Hypoglycemia and hyperglycemia. What you should do if you get it.

Many people with diabetes don't really know what to do when they have an very low or very high sugar level readings. Here I explain some easy, practical things to keep in mind.

If the sugar levels in your blood is very low (Hypoglycaemia) you might feel some of these symptoms:

• Shakiness, 
• jerky movements, 
• dizziness, 
• seizure, 
• sweating, 
• hunger, 
• headache, 
• perspiration, 
• difficulty speaking, 
• difficulty paying attention, 
• pale skin colour, 
• tingling sensations around the mouth, 
• feeling anxious or weak

In such a case, this is what you should immediately do:

• Drink a soft drink like Pepsi, 7up, Sprite, etc. 
• In case only sugar is available then take one or two tablespoons of sugar and mix it in some water and drink it.

Once you feel better eat a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range. Half a sandwich is a reasonable option.

If the hypoglycemic episode has progressed to the point where you cannot or will not take anything by mouth, you need to make sure someone around you knows how to give you a glucagon injection. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range.

If the sugar level in your blood goes up very much (Hyperglycaemia) you might feel the following symptoms

Early signs

• Increased thirst,
• Headaches, 
• Difficulty concentrating, 
• Blurred vision, 
• Frequent urination, 
• Fatigue (weak, tired feeling), 

Prolonged hyperglycemia in diabetes may result in:

• Vaginal and skin infections, 
• Slow-healing cuts and sores, 
• Decreased vision, 
• Nerve damage causing painful cold or insensitive feet, 
• loss of hair on the lower extremities, and/or 
• erectile dysfunction, 
• Stomach and intestinal problems such as chronic constipation or diarrhoea,

Here are some measures that you can take if you know (after a blood test) that you have hyperglycaemia:

• Drink lots of water. Water helps remove the excess glucose from your urine and helps you avoid dehydration.
• Exercise more. Exercise will help to lower your blood glucose.

Caution:

If you have type 1 diabetes and your blood glucose is over 240 mg/dL, you need to check your urine for ketones. When you have ketones, do NOT exercise.

If you have type 2 diabetes and your blood glucose is over 300 mg/dL, even without ketones, do NOT exercise.

• Change your eating habits. You may need to meet with the dietitian to change the amount and types of foods you are eating.
• Change your medications. Do not make adjustments in your diabetes medications without first talking to your doctor.

When one has hyperglycemia for a prolonged duration, the body starts breaking down fats for energy. When fats are broken down a substance called ketones are released into the blood which if not managed early can lead to a dangerous condition called Ketoacidosis.

Symptoms include:

• shortness of breath
• breath that smells fruity
• nausea and vomiting
• a very dry mouth

In such cases rush to the emergency department to see a doctor ASAP !