and can be life-threatening. For more information on DKA, read “Ketosis vs. Ketoacidosis: What’s the Difference.”
Why Does Blood Sugar Go Up at Night?
There are many factors that can cause your blood sugar to increase at night. For example: what food you ate during the day, how much and when you exercised, whether you ate snacks before bed, the timing of your insulin doses, and your stress level. You can experience different patterns of high blood sugar at night. You may start with high glucose when you go to bed, start the night in range but go high several hours later, or spend most of the night in range until the hours just before you wake up. By identifying your body’s patterns, you can figure out what is causing your high blood sugar and how to address it.
Common causes of a glucose increase at night include:
Eating too close to bedtime: whether you’re snacking or eating a late dinner, a post-meal glucose spike can lead to high glucose levels overnight. In particular, high-fat, high-carb meals (like pizza or pasta with creamy sauces) might delay glucose absorption causing an extended period of high blood sugar levels.
If you have type 2 diabetes, a treatment plan that doesn’t adequately address your nighttime insulin resistance or missed doses of your glucose lowering medication can cause high glucose levels at night (and often also during the day).
Over-correcting a low glucose level before bed. If you need to bring your glucose level back into range before you sleep, take just enough glucose to stabilize your blood sugar. Quantity-limited treatments (like glucose tablets or small candies) that will raise your glucose levels by a specific amount can be very helpful – learn more here.
If you take insulin, your insulin levels may be inadequate during the night. Depending on your dose and timing of basal insulin, the insulin may not last in your body until the morning. Learn about different types of insulin, insulin pumps, and automated insulin delivery (AID) systems, all of which can be helpful for staying in your target glucose range overnight.
Taking less insulin before bedtime due to fear of low blood sugar overnight.
What is the Dawn Phenomenon?
Another reason for high nighttime blood sugar levels is the “dawn phenomenon.” The dawn phenomenon occurs early in the morning when the body naturally signals your liver to produce glucose, giving your body the energy it needs to wake up.
The hormonal changes associated with the dawn phenomenon happen to people with or without diabetes, though those without diabetes do not experience hyperglycemia. If you take insulin, you may need to try a new basal insulin or adjust the timing and amount of your basal dose (with injected insulin) or your nighttime basal rates (with an insulin pump) to cover an early morning rise.
How to Stabilize Your Blood Sugar Overnight
The most important thing you can do to stabilize your blood sugar is monitor your glucose levels at bedtime, during the night, and when you wake up to look for patterns. This will help you determine what’s going on in your body and how you can fix it. While there are many strategies people use to stabilize blood sugar at night, every person is different – you’ll have to look for trends in your body, experiment with ways to lower glucose levels over a period of time, and learn what works best for your body.
Check your blood sugar (or CGM) before bed. If it’s already high, your blood sugar levels may remain high throughout the night. To address this, you’ll want to start by adjusting when you eat your evening meal and what it consists of, and how much mealtime insulin you take to cover it.
Avoid eating lots of food close to bedtime. For diaTribe writer Adam Brown, the key to staying in range overnight is low-carb, early dinners, with no snacking after dinner.
Consider eating less food at night and taking more basal insulin to cover your evening meal.
Check your blood sugar (or CGM) during the night, between midnight and 3am. If you were in range before bed but have high glucose levels between midnight and 3am, you may need to adjust your basal insulin dosage and timing. If you are low during that time, you may experience a rebound high blood sugar later on – this is usually associated with overcorrecting the low.
Talk with your healthcare team about the optimal nighttime insulin regimen for you. You may need to adjust your insulin to avoid both early low blood sugar and later high blood sugar.
If you take basal insulin, see if you’re able to get an insulin pump or an automated insulin delivery (AID) system. AID systems will automatically adjust your basal insulin doses throughout the night to help keep your glucose levels stable.
For some people, a small snack before bed (with a small dose of insulin, if appropriate) can help stabilize glucose levels throughout the night and avoid an early morning high. Keep reading for a list of healthy bedtime snacks.
Check your blood sugar (or CGM) when you wake up. If you were in range before bed and between midnight and 3am, but have high blood sugar in the morning, you may be experiencing the dawn phenomenon or running out of insulin (or other medication).
If you take insulin, you may need to delay the timing of your basal dose to as close to bedtime as possible. Or, you may increase your basal rates with an insulin pump from around 3am on.
If you have type 2 diabetes, talk with your healthcare professional about your glucose-lowering medications to make sure that your treatment plan addresses overnight hyperglycemia.
It’s possible to experience a combination of these events – you may have high blood sugar levels at various points throughout the night. If you have a continuous glucose monitor (CGM, you’ll be able to better track your glucose levels throughout the night. You can use your CGM data to relate your behaviors to patterns in your nighttime glucose levels. Does the timing of physical activity affect your glucose levels overnight? What about food choices throughout the day, in terms of type, quantity, or timing of food? If you don’t have a CGM, the more frequently you can take a blood sugar readings the better. Learn how to get the most of your fingerstick blood sugar data here. It’s important to share your nighttime glucose observations with your healthcare team so that you can find the best ways to stabilize your blood sugar over the entire night.
