Q: I suffered what I beleive was a low blood sugar attack with extreme dizziness and nausea. I take medication for type 2 diabetes. What should I do next time this happpens?
A: It sounds like you did have a low blood sugar attack. It could be that you are not requiring as much medication, and/or you waited too long between meals. You should be checking your blood sugars and make sure that you know what ranges your physician wants you in. The idea is not to eat more to feed the medication, but to hopefully lower the medicine dose. Glucose tablets are good to carry with you in emergencies as the dose is then measured. Lifesaver candies can also work. The usual amount is 15 grams of carbs every 15 minutes until blood sugars come up.
Q: Can sunbathing and high temperatures increase blood sugar levels?
A: High heat can lead to dehydration, which in turn can cause high blood sugars. It takes 6 molecules of water to move one molecule of sugar from the blood stream, so the higher the sugar, the more water you need to drink. Extreme hot or cold temperatures can cause changes in the vascular system that can affect blood sugar and cause reactions.
Q: Is a 132 glucose level, after a ten hour fast, high enough to be concerned about?
A: Two fasting levels of 126 or greater is a diagnosis of diabetes. If this was a lab test, your physician should order another fasting glucose to confirm, and an A1C to get your average level over a 3 month period. Meanwhile, start practicing a very healthy lifestyle, understanding what food choices to focus on. In a nutshell, focus on eating lots of veggies, some fruit, legumes, lower starch, and fish or smaller amounts lean meat. BE ACTIVE! That is the best key to control.
Q: Why is my fasting reading higher first thing in the morning than after I eat?
A: This is the usual pattern for blood sugars: higher in the morning due to elevated hormonal and other factors during the early morning hours. During the day, activity tends to keep sugars under control if following a healthy, active lifestyle. Reevaluate you habits, with attention to your nighttime eating.
Q: My fasting blood glucose is normal, but the A1c was 6.5. What would you recommend?
A: I suggest to closely review what you eat the entire day, and increase your activity level if necessary. If your fasting is between 80-90, great! If higher, then lifestyle habits certainly are what need to be addressed first. You may also request an Oral Glucose Tolerance Test to see what your blood sugar response is post-meal.
Q: Why does my blood sugar get highest 3 hours after eating? One hour after eating my blood sugar is around 160-180, after 2 hours it is around 100-125. What's confusing is it goes up again after 3 hours post-meal to reach 140 then drops down again to 100, and stays at that level. Readings taken after fasting are between 90 to 110. Is this usual?
A: Most of what you describe is usual, particularly depending on what you are eating. Is the 3 hour rebound the same daily? Do you monitor that often? If you are exercising or particularly active before that 3 hour measurement, that could account for a slight rise, followed by the drop. That is a normal pattern for the immediate effect of exercise on blood sugar. Are you on insulin? It sounds as though you may need to revisit your eating habits and tweak your medication program to help you start with an even lower fasting blood sugar.
Q: I have type 2 diabetes and am having problems keeping my morning blood sugar to desired levels. My afternoon levels are usually in the normal range. I’m overweight, but I’ve lost about 27 pounds hoping to reduce my average blood sugar. However, this has not happened. What could this mean? Is my disease progressing?
A: There are several factors that affect morning blood sugars. Often, with reasonable control of diet and exercise resulting in weight loss as you indicate, you do experience a drop. Is your diet as "impeccable" as you can make it? Nutritional supplements also can be helpful when professionally guided. Don't give up; keep up with your good work. Insulin resistance can be just that: resistive! For some people, if they don't follow a disciplined program, blood sugars will keep rising. Sticking to a healthy lifestyle will only be a win-win situation for you in the long run.
Q: I sometimes experience a rise in blood sugar levels whenever I am under a great deal of stress or am ill. Even if I'm strict about my diet, is there any way of keeping the sugar levels down without having to take insulin? Will they return to "normal" levels without medication, or will I still require insulin shots?
A: In general, illness and stress do elevate blood sugar, and if you are already requiring insulin when you are otherwise healthy/unstressed, you may need more at these times. If your blood sugars fall into normal levels without needing medications, then triggers such as an illness may or may not raise them, and if so, may not raise them high enough or long enough to warrant medication. Be sure you understand the nature of the disease, and monitor yourself in all situations as closely as you can. No one will be able to manage this better than yourself.
Q: What is a good blood sugar reading after eating a meal?
A: In an entire day, we generally say your blood sugar should not go over 140 even after eating a large meal. Ideally it would not go over 120 two hours after eating. With diabetes, one's physician may have a higher goal, depending on the health of the person, in order to avoid hypoglycemia (low blood sugar).
Q: Does maintaining a level glucose mean that I should constantly keep my sugars the same, or will the numbers go up and down?
A: There are ranges to maintain your glucose within. Ideally, you will target to be under 100 before breakfast (fasting), and under 140 after meals. You are trying to avoid the extremes of high and low blood sugars. Ask your physician what his/her blood sugar goals are for you immediately and over the long term.
Q: Does high blood sugar cause your blood to get thick and sticky?
