Q: I test my blood sugar regularly, but my result is often higher than my target range. What should I do when my test result is too high?
A: When your blood sugar is too high, before making a decision on what to do, it’s important to first understand why it may be high. There are many reasons your blood sugar may be higher than your target range. In my experience, a lot of people think it’s related to what they ate. This may be true — but it’s usually not all about food. Managing diabetes is really a balancing act. A balance of what you eat, how active you are, the medications you take, what time of day it is, and, most important, how your body responds. After all, everyone is different. And the American Diabetes Association recommends treatment should be individualized, which means your diabetes care plan should be tailored to you.
Back to the question, “What should I do?”
Take some time to think and answer the following questions.
What did I eat last?
When did I eat last?
Have I been active?
What medicine am I taking?
Did I take my medicine?
What time of the day is it?
What did I eat last?
Certain types of foods raise your blood sugar more than others. For example, foods high in carbohydrates raise your blood sugar more than protein-rich or higher fat foods. What did you last eat before you tested your blood sugar? If the food was high in carbohydrates, lowering your carbohydrate intake could be helpful.
When did I eat last?
If you check your blood sugar one to two hours after you eat, you might find it’s higher than if you check your blood sugar four hours after you eat. You should have different goals for your blood sugar before and after you eat.
If it’s early in the morning, and you haven’t eaten since the night before, don’t be surprised if your blood sugar is higher than it was when you went to bed. Hormones are at work at night and in the early morning that can raise your blood sugar. If this is the case for you, it may mean you need to talk with your diabetes care team about treatment options, such as a change in your eating, medicine, and/or activity plan.
Have I been active?
Being active can lower your blood sugar. If you haven’t been very active, your blood sugar can be higher. Get active. Find something you like to do and will do to be more active. You may very well see your number go down. If you’re taking medicine that can cause low blood sugar (hypoglycemia) talk with your diabetes care team about how to best prevent low blood sugars during or after activity.
What medicine am I taking?
Not all people who have diabetes take medication to help lower blood sugar. If you aren’t taking medicine, you may need to. If you are, it may be that you need more, either a higher dose of the medicine you take or perhaps another type of medicine. Do not make changes in medicine without first discussing with your diabetes care team.
Did I take my medicine?
If you have been prescribed medicine and your blood sugar is high, you may not have taken your medicine. This can happen for many reasons. Do you forget to take your medicine? If this happens often, perhaps you need to change the time you take your medicine to a time you can and do remember to take them. If you have a smartphone, you can set the alarm to remind yourself. Is it difficult to afford your medicine? If so, you may need a different kind of medicine you can afford or learn more about a program that may be available to help you pay for your medicine. Discuss these issues with your diabetes care team before making changes.
What is the time of day?
It may be that your blood sugar is high all the time or perhaps just at a certain time of the day. If it’s high all of the time, you most likely need an overall tune up — changes in your food, activity, and medicine plan. If just at a certain time of the day, you may just need to work on making adjustments for that time of day, such as your early morning blood sugars, which may include making changes to your medicine. If it’s after a certain meal of the day, perhaps just decreasing the amount of food you eat at that meal can help.
If you’ve been experiencing high blood sugar, your homework should include taking notes, either handwritten or electronically, on your blood sugar levels and how your food, exercise, and medicine may have affected your results. With your information in hand, have the conversation with your diabetes care team so that together you can come up with a blood sugar management plan just for YOU.
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