Even when you’re doing your best to manage your diabetes, your blood sugar can get too low or too high. These are reasons to call your healthcare provider right away.
Low blood sugar (Hypoglycemia)
This happens when you eat too little or not often enough, exercise more than usual, take too much of some diabetes medicine(s), or drink alcohol. Here are some signs and symptoms to look out for:
- Hunger
- Nervousness and shakiness
- Sweating
- Dizziness or light-headedness
- Sleepiness
- Confusion
- Trouble speaking
- Feeling anxious or weak
If you have any of these symptoms, test your blood sugar. If it’s low, eat or drink a small amount of something that has sugar. This includes two or three glucose tablets, five or six pieces of hard candy, or 1/2 cup of fruit juice. After 15 minutes, test again. If your blood sugar is still low, or you still have symptoms, have another serving of sugar. Wait 15 minutes and test again. If your blood sugar is still low call your healthcare provider.
If you are feeling ill, but your meter shows that your blood sugar is fine, recheck your blood sugar and treat your symptoms as explained above.
Sometimes this might happen if your meter isn’t working right.
Extremely high blood sugar (Hyperglycemia)
This can lead to two life-threatening conditions:
Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a life-threatening condition most frequently seen in elderly people. HHNS can happen to people with either type 1 or type 2 diabetes, but it occurs more often in people with type 2 diabetes. HHNS is usually caused by an illness or infection.
In HHNS, blood sugar levels rise, and the body tries to get rid of the excess sugar by passing it into your urine. You will make a lot of urine at first. Later you may not have to go to the bathroom as often, and your urine becomes very dark. This might make you very thirsty. It is important even if you are not thirsty, to drink liquids. This will help you from getting dehydrated.
If HHNS continues, the severe dehydration will lead to seizures, coma and eventually death. HHNS may take days or even weeks to develop. Know the warning signs of HHNS:
- Very high blood sugar level (over 600 mg/dL)
- Extreme thirst (although this may gradually disappear)
- Dry mouth
- Warm, dry skin that does not sweat
- High fever
- Sleepiness or confusion
- Loss of vision
- Hallucinations (seeing or hearing things that are not there)
- Weakness on one side of the body
Test your blood sugar if symptoms appear. Drink fluids if you can. Call your healthcare provider right away.
The best way to avoid HHNS is to check your blood sugar regularly. You can also work with your healthcare professional to develop a sick day plan so that you can reduce the risk of HHNS caused by sickness.
Ketoacidosis
Ketoacidosis is a serious condition that can lead to diabetic coma or even death. Ketoacidosis may happen to people with type 1 diabetes. Ketoacidosis occurs rarely in people with type 2 diabetes.
Ketoacidosis means dangerously high levels of ketones. Ketones are acids that build up in the blood. They appear in the urine when your body doesn’t have enough insulin. Ketones can poison the body. They are a warning sign that your diabetes is out of control or that you are getting sick.
Treatment for ketoacidosis usually takes place in the hospital. But you can help prevent ketoacidosis by learning the warning signs and checking your urine for ketones and blood sugar regularly. Ask your healthcare provider when and how you should test for ketones.
Many experts advise checking your urine for ketones when your blood glucose is more than 240 mg/dL. When you are ill (when you have a cold or the flu, for example), check for ketones every 4 to 6 hours. And check every 4 to 6 hours when your blood glucose is more than 240 mg/dL.
Also, check for ketones when you have any symptoms of ketoacidosis, such as:
Some of the first symptoms are:
- Thirst or a very dry mouth
- Frequent urination
- High blood glucose (sugar) levels
- High levels of ketones in the urine
Next, other symptoms appear:
- Constantly feeling tired
- Dry or flushed skin
- Nausea, vomiting, or abdominal pain (Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your healthcare provider.)
- A hard time breathing (short, deep breaths)
- Fruity odor on breath
- A hard time paying attention, or confusion
If you have these symptoms, test your blood sugar and your urine ketones.
Call your healthcare provider at once if:
- Your urine tests show large ketones
- Your urine tests show large ketones and your blood glucose level is high
- You have vomited more than twice in four hours and your urine tests show high ketones
Also of Interest
Create your personal type 2 diabetes Action Plan (PDF Format) with your healthcare provider.
Learn how to help a friend or family member who has type 2 diabetes.
