Handling High Blood Sugar Levels

Normal Blood Sugar Levels

Blood sugar, also known as glucose, is the major sugar in blood. We get glucose from food and it becomes a source of energy and nutrients for the human body. The small intestine, liver, and pancreas are the organs responsible for regulating the absorption, storage and production of blood sugar.

After a person eats, carbohydrates and blood sugar enters the bloodstream. The pancreas, an organ of the endocrine system, controls the levels of glucose the bloodstream contains.

This organ secretes a hormone called insulin after ingestion of proteins or carbohydrates, to facilitate the entry of blood glucose into your body tissues. 

It also delivers excess glucose to the liver in the form of glycogen. The pancreas also makes the hormone glucagon, which performs the opposite of insulin: raising glucose levels when necessary.

When the body needs more glucose in the blood, glucagon sends signals to the liver to convert glycogen back into glucose and release it to the bloodstream. The contrasting functions of both hormones keep blood sugar levels balanced.

When the body does not have enough sugar, the liver conserves the sugar supply for the body systems that need it, like the brain, red blood cells and kidneys. The liver then produces ketones for the rest of the body. Ketones break down fat into energy.

Glucagon Function: What Roles Does It Play When It Comes to Our Health?

What Should My Blood Sugar Level Be?

For healthy individuals, normal blood sugars are:

• Between 72 to 99 mg/dL (milligrams per deciliter, a unit of measurement used to measure an amount of substance in blood) or 4.0 to 5.4 mmol/L (millimoles per liter) when fasting
• Up to 140 mg/dL (7.8 mmol/L) a couple of hours after eating food

High blood sugar levels are a common problem for those with type 1 and type 2 diabetes. Type 1 diabetes is when your pancreas cannot produce enough insulin.

Type 2 diabetes is when your body resists the effects of insulin or it does not generate enough insulin to maintain a normal blood sugar level. High blood sugar levels, or hyperglycemia, occurs when the body produces too little insulin or else cannot use blood sugar properly.

For individuals living with diabetes, blood sugar levels should be as follows:

• 72 to 126 mg/dL (4 to 7 mmol/L) before meals, for those with type 1 or type 2 diabetes
• 162 mg/dL (9mmol/L) for those with type 1 diabetes after meals
• 144 mg/dL (8mmol/L) for those with type 2 diabetes after meals

How Commonly Do High Blood Sugar Levels Occur?

People with diabetes commonly have high blood sugar levels, especially if disease management is poor. Diabetes is the most common cause for high blood sugar level.

In 2014, the prevalence of type 2 diabetes was estimated to be around 3.2 million cases in the Philippines. Among adults aged 20 to 79, there is a 5.9% prevalence rate. Approximately 1.7 million people with the condition are undiagnosed.

In 2019, an estimated 463 million adults between the ages of 20 to 79 had diabetes worldwide. By 2045, this number is expected to increase to 700 million. 

The number of people with type 2 diabetes is rising in many countries, with 79% residing in low and middle income nations. About 20% (one in five) of adults above 65 years of age have diabetes, while 232 million people (one in two) are still undiagnosed. This condition resulted in 4.2 million deaths. 

Over 1.1. million children and teenagers have type 1 diabetes. 374 million people are likely to get type 2 diabetes.

Signs and Symptoms

What Are the Symptoms of High Blood Sugar Levels?

High blood sugar levels (also known as hyperglycemia) do not show symptoms until glucose values climb to 180 to 200 mg/dL or 10 to 11 mmol/L.  These symptoms become more severe the longer blood sugar levels stay at a high level.

There are some cases however, where individuals with type 2 diabetes do not show symptoms for a long period of time in spite of the higher levels of blood glucose. 

Hyperglycemia: What You Should Know About Extreme High Blood Sugar

The common symptoms of having high blood sugar levels are:

• Frequent urination
• Frequent thirstiness
• Blurry vision
• Fatigue
• Headaches

If high blood sugar is left untreated, ketones can build up in the blood or urine, causing ketoacidosis. The symptoms for this are:

• Breath smelling like fruit
• Nausea and vomiting
• Shortness of breath
• Abdominal pain
• Dry mouth
• General weakness
• Confusion
• Coma

When Should I See My Doctor?

