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AskNadia: How to Bring Down A 434 Blood Sugar?

Dear Nadia:


My mother’s blood sugar level is 434. What kind of fruits and food is she supposed to be eating?




Dear JN,

I am happy to read that your mother has an advocate like yourself. You did not mention how long your mother has had Type 1 or Type 2 diabetes?


If your mother’s average blood sugar is 434 mg dL, it means her A1c is in the neighborhood of 16-17. This is alarming as the American Diabetes Association recommends an A1c of 7. After a meal, blood sugar should not exceed 180 mg dL, while pre-meal blood sugar should fall between 80-130. These standards of care are general guidelines.


My first recommendation is to reach out to your mother’s healthcare professional to discuss her high blood sugars. Many variables can be the cause of her high blood sugar. Diet is undoubtedly the most common. But, sometimes, specific medications, like anti-inflammatory can raise her blood sugar as a side effect. Getting sick or feeling stressed can also impact blood sugar levels. You also want to know if the ADA blood sugar guidelines are appropriate for your mother.


You did not mention if your mother is on an oral type 2 medication or if she is taking insulin. Depending on how long she has been on her medication, healthcare professionals adjust medications as needed.


Let’s suppose your mother has type 2 diabetes, is not on medication, and you change her diet, but she still has high blood sugars. In this case, physicians will generally put her on metformin and increase the dose until she achieves the desired blood glucose range. What if her blood sugars continue to be high? The doctor may prescribe an SGLT2, Sensitizer, Starch Blocker, DPP4, SGLT2/DDP4, GLP1, Amylin Mimetic, or insulin. Many of my Type 2 family members injected insulin.


Type 1’s are put on a basal (24-hour background insulin) and fast-acting insulin. In addition to the regular daily insulin dosing, healthcare professionals teach Type 1 how many insulin units to take to bring down a high blood sugar. Diet and insulin on board are factors when determining how many units of a fast-acting insulin are required to achieve a normal blood sugar range.


Your role as her advocate makes a big difference in your mother’s life. First and foremost, get her in to see her healthcare professional as soon as possible. The 434 blood sugar is a critical issue and can land her in the ER.


Keeping blood sugars over 180 mg dL for a prolonged period can cause diabetes complications. Review her diet with her healthcare professional. She may need to learn carb counting and, if she takes insulin, know how many units she needs to take to bring down her high blood sugar. It helps to have two people at the healthcare professional’s office. People tend to remember different instructions.


Medication dosing for healthcare professionals can start as a trial and error, requiring fine-tuning. Depending on your mother’s circumstance, her medication may need to be increased, and her diet may change. Her health needs to be reviewed holistically by her healthcare professional.


A big Kudos to your mother for testing her blood sugars. How else would she know how effective her medication and diet are unless she has feedback? I admire that she cares enough about her blood sugars by testing to see what range they may fall in.


I managed my Type 2 mother’s insulin, thyroid and depression medication. It was apparent to me when my mother needed to go back in to meet with her healthcare professional for blood work to see if her medication requirements needed to be increased or if it was time to start a different medication. Her depression and thyroid medication made a big difference in her will and motivation in her diabetes self-management.


One of my brothers, a Type 2, experienced high blood sugars and started seeing better blood sugar readings once he started carb counting. My former husband, a type 1, prefers a low-carb diet because it reduces his insulin requirements substantially.


In your mother’s case, it’s imperative to get her into her doctor’s office ASAP. Then, you can discuss her diet and agree on an achievable blood sugar range.

Sue Thom, a Certified Diabetes Educator, offers these evergreen tips for lowering your blood sugar:

1- Eating less food at the next meal, eliminating a snack, and/or eating foods with a lower glycemic index.
2- Increasing activity or incorporating more exercise.
3- Increasing, changing medications, and/or administering them more frequently.
4- Relaxation techniques and behavioral management.
5- Treating identified illnesses and/or infections.
6- Monitoring on a more frequent basis and/or monitoring other parameters.
7- Increasing consumption of sugar-free fluids.

Here is your full access to the article.


ADA Blood Sugar Guidelines



Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.

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About Nadia:

Nadia Al-Samarrie is a patient advocate. She helps people with diabetes make informed decision to prevent the devastating effects of diabetes complications.

AskNadia (ranked #1 by Google), named “Best Diabetes Blog for 2017 by Healthline, and with 24 nominations, Nadia Al-Samarrie’s efforts have made her stand out as a pioneer and leading patient advocate in the diabetes community.

 Nadia was not only born into a family with diabetes but also married into one. As a result, she was propelled at a young age into “caretaker mode.” With her knowledge of the scarcity of resources, support, and understanding for people with diabetes, she co-founded Diabetes Interview, now Diabetes Health magazine.

Under her reign- Diabetes Health magazine was named one of the top 10 magazines to follow in the world for 2018 by Feedspot Blog Reader.

Nadia has been featured on ABC, NBC, CBS, and other major cable networks. In addition, her publications, medical supply business, and website have been cited, recognized, and published in the San Francisco Chronicle, The Wall Street Journal, Ann Lander’s advice column, former Chrysler chairman Lee Iacocca, Entrepreneur magazine, Houston News, Phili.com, Brand Week, Drug Topics, and many other media outlets.


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