For more advice on stabilizing nighttime glucose levels, read Adam Brown’s “The Overnight Blood Sugar Conundrum.”
Great Bedtime Snacks for People Living with Diabetes
For some people, a healthy bedtime snack helps to prevent glucose swings during the night. By eating a small snack that is full of protein and healthy fats (and low in carbohydrates), your body may be better able to avoid an overnight high – but if you take insulin, be sure to cover the carbohydrates in your snack even if it only requires a small dose of insulin.
Here are some snack ideas:
Plain nuts or seeds – try eating a small handful
Raw vegetables, such as carrots, celery, cucumbers, or tomatoes, with a small amount of hummus or peanut butter
Plain yogurt, and you can add berries or cinnamon (read about choosing a healthy yogurt here)
Chia seed pudding
Remember, a bedtime snack is only helpful for some people. To see if it works for you, you’ll have to carefully monitor your glucose before bed, during the night, and when you wake up.
What Should Your Blood Sugar Be When You Wake Up?
The goal of diabetes management is to keep your blood sugar levels as stable as possible. This means that when you wake up, you want your glucose to be in range and to stay in range throughout the day.
For many people with diabetes, the overall target glucose range is between 70 mg/dL to 180 mg/dL (3.9 to 10.0 mmol/L). To start the day strong, the American Diabetes Association recommends that you aim to wake up with glucose levels between 80 to 130 mg/dL. Talk with your healthcare team about your glucose targets.
How to Lower Morning Blood Sugar
Whether a morning high is caused by the dawn phenomenon or something else, here are a few things you can try to lower your blood sugar levels:
Physical activity when you wake up can help bring your glucose level down. Even going for a walk can be helpful.
To learn about exercise guidelines and glucose management strategies, click here.
Read Adam Brown’s take on walking – the most underrated diabetes exercise strategy.
Eating a light breakfast can help keep a morning high from increasing even more. Taking your mealtime insulin will help lower your blood sugar.
Adam Brown suggests eating a breakfast that is low in carbs, and notes that sometimes mealtime insulin has to be adjusted in the morning. One of his favorite breakfasts is chia pudding, since it has little impact on glucose levels; see what else he eats for breakfast here.
Catherine Newman has six popular, low-carb, delicious recipes in “The Morning Meal.”
Intermittent fasting and time-restricted feeding approaches to meal timing can also help people keep morning blood sugar levels in range. Read Justine Szafran’s “Intermittent Fasting: Stabilizing My Morning Blood Sugars” to learn more.
For additional ways to navigate mornings, read seven strategies from Adam Brown in “A Home Run Breakfast with Diabetes.”
This article is part of a series on time in range.
The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand time in range to maximize patients’ health. Learn more about the Time in Range Coalition here.
What Are the Dangers of a Sugar Count Over 500? | Healthy Eating
By Janet Renee Updated November 28, 2018
Blood sugar control is a critical aspect of diabetes management. People without diabetes typically have fasting blood sugar readings below 100 milligrams per deciliter. If you are diabetic, your doctor sets an individualized blood sugar goal that you aim for with the help of an individualized treatment regimen. A reading higher than your target indicates your blood sugar is not under control, and having a reading over 500 is a medical emergency.
Importance of Blood Sugar Levels
Your body needs glucose to function properly, but it’s unhealthy for high levels to circulate in your bloodstream. The hormone insulin regulates blood sugar by allowing glucose to get into your cells. Typically, blood sugar is considered high when it’s 160 milligrams per deciliter or above your glucose target, notes the Joslin Diabetes Center. Your doctor may need to adjust your treatment plan if your glucose remains above 180 milligrams per deciliter for three consecutive days. If glucose stays elevated for a long time, it can affect your eyes, kidneys and heart.
A dangerously high blood sugar level increases your risk for diabetes-related ketoacidosis. When glucose circulates in your bloodstream and can’t get into your cells, your cells don’t get the energy they need. To compensate, your body begins to burn fat for fuel, producing acids called ketones. These acids build up in your bloodstream and can poison your body when levels get too high. This happens when your body doesn’t have enough insulin and is more common with Type 1 diabetes. The American Diabetes Association recommends checking your urine for ketones when your glucose is higher than 240 milligrams per deciliter.
Your kidneys typically excrete extra glucose to help compensate for high blood sugar levels, but when glucose is extremely high, you’re at risk for hyperglycemic hyperosmolar syndrome. This can occur when blood sugar reaches 600 milligrams per deciliter, and it can cause your blood to become thick like syrup. It typically occurs without the presence of ketones and is most common in middle-aged and older adults with Type 2 diabetes.