A: Very high blood sugars can accelerate dehydration, which could contribute to "thick" blood. Other medications may also lend to dehydration. It takes six molecules of water to move one molecule of sugar through the blood stream. With all the emphasis on food and lifestyle changes, drinking enough water is basic to good management. Generally, 8 glasses per day is a good start for most people, realizing some will need more, some less. If your first morning urine is not reasonably pale, you are probably not getting enough water.
Q: Do I need to be concerned that my blood glucose runs about 106 fasting every morning? The rest of the day it is fine. I run and lift weights regularly, and my diet is good while watching my carbs. I do not drink. I am also careful with snacks at night.A: It is good that you are normal during the daytime. The biggest wear and tear on the body seems to come from fluctuating daytime levels rather than a stable but slightly high fasting level. Yes, it would be good to get under 100, ideally between 80-90, but if you truly are most diligent in your lifestyle, you should be able to maintain good health. Certain hormones elevate nighttime levels, contributing to morning highs. Research is out there on many nutraceuticals that may lower fasting blood sugar levels. Water soluble cinnamon in capsule form is one of the most recent that is showing good results.
Q: What should my blood sugar be before meals and 90 minutes after a meal to be an acceptable level? I am pre-diabetic.
A: In general, you do not want to be over 140 post-meal at any time of day. Staying closer to 120 post-meal is an even tighter goal and mimics the non-diabetic state better. Pre-meal blood sugars will vary depending on the last time food was consumed; a goal is to stay between 80-120. Maintaining consistent exercise and monitoring carbs and food quantity will assist in keeping your 2 hour post meal blood sugars under 140.
Q: However, I can have a normal blood sugar reading of about 90 before breakfast and then after a moderate cereal-toast breakfast, my blood sugar will go over 200. I am not diabetic according to medical tests.
A: Have you had an Oral Glucose Tolerance Test? Newer research is placing more emphasis on the after meal glucose elevations as opposed to just monitoring fasting glucose. You are experiencing hyperglycemia, which as an initial diagnosis, generally manifests as slowly elevating fasting glucose. Ideally, your fasting glucose should be closer to 80. 100 is pre-diabetes. I would suggest that your breakfasts now consist of more protein and less carbs. Good choices include egg, yogurt, nut butter, cheese, meat, oatmeal, etc. Target for 20-30 grams of protein at each meal. Any carbs you eat should have fiber: whole grain toast, fresh fruit, etc. Breakfast cereals generally don't fit these criteria unless you search for a type with higher fiber. I suggest an overabundance of plant foods now, to clean out your system a bit, giving your liver a work break. This should help to fine tune your metabolism. Make sure you have essential fatty acids in your intake: fish/plant foods are main sources.
Q: My husband is on an insulin pump but after a severe low blood sugar, he will struggle for several weeks to get his blood sugars under control again. The blood sugars go low and then high for no reason, regardless of diet, exercise, insulin.
A: I suggest you work a bit more closely with the pump trainer on how to cut back on insulin depending on time of day, activity level, etc. With the abilities of today's pumps, there are many options for programming different dosages throughout a 24 hour cycle. In my experience, most pumpers need at least 2-3 different program rates. If you begin to notice a pattern of lows, that would be the time of day or activity relationship to begin cutting back with. This may mean both bolus and basal rates. If lows do occur, try to avoid over treating. Four ounces of juice may be enough if he is really low. Tablets may be a better choice to control the carb amounts, re-administering every 15 minutes until a desired blood sugar level is reached. With perseverance and lifestyle consistency, he should reach a more stable pattern.
Q: Do cold temperatures affect blood sugar? My blood sugar numbers have gone up since the building turned the air conditioning down. The cold air vent is directly above my desk, blowing cold air directly on me.
A: Extreme temperature changes can create a stress reaction, elevating blood sugars. If you are cold, I'm sure you are "bundling up". Hopefully, you will adjust with time. And is it possible to shift your desk?
Q: How often should pen needles be used before discarding?
A: Pen needles technically are to be used once. In reality, most people who do more than one injection per day immediately cap their needles after use, discarding at the end of the day. Most pens are prefilled, so when finished, discard and start another pen.
Q: Why does my blood sugar increase after exercise? I had a blood sugar reading of 135 first thing in the morning but after a 3 mile walk my reading was 155. I had nothing to eat or drink during this time. I repeated this test and got the same results a few days later.
A: Wait an hour after you exercise and see if you get the same results. Exercise is a stressor, so blood sugar will be higher immediately after your session. Also, blood sugars tend to be higher in the mornings because of hormonal activity during the night.
Q: What is the normal range that your blood sugar should be if you test it at home?
A: For a basically healthy person, a good fasting is under 100, and 80-90 is even better for most people. If you test two hours after a meal, under 120 is ideal. I would suggest, if symptoms persist, that you get some blood work done, perhaps another Oral Glucose Tolerance Test may be indicated. This is also a good time to review your lifestyle habits which are important for keeping a lid on potential blood sugar changes.
Q: After 8 years of successfully controlling my type 2 diabetes, my fasting numbers are starting to creep up into the 200+ range and my doctor wants to put me on insulin. What am I doing wrong?
