Glucose Meters Can Give False Readings
While physiologic reasons cause higher glucose readings, technical reasons can cause them, too. The US Federal Drug Administration allows home glucose monitors to have a variance of 15% in results. That means a reading of 100 mg/dl might actually be as low as 85 mg/dl or as high as 115, a huge variation!9
Dave Feldman, the software engineer who has cracked the Cholesterol Code, has blogged about his glucose meter variance, charting and taking pictures of his two glucose meters, measuring the same drop of blood. While he was expecting his blood glucose set point to be higher because of his long-term low-carb keto eating, he was surprised by the sometimes huge variation in results. He notes that whenever he gets an unexpected result, he takes three readings, all within a few minutes of each other, and then averages the result.
Other researchers have noted that false readings can be caused by pricking a finger for blood with hands that have minute traces of sugar or food Dehydration raises results, too. You should always wash your hands before testing, but some soaps have additives like honey or a fragrance that can linger on fingers and distort readings. As well, strips that are too hot or too cold, or other environmental conditions like high altitudes, can produce higher or lower readings. Even different lots of strips can produce different results on the same meter.
Insulin Is Low An Important Difference
Only testing fasting blood glucose without testing fasting insulin tells you very little. Thats because two people could have exactly that same fasting blood glucose levels and have very different circulating insulin levels.5
It is all about the relationship between glucose and insulin and how they work in concert. This is called the homeostatic model assessment of insulin resistance or HOMA-IR. The name is a mouthful, but it simply means that the body is always trying to keep its essential systems in balance or in an equilibrium called homeostasis. Insulin is working against glucose in an attempt to keep blood sugar levels stable, a.k.a in homeostasis.6
In one individual for example someone with pre-diabetes, type 2 diabetes, or polycystic ovarian syndrome insulin may over time be pulsed out in higher and higher amounts just to keep the blood sugar relatively stable. While fasting blood glucose could still be in the normal range, it is taking increasing amounts of insulin to keep it there. As insulin resistance develops, and insulin becomes increasingly ineffective to bring blood sugars down, blood sugars will eventually rise too high.
In a second individual someone who has been on the keto diet for a number of months and is now burning fat for energy much lower amounts of insulin are being pulsed by the pancreas to keep the glucose stable. You have now, therefore, improved your insulin resistance and only need small amounts of insulin to keep glucose in check.
Main Symptoms Of High Blood Glucose
While an individual can have no noticeable symptoms and still have high blood glucose, knowing what kinds of symptoms tend to accompany high blood glucose helps us take the right action before things get worse. If for no other reason, keeping these markers of high blood glucose in mind can help you identify it more quickly in yourself.
The most common symptoms to be aware of are:
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Fasting & Elevated Blood Glucose
Type 2 diabetes for 20+ years. Started keto with intermittent fasting in January 2019. Why would my fasting blood glucose numbers during my 18-24-hour fast be elevated, then come down to normal ranges after eating?
Fasting can definitely raise blood glucose. This is due to the effect of insulin falling and the rising counter-regulatory hormones including increased sympathetic tone, noradrenaline, cortisol and growth hormone, in addition to glucagon. These all have the effect of pushing glucose from liver storage into the blood. This is normal. If you are not eating, you want to use some stored glucose. The question is this if you are not eating, and your blood glucose went up, where did that glucose come from? It can only have come from your own body . So, its a natural phenomenon, and the fasting now allows your body to use some of the glucose for energy.
Dr. Jason Fung
Dawn Phenomenon And Somogyi Effect
In diabetics, there are 2 common ways that high fasting morning blood sugar arises. The first reason is the Dawn Phenomenon and this impacts individuals who are following a ketogenic lifestyle as well. Overnight as we sleep between the hours of 2-8am a slurry of hormones including cortisol, growth hormone, adrenaline and glucagon all begin to rise.
These hormones cause a gluconeogenesis effect where the liver and muscles break down their stored sugar to increase circulating blood sugar. This helps us have energy and mental arousal in the morning. This is a normal physiological response and it is normal for keto dieters to have slightly higher fasting blood sugaralthough it shouldnt be too high and you can mitigate this with the strategies discussed further on in this article.
Diabetics who are also taking exogenous insulin can also have something called the somogyi effect where they shoot too much insulin before bed and they have a blood sugar crash, followed by a huge increase in stress hormones that dramatically increases blood sugar through gluconeogenesis. This is obviously not an issue unless you are a type I or type II diabetic taking prescription insulin.