What to Do
Ketoacidosis and hyperosmolar syndrome can lead to coma, and a reading above 500 means your blood sugar is uncontrolled and your health is at risk. The University of Washington recommends calling your doctor immediately if your blood sugar reading is 300 or above. High blood sugar can occur when you eat too much food or don’t take enough insulin. It also can happen if you forget to take insulin or if your insulin has spoiled after exposure to extreme temperatures. Not getting enough exercise can cause high glucose, too. Stay hydrated by drinking at least eight glasses of water a day.
Norms of blood sugar for adults and children
Norms of blood sugar for adults and children
Norms of blood sugar for adults and children. International tables.
The following glucose ranges are given in the UK National Institute for Health and Care Excellence (NICE) guidelines, but each person should check with their healthcare provider or diabetes educator.
Table 1. NICE Recommended Blood Glucose Target Ranges:
* Non-diabetic glucose values are provided for informational purposes only, but are not part of NICE guidelines.
For most healthy people, normal blood sugar values are as follows:
4.0-6.0 mmol / l (72-108 mg / dl) – on an empty stomach;
to 7.8 mmol / L (140 mg / dL) – 2 hours after eating.
For people with diabetes, the target blood sugar values are as follows:
Before meals: 4-7 mmol / L for people with type 1 or 2 diabetes;
After meals: to 9 mmol / L for people with type 1 diabetes and to 8. 5 mmol / L for people with type 2 diabetes
Table 2.Blood sugar levels in the diagnosis of diabetes
Measurement of fasting plasma glucose.
This test is performed after a minimum of eight hours of fasting (usually in the morning). According to NICE guidelines, a fasting plasma glucose of 5.5 mmol / L indicates an increased risk of type 2 diabetes, especially when combined with other risk factors for type 2 diabetes.
Oral glucose tolerance test .
First, three days before the study, you should eat as usual, not excluding “fast” carbohydrates, for example, sweets. Secondly, the beginning of the study is carried out on an empty stomach, therefore, after the evening meal before the morning test, there should be a time interval of at least 10 hours. Better yet, if it is 16 hours. The first blood sample is taken from a finger on an empty stomach. Then the patient drinks a saturated sugar solution (75 g of glucose is dissolved in 300 ml of water). Sometimes lemon juice is added to the solution to make it more pleasant to drink.If, 2 hours after exercise, the blood sugar level does not exceed 7.8 mmol / l, this is normal. A decrease in tolerance is diagnosed if this indicator is between 7.8 and 11.1 mmol / l.
Measurement of HbA1c level for the diagnosis of diabetes mellitus
Glycosylated hemoglobin is one of the most important laboratory parameters in diabetes mellitus. The rate of binding of hemoglobin to glucose is the higher, the higher the glycemic parameters, i.e. blood sugar levels.And since erythrocytes, on average, “live” only 90-120 days, then the degree of glycation can be observed only during this period. In simple terms, by determining the level of glycosylated hemoglobin, the degree of saturation of the body with glucose is assessed for three months. With this test, you can determine your average daily blood glucose level over the past three months. Indicators of glycosylated hemoglobin: up to 6. 0% – the norm; 6.0 to 6.5% – increased risk of developing diabetes; more than 6.5% – diabetes mellitus.
90,000 2 lethal effects of hyperglycemia
Hyperglycemia is a condition in which high blood sugar levels remain in the blood. Diabetics suffer from this disorder. High blood glucose (sugar) levels can be triggered by several factors. Diet, level of physical activity, the presence of other diseases, as well as taking certain medications play a role here.
It is very important to control blood sugar levels, otherwise hyperglycemia can lead to serious and even life-threatening complications.Fortunately, healthy people (non-diabetics) are not affected by this condition. But it is important to understand that after a meal, especially after consuming carbohydrates, even in healthy people, sugar rises for a short time. Although this does not mean that all healthy people are insured against the development of this disorder in the future. In this article, we will look at the symptoms, treatments, and consequences.
This condition does not cause symptoms until blood glucose levels rise significantly. Usually, signs of impairment appear after the sugar reaches a level above 180-200 milligrams per deciliter (mg / dL), or 10-11 millimoles per liter (mmol / L).Symptoms of hyperglycemia develop slowly over several days or weeks.
The longer the blood sugar remains high, the more severe the symptoms become. However, some people with type 2 diabetes do not show signs of the disorder for a long time.
Early Signs of High Sugar
Detecting early symptoms helps to quickly return to normal blood glucose levels. Early signs include:
- Frequent urination,
- Increased thirst,
- Blurred vision,
Late symptoms of high sugar
If left untreated, this condition can cause a build-up of large amounts of toxic substances (ketone bodies) in the blood and urine. As a result, a person runs the risk of facing a dangerous condition called ketoacidosis.
