Highs and Lows of Blood Sugar

The material contained in this video presentation provides general information on the management of diabetes. This information is for reference purposes only and should not be considered medical advice. For specific information and recommendations based on your health condition, please consult your medical provider.

Hello, my name is Annette McClanahan. I'm a registered nurse and certified diabetes care and education specialist here with Lee Health to talk to you about the highs and lows of blood sugar types of diabetes.

The two main forms of diabetes are type one diabetes and type two diabetes. Probably about five to 10% of people with diabetes have type one diabetes. Type one diabetes is an autoimmune condition where something in the body has attacked those cells in the pancreas that produce insulin. The body can no longer make insulin. This requires insulin injection therapy for survival.

The majority of people, about 90 to 95% of people with diabetes have type two diabetes. This is a condition of insulin resistance and/or insulin insufficiency. The body may make insulin, but it doesn't use it well enough and they may not make enough insulin to keep up with the body's needs. People with type two diabetes may or may not require insulin injection therapy.

Target glucose and A1C levels before meals. The target glucose is 80 to 130 for people with diabetes two hours after the first bite of a meal, the target glucose is less than 180 for people with diabetes, and the target A1C level for people with diabetes is less than 7%. These are based on the American Diabetes Association standards of care when to take action.

We're looking for a balance with the glucose levels. We wanna avoid them from being too high or too low. We don't ever wanna blood glucose level less than 70. That is considered hypoglycemia or a blood glucose level that is too low. We also wanna avoid consistently high blood glucose levels or consistently above 150, also known as hyperglycemia.

Hyperglycemia is a blood glucose level that is too high. Everybody has a high blood sugar. On occasion. What we're looking for is what the majority of your blood sugars run. A blood sugar consistently above 150 is considered too high. What causes hyperglycemia? There can be several different causes. Some of the common ones are eating too much carbohydrate, having an illness, being under stress, lack of exercise, or not taking enough medication.

Quite often if you're working on your meal, meal planning and sticking to your physical activity routine to the best of your ability, but the blood glucose levels are always too high, you may not be on enough medication.

Symptoms of hyperglycemia or high blood glucose symptoms can be increased thirst, increased urination, blurry vision, feeling tired or fatigued, slow to heal wounds and cuts, more frequent infections, weight loss, nausea, vomiting, and abdominal pain. Typically, weight loss is an unexplained weight loss or not an intentional weight loss. By the time somebody may have nausea, vomiting, and abdominal pain, it's important to understand that these can be symptoms of a severe condition called diabetic ketoacidosis. Managing hyperglycemia, the first thing we wanna do is look for the causes.

If you know it might have been too much carbohydrate at a meal, that would be understandable. There are times when you may have to adjust your medication as recommended by your healthcare provider. You may want to test that blood glucose level more often, and some of the things that you can do when your blood sugar is too high is drink more fluid. Water is best and about eight ounces every hour to help bring that high blood glucose level down.

Testing the urine for ketones may be necessary for people with type one diabetes that have a blood glucose level greater than 240. How to test urine for ketones Purchase available over the counter urine ketones, strips, they can be found usually in the pharmacy section with diabetes supplies. Follow the directions on the bottle to check urine for ketones.

Know when to contact your healthcare team and you may have to take insulin as directed severe hyperglycemia. If your blood sugar is not coming down and or if your ketones stay positive, contact your healthcare provider for guidance. Severe hyperglycemia may require emergency treatment to lower the blood sugar with fluid replacement, electrolyte replacement, and insulin therapy when to take action.

We are looking for that balance. We don't want our blood glucose levels to be too high or too low. Hypoglycemia, a blood sugar below 70 is considered too low and requires immediate action. The term for that is hypoglycemia.

What causes hypoglycemia or low blood glucose? Low blood glucose may occur if you use insulin and/or certain oral diabetes medications and you skip a meal. It can also occur if you go too long in between meals when you're on those certain medications or if you had a meal with not enough carbohydrate. Low blood glucose may occur if you use insulin or certain oral diabetes medications and you take too much medication. Low blood glucose may also occur if you use insulin or certain oral diabetes medications and exercise more than usual or are more active than usual. Low blood glucose usually occurs as a side effect of certain diabetes medications in combination with one of these actions.

