How can you prevent a blood sugar emergency?

An important part of living with diabetes is keeping your blood sugar in your target range. You'll need to know what to do if it's too high or too low. Managing your blood sugar levels helps you avoid emergencies. This care sheet will teach you about the signs of high and low blood sugar. It will help you make an action plan with your doctor for when these signs occur.

Low blood sugar is more likely to happen if you take certain medicines for diabetes. It can also happen if you skip a meal, drink alcohol, or exercise more than usual.

You may get high blood sugar if you eat differently than you normally do. One example is eating more carbohydrate than usual. Having a cold, influenza (flu), or other sudden illness can also cause high blood sugar levels. Levels can also rise if you miss a dose of medicine.

Any change in how you take your medicine may affect your blood sugar level. So it's important to work with your doctor before you make any changes.

Track your blood sugar

Work with your doctor to fill in the blank spaces below that apply to you.

Track your levels, know your target range, and write down ways you can get your blood sugar back in your target range. A log book can help you track your levels. Take the book to all of your medical appointments.

• Check your blood sugar _____ times a day, at these times:________________________________________________. (For example: Before meals, at bedtime, before exercise, during exercise, other.)
• Your blood sugar target range before a meal is ___________________. Your blood sugar target range after a meal is _______________________.
• Do this—___________________________________________________—to get your blood sugar back within your safe range if your blood sugar results are _________________________________________. (For example: Less than 4.0 or above 14.0 mmol/L.)

Call your doctor when your blood sugar results are ___________________________________. (For example: Less than 4.0 or above 14.0 mmol/L.)

What are the symptoms of low and high blood sugar?

Common symptoms of low blood sugar are sweating and feeling shaky, weak, hungry, or confused. Symptoms can start quickly.

Common symptoms of high blood sugar are feeling very thirsty or very hungry. You may also pass urine more often than usual. You may have blurry vision and may lose weight without trying.

But some people may have high or low blood sugar without having any symptoms. That's a good reason to check your blood sugar on a regular schedule.

What should you do if you have symptoms?

Work with your doctor to fill in the blank spaces below that apply to you.

Low blood sugar and "the rule of 15"

If you have symptoms of low blood sugar, check your blood sugar. If it's below _____ ( for example, below 4.0 mmol/L), eat or drink a quick-sugar food that has about 15 grams of carbohydrate. Your goal is to get your level back to your safe range. Check your blood sugar again 15 minutes later. If it's still not in your target range, take another 15 grams of carbohydrate and check your blood sugar again in 15 minutes. Repeat this until you reach your target. Then go back to your regular testing schedule.

Children usually need less than 15 grams of carbohydrate. Check with your doctor or diabetes educator for the amount that is right for your child.

When you have low blood sugar, it's best to stop or reduce any physical activity until your blood sugar is back in your target range and is stable. If you must stay active, eat or drink 30 grams of carbohydrate. Then check your blood sugar again in 15 minutes. If it's not in your target range, take another 30 grams of carbohydrates. Check your blood sugar again in 15 minutes. Keep doing this until you reach your target. You can then go back to your regular testing schedule.

If your symptoms or blood sugar levels are getting worse or have not improved after 15 minutes, seek medical care right away. If you take insulin, always carry glucagon with you. Be sure your family, friends, and co-workers know how to give glucagon.

Here are some examples of quick-sugar foods with 15 grams of quick-sugar carbohydrate:

• 3 or 4 glucose tablets
• 1 tablespoon (15 mL) table sugar
• 2/3 cup (150 mL) of fruit juice or regular (not diet) soda
• Hard candy (such as 6 Life Savers)

High blood sugar

If you have symptoms of high blood sugar, check your blood sugar. Your goal is to get your level back to your target range. If it's above ______ ( for example, above 14.0 mmol/L), follow these steps:

• If you missed a dose of your diabetes medicine, take it now. Take only the amount of medicine that you have been prescribed. Do not take more or less medicine.
• Give yourself insulin if your doctor has prescribed it for high blood sugar.
• Test for ketones, if the doctor told you to do so. If the results of the ketone test show a moderate-to-large amount of ketones, call the doctor for advice.
• Wait 30 minutes after you take the extra insulin or the missed medicine. Check your blood sugar again.

If your symptoms or blood sugar levels are getting worse or have not improved after taking these steps, seek medical care right away.