Does Not Having Symptoms Mean Diabetes Is Being Managed Well
Blood sugar control is crucial when youre living with type 2 diabetes. Dips and spikes can not only make you feel cranky and sluggish, but they can also wreak havoc on your personal health.
For the record, the American Diabetes Association notes that you have diabetes if one of the following applies to you:
- Your blood glucose after fasting is 126 milligrams per deciliter or higher.
- Your blood glucose two hours after eating a meal is 200 mg/dl or higher.
- Your hemoglobin A1C is 6.5 or higher.
The tricky part is that with type 2 diabetes you may not feel it when blood sugar levels are too high, according to the ADA. It feels different for everyone. Not everyone will have the same symptoms, and some individuals will have no symptoms at all, says Lori Zanini, RD, CDE, a Los Angelesbased former spokesperson for the Academy of Nutrition and Dietetics.
Because blood sugar management is so important to your overall health with type 2 diabetes, you need to take action if you think your levels may be out of control, even if youre feeling totally fine.
What Causes Hyperglycemia In People With Diabetes
- The dose of insulin or oral diabetes medication that you are taking is not the most helpful dose for your needs.
- Your body isnt using your natural insulin effectively .
- The amount of carbohydrates you are eating or drinking is not balanced with the amount of insulin your body is able to make or the amount of insulin you inject.
- You are less active than usual.
- Physical stress is affecting you.
- Emotional stress is affecting you.
- You are taking steroids for another condition.
- The dawn phenomenon is affecting you.
Other possible causes
- Pancreatic diseases such as pancreatitis, pancreatic cancer and cystic fibrosis.
- Certain medications .
- Gestational diabetes, which happens in 4% of pregnancies, and is due to decreased insulin sensitivity.
- Surgery or trauma.
Managing Your Diabetes Devices
If you are using an insulin pump, talk to your diabetes team about how to best manage hyperglycemia. In general, be sure to check your pump first. Make sure all parts are connected and working correctly. Check your bolus history and temporary basal rate. Also check your insulin to make sure it has not expired or gotten too warm.
If you use a CGM, try not to react to it too often. You might be tempted to give another dose of insulin too soon, before the first one finishes working, which is known as stacking insulin this can cause low blood sugar .
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How To Prevent Hyperglycaemia
There are simple ways to reduce your risk of severe or prolonged hyperglycaemia:
- Be careful what you eat be particularly aware of how snacking and eating sugary foods or carbohydrates can affect your blood sugar level.
- Stick to your treatment plan remember to take your insulin or other diabetes medications as recommended by your care team.
- Be as active as possible getting regular exercise can help stop your blood sugar level rising, but you should check with your doctor first if you’re taking diabetes medication, as some medicines can lead to hypoglycaemia if you exercise too much.
- Take extra care when you’re ill your care team can provide you with some “sick day rules” that outline what you can do to keep your blood sugar level under control during an illness.
- Monitor your blood sugar level your care team may suggest using a device to check your level at home so you can spot an increase early and take steps to stop it.
Page last reviewed: 08 August 2018 Next review due: 08 August 2021
What Is High Blood Sugar
Elevated blood sugar levels are known as hyperglycemia. Blood sugar levels are measured using a small sample of blood that is tested in a lab. Blood sugar can also be tested using at home devices such as a handheld glucometer. Levels that indicate hyperglycemia are indicative of prediabetes and both type 1 and type 2 diabetes.
Normal ranges of blood sugar will vary depending on the test being done. In general, a normal fasting glucose level will be between 70-100 mg/dL. After a meal, these levels are expected to rise slightly around 1 to 2 hours after the beginning of a meal, but should be less than 180 ml/dL.
Maintaining healthy blood sugar levels is important not only for metabolic health, but heart health too. Over time, high blood sugar can damage blood vessels and the nerves that control your heart. People with diabetes are also more likely to have other conditions that raise the risk for heart disease:
- High blood pressure increases the force of blood through your arteries and can damage artery walls. Having both high blood pressure and diabetes can greatly increase your risk for heart disease.
- Too much LDL cholesterol in your bloodstream can form plaque on damaged artery walls.
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Correcting High Blood Sugar Levels With Insulin
If you take insulin, one way to reduce blood sugar is to inject insulin.
However, be careful as insulin can take 4 hours or longer to be fully absorbed, so you need to make sure you take into account how much insulin you may already have in your body that is yet to be absorbed by the blood. Insulin that is yet to be absorbed by the blood is called active insulin.
