What should you do when you have a “spike” of high blood sugar? Maybe you forgot or missed or didn’t take enough of your meds or insulin injection. Maybe your insulin has gone bad. Or maybe you were naughty and binged — even a little binge can cause a spike in blood sugar.
What is a spike in blood sugar and how would you know it?
You should always test your blood sugar two hours after meals or snacks. Anything over 140 mg/dl (7.5 mmol/l) at that time is high, but a “spike” is anything over 180 mg/dl (10 mmol/l).
What should you do? That depends on whether you are type 1 or type 2.
If you are type 1:
Anything above 250 mg/dl (14 mmol/l) requires at least testing for ketones.
(If you are newly diagnosed with type 1 diabetes you really need to educate yourself on ketones. They are the toxic by-products of burning fat for energy instead of sugar. You can detect the presence of ketones with urine test strips.)
IF KETONES ARE PRESENT, DO NOT EXERCISE in an effort to try to lower your blood sugar level. You have ketones because insulin isn’t present. That means the sugar cannot be metabolized. Worse than that, your body will burn fat for the energy to exercise and produce even more ketones.
DRINK LOTS OF WATER and don’t eat anything. Call your doctor to find out whether you should take insulin now (which is likely) and how much. The doctor will want to know your blood sugar level and ketone strip reading. He or she may also want you to go to the hospital or clinic.
High ketones can lead to diabetic ketoacidosis, or “DKA”, symptomized by a flushed appearance, dehydration, exhaustion, shock, and eventual unconsciousness. Severe DKA requires immediate and expert medical care.
If your blood sugar is lower than 250 mg/dl but higher than 140 mg/dl (7.5 mmol/l), double-check whether it has been over two hours since you ate. If it has, check with your doctor as to whether and how much corrective insulin you should take. If it has not yet been two hours, drink a large glass of water and check your blood sugar again later.
If you are type 2:
There is such a thing as super-high blood sugar levels above 500–600 mg/dl (28–33 mmol/l) called the “hyperglycemic hyperosmolar state” (HHS). The symptoms begin similar to DKA. Such high levels can lead to coma and death.
Fortunately, this is not caused by a spike in blood sugars. HHS is a result of higher and higher blood sugar building up over time, at least over several days if not weeks. Regular testing — even if done just once a day — should reveal increasing high blood sugar levels long before they reach HHS.
Neither is DKA a concern for type 2 diabetics. They are usually able to produce some insulin and utilize enough of it to prevent fat-burning for energy and its ketone by-products.
If, however, your blood sugar spikes near 500–600 mg/dl, you should definitely call your doctor. He or she might well recommend you go to the hospital right away.
If your reading is above 350 mg/dl (19.5 mmol/l) two hours after eating, call the doctor. You may not have to go to the hospital, but corrective measures have to be taken under the doctor’s direction and care.
If your blood sugar level is not so high as that but still a spike (above 180 mg/dl) two hours after eating, there are some things you should and should not do.
DO NOT EXERCISE, thinking you will burn the extra sugar off. You will more likely cause your liver to release extra glucose into the bloodstream and drive your levels higher, not lower.
DRINK PLENTY OF WATER to help your kidneys and liver.
If spikes are frequent, be sure to check your blood sugar more often, before and after snacks and meals. Keep accurate records of the time, the amount of insulin if any, and what you ate. See if you can determine and prevent the causes of your blood sugar spikes.
Of course, if you’ve been naughty, there’s no one to blame but yourself. Be good and avoid not only blood sugar spikes, but diabetes complications down the road.
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