Blood sugar level 500

An hour or so after lunch, you start to get a bit of a headache and are having a hard time concentrating. As someone with diabetes, you decide to check your blood sugar to see if it is out of range. Lo and behold, it’s much higher than it should be. Maybe it was that dessert split with your coworker that made it spike? You can’t take more medication because you have already taken your prescribed dose for the day. You also know the dangers and complications related uncontrolled high blood sugar, so you need to know how to lower blood sugar immediately. So what do you do?

What is High Blood Sugar?

First, it’s important to know what your blood sugar should be. This will allow you to make an appropriate decision on what to do next to lower blood sugar immediately. Of course, you should always discuss your individualised goals with your doctor. Below is what the American Diabetes Association recommends as ideal blood sugar numbers for people with diabetes:

Fasting: 80-130 mg/dL (4.4-7.2 mmol/L)

2 hours after meals: less than 180 mg/dL (10 mmol/L)

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MOH guidelines mention the ideal range is:

Fasting: 4.0-7.0 mmol/L

2 hours after meals: less than 10 mmol/L

If your blood sugar is over 350 mg/dL (19.4 mmol/L) and you are experiencing symptoms such as blurred vision, extreme thirst, lightheadedness, restlessness, or drowsiness, you should seek immediate medical attention.

Let’s say your blood glucose is not critical, but higher than you would like it to be, what should you do next?

Drink Water

Drinking enough water may help reduce the risk of getting high blood sugar levels. If you see your blood glucose is high, drink at least 500ml of water. This might help flush out some of the sugar through the kidneys. Try to stay hydrated all the time, so aim for around 8-10 glasses of water a day.

Move

A little exercise can help lower blood sugar by encouraging the body’s cells to take in excess glucose. When you exercise, the muscle cells begin to use up glucose as energy. This causes them to take in more glucose, removing it from the blood stream, making your blood sugar go down. Exercise is one of the best ways to lower blood sugar immediately. Just a 15-20 minute walk can help lower your blood sugar. But, remember, exercise should be a part of your daily life, not just when you overdid it on dessert.

A few words of caution with exercising, if you are feeling lightheaded or dizzy, don’t push yourself too hard. If it is very hot, try to exercise indoors if you can. Be sure to drink plenty of water while exercising. Water will help bring your blood sugar down and keep you hydrated.

If you feel hungry, eat some protein or fat

Sometimes, when our blood sugar is high, our cells are not getting the food they need and we still feel hungry. It is important at this time to not eat more carbohydrates, which will only raise blood sugar even higher. If you feel hungry, eat some protein or healthy fat, which can help stabilise blood glucose. Try an ounce (30g, or a thumb-size) of cheese or a few slices of chicken or turkey to help curb your hunger a bit.

Cinnamon

Cinnamon has been shown in many clinical studies to help lower blood sugar and improve insulin sensitivity. However, results have been mixed and its use in diabetes is controversial. Although much of the current research on cinnamon and blood sugar is long-term, it doesn’t hurt to try to use it in the short-term also to help lower a high blood sugar. There needs to be further evidence to determine exact dosages for cinnamon and determine, but as a food or tea is considered safe with no real side effects. If your blood sugar is high, consider drinking an unsweetened cup of cinnamon tea (or even add a dash of cinnamon to black tea) which may help lower your numbers.

Green Tea

Green tea has also been shown to help improve glucose metabolism, increase insulin sensitivity, and possibly reduce some of the damaging effects of high blood sugar. Drinking a cup of green tea also promotes relaxation, so enjoy some tea to help relax and possibly bring down your numbers.

Stress can increase blood sugar. When you are stressed, your body prepares to “fight or flight” signaling the liver and muscles to release any stored blood sugar, elevating levels. So, relaxation can help bring blood sugar back to normal. Try a little mediation, listen to some relaxing music, or just take a few deep breaths to help you relax.

