How to differentiate whether low sugar or high sugar? What precautions to be taken? What are the remedies?

Dr. Gopala Krishnam Raju AmbatiDiabetologist9yrs exp

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What are the Symptoms of Hyperglycemia? The signs and symptoms include the following: High blood glucose High levels of sugar in the urine Frequent urination Increased thirst Treatment depends Hypoglycemia (Low Blood Glucose) Hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels, usually less than 70 mg/dl. However, it is important to talk to your health care provider about your individual blood glucose targets, and what level is too low for you. Hypoglycemia may also be referred to as an insulin reaction, or insulin shock. Hypoglycemic symptoms are important clues that you have low blood glucose. Each person's reaction to hypoglycemia is different, so it's important that you learn your own signs and symptoms when your blood glucose is low. The only sure way to know whether you are experiencing hypoglycemia is to check your blood glucose, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia. Severe hypoglycemia has the potential to cause accidents, injuries, coma, and death. Signs and Symptoms of Hypoglycemia (happen quickly) Shakiness Nervousness or anxiety Sweating, chills and clamminess Irritability or impatience Confusion, including delirium Rapid/fast heartbeat Lightheadedness or dizziness Hunger and nausea Sleepiness Blurred/impaired vision Tingling or numbness in the lips or tongue Headaches Weakness or fatigue Anger, stubbornness, or sadness Lack of coordination Nightmares or crying out during sleep Seizures Unconsciousness Treatment Consume 15-20 grams of glucose or simple carbohydrates Recheck your blood glucose after 15 minutes If hypoglycemia continues, repeat. Once blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away. 15 grams of simple carbohydrates commonly used: Glucose tablets (follow package instructions) Gel tube (follow package instructions) 2 tablespoons of raisins 4 ounces (1/2 cup) of juice or regular soda (not diet) 1 tablespoon sugar, honey, or corn syrup 8 ounces of nonfat or 1% milk Hard candies, jellybeans, or gumdrops (see package to determine how many to consume) Glucagon If left untreated, hypoglycemia may lead to a seizure or unconsciousness (passing out, a coma). In this case, someone else must take over. Glucagon is a hormone that stimulates your liver to release stored glucose into your bloodstream when your blood glucose levels are too low. Injectable glucagon kits are used as a medication to treat someone with diabetes that has become unconscious from a severe insulin reaction. Glucagon kits are available by prescription. Speak with your health care provider about whether you should buy one, and how and when to use it. The people you are in frequent contact with (for example, family members, significant others, and coworkers) should also be instructed on how to administer glucagon to treat severe hypoglycemic events. Have them call 911 if they feel they can't handle the situation (for example, if the hypoglycemic person passes out, does not regain consciousness, or has a seizure, if the care taker does not know how to inject glucagon, or if glucagon is not available). If glucagon is needed: Inject glucagon into the individual's buttock, arm or thigh, following the manufacturer's instructions. When the individual regains consciousness (usually in 5-15 minutes), they may experience nausea and vomiting. If you have needed glucagon, let your health care provider know, so they can discuss ways to prevent severe hypoglycemia in the future. Do not: Inject insulin (will lower blood glucose even more) Provide food or fluids (individual can choke) Put hands in mouth (individual can choke) Hypoglycemia Unawareness Very often, hypoglycemia symptoms occur when blood glucose levels fall below 70 mg/dl. But, many people have blood glucose readings below this level and feel no symptoms. This is called hypoglycemia unawareness. People with hypoglycemia unawareness are also less likely to be awakened from sleep when hypoglycemia occurs at night. Hypoglycemia unawareness occurs more frequently in those who: Frequently have low blood glucose episodes (which can cause you to stop sensing the early warning signs of hypoglycemia) Have had diabetes for a long time Tightly control their diabetes (which increases your chances of having low blood glucose reactions) If you think you have hypoglycemia unawareness, speak with your health care provider. Your health care provider may adjust/raise your blood glucose targets to avoid further hypoglycemia and risk of future episodes. If you have type 2 diabetes and your blood sugar levels are racing up and down like a roller coaster, it's