What Is Diabetic Ketoacidosis
Someone who has high blood sugar can develop a serious problem with a serious-sounding name: diabetic ketoacidosis . This happens if the body gets desperate for a source of fuel. The body wants to use glucose . But without insulin, that glucose stays stuck in the blood and isn’t available to the cells so the body uses fat instead.
But that can sometimes cause problems. Why? Because when the body uses fat, chemicals called ketones are produced. These ketones get into a person’s blood and urine and they can make a person very sick. DKA is a very serious problem for people with diabetes, but the good news is that it can be prevented and treated.
A Healthy Morning Routine For Diabetes Management
Additionally, stick to your medication plan as prescribed by your physician to help manage your blood sugar levels when lifestyle changes alone arent sufficient to control your condition. Remember, sticking to the scheduling is crucial for controlling any health conditions and overall long-term health and well-being.
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Normal Blood Sugar Ranges In Healthy Non
For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal.
Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.
Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:
- Fasting blood sugar : Less than 100 mg/dL
- 1-2 hours after a meal: Less than 140 mg/dL
- 2-3 hours after eating: Less than 100 mg/dL
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It’s Easy To Get The Care You Need
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Whether you know it or not, every morning you experience a natural biological event called the dawn phenomenon. For most, this passes without health risk. Thats not the case, however, if you have diabetes.
But to ease your concerns, if you do have diabetes, endocrinologist Miguel Parilo, MD, offers advice on ways to control the effects of dawn phenomenon on your health.
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How To Prevent Hyperglycaemia And Lower Your Blood Sugar Levels
Testing your blood sugar levels regularly can help you spot the signs of hyperglycaemia. But there are some steps you can take to either prevent a hyper from happening or to bring down your blood sugar levels.
You can start by making sure you are aware of your carbohydrate portions and how they may be affecting your blood sugar levels after eating. Carb countingis one of the ways you can manage this. Avoid foods that have a high glycemic index and choose low GI foods that can help manage your blood sugar levels more effectively. Increase the fibre in your diet. This can help slow down carbohydrate digestion, which can help limit the rise in your blood sugars.
Try to maintain a healthy weight as this promotes regular blood sugar levels in the body. Be as active as possible, regular exercise can help your body process more of the sugar.
Remember to take your insulin and other diabetes medication, and always take them correctly. Continue to take your diabetes medication even if you are ill and not eating.
Concentrate on your emotional wellbeing, get a quality nights sleep and find ways to manage your stress. Stress can cause hormones to be released, which keep your blood sugar levels high.
If your blood sugar levels continue to be high, or youre unsure of what to do, contact your doctor for further guidance.
For People With Type 2 Diabetes
It is normal for blood glucose levels to go up and down throughout the day. An occasional high blood glucose level is not a problem. But if your blood glucose level remains high for a few days or if you are sick, contact your doctor or Credentialed Diabetes Educator.
If not treated, high blood glucose levels can be dangerous and lead to Diabetic Ketoacidosis. Find out more here:
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What Is The Dawn Phenomenon
Your body uses glucose for energy and it is important to have enough extra energy to be able to wake up in the morning. So for a period of time in the early morning hours, usually between 3 a.m. and 8 a.m., your body starts churning out stored glucose to prepare for the upcoming day.
At the same time, your body releases hormones that reduce your sensitivity to insulin. In addition, these events may be happening while your diabetes medication doses taken the day before are wearing off.
These events cause your body’s blood sugar levels to rise in the morning .
What To Do About The Dawn Phenomenon
The dawn phenomenon can be more of a problem if you have type 1 diabetes, in which the body struggles to make enough insulin, compared totype 2 diabetes, the more common form of diabetes, Dr. Parilo says.
People with type 2 diabetes can usually do something about it limit the amount of snacking the night before, reduce carbohydrates to lessen the impact, or reasons, for blood sugar elevation overnight, he explains.
Dr. Parilo said that a sign that you may need help managing the effects of dawn phenomenon on your diabetes is when, despite positive lifestyle changes that youve made, youre still noticing this escalation of blood sugar beyond the goals that you and your health care provider have set for you.
When this happens, he said, your doctor will likely recommend further changes to overcome the effect of the dawn phenomenon. Perhaps, timing exercise or timing the types of meals or timing your medications to peak or work . Then the blood sugar may not escalate to the same extent.
If you use insulin, he said, we can change the type, the timing of it, and that can often positively affect the problem.
Dr. Parilo explains how to reduce the effects of the dawn phenomenon.
Click play to watch the video or read video transcript.
How can someone with diabetes help reduce the effects of the dawn phenomenon?
Other Causes Of High Morning Blood Sugar
Blood sugar can rise in the morning for reasons other than the dawn phenomenon. Dr. Parilo says these can include:
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What Causes High Blood Sugar Levels In The Morning
Commonly known reasons why your blood sugar may be high in the morning include high-carb bedtime snacks and not enough diabetes medications.
Yet two lesser-known reasons may be causing your morning blood sugar woes: the dawn phenomenon and the Somogyi effect. These causes of high morning blood sugar levels are a result of body changes and reactions that happen while you are sleeping.
Can High Levels And Dka Be Prevented
These two problems don’t sound like much fun, so you’re probably wondering how to prevent them. The solution is to keep your blood sugar levels as close to normal as possible, which means following your diabetes management plan. Checking your blood sugar levels several times a day will let you and your parents know when your blood sugar level is high. Then you can treat it and help prevent DKA from happening.