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Diabetes Medication That Can Help You Control Your Blood Sugar
If youve been diagnosed with diabetes, your doctor will likely discuss medication options to help bring your blood sugar down. If you have prediabetes, on the other hand, youll probably rely on diet and lifestyle changes to help stabilize your numbers, though in some cases, you may need medication, Dodell says.
Diabetic ketoacidosis is treated with emergency insulin and fluids administered intravenously. But the goal with blood sugar control is to prevent this type of medical emergency from happening in the first place. If your blood glucose readings are consistently higher than usual, you may not be getting enough insulin. Talk to your doctor about adjusting your dosage. You should also tell them about any other prescription or over-the-counter medication you take, as these could affect your blood sugar, too. Corticosteroids for inflammation are just one example.
When To Get Urgent Medical Attention
Contact your diabetes care team immediately if you have a high blood sugar level and experience the following symptoms:
- feeling or being sick
- a fever for more than 24 hours
- signs of dehydration, such as a headache, dry skin and a weak, rapid heartbeat
- difficulty staying awake
These symptoms could be a sign of a more serious complication of hyperglycaemia, such as diabetic ketoacidosis or a hyperosmolar hyperglycaemic state, and you may need to be looked after in hospital.
How To Prevent High Morning Blood Sugar
Do not fret, friends. There are ways to deal. Here are three simple ways:
1) Take insulin right when you wake up
If its 2 pm and you notice your blood sugar is shooting up for no apparent reason, youd take a correction dose of insulin to prevent that spike, right? .
The same concept applies here.
To determine how much insulin to take, wake up, record blood sugar values at 30 and 60-minute intervals, and record this for a few days . Then, you can use your insulin to carb ratio to determine a correction bolus.
2) Increase your basal rate around your wake up time
If you fight Dawn Phenomenon, whats a common strategy for success? Increasing basal rates in the wee hours of the morning to counteract that hormone-induced spike.
Well, if youre used to a particular morning routine and know itll take you a little while to prepare food and eat, consider increasing that basal rate during that time period. That additional insulin may overcome the liver dumping glucose and blunt your blood sugar spike, or ideally, prevent it in the first place.
3) If you skip breakfast, stop skipping it and EAT SOMETHING
As a registered dietitian, I can regurgitate all the information from the Academy of Nutrition and Dietetics about why breakfast is important. This isnt about that, but in all honesty here, try eating SOMETHING. Id love if it were healthy, but if youre just DYING to have Cinnamon Toast Crunch, by all means, have at it. If youre about the low-carb life, go for some eggs.
What Causes High Blood Sugar
A variety of things can trigger an increase in blood sugar level in people with diabetes, including:
- missing a dose of your diabetes medicine or taking an incorrect dose
- overtreating an episode of low blood sugar
- taking certain medicines, such as steroids
Occasional episodes of hyperglycaemia can also occur in children and young adults during growth spurts.
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Ultragenyx Announces Additional Positive Multi
Ultragenyx Pharmaceutical Inc. , a biopharmaceutical company focused on the development and commercialization of novel products for serious rare and ultra-rare genetic diseases, today announced new long-term durability data from the Phase 1/2 studies of DTX401 for Glycogen Storage Disease Type Ia and DTX301 for Ornithine Transcarbamylase deficiency that were presented at the 14th International Congress of Inborn Errors of Metabolism .
How To Prevent Hyperglycaemia And Lower Your Blood Sugar Levels
Testing your blood sugar levels regularly can help you spot the signs of hyperglycaemia. But there are some steps you can take to either prevent a hyper from happening or to bring down your blood sugar levels.
You can start by making sure you are aware of your carbohydrate portions and how they may be affecting your blood sugar levels after eating. Carb countingis one of the ways you can manage this. Avoid foods that have a high glycemic index and choose low GI foods that can help manage your blood sugar levels more effectively. Increase the fibre in your diet. This can help slow down carbohydrate digestion, which can help limit the rise in your blood sugars.
Try to maintain a healthy weight as this promotes regular blood sugar levels in the body. Be as active as possible, regular exercise can help your body process more of the sugar.
Remember to take your insulin and other diabetes medication, and always take them correctly. Continue to take your diabetes medication even if you are ill and not eating.
Concentrate on your emotional wellbeing, get a quality nights sleep and find ways to manage your stress. Stress can cause hormones to be released, which keep your blood sugar levels high.
