Janet Still FNP
Lifestyle Modification Support http://stilljanet.com
High Blood Sugar in Diabetes 2: What To Do?
You have a diagnosis of Diabetes type 2 and are doing a great job taking your new medications on time and paying attention to your diet to prevent high blood sugar. Today is, perhaps, a different day from your routine though; before you know it, time has run away from you, and you do not feel so well. Could this be your blood sugar running high (hyperglycemia)?
Classic signs that your blood sugar is running higher than is safe in Diabetes type 2 are emptying your bladder more often than is typical and feeling much thirstier. These two symptoms can fool the distracted mind since they seem to go hand in hand. Just because you are drinking more, you expect to empty your bladder more. Yet when you have Diabetes 2, you now are the captain of your body with full duties to respond to signs from your body that the ship may be experiencing a violation to the integrity of its hull. So, make a mental note: any signs of change in your routine bodily behavior could be a distress signal from your body. Fatigue, blurred vision, headache are also signs for increasing blood sugar levels. Start issuing orders to self and, if necessary, your healthcare team.
Before I go any further, if you have not been advised, or have not taken the forthcoming instruction to heart yet, your blood sugar running high for long periods of your day is a recipe for disaster. This fact can be a struggle to accept until the individual recognizes that high blood sugar is not merely something to worry about far off in the future, but if your body is unable to keep your blood sugar levels from rising right now, you are potentially heading for a diabetic coma…right now, today!
For those of you that are seeking a way to turn around this character in your life called Diabetes 2, this brief article is to provide you some resources and information that you can implement quickly, six steps for your immediate hyperglycemic situation. Steps that can be used to prevent hyperglycemia over the long term are mentioned at the end of the article. Taking charge of your Diabetes 2 or even the pre-diabetes condition is as simple as educating yourself and implementing lifestyle changes that you can truly live with…figuratively, and literally. The information in this article is not meant to replace instructions from your Diabetes provider and instructors. This information is meant to help you follow your Diabetes 2 instructions with more ease, and hopefully, with more joy.
Life is famous for changing the game up, as the saying goes. This goes double for someone with Diabetes 2. Staying with our first example, let’s say you are able to check your blood sugar and learn it is above 200. You recall your Diabetes 2 instructors telling you that above 180 is moving into dangerous levels and that means your body does not have enough insulin. What can you do right now to move into a safer blood sugar level?
Wait! How the heck did my blood sugar go up? I did everything right this morning. I took my medications on time, ate a healthy breakfast, and even got in some calisthenics before my morning shower.
First of all, if you do not already know, many particular activities or situations can cause your blood sugar to rise. Supplies to always have on hand are your glucometer for checking your blood sugar level, a travel ketone urine kit, and extra anti-diabetic medications. Stress is a biggie, which includes stress from being sick, overworked, happy or sad, or simply overly anxious. Why? Increased stress causes your body to release hormones related to the cause of the stress, which in turn elevate the level of glucose in your body. Even people who do not have Diabetes 2 can have hyperglycemia from increased or prolonged stress.
Checking your blood sugar levels when you experience suspicious changes in your body’s routine is a seriously necessary step in addressing hyperglycemia. Returning to our example of a busier and more demanding day than usual being today’s cause of high blood sugar, ditching the worksite to run around the block in your best professional attire may not be appropriate or even possible. More importantly, because your blood sugar may have risen quickly in response to stress, your body may have begun making ketones. Depending on the severity of your stress level today and how high your blood sugar has risen, collecting some urine for your travel ketone test is a smart idea. Exercise is dangerous when your body is producing ketones. If your urine kit tests positive for ketones, call your doctor now for immediate advice. Repeat: call your doctor now for immediate advice. Ketones need to be addressed now.
