The emergency condition most type 2s dread is hypoglycemia, where plummeting blood sugar levels can bring on a dangerous semi-conscious state, and even coma or death.
However, hyperglycemia, high-blood sugar levels consistently above 240 mg/dL, can be just as dangerous. Left untreated, at its most extreme high-blood sugar, can induce ketoacidosis, the build-up of toxic-acid ketones in the blood and urine. It can also bring on nausea, weakness, fruity-smelling breath, shortness of breath, and, as with hypoglycemia, coma.
However, once they’ve been diagnosed with diabetes, most type 2s have taken steps to prevent or lessen the most dangerous effects of high-blood sugar levels. Their concern shifts to dealing with unexpected, sometimes alarming spikes in blood sugar levels. The symptoms of those spikes are the classic ones we associate with the onset of diabetes—unquenchable thirst, excessive urination, fatigue, weight loss, and headaches.
When you do spike, what can you do right away to bring blood sugar levels down?
Immediate Steps You Can Take:
1. Insulin—If you are on an insulin regimen; a bolus injection should drive numbers down fairly rapidly.
2. If you are not on insulin or don’t use fast-acting insulin, taking a brisk walk or bike ride works for most people to start bringing their numbers down.
3. Stay hydrated. Hyperglycemic bodies want to shed excess sugar, leading to frequent urination and dehydration. You need to drink water steadily until your numbers drop.
4. Curb your carb intake. It does not matter how complex the carbs in your diet are, your body still converts them to glucose at some point. Slacking off on carb consumption is a trackable maneuver that lets you better understand how to control your numbers.
These are extensions of the immediate steps listed above. By adapting them as long-term practices, you lessen your chances of undergoing distressing hyperglycemic episodes.
• Regular exercise—Although some of us do not experience a drop in blood sugar from exercise, the habit itself is a good one. Exercise helps control weight and appetite, maintain muscle strength, and generate a general feeling of well-being. These are important quality-of-life factors for type 2s.
• Shun high-carb foods.
• Reduce weight—The cliché may be old, but it is true: A reduction in body weight of only 5 to 7 percent can have a dramatic effect on A1c’s and insulin sensitivity. It is also good for the heart, which, thanks to the inflammatory nature of diabetes, is already under stress.
• Reduce stress—Stress is also an inflammatory. Even if your life is too complex to allow for extended breaks to de-stress, grabbing a few minutes whenever you can to relax and take your mind off current problems is a little thing that can become a big help.
• Revisit your prescriptions—Remember, most type 2 medications lose their effectiveness over time. That is why you can start on metformin or a sulfonylurea but later have to add or switch to Januvia, or Byetta, or Invokana. If your control is slipping even though you’ve been good about taking your medications, it is time to talk to your doctor and look at alternative drugs. It may also be time to look at insulin.
• Insulin—If you start on insulin, you’ll be taking as close to a wonder drug as type 2s can get. However, keep in mind what Dr. Richard Bernstein has cautioned for years: Small doses are better than large, which means managing your disease so that you do not fall into the habit of “covering” high-carb indulgences with big doses of insulin.
• Track your patterns—The more you know about your body’s unique diabetic patterns, the better. Knowing your patterns helps you to know not to over-react in some instances or to take drastic action in others. Give yourself time to detect your patterns—that means many finger pricks and tracking of different combinations of time, exercise, and food to find them. However, find them you will.