What else can you do? Wear a medical identification bracelet that says you have diabetes. Then, if you are not feeling well, whoever’s helping you even if the person doesn’t know you will know to call for medical help. And the doctors will be able to get you better more quickly if they know you have diabetes. These bracelets also can include your doctor’s phone number or a parent’s phone number. The quicker you get the help you need, the sooner you’ll be feeling better!
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Blood Sugar: When Its Too Low Or Too High
The hormone insulin takes sugar from food and uses it for energy. With type 2 diabetes, you dont have enough insulin or your body isnt effective at using insulin, and excess sugar continues to circulate in your bloodstream.
A target blood sugar range for most people with type 2 diabetes is 80 to 130 milligrams per deciliter before a meal and less than 180 mg/dl one to two hours after starting a meal, according to the American Diabetes Association.
A reading of 160 mg/dl or higher is typically considered high blood sugar . Over time, blood sugar in the range of 160 to 250 mg/dl can affect every organ in your body, Dr. Reddy says. Its associated with heart disease, eye disease, kidney disease, neuropathy, stroke, and vascular disease. If blood sugar goes as high as 500 mg/dl, you may experience symptoms such as thirst, the urge to urinate more often, weight loss, low energy, and drowsiness, he says.
Low blood sugar occurs when levels fall to less than 70 mg/dl. This is a risk when you take insulin or other diabetes medications, have gone too long without a meal, have been active, or have been drinking alcohol.
If your blood sugar goes too low, youll probably feel shaky and sweaty and you may develop tremors, Reddy says. Other symptoms may include a racing heart, headache, weakness, confusion, hunger, irritability, lack of coordination, and pale skin. If your blood sugar continues to drop to 30 mg/dl and below, you could slip into a diabetic coma.
Improving Blood Sugar Control
Good blood sugar control can help you avoid the symptoms and complications of going too high or low. Youll also feel better and have more energy, says Rasa Kazlauskaite, MD, medical director of the Rush University Prevention Center in Chicago, Illinois, and associate professor in the department of preventive medicine and internal medicine.
Get started with these 10 tips to help you rein in your blood sugar and better manage type 2 diabetes:
1. Stick to your medication plan. There are many drugs to help control blood sugar, Reddy says. Taking your medication as directed is vital dont skip doses.
2. Eat on schedule. Eating healthy meals at about the same time every day helps keep blood sugar steady. Also, meal routines and consistency help to avoid severe hunger and help medications work better, Dr. Kazlauskaite says.
3. Distribute carbohydrates throughout the day. Make it a goal to eat two to four carbohydrate servings about 30 to 60 grams per meal, says Margaret Powers, PhD, RD, CDE, president-elect of health care and education for the American Diabetes Association and a research scientist at Park Nicollet Health Services International Diabetes Center in Minneapolis, Minnesota. Because carbohydrates raise your blood sugar, spacing them out can help keep your levels in a healthy range.
9. Make it a family affair. Reddy suggests recruiting family members to eat healthy and exercise with you so it feels more like fun than a task.
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Diagnosing Prediabetes Type 2 And Type 1 Diabetes
Depending on which country or medical organization you ask, the qualifying numbers for normal versus prediabetes versus diagnosed type 1 or type 2 diabetes can vary slightly.
- HbA1c: 5.7 to 6.4 percent
- Fasting: 100 to 125 mg/dL
- 2 hours after a meal: 140 mg/dL to 199 mg/dL
Type 1 or 2 diabetes
- HbA1c: 6.5 percent or higher
- Fasting: 126 mg/dL or higher
- 2 hours after a meal: 200 mg/dL or higher
Please note:Type 1 diabetes tends to develop very quickly which means that by the time symptoms are felt, blood sugar levels are generally well above 200 mg/dL all the time. For many, symptoms come on so quickly that they are dismissed as the lingering flu or another seemingly ordinary virus.
By the time blood sugar levels are tested, many newly diagnosed type 1 patients will see levels above 400 mg/dL or higher. If you do suspect that you or a loved one has type 1 diabetes, visit your primary care or urgent care immediately and ask for a urine test to measure ketones in addition to testing blood sugar levels and A1c.
Read more about ketones at diagnosis in ourDiabetic Ketoacidosis Guide.
Why Are My Blood Sugars High In The Morning
Heres a simple plan for diagnosing the source of high blood sugars in the morning.
It takes a little bit of effort, but you probably only need to do it a few times to diagnose the issue.
To diagnose either dawn phenomenon or Somogyi effect, experts recommend checking blood sugar levels for several nights, specifically between 3 a.m and 5 a.m.
Compare these three glucose values and find the pattern:
- If your blood sugar stayed steady overnight, but rose in the morning, you are likely experiencing dawn phenomenon.
- If your blood sugar rose steadily throughout the night, your morning glucose highs may be the result of your diet choices , or a sign that you may want to adjust your insulin and glucose-lowering medication regimen.
- If your blood sugar dipped low in the middle of the night, you may be experiencing Somogyi effect.
The best option is to use a continuous glucose monitoring system . This will give you an entire nights worth of blood sugar values, making it easy to identify what direction your blood sugar moved while you slept, without having to set an alarm in the middle of the night.
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