Late symptoms of high sugar include:
- Fruit odor from the mouth,
- Nausea and vomiting,
- Shortness of breath,
- Dry mouth,
- Abdominal pain,
- To whom.
What are the causes of hyperglycemia?
Blood glucose rises after consuming carbohydrates from bread, rice, pasta and other cereals, starchy vegetables, and sweets. Our digestive system digests this food and absorbs glucose into the bloodstream. In order for the body to use glucose for energy production, the pancreas secretes the hormone insulin. This hormone acts as a guide for glucose, forcing the cells to let it in. Due to this mechanism, the blood glucose level is reduced to normal.
In diabetes mellitus, the effect of insulin decreases sharply for one of 2 reasons:
- Either because of the inability of the pancreas to produce insulin (type 1 diabetes),
- Or because the cells resist the effect of insulin, not letting in glucose, or due to the inability of the pancreas to produce the required amount of insulin (type 2 diabetes). You can read more about this in the articles on insulin resistance and diabetes.
Regardless of the type of diabetes mellitus – the result is the same.Glucose builds up in the blood and can reach dangerous levels if left untreated. This is hyperglycemia.
Among the factors that contribute to an increase in glucose levels:
- If a person is already sick with diabetes – no treatment or missed medication,
- Inappropriate insulin administration or use of expired insulin,
- Patient’s reluctance to follow an appropriate diet,
- Low level of physical activity,
- Illness or infection,
- Use of certain drugs, for example, steroids,
- Trauma or surgery,
- Emotional stress.
Illness or stress can trigger hyperglycemia. This is because hormones that are produced to fight disease or stress can raise blood glucose levels. For this reason, diabetics sometimes need to increase the dosage of their medications to keep their sugar levels in check under stress or illness.
What are the consequences Hyperglycemia ?
This disease has both long-term complications and complications that require urgent medical attention.
Long term effects
Blood sugar control helps prevent many complications. If glucose is not monitored and treated, the patient may develop the following effects of hyperglycemia:
- Cardiovascular disease,
- Nerve damage (neuropathy),
- Kidney damage (diabetic nephropathy) or renal failure,
- Damage blood vessels in the retina (diabetic retinopathy), which can result in blindness,
- Joint and bone problems,
- Tooth and gum infections.
The consequences of hyperglycemia , which require emergency care
If the blood glucose level remains elevated for a very long time, a person runs the risk of facing two critical conditions:
- Diabetic ketoacidosis. This condition develops when the body lacks insulin. When this happens, glucose is unable to enter the cell (insulin is a glucose conductor).In this situation, the body breaks down fatty acids in very high quantities to obtain the necessary energy. During the breakdown of fatty acids, ketone bodies, or ketones, are formed. When ketones accumulate in the blood faster than the body has time to excrete them, they become toxic and acidify the blood. If you do not take urgent measures, everything will end in a coma, and in the most severe cases, death.
- Hyperglycemic coma . If you do not control sugar for a long time, the glucose level can rise to critical levels – above 600 mg / dL, or 300 mmol / L.Glucose leaks into the urine, which causes a very frequent urge to run to the toilet. If this condition is ignored, the person runs the risk of facing life-threatening dehydration and falling into a coma. In this situation, urgent medical attention is needed.
How to lower blood sugar?
One of the most important conditions is monitoring the patient’s condition at home. To do this, you must adhere to a set of measures:
- Maintain physical activity.Regular exercise is an effective way to control your glucose levels. However, according to scientists from the American Diabetes Association, training in the presence of ketone bodies in the urine is impossible. This can increase sugar even more.
- Follow your medication schedule closely. It is very important to adhere to the appointment of an endocrinologist. The dosage and frequency of administration of drugs, including insulin injections, are selected only by a doctor.
- Eat according to the developed diet.It’s best to completely avoid sugary drinks and indulge in frequent snacks. You should consult a dietitian doctor to develop a special meal plan.
- Monitor blood glucose regularly. This can be done at home using a meter or test strips. If a person is sick, these procedures should be done more often.
Treatment of hyperglycemia is a critical condition that helps prevent dangerous complications. And remember that self-medication is a very risky endeavor.It is better to be monitored by an endocrinologist.
- Hyperglycemia in diabetes, Mayo Clinic,
- Hyperglycemia (High Blood Glucose), American Diabetes Association,
- High Blood Sugar and Diabetes, WebMD.
Central District Hospital Vyksa / News / Articles / How to live with diabetes?
According to the World Health Organization, there are more than 180 million people with diabetes in the world.
In Russia, more than three million people suffer from this disease; 95 thousand patients were registered in the Nizhny Novgorod region. If we consider that every 13-15 years the number of diabetics on our planet doubles, then by 2025 there will be more than 300 million people.
