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High blood sugar, also called hyperglycemia, can happen when the body does not have enough insulin or cannot use the body’s insulin. If you are looking for guidance in managing high blood sugar with type 1 diabetes, this article is a good starting point!
What are the symptoms of high blood sugar (hyperglycemia)?
Symptoms of high blood sugar may include:
This is also called ‘polyuria’. It occurs as a result of the body trying to correct the high blood sugar level. The clinical definition of polyuria in adults is urinating more than 2.5 liters per day. This volume is equal to about 10 cans of pop per day.
This is also called ‘polydipsia’. It occurs in response to the dehydration that is caused by increased urination. Thirst is the body’s way of signaling that it needs more water. It is best to avoid drinking pop, as this can further increase the blood sugar level.
This may also be referred to as ‘fatigue’. It occurs because your body is not burning energy efficiently. Also, you may be tired from getting up in the night to urinate. When using food as an energy source, it is important to choose low-carbohydrate snacks. Foods with high amounts of carbohydrates can further raise blood sugar levels.
What causes high blood sugar (hyperglycemia)?
Before discussing how to manage high blood sugars, let’s consider what might cause blood sugars to rise.
There are many causes of high blood sugar, some of which include:
- Not taking enough insulin for the carbohydrates you eat
- Eating more than you planned
- Exercising less than you planned
- Illness (especially when it includes vomiting)
- Emotional stress
- Problems with insulin or insulin administration (e.g. a broken insulin pump, insulin being left out in the heat for too long)
There are a number of strategies that can be used to help manage high blood sugars in children and adults with type 1 diabetes.
How to prevent high blood sugar (hyperglycemia)
Insulin and monitoring
Take insulin (and other diabetes medications) as prescribed or based on the meal plan that you have created with your healthcare team. Ensure to monitor your blood sugars regularly and keep a record of the results.
Plan your meals and eat healthy. If you use the carb counting approach, make sure you are comfortable with this strategy. You may need to make changes to your meals to ensure blood sugars are in the target range. For example, eating soluble fibre (e.g. oatmeal, oat bran etc.) can help control blood sugars. Speak to a dietitian if you have questions or concerns.
Be physically active, as this can lower blood sugar levels and help your insulin work better. It is good to learn how different types of exercise affect blood sugar, therefore, it is important to check blood glucose frequently before, during and after exercise. It is even possible that low blood glucose (hypoglycemia) can happen during or after exercise, when the body has used up much of its stored sugar.
How to treat high blood sugar (hyperglycemia)
Taking insulin will help to lower high blood sugars, but make sure not to overcorrect (take too much insulin), as this can lead to low blood sugars (hypoglycemia) and can be dangerous. For more information about managing hypoglycemia click here.
Exercise can help to lower blood sugars, but intense exercise is not recommended as it can lead to a stress response and increase blood sugars in the short term. Do not exercise if you have ketones (ketones will be discussed further below). Walking is a more moderate form of exercise that can help to correct blood sugars.
When you have high blood sugar, your body tries to remove it from the body through increased urination. Drinking water helps to flush out sugar and also is important for staying hydrated.
Why is it important to treat high blood sugar (hyperglycemia)?
If blood sugars remain high for an extended period of time, this can lead to complications affecting many different parts of the body. This may include the heart, eyes, nerves, and kidneys.
A complication of prolonged high blood sugar, that is more common in type 1 than type 2 diabetes, is diabetic ketoacidosis (DKA). DKA is a medical emergency, as it can lead to coma or even death. If there is not enough insulin to move glucose (sugar) into the body’s cells, fat is used to burn energy instead of sugar. When the body uses fats instead of sugar, toxic chemicals called ketones can form.
Key signs and symptoms of DKA include:
- Thirst, dry mouth and tiredness (similar to symptoms of hyperglycemia)
- High blood sugars (usually greater than 15 mmol/L)
- Rapid breathing or shortness of breath
- A “fruity” smell to your breath
- Nausea and vomiting
- Confusion or loss of consciousness/coma
Ketones can be detected using a blood ketone meter or urine ketone strips. If DKA is recognized early, it may be treated at home, but if blood sugars stay high, ketones are not lowering, or you are vomiting, it is important to go to the hospital and seek medical attention immediately.
It is important to determine what may have caused an episode of high blood sugar and make changes to your insulin or meal planning if needed. If other strategies to lower blood sugars are not effective (e.g. diet and exercise), your insulin dose may need to be adjusted by your health care team. Also, the time of day of your high blood sugar (e.g. morning, after meals, etc.) may affect the recommendations provided to you. Speak to your diabetes team if you have severe and/or frequent episodes of hyperglycemia or if you have any questions about its management.