Diabetes: Overview

Blood sugar levels

Your blood sugar level depends on several things. These include food, medicine, insulin, and exercise.

Your healthcare team can show you how to check your blood sugar. They will also tell you how often to check it. Ask what target range is right for you. Normal blood sugar levels are often:

• 80 mg/dL to 130 mg/dL before a meal

• Less than 180 mg/dL in the 1 to 2 hours after the start of a meal

These things can cause high blood sugar (hyperglycemia):

• Eating too much of certain foods

• Not taking diabetes medicines on time, skipping doses, or taking less medicine than prescribed

• Stress

• Illness, such as a cold or the flu

• Infection

• Exercising less than planned

These things can cause low blood sugar (hypoglycemia):

• Missing meals

• Not eating enough food after taking diabetes medicine

• Doing unplanned or heavy exercise

• Taking too much diabetes medicine

Complications

Diabetes can cause serious problems over time if it isn't managed well. These problems include:

• Heart disease

• Diabetic ketoacidosis

• Stroke

• Kidney failure

• Blindness

• Nerve damage (neuropathy)

• Loss of feeling in the legs and feet

• Tissue death (gangrene)

You can prevent or delay these problems by keeping your blood sugar under control.

Home care

Follow these guidelines when caring for yourself at home:

• Follow the diet your healthcare provider gives you.

• Take insulin or other diabetes medicine exactly as you have been directed.

• Check your blood sugar as you have been directed. Keep a log of your results. Share the results with your provider. This will help them change your medicines as needed to keep your blood sugar under control.

• Ask your provider what your ideal weight is. Then take steps to reach that weight. Your provider can help you. You may be able to cut back on or not have to take diabetes medicine if you eat well and get exercise.

• Don't smoke. Smoking makes the effects of diabetes on your circulation worse. You are much more likely to have a heart attack if you have diabetes and you smoke. Also don't use e-cigarettes or vaping products.

• Take good care of your feet. You may not notice an injury or infection if you have lost feeling in your feet. Check your feet and between your toes at least once a day. Use a mirror to check the bottoms of your feet.

• Wear a medical alert bracelet or necklace. Or carry a card in your wallet that says you have diabetes. This will help healthcare providers give you the right care if you get very ill and can't tell them that you have diabetes.

Sick-day plan

If you get a cold, the flu, or an infection, take these steps unless directed otherwise by your healthcare provider:

• Look at your diabetes sick plan. Call your healthcare provider as you were directed. Call your provider right away if:

  • Your blood sugar is above 240 mg/dL (or as directed by your healthcare provider) while taking your diabetes medicine

  • Your urine ketone levels are above normal or high

  • You have been vomiting more than 6 hours

  • You have trouble breathing or your breath has a fruity smell

  • You have a fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • You have a fever for several days and you are not getting better

  • You get lightheaded and are sleepier than usual

• Keep taking your diabetes pills (oral medicine) even if you have been vomiting and are feeling sick, or as directed by your healthcare provider. Call your provider right away. This is because you may need insulin to lower your blood sugar until you recover from your illness.

• Keep taking your insulin even if you have been vomiting and are feeling sick, or as directed by your provider. Call your provider right away to ask if you need to change your insulin dose. This will depend on your blood sugar results and the type of illness or symptoms you have.

• Check your blood sugar every 2 to 4 hours, or at least 4 times a day.

• Check your ketones often. Watch them more often if you are vomiting and having diarrhea.

• Don't skip meals. Try to eat small meals on a regular schedule. Do this even if you don't feel like eating.

• Drink water or other liquids that don't have caffeine or calories. This will keep you from getting dehydrated. If you are nauseated or vomiting, takes small sips every 5 minutes. To prevent dehydration, try to drink a cup (8 ounces) of fluids every hour while you are awake.

Treat low blood sugar (hypoglycemia)

Low blood sugar can be an emergency. Always bring a source of fast-acting sugar with you. This is in case you have symptoms of low blood sugar. This means below 70 mg/dL or as directed by your healthcare provider. At the first sign of low blood sugar, eat or drink 15 grams of fast-acting sugar to raise your blood sugar. Examples are:

• 3 to 4 glucose tablets (follow directions on the packaging). You can buy these at most drugstores.

• 4 ounces (1/2 cup) of regular (not diet) soft drinks

• 4 ounces (1/2 cup) of any fruit juice

• 1 tablespoon of sugar or honey

Check your blood sugar 15 minutes after treating yourself. If it's still below 70 mg/dL, take 15 more grams of fast-acting sugar. Test your blood sugar again in 15 minutes. If your blood sugar returns to normal (70 mg/dL or above), eat a snack or meal to keep your blood sugar in a safe range. If it stays low, call your healthcare provider right away or go to an emergency room.

If you have had severe low blood sugar episodes, see that someone in your family is trained to give you a shot of glucagon. This will raise your blood sugar if you are unconscious and can't eat any of the above tablets or foods.

Follow-up care

Follow-up with your healthcare provider, or as advised. For more information about diabetes, visit the American Diabetes Association website at www.diabetes.org. Or you can call 800-342-2383.

When to get medical care

Call your healthcare provider right away if you have any of these symptoms of high blood sugar:

• Peeing often

• Drowsiness

• Thirst

• Headache

• Upset stomach (nausea) or vomiting

• Belly (abdominal) pain

• Eyesight changes

• Fast breathing

Also call your provider right away if you have any of these signs of low blood sugar and they don't go away with the above treatment suggestions:

• Severe tiredness (fatigue)

• Headache

• Shakes

• Chills

• Excess sweating or clamminess

• Hunger

• Feeling anxious or restless

• Eyesight changes

• Drowsiness

• Weakness

Call 911

Call 911 if any of these occur:

• Chest pain

• Shortness of breath

• Dizziness or fainting

• Weakness of an arm or leg or one side of the face

• Trouble speaking or seeing 

• Confusion or loss of consciousness