Diabetes mellitus is one of the most mysterious pathologies that has ever struck a person. But diabetes itself is not so terrible – the achievements of modern medicine make it possible to quite successfully control the level of glucose in the blood with the help of hypoglycemic drugs and diet.The greatest threat to human health and life are complications of the disease, which can truly be called formidable: vascular damage leading to myocardial infarction and stroke, kidney pathology, the development of leg ulcers …
Type I diabetes mellitus, as a rule, develops as a result of a malfunction of the pancreas, which stops producing the hormone insulin, a substance that regulates blood sugar levels. In type II diabetes mellitus, insulin is produced as expected, but the cells of the body cease to perceive it.
To the question: “Why does diabetes occur?” – scientists have so far found the answer. Only one thing has been established for sure: diabetes cannot be contracted through contact with a sick person.
Diabetes can be provoked by:
– Hereditary predisposition. Almost all experts agree that the risk of developing diabetes increases if someone in your family has diabetes – one of your parents, brother or sister.
– Obesity.This factor, fortunately, can be neutralized if a person, realizing the full extent of the danger, will strenuously fight overweight.
– Diseases resulting in damage to the beta cells of the pancreas.
This is pancreatitis, pancreatic cancer, diseases of other endocrine glands. Trauma can be a provoking factor in this case.
– Viral infections. (rubella, chickenpox, viral hepatitis and some other diseases, including influenza).These infections act as a trigger. It is clear that for most people, the flu will not be the onset of diabetes. But if this is an obese person with a burdened heredity, then the flu is a threat to him. A person whose family was not diabetic can suffer from influenza and other infectious diseases many times – and at the same time, they are much less likely to develop diabetes than a person with a hereditary predisposition to diabetes. So the combination of risk factors increases the risk of the disease several times.
– Nervous stress can also be a predisposing factor. This should be especially taken into account by persons with aggravated heredity and overweight.
– Age. The older a person is, the more reason he has to fear diabetes. It is believed that for every ten years, the likelihood of developing diabetes doubles.
Many believe (obviously, guided by the name of the disease) that the main cause of diabetes in food, that diabetes is sick with a sweet tooth, who put five tablespoons of sugar in tea and drink this tea with sweets and cakes.There is some truth in this, at least in the sense that a person with such eating habits is likely to be overweight. And the fact that obesity provokes diabetes is absolutely proven. It should not be forgotten that the number of patients with diabetes mellitus is growing, and it is rightly attributed to the diseases of civilization, that is, the cause of diabetes in many cases is excessive, rich in easily digestible carbohydrates, “civilized” food.
So, diabetes has several causes, in each case it may be one of them.
The main symptoms of diabetes are:
– fast weight loss;
– dehydration of the body;
– increased fatigue;
– bad dream;
– itching of the skin.
Diabetes mellitus of the first type sometimes manifests itself as a sharp deterioration in the condition, when severe weakness occurs, abdominal pain, vomiting, and the smell of acetone from the mouth (ketoacidosis) appear. Type 2 diabetes usually develops gradually over time.
Patients with diabetes mellitus must be registered with an endocrinologist.
Today, dietary products have been developed for those who suffer from diabetes mellitus, there are “schools” where each patient can undergo special training.
Diabetes mellitus treatment includes:
– Special diet: avoid sugar, alcoholic beverages, syrups, cakes, biscuits, grapes and dates. Food should be taken in small portions, preferably 4-5 times a day.Products containing various sweeteners are recommended.
– Daily use of insulin (insulin therapy) – necessary for patients with type 1 diabetes. The drug is produced in special syringe pens, with which it is easy to give injections. When treating with insulin, it is necessary to independently control the level of glucose in the blood and urine (using special strips).
– The use of tablets to help lower blood sugar levels.As a rule, such drugs are used to start the treatment of type II diabetes mellitus. With the progression of the disease, the appointment of insulin is also possible.
– People with diabetes benefit from exercise. Weight loss in obese patients has a therapeutic role.
Self-control and precise implementation of the doctor’s recommendations allow avoiding or significantly slowing down the development of complications of the disease. However, not all patients will be able to eat limited food, count calories and voluntarily for the rest of their lives refuse to eat their usual fatty, flour, sweet foods in favor of rusks, vegetables, fruits and dietary products.The body will inevitably respond with a rise in blood sugar to any dietary disturbances, and the more often and to the greater extent these disturbances occur, the more likely complications will develop.
In addition to observation and treatment under the supervision of a doctor, the patients themselves must comply with some rules:
– Constant monitoring of blood sugar levels is necessary for all patients, without exception, who are on insulin therapy. Knowing the sugar level, it is easy to evaluate the effectiveness of treatment and calculate the amount of insulin required for an injection.
– It is advisable to determine the sugar level before each meal. Additionally, you need to control the sugar level before bedtime and in all cases of deterioration of health. Only daily and repeated performance of the procedure will help to adjust the insulin doses according to the lifestyle and diet.