How to Lower Blood Sugar Immediately Without Medication

Several of these options can work to get blood sugar immediately without medication in the short-term without additional medication. These solutions are meant to be implemented on days when life just doesn’t go as planned, maybe you eat something you weren’t supposed to or forget to take your medicine. But, if you are correctly managing your blood sugar you should not need to be constantly chasing highs and lows. With the correct combination of healthy lifestyle choices and medication, you can maintain a stable blood sugar level most of the time. Additionally, checking your levels frequently and keeping a log of your numbers, can help you learn how your body reacts to stress, food, exercise, and whatever life throws your way.

10 Simple Strategies for Blood Sugar Control

Maintaining good blood sugar control might take dedication and time, but making it a priority can help you avoid or delay serious complications of type 2 diabetes.

“Managing type 2 diabetes is a long war, not a battle won within a month or two,” says Sethu K. Reddy, MD, MBA, chief of the adult diabetes section at Joslin Diabetes Center in Boston, Massachusetts.

Blood Sugar: When It’s Too Low or Too High

The hormone insulin takes sugar (glucose) from food and uses it for energy. With type 2 diabetes, you don’t have enough insulin or your body isn’t effective at using insulin, and excess sugar continues to circulate in your bloodstream.

A target blood sugar range for most people with type 2 diabetes is 80 to 130 milligrams per deciliter (mg/dl) before a meal and less than 180 mg/dl one to two hours after starting a meal, according to the American Diabetes Association.

A reading of 160 mg/dl or higher is typically considered high blood sugar (hyperglycemia). Over time, blood sugar in the range of 160 to 250 mg/dl can affect every organ in your body, Dr. Reddy says. It’s associated with heart disease, eye disease, kidney disease, neuropathy, stroke, and vascular disease. If blood sugar goes as high as 500 mg/dl, you may experience symptoms such as thirst, the urge to urinate more often, weight loss, low energy, and drowsiness, he says.

Low blood sugar (hypoglycemia) occurs when levels fall to less than 70 mg/dl. This is a risk when you take insulin or other diabetes medications, have gone too long without a meal, have been active, or have been drinking alcohol.

If your blood sugar goes too low, you’ll probably feel shaky and sweaty and you may develop tremors, Reddy says. Other symptoms may include a racing heart, headache, weakness, confusion, hunger, irritability, lack of coordination, and pale skin. If your blood sugar continues to drop to 30 mg/dl and below, you could slip into a diabetic coma.

Improving Blood Sugar Control

Good blood sugar control can help you avoid the symptoms and complications of going too high or low. You’ll also feel better and have more energy, says Rasa Kazlauskaite, MD, medical director of the Rush University Prevention Center in Chicago, Illinois, and associate professor in the department of preventive medicine and internal medicine.

Get started with these 10 tips to help you rein in your blood sugar and better manage type 2 diabetes:

1. Stick to your medication plan. There are many drugs to help control blood sugar, Reddy says. Taking your medication as directed is vital — don’t skip doses.

2. Eat on schedule. Eating healthy meals at about the same time every day helps keep blood sugar steady. Also, “meal routines and consistency help to avoid severe hunger and help medications work better,” Dr. Kazlauskaite says.

3. Distribute carbohydrates throughout the day. Make it a goal to eat two to four carbohydrate servings — about 30 to 60 grams — per meal, says Margaret Powers, PhD, RD, CDE, president-elect of health care and education for the American Diabetes Association and a research scientist at Park Nicollet Health Services International Diabetes Center in Minneapolis, Minnesota. Because carbohydrates raise your blood sugar, spacing them out can help keep your levels in a healthy range.

4. Test your blood sugar. Testing with a meter is the only way to know how your body responds to the meals you’re eating. It also gives you valuable information on blood sugar control. “Not everyone with type 2 diabetes has to do this every single day,” Dr. Powers says. A few times a week might be enough for some people, but that’s something to determine with your doctor. In general, someone who is not taking insulin would begin by testing their blood sugar three times a day: fasting in the morning, before their largest meal, and one to two hours after that meal, she says, adding that people who take insulin might test more often, depending on their insulin regimen.

5. Put your stats in writing. Writing down what you’re eating along with your blood sugar readings will enable you and your doctor to review your progress. Use a notebook, website, or app to keep track.

