by Katie Little, Institute Fellow
Last week's blog talked about the high costs of insulin and provided some resources for gaining access to insulin in more affordable ways. The photos above are important for this week's post about insulin, high blood sugar, and low blood sugar. The spoon on the left represents 2 units of short acting insulin, the spoon on the right represents 10 units of short acting insulin. (Insulin is not blue, water was colored blue for this visual). As you can see, there is a noticeable difference between the spoon on the left and the spoon on the right.
People living with diabetes, and taking insulin, are making decisions daily regarding how much insulin they need. This can literally be a daily life and death decision. For this reason, it is important that people living with diabetes work with their health care team in order to understand their ideal blood sugar ranges and medication doses, how to correct for high blood sugar levels, and how to treat low blood sugar levels. The Juvenile Diabetes Research Foundation (JDRF) outlines a typical blood sugar level for someone with diabetes to be at 70-180 mg/dl. Glucose levels can vary a lot throughout the day so it is important to be prepared for both high and low blood sugar levels.
Hypoglycemia (Low Blood Sugar)
Hypoglycemia can occur when medication is taken, but too few carbohydrates are consumed, if meals are skipped, when too much medication is administered, if too much physical activity occurs, you are sick, or you drink too much alcohol without eating. Signs of low blood sugar, or hypoglycemia, may look like being shaky, sweaty, dizzy, tired, weak, nervous, upset, confused, hungry, having difficulty speaking, or having a headache. Some people living with diabetes may not feel their low blood sugars when they come on or recognize them causing them to be hypoglycemia unaware. For this reason they may choose to wear a continuous glucose monitor or will make sure their friends and family can support them if their blood sugars become too low.
Treatment for low blood sugar includes using 15 grams of fast acting sugar (sometimes less for children) such as juice, ½ cup of regular soda, 4 glucose tabs, 2 packs of Smarties, fun size Skittles, or one applesauce pouch.You should then wait 15 minutes and recheck your blood sugar level. Additionally, it is helpful to follow the fast acting sugar with protein and carbs in order to maintain a healthier blood sugar level and prevent a future low. Severe low blood sugar may require the use of a glucagon injection or a glucagon nasal spray.
Hyperglycemia (High Blood Sugar)
Hyperglycemia can occur when diabetes medication is skipped, more carbohydrates are consumed than the amount of medication taken for them, if you are less active than usual, and if you are under stress or sick. Signs of high blood sugar, or hyperglycemia, may look like being very thirsty, needing to use the restroom more than usual, increased hunger, sleepiness, blurry vision, and having infections or injuries that take longer to heal. High blood sugar that goes untreated for too long could lead to a very serious issue of diabetes ketoacidosis (DKA).
Treatment for high blood sugar includes informing your diabetes care team, taking your medications properly, eating well, and staying hydrated. Additionally, if you are on insulin, check to make sure your insulin is not expired and has not been exposed to heat. Those on insulin pumps may consider changing their pump site and looking for a kinked or failed pump site.
Below are two resources provided by Novo Nordisk that outline symptoms of low and high blood sugar. It may be helpful for someone living with diabetes to print this resource to have in their home, at work, or to share with those who might assist them with low or high blood sugars. Additionally, highlighting or adding the symptoms that personally apply to the individual living with diabetes may be helpful as they teach and educate others about their diabetes.
Signs of low blood sugar, or hypoglycemia: Low Blood Sugar
Signs of high blood sugar, or hyperglycemia: High Blood Sugar
*Please consult with your diabetes care team for the best way to manage your low and high blood sugar levels.