If your blood sugar levels continue to be high, or youre unsure of what to do, contact your doctor for further guidance.
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How Are High Blood Sugar Levels Treated
Treating high blood sugar levels involves fixing what caused them in the first place. Your diabetes health care team will give you specific advice on how to keep your blood sugar levels in a healthy range. But here are some ways to manage the common causes of high blood sugar levels:
|Reason for High Blood Sugar Level||What to Do|
|Not getting enough insulin or other diabetes medicine|
|Not following the meal plan|
|Not getting enough exercise|
|Illness or stress|
|Use of other medicines that can increase blood sugar|
What Causes High Morning Blood Sugars
Two main culprits prompt morning highs: the dawn phenomenon and waning insulin. A third, much rarer cause, known as the Somogyi effect, may also be to blame.
The occasional morning high will have little impact on your A1C, a measure of your average blood sugar levels over time that indicates how well managed your diabetes is. But if those highs become consistent, they could push your A1C up into dangerous territory.
What Are The Signs & Symptoms Of High Blood Sugar Levels
Signs of high blood sugar levels include:
- Peeing a lot: The kidneys respond by flushing out the extra glucose in urine. People with high blood sugar need to pee more often and in larger amounts.
- Drinking a lot: Someone losing so much fluid from peeing that often can get very thirsty.
- Losing weight even though your appetite has stayed the same: If there isn’t enough insulin to help the body use glucose, the body breaks down muscle and stored fat instead in an attempt to provide fuel to hungry cells.
- Feeling tired: Because the body can’t use glucose for energy properly, a person may feel unusually tired.
If You Regularly Have High Blood Sugar Levels
Having high blood sugar levels regularly is not something you should live with. This is because in the long-term it can increase your risk of developing diabetes complications, such as neuropathy and retinopathy.
If you notice that your blood sugar levels are often high, you should contact your diabetes healthcare team. They will review your treatment and provide you with advice on how to get your blood sugar levels back within your target range. This advice may include increasing your medication.
In the video below, Lynsey talks to Khalida about feeling anxious after getting a high blood sugar level reading. If youre finding it hard to deal with similar feelings, weve got information on emotional health that you may find helpful.
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Is Having High Blood Glucose Dangerous
In short, it can be. Zanini says that untreated high blood glucose can lead to a wide range of health issuesâsome of the most common being chronic inflammation, heart disease, vision impairment, kidney disease, nerve damage, tooth decay, damaged blood vessels, and periodontal disease.
Having high blood glucose also puts us at risk of mitochondrial dysfunction and oxidative stress. The former is a condition in which mitochondria fail to produce energy for cells. The latter occurs when free radicals outnumber antioxidants in the body and increase the risk of disease and other damage.
Phipps notes to avoid these risks, catching high blood glucose early on, then taking action to treat it is extremely important.
Why Does Blood Sugar Go Up At Night
There are many factors that can cause your blood sugar to increase at night. For example: what food you ate during the day, how much and when you exercised, whether you ate snacks before bed, the timing of your insulin doses, and your stress level. You can experience different patterns of high blood sugar at night. You may start with high glucose when you go to bed, start the night in range but go high several hours later, or spend most of the night in range until the hours just before you wake up. By identifying your bodys patterns, you can figure out what is causing your high blood sugar and how to address it.
Common causes of a glucose increase at night include:
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A Warning Of Developing Type 2 Diabetes
Impaired fasting glycaemia is sometimes called pre-diabetes. This is when blood glucose levels in the body are raised, but are not high enough to mean that the person has diabetes. IFG means that the body isnt able to use glucose as efficiently as it should. This is because a layer of fat around the cells of the body, prevents insulin doing its job and taking the glucose into the cells of the body where its needed for energy. This situation is reversible by losing weight and hence the fat around the cells disappears. If you dont lose weight however, is it unlikely that you wont eventually develop Type 2 Diabetes.
IFG has no symptoms and can often go undiagnosed for years. Although there are no symptoms, many people diagnosed with IFG are overweight. Nine out of 10 people with IFG have high blood pressure, raised cholesterol levels or a family history of the condition.
IFG can lead to the development of type 2 diabetes. People with IFG are five to 15 times more likely to develop type 2 diabetes than people with normal glucose levels. However, this isnt inevitable. You can take steps to reduce the chances of this happening. People with IFG also have a slightly increased risk of heart disease and stroke.