6. React to signs of low blood sugar. The most common reason for low blood sugar is incorrect timing of a meal when taking diabetes medications, Kazlauskaite says. When you feel the warning signs, have 15 grams of carbohydrate, such as 4 ounces of juice, the Joslin Diabetes Center recommends. After resting for 15 minutes, test your blood sugar. If it’s below 70, have another 15 grams of carbohydrate.

7. Get moving. People with type 2 diabetes who exercise tend to have better control of their blood sugar and better blood pressure and cholesterol levels, according to a study published in 2015 in the Journal of Physical Therapy Science. To avoid low blood sugar, eat an extra serving of carbohydrate a half-hour before starting to exercise, Powers advises. If you’re exercising for a long time or doing strenuous activity, you may need to drink diluted juice or consume another carbohydrate during the workout.

8. Have a plan for dining out. Extra carbs lurking at restaurants, such as breading on chicken, can make eating out with type 2 diabetes a challenge, Powers says. Plan ahead by looking at the restaurant’s menu online. When ordering, also limit fats, such as butter and cream, for better heart health.

9. Make it a family affair. Reddy suggests recruiting family members to eat healthy and exercise with you so it feels more like fun than a task.

10. Stop the blame game. Don’t beat yourself up if you struggle with controlling your blood sugar, Reddy says. Because of the natural progression of the disease, blood sugar levels tend to go up over time and more medication may be needed.

How do you recover from a diabetic coma?

There are three main causes of diabetic coma. Two causes are most often associated with type 1 diabetes, and one is most often associated with type 2 diabetes.

Type 1 diabetes

A diabetic coma can happen when one of the following is present:

  • very low blood glucose levels, also known as hypoglycemia
  • high blood ketone levels, also known as diabetic ketoacidosis

Type 2 diabetes

A diabetic coma can result from one of the following:

  • very low blood sugar
  • very high blood glucose levels, also known as hyperglycemic hyperosmolar syndrome

Hypoglycemia

Hypoglycemia is when blood glucose levels are too low (under 70 mg/dL).

According to a study published in Diabetes, a person with type 1 diabetes will experience symptoms of hypoglycemia twice a week on average.

People with type 2 diabetes who use insulin are less likely to experience hypoglycemia, but it can still happen.

Hypoglycemia usually only occurs in people who are receiving treatment with insulin, but it can occur with oral medications that increase insulin levels in the body.

Factors that can result in low blood sugar levels are:

  • too much medication
  • too little food
  • too much exercise
  • a combination of these factors

Signs of low blood sugar are when a person:

  • feels shaky, sweaty, and tired
  • is dizzy
  • has a headache

Eating or drinking a source of glucose will bring blood glucose levels back into the healthy range, and the person will feel better almost immediately.

If the person does not notice or act on the symptoms and the glucose levels continue to decrease, they will become unconscious.

Prolonged unconsciousness due to altered blood sugar levels is called a diabetic coma.

Diabetic ketoacidosis

Share on PinterestTreatment may include hydration and either glucose or insulin treatment.

Diabetic ketoacidosis is a serious complication of type 1 diabetes that arises when levels of ketones in the blood become too high and the acid level of the blood increases. It can also result in a diabetic coma.

The levels of ketones in the blood can become too high if an individual is using fat rather than sugar as an energy source.

This occurs in people with type 1 diabetes for a variety of reasons, including not receiving enough insulin or illness.

People with diabetic ketoacidosis will also have high levels of glucose in their blood since the sugar cannot go from the blood and into the cells.

The body tries to reduce the high glucose levels by allowing glucose to leave the body in the urine. However, this also causes the body to lose more water.

A person with diabetic ketoacidosis will:

  • feel tired and thirsty
  • need to urinate more frequently

They may also have:

  • an upset stomach with nausea and vomiting
  • flushed and dry skin
  • a fruity smell to the breath
  • shortness of breath

Treatment is with insulin and fluid.

It is a medical emergency that needs prompt attention, as it can lead to a diabetic coma.

Without treatment, diabetic ketoacidosis can be life-threatening.

Hyperglycemic hyperosmolar syndrome

Diabetic hyperglycemic hyperosmolar syndrome usually affects older people who have poorly-controlled type 2 diabetes.

It occurs when blood glucose levels are extremely high.

