High blood sugar with type 1 diabetes
Long-term problems from high blood sugar
High blood sugar over a long period of time, such as months or years, causes damage to body organs. This damage is not usually seen for 10 years or longer.
High blood sugar, over time, leads to:
- Kidney damage and kidney failure
- Blood vessel damage that can cause heart attacks and strokes
- Eye disease that can cause poor vision or blindness
- Nerve damage that can cause pain like pins and needles in the feet
- Sores on the feet or legs that do not heal and could lead to removal of a toe, foot, or leg
- Sexual problems, such as not being able to get an erection
Taking care of your diabetes and keeping most of your blood sugars near the normal range throughout your life lowers your chance for these long-term problems.
What should I do when my blood sugar is high?
If your blood sugar is 240 or higher:
- Check ketones. If you do not check for ketones, you will not know if you have them.
- If you have small, moderate, or large ketones, take extra rapid-acting insulin right away.
- Drink a lot of carbohydrate-free drinks right away.
Follow the instructions for taking extra insulin.
High blood sugar and checking ketones
There are many reasons your blood sugar can go too high. It is important to know what causes high blood sugar and why high blood sugar is dangerous.
Causes of high blood sugar
- Eating too much carbohydrate or too much quick-acting carbohydrate
- Not enough activity
- Not taking enough insulin
- Forgetting to take insulin
- Illness or infections
- Injury or surgery
Signs of high blood sugar
- Urinating (going pee) a lot
- Thirsty and drinking a lot
- Dry mouth and dry skin
- Blurry vision
- Yeast infections in the groin area
It is normal to have high blood sugar once in a while.
Call your diabetes nurses if:
- You have high blood sugar a lot of the time
- You have high blood sugar that keeps happening about the same time each day
The nurses can help figure out the reason for the high blood sugar and suggest changes in insulin, exercise, or eating to help the high blood sugar come down.
What are ketones?
Ketones are an acid that can build up in the body when your body uses fat instead of sugar for energy. Ketones are caused from the breakdown of fat. Ketones harm the body.
Body fat is used for energy when:
- There is not enough insulin in the body to use sugar for energy
- You do not eat carbohydrate for long periods of time, such as skipping meals
When should I check for ketones?
- When your blood sugar is 240 or higher
- Check ketones even if your blood sugar is not high if you are:
- Sick, have an infection, or trauma
- Vomiting (throwing up)
- If you forgot an insulin shot.
How do I check for ketones?
There are two ways to check for ketones:
- Urine ketones
- Blood ketones
Steps to check for urine ketones:
- Gather the supplies
- Urine ketone strips (check expiration date)
- Small paper cup to pee in
- Timer or watch with a second hand
- Unscrew the lid and take 1 strip out of the bottle.
- Screw the lid back on right away to keep them fresh.
- Do not touch the test end of the strip.
- Dip the test end of the strip into the cup of fresh urine.
- Take it out right away.
- Remove extra urine by drawing it along the rim of the cup.
- Exactly 15 seconds after dipping it in the urine, compare the ketone strip with the color chart on the bottle of ketone strips.
- If you have ketones, follow these instructions.
Ketone strip storage
- Keep ketone strips at room temperature between 59° and 86° F. Keep them out of direct sunlight.
- After opening the first time, write the date on the bottle.
- Always put the lid back on right away after opening.
- Do not keep them in the bathroom because the moisture could ruin the strips.
- Throw the ketone strips away 6 months after first opening if they are not gone.
- Do not use them after the expiration date. Call your pharmacy for a refill.
Steps to check for blood ketones:
- Gather the supplies:
- Blood ketone meter
- Blood ketone test strips
- Lancet device with lancets
- Wash and dry your hands.
- Take the blood ketone strip out of the foil wrapper.
- Put a test strip into meter and it will turn on.
- Use a small needle, called a lancet, to poke your finger. Get a drop of blood on your fingertip.
- Touch the window of the test strip to the drop of blood on your finger. The test strip “sucks” the drop of blood into the strip.
- In a few seconds, your blood ketone reading will show on the screen of the meter.
- Readings below 0.6 mmol/L are in the normal range.
- Readings between 0.6 and 1.5 mmol/L may indicate the development of a problem that may need medical help. Contact your health care provider for instructions.
- Readings above 1.5 mmol/L indicate the patient may be at risk for developing diabetic ketoacidosis (DKA). Contact your health care provider immediately.
What should I do if I have ketones?
If you have small, moderate, or large ketones, take extra rapid-acting insulin and drink lots of carbohydrate-free drinks right away.
Follow the instructions for taking extra insulin.
Call your diabetes doctor or nurse right away if you do not know what to do.
Diabetic ketoacidosis (DKA)
When ketones are large and stay large 4 or more hours, the amount of acid in your body is very high. Very high ketones are dangerous. It can turn into DKA if it is not treated with extra insulin and carbohydrate-free drinks right away.
DKA is an emergency and can lead to coma or death.
DKA can be prevented by knowing:
- When to check for ketones
- How to check for ketones
- What to do for ketones
If you do not check for ketones, you will not know if you have them.
Warning signs of DKA are:
- Ketones in the blood and/or urine
- Vomiting (throwing up) or stomach pain
- Fruity odor to your breath
- Drowsiness or trouble staying awake
- Fast and deep breathing
Go to an emergency room right away if you have any of the signs of ketoacidosis.