A:Many variables can cause this change. One factor is that as we age (I like to refer to this as "chronological maturity"), hormones change as well. Another very common variable is that we often eat the same way, not increasing our intake, but neither do we increase our activity levels. Taking insulin for a time may give the beta cells the rest they need, with perhaps returning to your lower levels. Conversely, many do experience a decline of insulin output over time, regardless of lifestyle management. Your gene pool may have you on this path. Do what you need to to get back into good management. Managing one's stress levels is a "must"; yoga, Tai Chi, dance are just a few examples of very positive supports. Find what works for you.
Q: My wife is having problems with her blood sugar levels. She has been watching her carbohydrate intake but when she sleeps for at least 8 hours, her sugar levels are higher. Why?
A: It is good she is monitoring her carbs closely, but it is also about the total intake of food and her activity level. Glucose is generally higher in the early morning due to hormonal activity during the night. If she is also elevated during the day, it again may be the types and quantities of foods. Perhaps her medication needs reevaluating. I would suggest she pose these questions to her physician.
Q: I have had type 1 diabetes for about 16 years now. My A1C was 8.6 for a while but now I have it down to 7.6 and lower now. The problem is that nowI feel like I am having low blood sugar even when I am in thegood range.
A: For many who have adapted to functioning on higher sugars for many years, then in a reasonably short period drop into more normal ranges, low blood sugar symptoms may persist for a time. This means that your insulin is functioning far more efficiently in removing sugar from your bloodstream. At 7.6, you are still in a higher range, but certainly closer to numbers that are more protective for complications. If you are on other medications, particularly for CAD, these may also contribute to symptoms. Make sure you know from your physician what range you should be in. If the symptoms persist, perhaps something else would be the cause not directly related to glucose lowering in the bloodstream. Hormonal changes as part of the life cycle can also play a role.
Q: Do I use the first or the second drop of blood when testing my blood sugar?
A: With most strips now, you can touch them with the first drop. It takes far less blood than it used to to get a good sample. One drop is all that is needed.
Q: I've been taking my blood sugar readings for 2 years. The highest reading was 200 after a meal by 1 hour. Fasting blood sugar is almost between 80 to 100. With such readings, should I be concerned about being diabetic?
A: You are showing readings of hyperglycemia. There is a greater movement among diabetes management practitioners to emphasize the importance of post meal control. This is because blood sugar excursions contribute to higher oxidative stress, which in turn may cause increased tissue damage leading to greater risk of complications. This seems to be more true than chronic sustained high blood sugars, such as only high fasting levels.
The ideal fasting blood glucose reading is less than 100. The ideal post-meal blood glucose reading is less than 140. 140-200 post meal/random reading is considered pre-diabetes. I suggest you carefully reevaluate your daytime eating, perhaps being more careful of carb intake and type and follow up with your health care practitioner.
Q: I am a 74 year old male whose glucose level has gone slightly but steadily up over the past year and a half: 99, 104 and today 106. My doctor seems not concerned as I have none of the usual diabetes symptoms, have loads of energy, exercise a great deal at recreational sports, and eat wisely. Given the glucose level and fact that many in my family have diabetes, I am concerned and wonder what I could do?
A: It sounds like you are on a good path geared towards a healthy lifestyle. You may want to seek professional nutritional counseling to fine tune if you are not already very aware of such issues as the impact of carbohydrates. You are still maintaining a low pre-diabetes status. There are nutritional supplements such as cinnamon that may also be helpful in keeping your blood sugars down. Be certain too that you stay well hydrated by drinking lots of water. If you maintain these numbers and don't go any higher, you should do well.
Q: My blood glucose runs about 106 fasting every morning. The rest of the day it is fine. I run and lift weights regularly, and my diet is good while watching my carbs. I do not drink. I am also careful with snacks at night. Is this morning level a reason for concern and why is it high in the morning?
A: It is good that you are normal during the daytime. The biggest wear and tear on the body seems to come from fluctuating daytime levels rather than a stable but slightly high fasting level. Yes, it would be good to get under 100, ideally between 80-90, but if you truly are most diligent in your lifestyle, you should be able to maintain good health. Certain hormones elevate nighttime levels, contributing tomorning highs. Research is out there on many nutraceuticals that may lowering fasting blood sugar levels. Cinnulin PF, from cinnamon, is one of the most recent that is showing good results. It can be found in capsule form.
Q: I have been overweight for years and have been having my blood sugar checked at bi-annual doctor’s appointments, always to be told it was “fine” or “normal”. Five months ago the A1c was 6.3. Now it has gone to 10.1 with a fasting blood sugar of 329. While at my first diabetic management appointment, the nurse showing me how to test my blood sugar got a 428, stuck a needle of insulin in me, and sent me home with vials and needles. Is it normal for someone to go from fine to insulin diabetic so rapidly?
A: I would hope you had a bit more instruction than what you are conveying. With blood sugars over 300, it is now the thought of many endocrinologists to start a person on insulin to detox the beta cells of the pancreas. This may only be for a short period if lifestyle changes are diligently made. Sometimes, it is a shift to oral medication, or none at all. Over the years, one may need a return to insulin and/or other medications. Take charge of you lifestyle habits andget all the education you can on managing this disease.
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