As with diabetic ketoacidosis, a person with hyperglycemic hyperosmolar syndrome will:

  • feel tired
  • be very thirsty
  • need to urinate more frequently

A blood test can differentiate between diabetic ketoacidosis and hyperosmolar syndrome.

A person with hyperosmolar syndrome will have normal blood ketone levels and a normal acid balance.

Initial treatment is with an injection of saline solution into the veins. This will rehydrate the person and help to lower blood glucose levels.

They may need insulin, however, if glucose levels do not return to normal with rehydration.

Without treatment, hyperglycemic hyperosmolar syndrome can result in:

  • a diabetic coma
  • blood vessel complications, such as a heart attack, stroke, or blood clots

When Blood Sugar Is Too High

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If you have diabetes, you know that controlling blood sugar levels (or blood glucose levels) is important. You have to keep your levels steady. Having a blood sugar level that’s too high can make you feel lousy, and having it often can be unhealthy.

What Is High Blood Sugar?

The

is the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat, and it’s also formed and stored inside the body. It’s the main source of energy for the cells of our body, and it’s carried to each cell through the bloodstream.

Hyperglycemia (pronounced: hi-per-gly-SEE-me-uh) is the medical word for high blood sugar levels. High blood sugar levels happen when the body either can’t make insulin (type 1 diabetes) or can’t respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells of the body where it can be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia.

Having too much sugar in the blood for long periods of time can cause serious health problems if it’s not treated. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems. These problems don’t usually show up in kids or teens who have had the disease for only a few years. But they can happen in adulthood in some people with diabetes, particularly if they haven’t managed or controlled their diabetes well.

Blood sugar levels are considered high when they’re above your target range. Your diabetes health care team will let you know what your target blood sugar levels are.

What Causes High Blood Sugar Levels?

Managing diabetes is like a three-way balancing act because you have to watch:

  1. the medicines you take ( or pills)
  2. the food that you eat
  3. the amount of exercise you get

All three need to be balanced. If any one of these is off, blood sugar levels can be too. In general, higher than normal blood glucose levels can be caused by:

  • not taking your diabetes medicine when you’re supposed to or not taking the right amounts
  • not following the meal plan (like eating too much on a special occasion without adjusting your diabetes medicines)
  • not getting enough exercise
  • having an illness, like the flu
  • stress
  • taking other kinds of medicines that affect how your diabetes medicines work

A single high blood sugar reading usually isn’t cause for alarm — it happens to everyone with diabetes from time to time. But if you have high blood sugar levels a lot, let your parents and your diabetes health care team know. Insulin or meal plans may need adjusting, or you may have an equipment issue, like an insulin pump that isn’t working right. Whatever the case, make sure you get help so you can get your blood sugar levels back under control.

What Are the Signs & Symptoms of High Blood Sugar Levels?

Signs of high blood sugar levels include:

  • Peeing a lot: The kidneys respond by flushing out the extra glucose in urine. People with high blood sugar need to pee more often and in larger amounts.
  • Drinking a lot: Someone losing so much fluid from peeing that often can get very thirsty.
  • Losing weight even though your appetite has stayed the same: If there isn’t enough insulin to help the body use glucose, the body breaks down muscle and stored fat instead in an attempt to provide fuel to hungry cells.
  • Feeling tired: Because the body can’t use glucose for energy properly, a person may feel unusually tired.

How Are High Blood Sugar Levels Treated?

Treating high blood sugar levels involves fixing what caused them in the first place. Your diabetes health care team will give you specific advice on how to keep your blood sugar levels in a healthy range. But here are some ways to manage the common causes of high blood sugar levels:

Reason for High Blood Sugar Level What to Do
Not getting enough insulin or other diabetes medicine
  • Make sure that you take the proper type of insulin and the correct dose at the right time.
  • Check that insulin is not expired.
  • Make sure that all equipment (pumps, meters, etc.) is working properly.
  • Diabetes medicines may need to be changed or adjusted — check with your diabetes health care team.
Not following the meal plan (like eating too much food on special occasions without adjusting medicines)
  • Work with a registered dietitian to make adjustments to your meal plan as needed.
  • Adjust insulin/pills when you eat more or less than recommended on your meal plan (your diabetes health care team can instruct you on making adjustments).
Not getting enough exercise
  • Figure out a plan to make time for exercise.
  • Adjust your medicines based on the diabetes health care team’s instructions.
Illness or stress
  • Contact your diabetes health care team.
  • Continue to take insulin (the dose may need to be adjusted).
  • Check your blood sugar levels frequently.
Use of other medicines that can increase blood sugar
  • Contact your diabetes health care team if you start taking any other medicine.
  • Your insulin or pills may need to be adjusted while you take the medicine that’s causing high blood sugar levels.

