Managing diabetes can be tough, especially when the sugar levels fluctuate throughout the day and for most patients with type 2 diabetes, it becomes challenging to keep their sugar levels in control as they tend to spike when the medications are missed, calorie intake increases, particularly with foods high in sugar or sufficient physical activity is absent. Stress can further trigger the levels, causing a higher risk of diabetes complications.
If you are living with diabetes, managing your blood sugar levels is essential as both high and low sugar levels are dangerous conditions where these fluctuating blood sugars are also known as Glycemic variability and can lead to poor quality of life in those with diabetes. Hence, identifying the symptoms or signs and preventing or managing high or low blood sugar is necessary.
Managing high blood sugar levels:
In an interview with HT Lifestyle, Dr Vidya Walinjkar, Consultant Diabetologist at Fitterfly, shared, “Frequent high blood sugars in patients with long-standing diabetes can affect their nerves, kidneys, eyes, heart and blood vessels too. It can also lead to serious conditions like Diabetic ketoacidosis or (HHNS) Hyperglycemic Hyperosmolar nonketotic syndrome which can be a life-threatening emergency situation. So it’s very important to treat hyperglycemia in order to prevent complications.”
She suggested, “If you have frequent high sugars look for carbohydrate content in your diet, and look for any ongoing infections, stress, lack of exercise, medication dosages, etc. If you are symptomatic or when you find that sugars are high make sure you drink enough water, work out regularly as advised and manage stress and sleep. Also, you need to monitor sugars and ketones frequently. You may also need to meet a nutritionist in order to change your eating habits and most importantly meet your Diabetologist for adjustment in medication dosages, as your doctor may change the amount, timing or type of diabetes medications that you take.”
According to Dr Niteesh Choudhry, Co-Founder and Chief Medical Advisor at Decipher Health, it is best to consult the doctor if you are experiencing symptoms like fatigue, excessive thirst and blurry vision. He said, “You may be prescribed to take an extra dose of medication or increase your fluid intake. Still, to prevent further sugar spikes, it is also crucial to evaluate the triad of diabetes management — medications, diet and exercise. For example, a consistently poor diet will only require more medication and make it harder to control sugar levels. Conversely, good dietary choices can substantially reduce the amount of medication.”
Asserting that there is no one-size-fits-all diabetic-friendly diet, he said, “Different foods, including carbs, can have diverse effects on different people, and advances in machine learning and AI are making it possible to personalise dietary recommendations. The science of chrono nutrition additionally demonstrates that making small changes in how we eat can impact blood sugar levels. For example, eating the protein part of a meal before the rest of the meal or starting your meal with a bowl of salad can help prevent your sugars from spiking in the future.”
Managing low blood sugar levels:
Dr Vidya Walinjkar explained, “Low blood sugar is a condition that can affect people with diabetes, especially they are taking insulin or tablets to control their blood sugar. If your blood sugar is less than 70mg/dl on a glucometer it can be dangerous especially if left untreated. Low blood sugar can lead to a variety of symptoms like feeling weak or tired, sweating, headaches, increased hunger, uneasiness, nervousness, anxiety, irritability, trouble thinking or having blurring or double vision and a fast or pounding heartbeat.”
She insisted, “If left untreated severe hypoglycemia or sugar less than 55mg/dl on a glucometer can also lead to seizures,convulsions, loss of consciousness, or coma. Frequent low sugars can also lead to unawareness known as Hypoglycemia unawareness. So frequent monitoring with a Glucometer or CGMS is very essential.” If you have low blood sugar or hypoglycemia, Dr Vidya Walinjkar recommended:
1. Eat something that has about 15 grams of carbohydrates, like glucose tablets, fruit juice, candies, etc.
2. Recheck your blood sugar.
3. If you do not feel better in 15 minutes, eat another snack with 15 g of carbohydrates.
If you still do not feel better, call your doctor right away. Dr Vidya Walinjkar highlighted:
-Both low and high blood sugar can quickly become a medical emergency; hence it is important to prevent them by
-frequently monitoring blood glucose levels either with the help of Glucometer or CGMS Continuous glucose monitoring device
-Be aware of symptoms of both hyper and hypoglycemia so you can treat it to optimize blood glucose immediately.
-Be careful while exercising, drinking alcohol, skipping meals or fasting.
-Carry small snacks or glucose while travelling or exercising
-Also if you keep getting high or low blood sugars frequently talk to your diabetes care team so as to prevent it
-Also check for complications of Diabetes like kidney function, liver function tests etc as advised by your Diabetologist.
Bringing his expertise to the same, Dr Niteesh Choudhry said, “Those suffering from low blood sugar can experience a drop in their sugar levels with symptoms like sweating, nervousness, confusion, nausea, and dizziness if they don’t eat enough food or skip meals. The key in this situation is to follow the 15–15 rule, having 15 grams of carbohydrates such as glucose tablets, fruit juice, and a tablespoon of sugar to raise the blood sugar. Wait 15 minutes, and then recheck your blood sugar. If it is not back in the target range, repeat the process. Consistently experiencing high and low sugars can be problematic and a sign to consult a physician immediately.”