All Blood Tests

Today I am going to write about why your blood sugar may be too high. First, what value is considered too high? The two top authorities, the American Diabetes Association (ADA) and the American Academy of Endocrinologists (AACE) have blood glucose guidelines. According to the ADA, you should try to keep your fasting blood sugar (or pre-prandial plasma glucose) between 90-130mg/dl. AACE recommends your fasting blood sugar should be below 110mg/dl. Fasting blood sugar is the value before you eat your meals. There is also a blood sugar goal two hours after you eat your meals. This value is called post-prandial blood glucose. The ADA recommends this value is less than 180mg/dl and AACE suggests less than 140mg/dl. Both organizations agree your bedtime blood sugar should be between 100-140mg/dl. Who is right? Look at the AACE recommendations as taking a class in school and getting an A+ and look at the ADA recommendations as getting an A-. No matter how you look at it, you are getting an A. Now, your blood sugar may be too high for the following reasons:

1. You ate too many carbohydrates or calories.  I thought I would mention the obvious. Many people with diabetes miscalculate the amount of carbohydrates they need for a meal. Some people skip meals and binge the next meal. Consuming too many carbohydrates and eating inconsistently causes your blood sugar to rise. Solution: Try to eat at least three to five small meals a day instead of one big meal. Additionally, try to eat around the same amount of carbohydrates each meal. These practices ought to help keep your blood sugar at an even keel.

2. You may be sick.  If you are ill your blood sugar will rise. Sometimes I order labs for my nursing home residents when their blood sugar is too high to find out if they have an infection, especially when they are watching what they eat. Most of the time, the labs reveal the resident has some type of infection. Solution: Be certain you check your blood sugar about every four hours when you are sick and drink plenty of fluids. Dehydration also causes high blood sugar for people with diabetes.

3. You may be stressed out.  Believe it or not, stress will increase your blood sugar. I had a resident in one of my nursing homes whose blood sugar would elevate every time her daughter came to visit. No kidding! Her daughter would complain to me her mother was getting too many carbohydrates but when the daughter left the resident’s blood glucose would improve. Luckily, her daughter only visited once a month. Solution: If you are stressed out I’d recommend a relaxing activity. You can try taking a bath, listening to soft music, prayer or meditation. Walking can also calm you down. However, if you have kind I diabetes, just make sure your blood sugar is below 250mg/dl before you decide to walk. Do no matter what you can to reduce stress in your life.

4. You may need to adjust your medications.

If you are counting your carbohydrates, you are healthy and you have reduced stress in your life, you should speak to your doctor about adjusting your medications if you still are not reaching your blood sugar goals. The doctor will need to raise or try another diabetic medication to get your blood glucose under control. It’s not uncommon for someone with diabetes to take several medications. Keeping your blood sugar close to normal range is important to prevent side effects (i.e. blindness, kidney disease, or amputation).