So you’ve checked your blood glucose (sugar) levels, but what now? Checking blood sugar levels is only beneficial if we know how to interpret what the number means and what actions we need to take if they are too high or low. We know that many people struggle with controlling their blood sugar levels and more so if they are unsure how to resolve high or low blood sugar readings. Our team has found that improving our clients understanding of sugar levels and what to do if their levels are above or below optimal levels significantly improves their overall management, because both high and low levels can be dangerous. To understand how to respond to blood sugar levels, first we will discuss what impacts blood sugar levels, what optimal blood sugar levels are, classifications of high and low levels, and lastly what to do if levels are high or low.
What impacts blood sugar levels?
Many aspects of our day can impact blood sugar levels, some will increase your blood sugar levels and some will lower them, these can include:
• Food and drinks, including alcohol (particularly foods containing carbohydrates and/or sugar)
• Physical activity
• Medication (some medications not prescribed for diabetes can also affect your blood sugar levels)
• Hormonal changes
• Illness, infection, or pain
Optimal levels for blood sugar levels
Individuals living with diabetes may have a specific and individualised target range recommended by their Doctor (GP), Nurse Practitioner or Endocrinologist. These target ranges may be similar to the general recommendations for all individuals living with Type 1 or Type 2 diabetes, however some individuals may have a target range recommended to them that is outside the general recommendations depending on their individual medical history. Unless you have been recommended individualised target ranges, it is recommended that your blood sugar levels are:
• 4-7 mmol/L fasting or before meals.
• 5-10 mmol/L 2 hours after starting meals.
Hypoglycaemia (low blood sugar levels): classified as any level below 4 mmol/L regardless of your symptoms.
If your blood sugar levels are below 4 mmol/L:
1. Have 15 grams of glucose (equivalent to 150 ml fruit juice OR 4 large/7 small jellybeans).
2. Wait 10-15 minutes and then re-check your blood glucose level.
3. If your blood glucose level is still less than 4 mmol/L, have another 15 g of glucose. (Continue to repeat steps 1 & 2 until glucose levels are above 4mmol/L)
4. If your next meal is more than 15-20 minutes away, consider the need for a longer-acting carbohydrate (e.g., 1 slice of bread, 1 piece of fruit, 100g fruit yogurt)
• If you are planning to drive, you must wait 30 minutes after a hypo and then ensure your blood sugar levels are above 5 mmol/L before driving.
• It is important not to overtreat your hypoglycaemia as this can easily lead to hyperglycaemia (high blood sugar levels)
• If you are having regular hypoglycaemia, see your GP and Diabetes Educator to ensure you are eating enough and your medication doses are not too high.
Hyperglycaemia (high blood sugar levels): classified as any blood glucose levels above 15.0mmol/L.
If your blood sugar levels are above 15.0 mmol/L:
1. Drink water to ensure you stay hydrated, hyperglycaemia can contribute to dehydration.
2. Reflect on your day: did you take your medication this morning and last night? Did you have more to eat or drink than usual in your last few meals? Are you getting a new illness or infection? Have you had a stressful morning or less sleep than usual? All these questions may help you explain why your blood glucose levels have risen above usual levels.
a. If you cannot explain why your blood glucose levels are higher than usual it is important your see your GP or Diabetes Educator so they can assist you.
3. If you feel well, low-moderate intensity exercise can help lower your blood glucose levels. This can be a walk or doing some light strength exercises can help your body process the excess glucose in your body and lower your blood sugar levels.
4. If you feel unwell, it is important not to exercise. You should seek medical attention if you are unsure of how to remedy your hyperglycaemia and continue to feel unwell.
5. For the rest of the day, continue to stay hydrated and consider your next few meals wisely, it is important to continue to eat your main meals however choosing nutritional foods with lower carbohydrates and smaller portions will help to ensure you are not adding too much extra glucose to your already high blood glucose levels.
Knowing how to treat events of hypoglycaemia and hyperglycaemia is very important for your safety while living with diabetes. Prevention of these events is always best to ensure you are not regularly feeling unwell due to high or low glucose levels. Regular physical activity, adequate nutritional intake and understanding your medications is best to prevent glycaemic events. If you need help in these areas, as Exercise Physiologists we can help you with appropriate physical activity, a Dietitian can support your nutrition, and a Diabetes Educator can help with understanding your medication and any other aspects of your diabetes you are unsure of.