Hyperglycemia - High Blood Sugar

How Monitoring Your Blood Sugars Can Help You

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Signs and symptoms of hyperglycemia (high blood sugar) include excess hunger, thirst, increased urination and fatigue. High blood sugar typically occurs because you have eaten too much carbohydrate, you do not have enough insulin, or the insulin you are making is not working properly. Elevated blood sugar means that your body is unable to use glucose for fuel. The body tries to rid the excess sugar in the urine, resulting in feelings of hunger and thirst.

 Some people notice their symptoms right away, while others may walk around with elevated blood sugars without knowing. 

It can be shocking to see an elevated blood sugar on a glucose monitor. I asked that one of my patients to test her blood sugar the other day in the office and when she read the number, 350mg/dL, she was shocked. She didn't feel a thing, but her new awareness made her want to learn more about diabetes. 

How Can I Know for Certain That My Blood Sugars are Elevated? 

Blood glucose monitoring can help you detect and manage hyperglycemia. Knowing your daily blood sugars enables you to pattern manage. The information you receive from consistent blood sugar readings can help you mange your medications, exercise and diet. For example, if your blood sugar is high every day after breakfast, perhaps you are not taking enough medicine in the morning or you are eating too much carbohydrate at breakfast.

Or, if you are falling asleep at your desk after lunch, perhaps lunch sent your sugars too high. Discuss with your health care provider or Certified Diabetes Educator how often you should be testing your blood sugars and what your blood glucose goals are. 

Blood glucose targets should be individualized based on: 

  • age
  • medical history/comorbidities
  • duration of diabetes
  • known cardiovascular disease or advanced microvascular complications
  • hypoglycemia unawareness
  • type of medication (oral medicines vs. insulin) 

People with Type 2 diabetes benefit from alternating when they test their blood sugar. Ideally, it's best to test fasting blood sugars and post meal blood sugars. Fasting blood sugars can give us an idea of what is happening to your sugar during the night while you are sleeping (fasting blood sugar is defined as 8 hours without eating). Post meal blood sugars give us an idea of how your body is responding to food. If you are overeating carbohydrates at your meals because you are very hungry, you will have to work with your health care provider on ways to increase satiety while cutting back on carbohydrates. A simple tip would be to reduce your carbohydrate intake at meals by half and replace them with a non-starchy vegetable like: salad, broccoli, spinach, peppers, etc. 

What Should My Blood Sugars Be? 

The American Diabetes Association Blood Glucose Goals Are (for most nonpregnant adults): 

  • Before a meal (preprandial plasma glucose): 80–130 mg/dl
  • 1-2 hours after beginning of the meal (Postprandial plasma glucose)*: Less than 180 mg/dl 

If your blood sugars are above these ranges on a consistent basis then you should talk to your health care provider on how you can better manage your diabetes. If however, you randomly have an elevated blood sugar one morning because you ate cake the night before that is not considered a pattern of high blood sugars.

What if I Don't Have a Meter? 

If you have Type 2 diabetes and do not have a blood glucose monitor you can ask your health care provider to write you a prescription. Monitoring your blood sugars can help you to keep your diabetes in check. 

Sources: 

American Diabetes Association. Checking Your Blood Glucose. Accessed on-line: February 27, 2014. 

American Diabetes Association. Standards of Medical Care in Diabetes – 2015. Diabetes Care. 2015 Jan; 38 (Suppl 1): S1-90.

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