No ketones? Awesome news! You have caught the body’s signals in time to take charge without calling the doctor’s office. Your Diabetes 2 provider may have already given you instructions for additional amounts of medication to take when your blood sugar has risen. Follow the game plan and keep track of details, maybe jotting some notes on things like: what caused you to check your blood sugar level initially before the scheduled time, whether you get in some exercise after taking the medicine and before checking your blood sugar level again, and how fast the symptoms that annoyed you (thirst, fatigue, headache) change or improve.
About getting in some exercise ….. I have written previously on ideas for including moderate exercise that is enjoyable to you on a more routine basis (see LMS article dated September 2013). Unexpected, undesired! bouts of hyperglycemia are why you want to make a habit of moderate exercise. In pre-diabetes, adding routine moderate exercise and reducing foods that increase blood sugar dramatically can prevent your ever having to take medication for persistent high blood sugar levels. With a Diabetes 2 diagnosis, exercising can prevent the ravaging effects of continued high blood sugar on your body. Besides the short term danger of runaway blood sugar levels causing a diabetic coma, long term uncontrolled hyperglycemia is what causes all the frightening complications of Diabetes 2. Becoming the captain of your body, this proverbial ship, is as simple as learning what exactly is causing what to happen in your body, and changing up the orders to yourself regarding when to enjoy various activities.
Six steps to taking charge of high blood sugar levels (hyperglycemia) are:
1- Take notice of changes in your body; and know the signs of rising blood sugar levels;
2- Carry a glucometer, always, in order to check your blood sugar levels routinely as well as when your body is signaling you that something is off;
3- Carry a travel urine kit for checking ketones for the unplanned/unexpected blood sugar rise;
4- Learn exercises that are possible to do in unique circumstances, such as sitting at a desk; and do not eat additional foods, unless instructed to do so, until you re-establish a safe level of blood sugar;
5- Always be ready and able to contact your Diabetes 2 provider for instructions when ketones are found, and for when your blood sugar level is not going down, even after taking additional medications per instructions;
6- Follow the game plan created by your Diabetes 2 instructors until your blood sugar level returns to normal.
Discovering your blood sugar level is rising and learning to recognize the signs of blood sugar rising are key elements in preventing serious consequences from hyperglycemia. When life has altered from the routine, be ready to alter your routine Diabetes instructions to make unscheduled checks on blood sugar levels and ketones by having a glucometer and urine ketone kit available. If your body is not producing ketones yet, exercise to use up as much of the additional blood sugar as possible. Learn or create ways to increase exercise for your unique situations, like desk yoga, tai chi while talking on speakerphone, jogging in place between customers, whatever applies to your personal circumstances. Most imperative, know your Diabetes provider’s instructions for elevated blood sugar levels and act on them without procrastination. Your body relies on you to stay afloat through life’s changes. Be the smart captain of your ship by seeking and creating simple ways to remember your healthcare plan.
Smooth sailing, mates!
Resources and References:
American Diabetes Association; 2013. Fitness; American Diabetes Association: Food and Fitness. Retrieved from: http://www.diabetes.org/food-and-fitness/fitness/
Casteneda, C., Layne, J., Munoz-Orians, L., Gordon, P., Walsmith, J., Foldvari, m., Roubenoff, R., Tucker, K., and Nelson, M.; 2002. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes; Diabetes Care 25, 12; 2335-2341.
Center for Disease Control and Prevention CDC; 2011. How much physical activity do adults need?; CDC 24/7: Saving Lives, Protecting People: Physical Activity. Retrieved from: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html
Mayo Clinic Staff; 2012. Hyperglycemia in diabetes; Diseases and Conditions on Mayo Clinic webpage. Retrieved from: http://www.mayoclinic.com/health/hyperglycemia/DS01168
Nathan, D., Buse, J., Davidson, M., Heine, R., Holman, r., Sherman, R., and Zinman, B.; (2006). Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy - A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes in Diabetes Care 29, 8; 1963-1972.
van Dijk J, Tummers K, Stehouwer C, Hartgens F, van Loon L.; 2012. Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control? Diabetes Care 35, 5; 948-54.