If you decide to correct with insulin, watch you dont over correct as this can lead to hypoglycemia and can be dangerous, particularly so before bed.
You Notice Tingling And Numbness In Your Hands Or Feet
As mentioned, uncontrolled blood sugar can cause nerve damage, also known as diabetic neuropathy. What you may notice is a tingling sensation or even numbness in your hands and feet. Some people experience pain in their hands and feet as well. Though neuropathy is most common in people who have had diabetes for a long time, it can occur in anyone with poorly controlled diabetes.
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What Are Risk Factors For Hyperglycemia
Major risk factors for hyperglycemia are:
- You have a family history of type 2 diabetes.
- You are African American, Native American, Hispanic or Asian American.
- You are overweight.
- You have high blood pressure or cholesterol.
- You have polycystic ovarian syndrome .
- You have a history of gestational diabetes.
Will I Need Medication Or Insulin For Type 2 Diabetes
Some people take medication to manage diabetes, along with diet and exercise. Your healthcare provider may recommend oral diabetes medications. These are pills or liquids that you take by mouth. For example, a medicine called metformin helps control the amount of glucose your liver produces.
You can also take insulin to help your body use sugar more efficiently. Insulin comes in the following forms:
- Injectable insulin is a shot you give yourself. Most people inject insulin into a fleshy part of their body such as their belly. Injectable insulin is available in a vial or an insulin pen.
- Inhaled insulin is inhaled through your mouth. It is only available in a rapid-acting form.
- Insulin pumps deliver insulin continuously, similar to how a healthy pancreas would. Pumps release insulin into your body through a tiny cannula . Pumps connect to a computerized device that lets you control the dose and frequency of insulin.
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Avoiding High Blood Sugar And Dka
No matter how well they take care of themselves, people with diabetes will sometimes have high blood sugar levels. But the best way to avoid problems is to keep your blood sugar levels as close to your desired range as possible, which means following your diabetes management plan. Checking your blood sugar levels several times a day will let you know when your blood sugar level is high. Then you can treat it and help prevent DKA from happening.
High blood sugar levels don’t always cause symptoms, and a person who isn’t testing regularly might be having blood sugar levels high enough to damage the body without even realizing it. Doctors may use the HbA1c test to find out if someone has been having high blood sugar levels over time, even if the person has not had obvious symptoms.
Here are some other tips for avoiding high blood sugar levels and preventing DKA:
- Try to eat all your meals and snacks on time and not skip any.
- Take the right amount of insulin.
- Check your blood sugar levels regularly and your ketone levels when your diabetes management plan recommends it.
- Stick to your diabetes management plan.
You Can Prevent Type 2 Diabetes
Before developing type 2 diabetes, most people have prediabetes, where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. People who have prediabetes are at increased risk of developing type 2 diabetes.
If you have prediabetes, losing a small amount of weight if youre overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A lifestyle change program offered through the CDC-led National Diabetes Prevention Program can help you make those changesand make them stick. Through the program, you can lower your risk of developing type 2 diabetes by as much as 58% .
Take the 1-minute test to see if you may be at risk of prediabetes.
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What Is Type 2 Diabetes
Type 2 diabetes is a disease where your body cant use energy from food properly. Your pancreas produces insulin to help your cells use glucose . But over time your pancreas makes less insulin and the cells resist the insulin. This causes too much sugar to build up in your blood. High blood sugar levels from Type 2 diabetes can lead to serious health problems including heart disease, stroke or death.
Which Foods Keep Your Sugar Levels In Control
Carbohydrates need to be consistent. You dont want to eat all of your daily carb count in one meal. That will cause your blood sugar to spike, and then drop during the other meals. Giving your body a steady amount of carbohydrates will provide a stable amount of energy. It will also help your body make enough insulin to keep your blood sugar at a healthy number.
The easiest way to make sure that your carb intake is appropriate is to count carbohydrates. It is a simplified way to evaluate foods based on their nutritional value. The best place to start when counting is to aim for 45 to 60 grams of carbohydrates per meal and roughly 15 to 30 grams for each snack in between meals. You may have to adjust this based on your individual needs and your blood sugar readings. It is a lot easier to calculate the carbohydrates when you have a food with a label, but many foods do not. Check the serving size on the label to be sure that you are counting correctly. The US Department of Agriculture has a website that allows you to type in any food and it will give you the nutritional values. Check it out at . A few examples of 15 grams of carbs include:
- 1 slice of bread
- ½ cup of oatmeal
- 1 small piece of fresh fruit
It is important that you pay attention to nutrients other than the carbs too. Be sure to have adequate protein and fiber, while keeping lots of fat to a minimum.
