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Hyperglycaemia (hypers) and mealtime challenges

The experience of living under lockdown due to COVID-19 has created new and varied challenges for us all, many of which may be here to stay as we adapt to life beyond COVID-19. Our lives and daily routines have been severely affected. We had to learn to work in isolation or in busy households, look after, and home school our children, and maintain our physical and mental health all at the same time.

Such disruption to routines can be very stressful, especially for those living with long-term conditions that require careful monitoring, such as diabetes

This could result in eating the wrong food, difficulty in being able to exercise in your usual way or forgetting a dose of your medication, which can potentially put you at risk of experiencing high blood glucose levels, also known as hyperglycaemia or ’hypers’.

This article provides information to help you understand the signs of experiencing a hyper, as well as some ideas for how you can try to prevent your blood glucose levels from above your optimal range. 

Dealing with hyperglycaemia (high blood glucose)

This article provides information to help you understand the signs of experiencing a hyper, as well as some ideas for how you can try to prevent your blood glucose levels from getting above your optimal range. 

How to spot high blood glucose levels (hyper)

The most common symptoms of experiencing a hyper include:

  • tiredness and lethargy
  • passing more urine than usual (peeing more)
  • being very thirsty
  • blurred vision
  • headaches
  • feeling flushed

You may experience one or more of these symptoms when your blood glucose levels are high, or a family member or friend may mention that you do not quite seem your usual self. 

It may take a few days or weeks for the symptom(s) to develop while some people may not show any symptoms despite elevated blood glucose levels, specifically those who have had diabetes for a longer period.

As very high blood glucose levels can lead to serious complications, it is therefore very important to regularly check your blood glucose (sugar) at home. This is easy to manage and should only be started following a discussion with your doctor or nurse. They can advise whether home monitoring is suitable for you and the available options, explain what you need to do, and how often. Should you notice that your blood glucose level is elevated during home monitoring, consult with your doctor or nurse.

Helping reduce the risk of hypers

Having a daily routine is one of the best ways to help you adapt to your new life during this unprecedented situation. As you are likely to be preparing most of your meals at home, you may even find it easier to manage your mealtimes and the amount of insulin you may need.

Creating a daily routine, planning your mealtimes and trying to avoid snacking, plus having planned time to check your blood sugar levels and take your insulin will help you to spend more time within your ideal blood glucose (sugar) range and help to reduce the risk of hypers.

Try to still exercise at home if you cannot get outside much – even 10 minutes a day of physical activity will be beneficial to your physical and mental wellbeing. There are many online fitness classes that you may wish to try. More ideas can be found in the “Exercise and type 2 diabetes” article.

Coping with stressful times as a person with diabetes

Prolonged periods of emotional stress can also lead to changes in blood sugar levels. If you’re feeling stressed, your body releases stress hormones like cortisol and adrenaline. These hormones make it harder for insulin to regulate blood sugar level properly and can lead to an increase in your blood glucose (sugar) level.

Therefore, it is recommended to try to manage your stress levels during this challenging time by doing things you like or that help you relax, such as reading, meditating, yoga, or perhaps something creative like drawing and painting. Spending time with any pets you may have can also help ease any worries and stress.

What to do if you experience a hyper

If you start to feel unwell or notice some of the typical symptoms of high blood glucose levels – (hypers), first check your blood glucose levels. If your blood glucose levels are too high, you will need to consult with your doctor to adjust your medication(s) accordingly.

There are many potential causes for hypers, including:

  • Not using enough or missing a dose of your insulin or other diabetes medication(s)
  • Eating more carbohydrates than your routine eating plan
  • Feeling emotionally stressed
  • Being unwell due to an infection or injury

If you experience frequent high blood glucose levels, you can also try to remember to:

  • Check your blood glucose (sugar) more often than usual, specifically before and after your meals
  • Look for patterns in your blood glucose (sugar) results to understand what may be causing it

Learn more about how to monitor your blood sugar and track how your body reacts to food, exercise and medication.

If you are having difficulties in controlling your blood sugar levels and they are regularly too high, it’s important to speak to your doctor or nurse. They can offer tips and advice, or they may need to adjust your medication(s).

What to do if you experience a hyper

  • Don’t panic
  • It is normal for your blood glucose level to go up and down in a day
  • Never miss your insulin injection(s)
  • If you have unusually high blood glucose readings or if you feel unwell, you should contact your nurse or doctor immediately
  • Test your blood or urine for ketones if you have been instructed to do so by your nurse or doctor

Emergency situations

Contact your nurse or doctor or dial 112/999 if:

  • You are vomiting and unable to hold down fluids
  • You have high blood glucose levels and ketones in your blood or urine

What are ketones?

Normally, with the help of insulin as a ‘key’, the body uses glucose from food to produce energy. When there is little or no insulin to allow the conversion of the glucose from food into energy, the body starts breaking down fat cells for energy. When this occurs, ‘ketones’ form in the blood and spill into the urine. These ketones can make you ill and if left untreated eventually lead to ‘diabetic ketoacidosis’ or DKA, a potentially life threatening condition.

How do you test for ketones?

You can test for ketones in the blood or urine. Several products are available for doing this - your nurse or doctor will advise you.

When should you test for ketones?

  • If your blood glucose level is over 15 mmol/L
  • When you are ill / vomiting
  • If you have taken extra insulin and your glucose level does not come down

Ketone levels can be checked in two different ways - in blood or in urine.


Novo Nordisk would like to thank the Diabetes Nurse Specialists and dietician who were instrumental in developing this content

What should you do if the ketone test is positive?

  • You will need additional insulin - call your nurse or doctor if you need advice
  • Ensure that you drink plenty of water or unsweetened fluids
  • Continue to test blood glucose levels and ketones every 1-2 hours until ketone free
  • Eat a small amount of carbohydrate if possible
  • Never stop taking your insulin

This is general disease awareness and should not be understood as medical advice. If you experience symptoms of COVID-19 or have questions, doubts or concerns, you should contact your doctor. Always follow the advice of local authorities.

In this article you will find links to third-party material not owned or controlled by Novo Nordisk. We are not responsible for the content or the accuracy of the information provided and have no control over the privacy policies or terms of use of such third-party sites.

January 2024. IE23DI00242

  1. NHS UK. Hyperglycaemia (high blood sugar). Available from: https://www.nhs.uk/conditions/high-blood-sugar-hyperglycaemia/. Last accessed: January 2022.
  2. Diabetes.co.uk. Diabetes and stress. Available from: https://www.diabetes.co.uk/diabetes-destress.html. Last accessed: January 2022.
  3. Diabetes.co.uk. Stress and Blood Glucose Levels. Available at: https://www.diabetes.co.uk/stress-and-blood-glucose-levels.html. Last accessed: January 2022.

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