Don’t worry too much if you get a high blood sugar reading occasionally. But if you have consistently high blood sugar levels, you should talk to your doctor about it.

What Is Diabetic Ketoacidosis (DKA)?

When the body doesn’t have enough insulin, glucose stays in the blood and can’t get into the body’s cells to be used for energy. This can happen, for example, when someone skips doses of insulin or when the need for insulin suddenly increases (like when a person is sick with the flu) and the doses are not adjusted.

When the body can’t use glucose for fuel, it starts to use fat. When this happens, chemicals called ketones are released into the blood. Some of these ketones, like extra glucose, pass out of the body through the urine.

High levels of ketones in the blood can be a problem because they cause the blood to become acidic. Too much acid in the blood throws off the body’s chemical balance and causes the symptoms listed below. In people with diabetes, this problem is called diabetic (pronounced: kee-toe-as-ih-DOE-siss), or DKA. DKA is a very serious condition that can lead to coma or death if it’s not treated. The good news, though, is that it’s preventable and can be treated.

DKA happens more often in people with type 1 diabetes, but can sometimes also happen to those with type 2 diabetes.

What Are the Signs & Symptoms of DKA?

The symptoms of diabetic ketoacidosis usually don’t develop all at once — they usually come on slowly over several hours. People who have DKA may:

  • feel really tired
  • feel really thirsty or pee way more than usual
  • have a dry mouth and signs of dehydration

These symptoms are caused by the high blood sugar levels that usually happen before someone develops DKA. If the person doesn’t get treatment, these signs of DKA can happen:

  • abdominal pain
  • nausea and/or vomiting
  • fruity breath odor
  • rapid, deep breathing
  • confusion
  • unconsciousness (“diabetic coma”)

Checking for DKA

How do you know if you have DKA? Because the signs and symptoms of DKA can seem like the flu, it’s important to check blood sugar levels and urine (or blood) ketones when you’re sick or if you think you’re having symptoms of DKA.

Because high levels of ketones appear in the urine (as well as the blood), ketones can be checked at home by testing a sample of your pee. If the urine test for ketones is negative, it usually means your symptoms are not due to DKA.

Follow your diabetes management plan about when to check for ketones and what to do if the test is positive. In some cases, your diabetes management team may also have you use special blood test strips to check ketone levels in your blood too.

How Is DKA Treated?

DKA is very serious, but it can be treated if you go to the doctor or hospital right away. To feel better, a person with DKA needs to get insulin and fluids through a tube that goes into a vein in the body (an IV).

Let your parents or someone on your diabetes health care team know if you have any of these symptoms or are sick and don’t know what to do to take care of your diabetes.

Always wear a medical identification bracelet or necklace that says you have diabetes. Then, if you are not feeling well, whoever’s helping you will know to call for medical help. Medical identification can also include your doctor’s phone number or a parent’s phone number.

Avoiding High Blood Sugar and DKA

No matter how well they take care of themselves, people with diabetes will sometimes have high blood sugar levels. But the best way to avoid problems is to keep your blood sugar levels as close to your desired range as possible, which means following your diabetes management plan. Checking your blood sugar levels several times a day will let you know when your blood sugar level is high. Then you can treat it and help prevent DKA from happening.

High blood sugar levels don’t always cause symptoms, and a person who isn’t testing regularly might be having blood sugar levels high enough to damage the body without even realizing it. Doctors may use the HbA1c test to find out if someone has been having high blood sugar levels over time, even if the person has not had obvious symptoms.