Seek emergency medical attention if:

• You are having trouble keeping down food or liquids without throwing up
• Blood sugar levels are constantly above 240 mg/dL (13 mmol/L) or if there are ketones in your urine
• You have ongoing diarrhea or vomiting but are able to eat some food or drink
• You have fever that lasts more than a full day

Causes and Risk Factors

Hyperglycemia has many causes, including diseases like diabetes, but not all the causes are related to illness. The following are some of the more common causes:

• For those with type 1 diabetes, not having enough insulin in the body 
• For those with type 2 diabetes, when the body has enough insulin but cannot use it properly 
• Eating more or exercising less than planned
• Stress due to illness
• Stress due to external factors (e.g., family, school, work or relationship problems)
• Dawn phenomenon (a flood of hormones produced by the body daily at approximately 4:00 AM to 5:00 AM) 

What Increases My Risk for High Blood Sugar Levels?

There are many risk factors contributing to high blood sugar levels:

• Insufficient insulin shots or oral medication for diabetes
• Too much sweet / sugary consumption (e.g. chocolates, cakes, soft drinks and fruit juices)
• Illness or infection
• Injury, trauma, or major surgery
• Emotional stress due to family, school, work or relationship problems

Hormones that fight sickness or stress may cause your blood glucose level to increase. People who do not have diabetes can also get hyperglycemia if they are very sick. Diabetics may have to take extra medication to maintain blood sugar at a normal level if they are ill or under stress.

Diagnosis and Treatment

Hyperglycemia can be determined through a number of procedures.

Random Plasma Glucose Test

A blood sample can be collected at any time and is also used in diagnosing type 1 diabetes.

Fasting Plasma Glucose Test

This is taken after a minimum of eight hours of fasting, usually in the morning. A result of 100 – 125 mg/dL is considered as a risk of getting type 2 diabetes especially if it occurs with other risk factors.

Oral Glucose Tolerance Test 

A blood sample is first collected then you will need to consume a sweet drink having 75 grams of glucose. You should be at rest as your blood will be drawn after two hours.

HBA1C Test (To Diagnose Diabetes) 

This procedure does not measure blood sugar level directly, but its results are influenced by how high or low your blood sugar levels have been within a span of two to three months

Conditions of diabetes or pre-diabetes are indicated by these values:

• Normal – <6 percent (under 42 mmol/mol)
• Pre-diabetes – 6 to 6.5 percent (42 to 47 mmol/mol)
• Diabetes – >6.5 percent (48 mmol/mol)

How Is High Blood Sugar Treated?

For emergency cases of hyperglycemia, you should seek emergency medical help. To lower blood sugar to a normal level, the following procedures may be done:

• Fluid replacement – You may be given fluids orally or intravenously in order to replace fluids lost due to excessive urination and to dilute extra sugar in the blood.
• Electrolyte replacement – Electrolytes will be administered to you intravenously to help your heart, muscles and nerves function.
• Insulin therapy – You may receive insulin intravenously to reverse processes causing ketone to accumulate in your blood.

Depending on the causes of your severe hyperglycemia, your doctor may recommend additional treatment.

If it is believed to be due to bacterial infection, he or she may prescribe antibiotics. If a heart attack is likely, your doctor may recommend a heart check-up.

Lifestyle Changes and Home Remedies

Those with diabetes will need to manage their diet and lifestyle to keep blood sugar levels at an ideal level. This involves constant monitoring and regular physical activity.

Healthy Weight Maintenance

Discuss with your doctor what your ideal weight should be before beginning any weight loss routine.

Improved Diet

Avoid food that contains simple carbohydrates (e.g., cookies, crackers) which can increase insulin levels and place stress on the pancreas. Avoid saturated fats as well. Opt instead for whole, unprocessed foods (e.g., fruits, vegetables).

Physical Activity

Simple physical activities such as brisk walking for 30 minutes can significantly lower blood glucose levels.

Mineral Levels Check

Magnesium helps insulin become more effective and helps prevent you becoming insulin-tolerant.

Insulin Levels Check

Make sure to get regular insulin checks along with blood sugar tests.

Home Monitoring of Blood Sugar

Routinely measure your blood sugar level with a blood glucose meter.  Studies have shown that those with diabetes who maintain normal or near-normal blood sugar levels are less at risk for diabetes-related complications.

This will help you determine if your treatment plan is working. Check as often as recommended by your doctor. If you are experiencing any symptoms of high blood sugar levels, measure it. 

When blood sugar levels reach 240 mg/dL, check your urine for ketones with an over-the-counter urine ketones test kit. If it comes out positive, seek medical help to reduce blood sugar level safely.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Learn more about Type 2 Diabetes here.