Diabetes: blood sugar levels

Regularly checking your blood sugar gives you essential insights into how food, medication, stress, and physical activity affect your glucose levels⁶. This empowers you to make timely decisions and tailor your care plan, accordingly, including the importance of exercising regularly.

Blood glucose meters are small devices that give you a snapshot of your current blood sugar level using a drop of blood from your fingertip⁷.

How to use a glucose meter:

• Wash your hands with soap and warm water
• Insert a test strip into the meter
• Prick your fingertip with a lancet
• Place a drop of blood on the strip
• Wait for the reading to appear

Your doctor will advise how often you should check your blood sugar, but typical times include:

• Before and after meals
• At bedtime
• When feeling unwell
• Before and after exercise

A CGM uses a sensor placed just under the skin, usually on the abdomen or upper arm, to continuously measure glucose levels, especially if there is a family history of diabetes. The device sends data to a reader or smartphone app⁸.

Benefits of a CGM:

• Real-time readings
• Alerts for highs and lows
• Fewer finger pricks
• Trends and patterns over time

CGMs are especially helpful for people on intensive insulin therapy or those with frequent fluctuations in their blood sugar levels due to their diabetes medications⁸.

Recording your results - manually or via an app - helps identify trends and triggers that influence your glucose control. Take care to note following:

• Time of reading
• Glucose level
• Food and drink consumed
• Physical activity
• Medications taken
• Symptoms (if any)

Sharing this data with your doctor and/or healthcare team helps support more personalised decisions around your treatment for diabetes⁶.

Hyperglycaemia is dangerous both in the short and long term, especially when coupled with high blood pressure⁹. Left unmanaged, high blood sugar can lead to severe medical emergencies or cause gradual damage to vital organs, including affecting red blood cells.

Hyperglycaemia can occur for various reasons, including:

• Skipping medication or insulin
• Overeating, particularly carbohydrates
• Stress or illness
• Physical inactivity
• Side effects from medications like corticosteroids¹⁰

Recognising what causes your blood sugar to rise can help you make better choices and take early action.

Though more common in type 1 diabetes, DKA can also occur in people with type 2 diabetes. It happens when the body uses fat for fuel due to a lack of insulin, leading to a build-up of acids called ketones¹¹.

Symptoms of DKA include:

• Nausea or vomiting
• Abdominal pain
• Fruity-smelling breath
• Rapid breathing
• Confusion

DKA is a medical emergency and requires immediate treatment.

HHS is a complication primarily associated with type 2 diabetes and various risk factors that can exacerbate the condition⁵. It’s marked by dangerously high blood glucose levels and severe dehydration, often triggered by illness or missed medication.

Symptoms include:

• Very high blood sugar (often above 600 mg/dL)
• Dry mouth
• Extreme thirst
• Weakness or confusion
• Loss of consciousness in severe cases

Like DKA, HHS is life-threatening and needs urgent medical intervention.

Prolonged high blood sugar levels damage the blood vessels and nerves, leading to multiple complications.

People with diabetes are at significantly higher risk of heart disease and stroke, making losing weight an important goal for reducing this risk¹². Hyperglycaemia contributes to the narrowing and hardening of arteries (atherosclerosis), which can lead to cardiovascular events¹³.

High glucose damages the tiny filters in the kidneys, especially when combined with certain medicines, if the body does not produce enough insulin - eventually leading to kidney failure if not managed properly¹⁴.

Symptoms include:

• Swelling in the hands, feet, or face
• Fatigue
• Protein in the urine

Regular kidney function tests are essential.

Diabetes can damage the small blood vessels in the eyes, leading to symptoms such as:

• Blurred vision
• Diabetic retinopathy
• Macular edema
• Cataracts
• Glaucoma¹⁵

These complications may cause vision loss if not detected early. Annual eye exams are strongly recommended.

Diabetic neuropathy affects about half of all people with diabetes¹⁶. It typically begins in the feet or legs and can cause:

• Tingling or numbness
• Burning pain
• Loss of sensation

Nerve damage increases the risk of foot injuries, infections, and even amputations¹⁶.

Chronically high blood sugar impairs circulation and immune function, making it harder for the body to heal cuts and bruises, highlighting the importance of an exercise program and regular blood sugar tests¹⁷. Even minor injuries can become infected if left untreated.

While medication is important, including knowing how to use insulin properly, lifestyle choices are the foundation of good blood sugar control¹. Daily habits make a significant difference in your ability to maintain target glucose levels and prevent complications.

Choose foods that are:

• High in fibre (e.g. vegetables, legumes, whole grains)
• Low in added sugars and refined carbohydrates
• Balanced with healthy fats and lean proteins

Avoid sugary drinks and snacks. Using smaller plates, measuring portions, and spacing meals evenly can help avoid spikes in blood sugar².

Exercise increases insulin sensitivity, helping the body use glucose more effectively¹⁸    .

Recommended activity:

• 150 minutes of moderate-intensity aerobic activity per week (e.g. walking, swimming, cycling)
• Strength training twice a week

Even small changes, like taking the stairs or walking after meals, can be beneficial.

Whether you're using a glucose meter or engaging in continuous glucose monitoring (CGM), tracking your levels helps you understand how your body responds to different inputs, which may mean needing more insulin⁸.

Never skip or alter doses without consulting your healthcare provider or discussing other medicines you may be taking, as this can lead to low blood sugar. Some people with type 2 diabetes will eventually require insulin - this is a normal part of disease progression, not a failure¹¹.

Stress hormones can increase blood sugar. Managing stress through meditation, breathing exercises, light movement, or speaking to a friend can make a measurable difference in your levels, especially for those at risk of gestational diabetes⁹.

Sticking to a routine helps stabilise your blood sugar. Aim for regular sleep, meal timing, exercise, and medication. Consistency creates predictability in how your body processes glucose⁶.

Consult your doctor to determine the best steps for your individual needs.

Start by learning about your condition and following your doctor’s advice. You can make a big difference by eating a healthy, balanced diet, staying active, and monitoring your blood sugar levels as recommended. Avoid smoking, limit alcohol, manage stress, and take medications as prescribed. Small, consistent lifestyle changes can greatly improve your health and help manage diabetes effectively.

At first, giving yourself insulin may seem challenging, but most people quickly become comfortable with it. Your healthcare team will show you how to use the syringe, pen, or pump correctly and safely. With practice, insulin injections become a quick and simple part of your routine. Many find it less painful and intimidating than they expected.

Yes, many people around the world live with type 1 or type 2 diabetes. It’s one of the most common chronic conditions, including gestational diabetes and you're definitely not alone. Many individuals manage it successfully every day with support from healthcare providers, family, and peer communities. Connecting with others can provide encouragement, shared experiences, and practical tips, especially when considering family history in diabetes management.