Use alcohol safely. Alcohol can lead to hypoglycemia or a low blood glucose when using insulin or certain diabetes pills. It's important to check with your healthcare provider and confirm that alcohol intake is approved for you. If approved, it's very important to use moderation. Moderation is one to two drinks as seen here. One drink is equivalent to 12 ounces of a beer, five ounces of wine, or one and a half ounces of liquor or spirit. Never drink on an empty stomach. Always have alcohol in moderation and with food.

Symptoms of hypoglycemia. Symptoms of hypoglycemia tend to hit all of a sudden, usually all of a sudden you may not feel right. Those things can be feeling shaky, being nervous or anxious, breaking out in a sweat, having chills or feeling clammy. Your mood may change or you may have irritability or feel impatient. You may have confusion. You may feel like your heart is pounding or beating fast. People may feel lightheaded or dizzy. You may have hunger or nausea. Everybody is different, but typically all of a sudden you may not feel right.

The rule of 15, the rule of 15 is the best practice to treat hypoglycemia. If you feel funny or don't feel right, check that blood sugar. If that blood sugar is below 70, eat 15 grams of a fast-acting carbohydrate. 15 grams of a fast-acting carbohydrate will increase the blood sugar anywhere from 30 to 50 points within 15 minutes for most people, so we wait 15 minutes and then we retest or recheck that blood glucose level. We repeat this until that blood glucose level is above 80. Once that blood sugar is above 80, if it's time for a meal, you wanna eat a meal with more complex carbohydrates to stabilize the blood sugar. If it's not mealtime or you won't be eating within the hour, you wanna have a snack to help stabilize that blood sugar.

Choose one of the following. Any of these have 15 grams of fast-acting carbohydrates. Portion is important. We want enough carbohydrate to bring the blood sugar up quickly, but we don't want so much that it spikes the blood sugar too high.

Things that contain 15 grams of fast acting carbohydrates are a half a cup or four ounces of most juices, six ounces of a regular soda, four glucose tabs. I recommend glucose tabs. It's very easy. They don't melt. You can carry them in the car in your pocket or a purse and they're quick and ready to go. If chewing glucose tablets is a trouble, you can also purchase a glucose gel pack.

Other things may be a small tube of cake icing that you can find in the baking section of the supermarket hard candy such as lifesavers, but you need seven lifesavers things that we have around the house, one tablespoon of sugar, honey, or syrup. All of those things have 15 grams of fast acting carbohydrates. Two, two tablespoons of raisins or one cup of low fat milk. I emphasize low fat milk because if you use a whole fat milk to treat low blood sugar, that fat content will slow the rise or increase in the blood sugar and you may be likely to drink more and more of that until you feel better.

You wanna use a skim milk if you are using milk to treat hypoglycemia. This is the same reason that things such as chocolate or candy bars do not work well to bring the blood sugar up rapidly. The best practice is if you feel funny, check or test that blood sugar. But if you don't have your meter and you feel funny, go ahead and treat it like a low blood sugar. It is safer to spike it a little high that one time versus it can be dangerous to leave a low blood sugar. Untreated driving can be a concern when it comes to hypoglycemia. Driving safely with diabetes means knowing what your blood sugar level is before getting behind the wheel. Medical id.

It's important to always wear your diabetes emergency identification. This can alert emergency response staff to check for that blood sugar first. Sometimes hypoglycemia or a blood sugar that is too low can mimic symptoms of a stroke. Having that ID can alert staff to look for the blood sugar first. There are a couple of ways that you can obtain a medic alert id. You can call the toll-free 800 number seen on the screen, or you could search medic alert.org on your computer.

This video is a brief overview of the highs and lows of blood sugar. For more information or to obtain support, please reach out to a certified diabetes care and education specialist.

Thank you.