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Type 1 Vs Type 2 Diabetes: Whats The Difference
Type 2 diabetes is not the same as Type 1 diabetes. In Type 1 diabetes, your pancreas doesnt make any insulin. In Type 2, your pancreas doesnt make enough insulin, and the insulin it is making doesnt always work as it should. Both types are forms of diabetes mellitus, meaning they lead to hyperglycemia .
Type 2 diabetes usually affects older adults, though its becoming more common in children. Type 1 diabetes usually develops in children or young adults, but people of any age can get it.
Can Type 2 Diabetes Be Prevented
You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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How Common Is Low Blood Glucose
Low blood glucose is common among people with type 1 diabetes and among people with type 2 diabetes who take insulin or some other diabetes medicines. In a large global study of people with diabetes who take insulin, 4 in 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported a low blood sugar event at least once over a 4-week period.2
Severely low blood glucose, defined as when your blood glucose level drops so low you cant treat it yourself, is less common. Among U.S. adults with diabetes who take insulin or some diabetes medicines that help the pancreas release insulin into the blood, 2 in 100 may develop severely low blood glucose each year.3
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When Is Blood Sugar Considered To Be Too High Or Too Low
Slight fluctuations in blood sugar levels are completely normal, and also happen every day in people who dont have diabetes, in response to the food they eat. Between around 60 and 140 milligrams of sugar per deciliter of blood is considered to be healthy. This is equivalent to a blood sugar concentration of between 3.3 and 7.8 mmol/l. Millimoles per liter is the unit that blood sugar is measured in. It describes the amount of a certain substance per liter.
If someone has readings over 7.8 mmol/l , they are considered to have hyperglycemia. These high blood sugar levels mainly occur if there isn’t enough insulin or the insulin doesn’t work properly. Without the effect of insulin, the organs can’t make good use of the sugar in the blood, so the sugar builds up. If type 1 diabetes is left untreated, blood sugar levels can increase to over 27.8 mmol/l . Such high levels tend to be uncommon in type 2 diabetes.
Blood sugar levels below 3.3 mmol/l are considered to be too low. But, as you can see in the illustration below, there are no clear-cut borders between normal blood sugar levels and too high or too low blood sugar levels.
Blood sugar: Normal range between hyperglycemia and hypoglycemia
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Exercise In The Afternoon
Exercise lowers blood sugar by increasing insulin sensitivity, which allows the body to use insulin and glucose more effectively, increasing glucose movement during and after exercise. Studies have shown that exercise will lead to optimal insulin regulation. Exercise after dinner will set you up for steady glucose levels through the morning.
Research has also shown that moderate-intensity aerobic exercise before breakfast reduced the morning rise of blood glucose in type 2 diabetes patients, partially counteracting the dawn phenomenon. The same study also found that exercise significantly reduced blood glucose fluctuations and improved blood glucose control throughout the day.
Some of the best exercises for avoiding morning blood sugar spikes include:
- A walk
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You Feel Tiredness And Fatigue Constantly
Fatigue and extreme tiredness are symptoms of uncontrolled blood sugar, the ADA says. Simply put, when your body is not processing insulin properly or it doesnt have sufficient amounts of insulin, the sugar is staying in our blood rather than getting into our cells to be used for energy, Zanini says. Also, frequent urination can lead to dehydration, which Bandukwala identifies as another contributing factor to fatigue.
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What Causes High Blood Sugar
A variety of things can trigger an increase in blood sugar level in people with diabetes, including:
- missing a dose of your diabetes medicine or taking an incorrect dose
- overtreating an episode of low blood sugar
- taking certain medicines, such as steroids
Occasional episodes of hyperglycaemia can also occur in children and young adults during growth spurts.
High Blood Sugar: Diet And Exercise Advice
People with high blood sugar may be able to lower their levels through exercise and eating a nutritious, well-balanced diet with smaller portions.
If a personâs blood sugar level is higher than 240 mg/dl, it may not be safe for them to exercise because ketones may be present in the urine. Ketones are waste products that the body creates when it uses fats as fuel instead of glucose.
Exercising with ketones in the urine may cause blood sugar levels to increase even further. A buildup of ketones can also lead to a life threatening condition called ketoacidosis.
A doctor can offer advice on a safe treatment plan for lowering blood sugar.
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