– All patients with diabetes mellitus are advised to keep a diary, which records the data on self-monitoring of blood and urine sugar levels, the amount of insulin injected or taken sugar-lowering tablets, especially the food taken.You also need to write down the characteristics of well-being.
– You must have a diary with you every time you visit a doctor. This will allow the doctor to notice the deterioration of the patient’s well-being in time and to carry out effective treatment of the disease.
Exercise, proper nutrition and timely medication can help avoid complications and stop the development of the disease. By following your doctor’s advice, you can live a long life.
We are working to keep you healthy and happy.
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Surgical treatment of type 2 diabetes mellitus
Type 2 diabetes mellitus – Today is no longer a verdict!
Type 2 diabetes mellitus is a metabolic disease (metabolic disorder) characterized by chronic hyperglycemia (increased blood sugar), which develops as a result of a violation of the interaction of insulin with tissue cells.
This disease has a number of formidable complications:
- Angiopathy. First of all, with diabetes mellitus, blood vessels suffer. Their walls become less and less permeable to nutrients, and the lumen of the vessels gradually narrows. All body tissues are deficient in oxygen and other vital substances.
- Nephropathy. The kidneys of a patient with diabetes mellitus gradually lose their ability to perform their functions, and chronic insufficiency develops.
- Retinopathy – damage to the retina, which then leads to hemorrhage in the fundus, retinal detachment. Gradually leads to complete loss of vision. Most often, retinopathy occurs in patients with type 2 diabetes. For a patient with more than 20 years of experience, the risk of retinopathy is close to 100%.
- Polyneuropathy. Loss of sensitivity to pain and warmth in the limbs. Most often it develops as “gloves and stockings”, beginning to manifest itself simultaneously in the lower and upper extremities.The first symptoms are a feeling of numbness and burning in the limbs, which are significantly worse at night.
- Diabetic foot. A complication in which open ulcers, purulent abscesses, necrotic (dead) areas appear on the feet and lower extremities of a patient with diabetes mellitus.
In recent decades, the prevalence of diabetes mellitus (DM) has acquired the character of an epidemic: for example, if at the end of the last century the number of patients with diabetes in the world did not exceed 130 million., then at present their number is more than 300 million, and by 2030, according to the forecasts of the International Diabetes Association, it will increase 1.5 times and amount to 438 million people, mainly due to patients with type 2 diabetes, which account for more than 90% of the total number of patients. Today, there is a tendency not only to an increase in the incidence of type 2 diabetes, but also the development of this pathology at a younger age, which is associated with urbanization of the territory, an increase in the prevalence of obesity and a sedentary lifestyle.
With drug treatment (taking hypoglycemic drugs, and in some cases insulin injections), it is impossible to cure this disease, because this therapy is substitutional.
At the present time, the world is already known for a surgical method of treating this pathology and its colossal effectiveness has been proven. Surgical treatment of type 2 diabetes mellitus allows you to get rid of this pathology and completely avoid taking antihyperglycemic drugs.This surgical direction belongs to the section of metabolic surgery.
Metabolic surgery is a method of surgical intervention aimed at restoring function or normalizing the metabolic system.
Based on clinical studies conducted over more than 10 years, the most effective surgical intervention has been shown to be – Gastric Bypass (Mini-Gastric Bypass)
It turned out that performing such operations leads to the cure of type 2 diabetes in 90-98% of cases.This fact served as the starting point for studies on the possibility of using such metabolic surgery for the radical treatment of type 2 diabetes mellitus in patients not only with obesity, but also with normal weight, or in the presence of moderate excess body weight (with a BMI up to 30).
What is the point of performing this operation?
- Blood sugar levels return to normal in the first days after surgery.
- Within a few years, the patient’s weight reaches satisfactory figures (for example, with a height of 180 cm, the approximate weight will be 80-85 kg)
- A decrease in stomach volume leads to rapid satiety.
- The entry of food from the stomach directly into the ileum, bypassing the jejunum.
- The patient avoids 98% of insulin injections and 85% of sugar-reducing drugs.
Question – why do we seek to accelerate the contact of food with the ileum?
L cells located in the mucous membrane of the ileum produce glucagon-like peptide-1. The less food that has entered the ileum will be processed by digestive juices, and the sooner it enters the ileum, the more L-cell irritation will be expressed.
When L-cells are irritated, the following occurs:
- Decreased appetite.
- Decreased evacuation of gastric contents
- Increases the growth of cells that synthesize insulin
- Increase the amount of insulin
- Decreases apoptosis of beta cells (reduces the level of “self-destruction” of cells that synthesize insulin), decrease glucagon secretion.
- Increases insulin sensitivity
- Leads to activation of the heart cell defense system.
Method of surgical intervention – laparoscopic!
In our medical center, this operation is performed using modern minimally invasive techniques.