time to get off the ride. Big swings in your blood sugar can make you feel lousy. But even if you aren't aware of them, they can still increase your risk for a number of serious health problems. By making simple but specific adjustments to your lifestyle and diet, you can gain better blood-sugar control. Your body uses the sugar, also known as glucose, in the foods you eat for energy. Think of it as a fuel that keeps your body moving throughout the day. Blood Sugar Highs and Lows Type 2 diabetes decreases the body?s production of insulin, which is a hormone that regulates blood sugar. Without enough insulin, sugar builds up in the blood and can damage nerves and blood vessels. This increase of blood sugar also increases your risk for heart disease and stroke. Over time, high blood sugar, also known as hyperglycemia, can lead to more health problems, including kidney failure and blindness" Keeping blood sugar stable can help prevent the long-term consequences of fluctuations, high blood sugar can cause a number of symptoms that include: Fatigue Increased thirst Blurry vision Frequent urination It's also important to know that you can have high blood sugar and still feel fine, but your body can still suffer damage, Symptoms of high blood sugar typically develop at levels above 200 milligrams per deciliter (mg/dL" You can have high blood sugar that's between 141 and 199 and feel perfectly fine,. Over time, your body can also get used to chronically high blood sugar levels, so you don?t feel the symptoms, she says. On the flip side, if you?re not closely monitoring your blood sugar levels, they can drop too low. Warning signs of low blood sugar, or hypoglycemia, include: Dizziness Irritability Sweating Weakness Lack of coordination Keeping Your Blood Sugar Steady With certain strategies, you can help prevent spikes in your blood sugar levels, Rather than focus on things you shouldn't have, try incorporating the following foods and healthy habits into your daily type 2 diabetes routine: Go nuts. Nuts such as almonds, walnuts, and pistachios contain healthy fat that slows the body's absorption of sugar. But be sure to limit how many nuts you eat in one sitting because even healthy fats contain calories, Smithson says. Just six almonds or four pecan halves have the same number of calories as one teaspoon of butter. Eat whole grains. Oat bran, barley, and rye are fiber-rich foods that contain beta-glucan. This soluble fiber increases the amount of time it takes for your stomach to empty after eating and prevents spikes in blood sugar. Remember, though, that these foods are still carbohydrates" Whole grains will still raise your blood sugar, just not as quickly and as high as processed foods, Veg out. Packed with fiber, non-starchy vegetables such as broccoli, cucumber, and carrots can also help prevent surges in blood sugar levels while providing essential nutrients. Spice up with cinnamon. Cinnamon may do more than just add flavor to foods. A 2013 study published in the journal Annals of Family Medicine showed that cinnamon is linked to a significant drop in fasting blood sugar levels. Cinnamon may stimulate insulin secretions from the pancreas, Although more research is needed, Smithson says there?s no reason why people with type 2 diabetes shouldn't try to add cinnamon in their diets. Be versatile with vinegar. A 2012 study published in the Journal of Community Hospital Internal Medicine Perspectives suggested that vinegar could help slow the absorption of sugar by the body. The research revealed that 2 ounces of apple cider vinegar improved fasting blood sugar levels and insulin sensitivity. Although the potential health benefits of vinegar are still being investigated, Li-Ng often advises people with type 2 diabetes to take 1 tablespoon of vinegar with each meal, saying that any type of vinegar is good. Don't skip meals. It's important to spread out your daily food intake, starting with breakfast. Consuming more food in just one or two meals a day causes greater fluctuations in blood sugar levels, Li-Ng says" Three healthy meals a day with two nutritious snacks in between can help maintain stable blood sugar, she says. Don't drink on an empty stomach. If you haven't eaten, drinking alcohol can cause your blood sugar to drop up to 24 hours later. This happens because the body is working to get rid of it. If you want to drink alcohol, check your blood sugar first. It's also important to eat before or while you drink. Another caution: symptoms of low blood sugar, such as slurred speech and dizziness, could be mistaken for drunkenness. Plan ahead. Anticipate the unexpected and carry healthy snacks that can prevent your blood sugar level from dropping too low. 

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