Teach Me

Blood Sugar and How to Keep It Balanced

When you have diabetes, numbers are very important. Understanding your diabetes numbers can help you feel better and have more control over the disease. 

One important set of numbers to monitor when managing your diabetes is your blood sugar, or blood glucose, levels. 

“Monitoring your blood sugar is an important tool in managing your diabetes, because it helps determine if you’re meeting your glucose targets, which helps to reduce unpleasant symptoms of high or low blood sugar as well as long-term complications,” said Rachel Calendo, a pediatric nurse practitioner and diabetes program manager at Banner Health in AZ. 

According to the American Diabetes Association, more than one million people in the United States are diagnosed with diabetes each year. If you’ve been recently diagnosed, here is everything you need to know about keeping your blood sugar balanced day after day.

What is blood glucose?

First, it’s helpful to understand what blood glucose is and how it affects your body. 

Glucose is a sugar in the bloodstream. When you eat, your body breaks down food into glucose. Your body uses glucose for energy and storage, but too much of it can cause damage to your kidneys, heart, eyes and other organs over time. 

“Normally, blood sugar is regulated by a hormone called insulin that moves glucose from your blood into the cells for energy and storage,” Calendo said. “People with diabetes either don’t make enough insulin (type 1 diabetes) or their cells don’t respond to insulin well enough to lower blood sugar levels (type 2 diabetes).”

What are blood glucose levels?

You have a blood sugar target range that is unique to you depending on your age, current health and lifestyle. This is the range you try to maintain as much as possible, day and night.

“For most people, the target range is 70mg/dL to 180mg/dL,” Calendo said. “The more time in range means a more consistent blood sugar level with less highs and lows. This will help you feel your best, stay healthy and avoid long-term complications of diabetes.”

Blood sugar target for most people with diabetes should be less than 130 mg/dL before meals and less than 180mg/dL one to two hours after eating. 

How do I check my blood sugar?

Checking your blood sugar provides important information that can help you monitor the effects of diabetes medication, diet and exercise on blood sugar levels, identify highs and lows and understand how other factors can affect your levels. 

You can use a blood glucose meter (glucometer), or a continuous glucose monitor (CGM) to check your blood sugar. The decision to use CGM or a meter should be decided with your health care team.

“The meter gives you a quick reading of the amount of sugar in a small sample of blood, usually from your fingertip,” Calendo said. “A CGM is a wearable device that is inserted under the skin and measures glucose level in interstitial fluid—the fluid that fills the spaces between cells—continuously. It provides real-time glucose readings every one to five minutes. Glucose data is transmitted from the sensor to a ‘reader’, receiver, smart phone app/watch, or insulin pump. An alarm goes off if your levels go up or down too quickly or are too low or too high.”

You should check your blood sugar at different times during the day. Ask your health care provider, nurse or dietitian about when and how often you should check your blood sugar.

What is an A1C test?

You’ll want to get an A1C test, or the hemoglobin A1C or HbA1c test about 4 times per year. This is a simple blood test that measures your average blood sugar levels over the past three months. It’s commonly used to diagnose prediabetes and diabetes but is also used to manage your diabetes. 

What do I do if my blood sugar levels are high?

High blood glucose, or hyperglycemia, is when your blood sugar levels are high enough that you need to take action to bring them back down to your target range. 

High blood sugar can be caused by a number of factors, including:

  • Missing an insulin dose
  • Taking too little insulin
  • Bad or expired insulin
  • Illness
  • Lipohypertrophy (injecting into the same area of skin too many times causing a buildup of fat, protein and scar tissue)  
  • Strenuous physical activity or exercise
  • Insulin pump site is kinked or not changed at proper intervals

Symptoms of hyperglycemia may include increased thirst and/or urination, hunger headaches, nausea, blurred vision, trouble concentrating, fatigue and weight loss. 

“In the short-term, missed or not enough insulin can cause diabetic ketoacidosis (DKA), a toxic buildup of ketones in the blood that can be fatal,” Calendo said. “Persistent high blood glucose can lead to long-term complications such as nerve damage, heart attack, stroke and kidney disease.”

Tips to lower glucose levels

Some easy ways to manage blood sugar and bring your levels back down include going for a quick walk to use up some of that excess glucose in your system, drinking water and taking insulin, if you’re using it. 

Continue to monitor your blood glucose until your levels fall within your target range. Contact your health care provider if you’re having trouble keeping your levels within your target range.

What do I do if my blood sugar levels are low?

Hypoglycemia, or low glucose levels, occurs when blood sugar levels fall low enough that you need to take action to bring them back up to your target range. 

Low blood sugar can be caused by a number of factors, including:

  • Taking too much insulin
  • Skipping meals or eating less or later than usual
  • Strenuous activity or exercise
  • Illness
  • Drinking alcohol

Symptoms of hypoglycemia may include dizziness, irregular or fast heartbeat, hunger, sweating, shakiness, anxiety and mood swings. 

“If glucose levels stay low for too long, starving your brain of glucose, it can lead to seizures, coma and even death,” Calendo said.

However, you may not have any symptoms when your blood sugar is low (hypoglycemia unawareness), and this can increase your risk for having severe lows, which can be life-threatening. If you have hypoglycemia unawareness, it will be harder to treat your low blood sugar early. This means you may need to check your glucose levels more often.

Tips to raise glucose levels

Hypoglycemia can be treated with fast-acting carbohydrates, such as fruit juice, soda or glucose tablets. “Always keep a supply of fast-acting carbohydrate and glucagon (an emergency medication) for severe low blood sugar, with you in case of emergency,” Calendo said.

It typically takes 15 minutes for blood sugar to rise. The Centers for Disease Control and Prevention recommends waiting 15 minutes after eating or drinking 15 grams of carbs and rechecking your blood sugars. If your levels remain low, repeat with another 15 grams of carbs, wait 15 minutes and then recheck. 

Contact your health care provider, nurse or dietitian if you regularly experience hypoglycemia.

Takeaway

There are many benefits to understanding your blood sugar levels, particularly as you learn more about how your body responds to different factors. With proper monitoring, you can increase your time within your target range and feel your best while avoiding long-term complications.

If you have further questions or concerns about your diabetes, contact your health care team. To find a Banner Health specialist near you, visit bannerhealth.com. 

Related resources:

Diabetes Wellness