Here are some other tips for avoiding high blood sugar levels and preventing DKA:

  • Try to eat all your meals and snacks on time and not skip any.
  • Take the right amount of insulin.
  • Check your blood sugar levels regularly and your ketone levels when your diabetes management plan recommends it.
  • Stick to your diabetes management plan.

Reviewed by: Steven Dowshen, MD Date reviewed: May 2018

Severe high blood sugars, ketosis (the presence of ketones prior to acidification of the blood), and ketoacidosis (DKA) are serious and potentially life-threatening medical problems which can occur in diabetes. High blood sugars become life-threatening in Type 1 or long-term Type 2 diabetes only when that person does not receive enough insulin from injections or an insulin pump. This can be caused by skipping insulin or not receiving enough insulin when large amounts are required due to an infection or other major stress.

Ketoacidosis surprisingly occurs almost as often in Type 2 diabetes as it does in Type 1. However, people with Type 2 diabetes also encounter another dangerous condition called hyperglycemic hyperosmolar syndrome, which is roughly translated as thick blood due to very high blood sugars. Here, coma and death can occur simply because the blood sugar is so high. The blood will have ketones at higher levels but does not become acidotic. HHS usually occurs with blood sugar readings above 700 mg/dl (40 mmol) as the brain and other functions begin to shut down.

When insulin levels are low, the body cannot use glucose present at high levels in the blood. The body then starts burning excessive amounts of fat which causes the blood to become acidic as excess ketone byproducts are produced. Even though the blood pH which measures acidity only drops from its normal level of 7.4 down to 7.1 or 7.0, this small drop is enough to inactivate enzymes that depend on a precise acid-base balance to operate.

High blood sugars and ketoacidosis can be triggered by:

  • not taking insulin
  • severe infection
  • severe illness
  • bad insulin

In Type 1 diabetes, ketoacidosis often occurs under the duress of an infection, and is also frequently present when a person first comes down with the disease between the time when they stop producing their own insulin and begin to inject insulin from the outside. In Type 1 diabetes, it can also occur whenever insulin delivery becomes interrupted for several hours (about 4.5 hours on Humalog or Novolog) on a pump, or after a day or so of missed injections. In Type 2 diabetes, ketoacidosis and HHS usually occur when there is a major stressful event, such as a heart attack or pneumonia.

In children and adolescents with Type 1 diabetes, ketoacidosis can also be triggered by growth spurts which make the body require more insulin, although blood sugar tests generally let parents know that additional insulin is required before the situation becomes that severe. If an infection or illness is triggering the problem, high blood sugars will be difficult to bring down until the underlying problem is dealt with.

High blood sugars may exist for weeks, months, or years without triggering ketoacidosis if enough insulin is present in the blood. Ketoacidosis begins only when insulin levels in the blood are quite low compared to need.

When insulin levels drop, the body starts burns more fat and produces more ketones, even though glucose levels are high in the blood. Burning fat might sound like a good thing, especially if you are trying to lose weight. But this excessive use of fat is quite unhealthy because the activity of hundreds of essential enzymes is affected. Ketones are a normal byproduct of fat metabolism, but when created in excess they acidify the blood, triggering nausea and vomiting.

Vomiting in the presence of very high blood sugars quickly leads to a dangerous state of dehydration. This combination is quite serious and can cause death. In a recent study from Malmo, Sweden, among 4,097 recently diagnosed people between 15 and 34 years of age, the death rate was 2.3 times higher in those with Type 1 diabetes and 4.1 times higher in those with Type 2. Among 58 deaths in this group, 11 deaths were due to ketoacidosis, with an additional 7 deaths related to hypoglycemia (J Intern Med, Mar 2001; 249(3): pgs. 263-270). Overall, the death rate when ketoacidosis occurs is 10%, or one in every ten cases, although most deaths occur in the elderly.