- Maximum patient comfort in the early postoperative period
- Minimum hospital stay
- Reduces the risk of infections and problems in the postoperative period
- Cosmetic effect
What are the indications for surgical treatment?
People suffering from diabetes mellitus in the early stages of the disease do not present complaints, and therefore it is not easy to decide on an operation.
The operation, even if it is planned, is always associated with a certain risk, therefore our center will not recommend this type of treatment without 100% indications.
- The patient’s age is from 30 to 65 years.
- type 2 diabetes mellitus not more than 10 years, treatment with oral medications.
- type 2 diabetes mellitus no more than 10 years, insulin dependence less than 7 years, difficult to control (HbA1c> 8.0%)
- patients with diabetes mellitus with sufficient pancreatic reserve (C-peptide> = 1 ng / ml, mandatory glucagon test).
- negative test for antibodies to pancreatic β-cells (ICA, IA-2, GAD 65 K).
- patients with a high body mass index (BMI> 30 kg / m2), accompanied by type 2 diabetes mellitus.
Clinical Trials – Thinking! 85% That’s A LOT!
Gastric bypass surgery has more than 50 years of history. The positive effect of this type of metabolic surgery on the course of diabetes mellitus has been repeatedly confirmed by numerous clinical studies in which long-term results of operations were studied.It has been shown that complete cure of diabetes was observed in 85% of patients after gastric bypass surgery. These patients were able to completely abandon any drug therapy. The remaining 2-15% showed significant positive dynamics in the form of a decrease in the dosage of antidiabetic drugs. The study of long-term results showed that mortality from complications of diabetes mellitus in the group where surgical treatment was performed was 92% lower than in the group where conservative treatment was carried out.
Clinical studies have been conducted in which the effect of metabolic surgery on the course of type 2 diabetes in patients with normal body weight and the presence of moderate overweight (with a BMI under 30) has been studied. These studies completely duplicated the positive results – 90% cure for type 2 diabetes in this category of patients and positive dynamics in the remaining 10%.
If the body mass index of a patient with diabetes is 35 or more, the operation is considered to be definitely indicated.
At the same time, when the situation concerns patients with normal to moderately overweight, it is necessary to assess the risks of surgery and the potential positive effects that can be obtained by curing diabetes. Considering the fact that even carrying out competent conservative therapy is not a reliable prevention of complications of diabetes (diabetic retinopathy, nephropathy, neuropathy and angiopathy with the entire spectrum of their severe consequences), the use of metabolic surgery may turn out to be a promising treatment method even in this group of patients with type 2 diabetes mellitus. …
Currently, it is believed that surgery is indicated for a patient with type 2 diabetes with a BMI of less than 35, if he cannot achieve compensation for the course of the disease with oral drugs, and it is necessary to resort to the appointment of insulin. Since in a patient with type 2 diabetes mellitus, the leading mechanism of the disease is insulin resistance, and not insulin deficiency, such an appointment of additional exogenous insulin seems to be a purely forced measure, in no way aimed at the cause of the disease.On the other hand, the operation leads to the removal of insulin resistance simultaneously with the normalization of the glycemic level. The third group of indications is bypass surgery in patients with diabetes mellitus with BMI 23-35 who do not receive insulin. This patient group is currently a research group. There are patients of normal or slightly overweight who want to radically solve the problem of their diabetes. They are the ones who are included in such studies. The obtained results are very encouraging – stable clinical and laboratory remission of diabetes in this group is achieved in all patients.
What to do if your sugar level is above 400
Many people do not need to worry about their blood sugar all the time, but if you belong to that particular group with diabetes or a similar condition, you should be alert to any food. which can affect glucose levels.
The reason is that if your glucose level drops too low , you may experience what is called hypoglycemia; its symptoms are tremors, heart palpitations, and dizziness.On the contrary, if your level gets too high, it is called hyperglycemia and you can suffer from diabetic ketoacidosis , which is potentially dangerous.
For all these reasons, we are teaching you what decisions to make if your blood sugar rises more than desirable.
Symptoms of High Blood Sugar
In general, when it comes to pre-meal sugar levels, experts recommend 80 to 130 milligrams per deciliter and less than 180 mg / dL after meals.However, your levels may vary depending on your needs, in fact, this is something that you should consult and monitor with your family doctor.
One way to tell you that your blood sugar is too high is if you are experiencing symptoms such as frequent urination and increased thirst. Plus, if you don’t pay attention to hyperglycemia, it can turn into diabetic ketoacidosis, which occurs when your body is unable to break down glucose for energy.
On the other hand, if your body does not have insulin, it starts using fats, which leads to an increase in the production of chemicals called ketones. The problem is that your body cannot handle that many ketones, so it will try to excrete them in the urine, although the body cannot completely remove them, which leads to their further accumulation, which leads to diabetic ketoacidosis.
