Problem Solving with Diabetes

Managing diabetes takes paying attention to many areas of life, including healthy eating, being active and monitoring blood sugar. It’s a daily routine that takes practice and planning. However, it is important to remember that everyone encounters problems with their diabetes control. That’s because you can’t plan for every situation you may face. Learning problem-solving skills can help you be prepared for the unexpected.

Common problems that a patient with diabetes may experience include having blood sugar that is too high, blood sugar that is too low, or varying blood sugar during times of sickness. These situations can happen on any given day and will require you to make rapid, informed decisions about food, activity and medications.


When Blood Sugar is Too High


Hyperglycemia means that your blood sugar is too high. You might experience:

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


Blood sugar more than 180 mg/dL

Studies show that keeping blood sugars at or around normal lower your risk of long-term complications from diabetes and can help you feel better now. Often high blood sugar is caused by too much food, too little insulin or other diabetes medication, illness or even stress. In some instances it could lead to a medical emergency if left unchecked, especially in patients with type 1 diabetes.

The best treatment for hyperglycemia is prevention. Most patients with diabetes need medications or insulin to keep blood sugar levels close to normal. And it is very common to need more or different types of medication as you age. Another way to help maintain lower blood sugar is regular physical activity and healthy eating.

If you feel symptoms, always check your blood sugar levels right away. If it is too high, check at least every four hours to make sure your blood sugar is going down. If not, call your diabetes care provider.


When Blood Sugar is Too Low


Hypoglycemia means that your blood sugar is low. You might experience:

  • Confusion
  • Dizziness
  • Feeling shaky
  • Hunger
  • Headaches
  • Irritability
  • Pounding heart; racing pulse
  • Pale skin
  • Sweating
  • Trembling
  • Weakness
  • Anxiety

A low blood sugar reaction is a common issue that most patients with diabetes will need to deal with at one time or another. Everyone is different but typical symptoms often come on quickly.

The best treatment is prevention. Knowing why blood sugar can go low will help to prevent low reactions in the future. Low blood sugar can be caused by too much diabetes medication or not timing it correctly with meals, not eating enough or delaying/skipping meals, increased physical activity or drinking too much alcohol.


Treating Hypoglycemia - Rule of 15


If you feel symptoms, follow the three simple steps of Rule of 15.

Step 1: Check blood sugar right away. If you cannot check, then treat anyway.

Step 2: If your blood sugar is 70mg/dL or below, treat with 15 grams of carbohydrates. If your blood sugar is less than 50mg/dL, treat with 30 grams of carbohydrates.

Step 3: Check blood sugar in 15 minutes. If your blood sugar is still less than 70mg/dL, eat another 15 grams of carbohydrate and re-check blood glucose in 15 minutes. Call your doctor if your blood sugar does not go above 70mg/dl after 3 treatments.

Once your blood sugar is above 70mg/dL, recheck blood sugar about an hour after to ensure blood sugar has stayed above 70mg/dL. A low blood sugar reaction can cause some anxiety; be careful not to over treat. Take only 15-30 grams of carbs based on blood sugar and give your body time to respond. Over treating a low reaction will only cause you to have blood sugar that is too high.


What to Do When You're Sick


When you’re sick, have experienced trauma, or are in pain, your body becomes stressed and responds by having the liver produce more sugar. Having diabetes can complicate your body’s reaction to this type of stress and blood sugar levels could go high even if you are not eating normally. It is important to discuss your sick day strategy with your doctor especially if you have type 1 diabetes or you are on insulin.

In general all patients with diabetes should:

  • Drink plenty of fluids.
  • Try to get at least 200 grams of carbohydrates daily by eating 45-60 grams every four hours while awake if not eating normally.
  • Take your medications as usual.
  • Check your blood sugar every two to four hours.
  • If taking OTC medications, pick those that are sugar free. Avoid pseudoephedrine containing products if you have high blood pressure.

Call your Doctor if:

  • You have persistent vomiting or diarrhea
  • You have a persistent fever of 101° or higher
  • Your blood sugar stays over 250mg/dL or under 70mg/dL
  • You can’t keep liquids down for more than four hours