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6 Things to Do If Your Blood Sugar Is Too High

Grapefruit also has a low glycemic index (GI), around 25, which means it doesn’t raise blood sugar as quickly or as much as high-GI foods like white bagel (72) or even a banana (48) or watermelon (72). (The highest GI score is 100.) A 2006 study published in the Journal of Medicinal Food, found that people who ate grapefruit (juice or half a fruit) before a meal had a lower spike in insulin two hours later than those taking a placebo, and fresh grapefruit was associated with less insulin resistance. All 91 patients in the 12-week study were obese, but they did not necessarily have type 2 diabetes.While the results are promising in those without diabetes, blood-sugar reactions to food can vary widely, so if you have been diagnosed with type 2 diabetes, test your blood sugar after eating grapefruit to make sure it can be part of your healthy eating plan.RELATED: 7 Ways to Make Blood-Sugar Testing Less Painful Getty Images

Blood sugar is a tricky little beast. Yes, you can get a high reading if you throw caution to the wind and eat several slices of cake at a wedding.

The problem is that you can also have a high blood sugar reading if you follow every rule in the type 2 diabetes handbook. That’s because it’s not just food that affects blood sugar. You could have a cold coming on, or stress may have temporarily boosted your blood sugar. The reading could be wrong, and you need to repeat it. Or it could mean that your medicine is no longer working, and it’s time to try a new one.

The point is, it’s the pattern that matters, not a single reading.

Whatever you do, don’t feel bad or guilty if you have a high blood sugar reading. A 2004 study found that blood sugar monitoring often amplifies feelings of being a “success” or “failure” at diabetes, and when readings are consistently high, it can trigger feelings of anxiety or self-blame.

This can cause some people to give up on testing completely. Try not to think of blood sugar monitoring as a “test” administered by a sour-faced teacher lurking in your distant past. Blood sugar monitoring is simply a tool that you can use to fight the disease. Here, six things you should know about how to lower your blood sugar when it’s way too high.

Test before you eat and two hours after

This will tell you how well your medication is controlling your blood sugar. It will also shed light on what food is boosting your sugar too high—and thus should be avoided. “You should consult your health-care provider to develop a plan that works for you,” says Donna Rice, immediate past president of the American Association of Diabetes Educators, who notes that the frequency and time of day you test will depend on how controlled your blood glucose is.

Look for patterns

If your blood sugar is high in the morning on one day, no big deal. If it keeps happening, though, it’s more meaningful. “An isolated high and low you can brush off. Anyone can have a high or low, your body might have been compensating,” says Rice. “If they’re high every morning, that’s important because it means that your liver is producing too much sugar during the night—that might require new or an additional medicine.

Make some small changes

You might try to get more exercise, or limit carbs at your next meal, but don’t go crazy. “One blood sugar that’s high doesn’t indicate a need for major changes—that should only be done on a pattern,” says Rice, such as “continuing highs despite following a doctor’s instructions.” If a pattern continues for two to three days or more, then you might want to let your health-care provider know.

Think about what’s going on

Irene Dunbar, 73, of Durham, N.C., woke up one morning recently to discover her blood sugar was at 119, which is high for her. “I had a cold and had had orange juice yesterday and I normally do not drink orange juice and I thought, ‘I better not do that,’ ” she said. When she gets a high blood sugar reading, she tries to remember if she had anything recently—like bread—that she knows are triggers, and avoids them next time.

Relax

It’s not just food that can turn your blood sugar into a roller coaster. “My blood sugar will get really wacky if I have a lot of stress,” said Carol Mullen, 62, of Sandia Park, N.M. “I try to avoid situations that are stressful, like serving on committees. I like to do volunteer work, but I’ll do something I can do by myself.” Mullen is an artist, but she avoids doing artwork on commission because she knows the extra stress can be “aggravating.” We all know stress is bad—now you have a concrete number that’s telling you it’s time to relax.

Consider talking to your doctor

If you think you’ve been doing all you can to keep blood sugar in control, but still have high blood sugar readings, it might be time to switch medication. Diabetes is a progressive disease, and over time, the beta cells in the pancreas that produce insulin can stop making the hormone. “So, even if your numbers have held steady for years, that could change if the beta cells change, which is usually a gradual change but can be sudden,” says Rice. “That change doesn’t mean you’ve done anything wrong, it’s just the nature of the disease. The beta cells can only put out so much insulin, and over time they start to put out less.” Your doctor will look at the big picture and do additional testing to find out if there is a bigger problem.

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