Risk Groups: High Sugar
The most common and easiest way to find out if too many ketones are present in your body is to do a simple urinalysis.Your doctor will tell you when it is correct. In general, ideally, this can be used to check if your sugar level is above 240 mg / dL. You may also experience other symptoms of diabetic ketoacidosis , such as nausea, shortness of breath, altered mental state, and fruity aroma from the mouth.
Doctors say that with a patient dose of more than 300 and 400 mg / dl, concern about the formation of diabetic ketoacidosis becomes a priority.
If you tested at home and found ketones in your urine, you should call your doctor to find out what to do next.There is a chance that you will need to go to the emergency room immediately. In addition, health care providers state that when ketones are present in your body, you should not do any kind of exercise, as this can lead to even more high blood sugar levels.
In fact, if your level exceeds 400 mg / dL, you may be at risk of dehydration. In this case, doctors will prescribe insulin for you to stabilize your blood sugar and replace any fluid you lose in your urine or vomit.
Diabetes Markers and Precautions
You must be careful because there is a possibility that your ketone readings will be false if you have a level above 400 mg / dL, especially if you have not had any symptoms. This usually happens when your tests have expired or when you run them, food particles remain on your fingers.
However, if your levels are really as high as you thought, follow your doctor’s advice, be it taking insulin or drinking more water.It is also very important that if you are suffering from symptoms of diabetic ketoacidosis, you go to the hospital immediately, as if you do not treat yourself, you could fall into a diabetic coma or even die.
- Maria, KM What to do if your blood sugar is over 400. For Livestrong. [Revised October 2019].
Determination of blood sugar level through saliva
More than 300 million people worldwide, according to the World Health Association, either already have diabetes mellitus or will soon become ill.That number is expected to double by 2030 – turning the disease down to epidemic proportions. Taking this into account, scientists from the Center of Excellence in Electrochemistry (CBE) of the University of Tehran, and endocrinological researchers of the Tehran Medical Research Institute, as part of a joint project, successfully built and tested a prototype device ( non-invasive glucometer ) for measuring glucose levels blood through saliva.
Many of the serious complications of diabetes , including heart disease, stroke and loss of vision, can be prevented with early diagnosis and proper blood sugar control.However, measuring blood sugar levels with conventional glucometers is a rather inconvenient procedure for patients. The patient needs to measure blood sugar several times a day, which is not a pleasant moment when using modern invasive methods. Scientists are puzzled by the search for a new painless method for measuring blood sugar levels.
Research has shown that salivary sugar levels are proportional to blood sugar levels, thus opening up a new, unique and painless method for diagnosing sugar levels.A distinctive feature is that the sugar level in saliva is lower than the same level in the blood (about 100-2000 times), which makes the use of saliva in diagnostics very difficult. Conventional blood glucose meters cannot detect such low concentrations, and therefore more sensitive devices are required for such measurements.
The idea of a device for non-invasive glucose measurement appeared about 3 years ago. In March 2010, the first version of the device was launched and successfully tested.Shortly thereafter, the second and then the third version of the device were developed and tested.
Today, the prototype of the final version of the device has been launched and is in the final stages of testing. It is predicted that by the end of April 2013 it will appear on the medical equipment market.
Also, the new method is less expensive, which sets it apart from other models.
Source: New medical technologies
Glucometer may appear in new Apple Watch
Apple Watch health monitoring features have kept users alive since the watch was first released in April 2015.In addition to the heart rate monitor, the watch now has an electrocardiogram function (in Apple Watch Series 4 in 2018).
ECG is used to detect irregular heart rhythms to provide early warning of atrial fibrillation. The latter can lead to strokes, blood clots, heart failure, and other serious ailments. And last year, Apple Watch Series 6 added a sensor to determine the degree of blood oxygen saturation. Knowing the percentage of oxygen that your red blood cells carry from your lungs to the rest of your body can give you a general idea of your health and may even give you an early warning about COVID-19.The normal value is between 95% and 100%. Another useful feature on the watch is notifying pre-selected contacts if you fall and can’t get up.
Over the years, there has been talk of adding a feature to the Apple Watch that would measure a user’s blood sugar. This is very important for insulin-dependent diabetics who need to have their blood sugar measured before each injection of insulin, as the amount of sugar found in their blood determines the dosage of each injection.Currently, a diabetic must draw blood for each test by applying it to an expensive test strip, which is then inserted into the meter for readings.
This process is painful and costly, and if Apple allows the Apple Watch to show blood sugar levels without requiring the user to draw blood and buy new test strips, Apple Watch sales could take off. As reported by The Telegraph, SEC documentation hints that Apple will add a blood glucose meter feature to the Apple Watch in 2022.
The Telegraph reports that Apple has been announced as the largest customer of Rockley Photonics, which has developed the next generation sensors. They will appear in wearable devices by next year.