Managing High Blood Sugar: A Practical Guide for Persons with Diabetes

05 Sep 2025 Lesley L. Williams, M.D.

Managing High Blood Sugar: A Practical Guide for Persons with Diabetes

High blood sugar, also known as hyperglycemia, is a common concern for individuals living with diabetes. Effectively managing blood sugar levels is crucial for preventing long-term complications and maintaining overall health. This comprehensive guide provides practical strategies, actionable tips, and essential information for people with diabetes to help them proactively manage high blood sugar. The Role Of Insulin How Your Body Manages Blood Sugar

Understanding the importance of managing high blood sugar is the first step towards better health. Chronically elevated blood glucose levels can damage vital organs, leading to serious health issues such as heart disease, kidney disease, nerve damage (neuropathy), and vision problems (retinopathy). Therefore, adopting strategies to keep blood sugar within the target range recommended by your healthcare provider is essential for a long and healthy life. How To Lower Your A1C A Practical Guide For Managing Diabetes

Key Benefits of Effective High Blood Sugar Management:

Reduced risk of long-term complications: Keeping blood sugar levels within the target range significantly lowers the chances of developing diabetes-related complications.
Improved energy levels: Managing blood sugar effectively can reduce fatigue and increase overall energy levels, allowing for a more active lifestyle.
Better mood and cognitive function: Stable blood sugar levels contribute to improved mood, concentration, and cognitive performance.
Enhanced quality of life: By controlling blood sugar, individuals with diabetes can lead more fulfilling and unrestricted lives.

| Health Parameter | Impact of Poor Management | Impact of Effective Management | |-----------------------|--------------------------------|-----------------------------------| | Blood Sugar Levels | Chronically elevated glucose levels | Maintained within target range | | Long-term Complications| Increased risk of heart, kidney, nerve and eye damage | Significantly reduced risk | | Energy Levels | Frequent fatigue and weakness | Improved and sustained energy levels | | Mood | Irritability, mood swings | Stable and positive mood |

Identifying and Understanding High Blood Sugar

Recognizing the symptoms of high blood sugar and understanding its causes are crucial for effective management. Being able to identify when your blood glucose is elevated allows you to take timely action and prevent further complications.

Symptoms of High Blood Sugar:

Frequent urination: Especially at night.
Increased thirst: Feeling constantly dehydrated.
Blurred vision: Changes in the lens of the eye due to high glucose.
Fatigue: Feeling unusually tired and weak.
Headaches: Mild to severe pain in the head.
Slow-healing cuts or sores: Impaired blood flow and immune function.
Dry and itchy skin: Dehydration and poor circulation.

Common Causes of High Blood Sugar:

Dietary indiscretion: Consuming large amounts of carbohydrates or sugary foods.
Missed or incorrect dosage of diabetes medication: Insulin or oral medications not taken as prescribed.
Inactivity: Lack of physical activity, which reduces glucose utilization by the muscles.
Illness or infection: Stress hormones released during illness can raise blood sugar.
Stress: Emotional stress can also elevate blood sugar levels.
Dehydration: Insufficient water intake, which concentrates glucose in the blood.
Certain medications: Some medications, such as steroids, can increase blood sugar.

Monitoring Blood Sugar Levels:

Regularly monitoring your blood sugar is the cornerstone of diabetes management. Using a blood glucose meter allows you to track your levels throughout the day and identify patterns that can help you adjust your diet, exercise, and medication.

Frequency: Your healthcare provider will recommend how often you should check your blood sugar based on your individual needs and treatment plan. Common times to check include:
- Before meals
- Two hours after meals
- Before bedtime
- Before, during, and after exercise
- When you suspect your blood sugar is high or low
Tools:
- Blood Glucose Meter: A portable device used to measure the amount of glucose in your blood from a small blood sample, usually taken from your fingertip.
- Continuous Glucose Monitor (CGM): A device that tracks your glucose levels continuously throughout the day and night using a small sensor inserted under your skin. CGMs provide real-time data and alerts for high and low glucose levels.

Dietary Strategies for Managing High Blood Sugar

Diet plays a pivotal role in managing high blood sugar. Making informed food choices and adopting healthy eating habits can significantly impact your blood glucose levels and overall health.

Key Dietary Recommendations:

Focus on Complex Carbohydrates:
- Choose whole grains (such as brown rice, quinoa, and whole wheat bread) over refined carbohydrates (such as white bread, pasta, and sugary cereals).
- Complex carbohydrates are digested more slowly, resulting in a gradual rise in blood sugar levels compared to refined carbs.
Prioritize Fiber-Rich Foods:
- Include plenty of fiber-rich foods in your diet, such as vegetables, fruits, legumes, and whole grains.
- Fiber slows down the absorption of sugar and helps regulate blood glucose levels.
Control Portion Sizes:
- Be mindful of portion sizes to avoid overeating, which can lead to spikes in blood sugar.
- Use smaller plates and bowls, and measure your food to ensure accurate portion control.
Limit Sugary Foods and Beverages:
- Avoid or limit the consumption of sugary foods and beverages, such as sodas, juices, candy, and pastries.
- These items can cause rapid and significant increases in blood sugar levels.
Choose Lean Proteins:
- Select lean sources of protein, such as poultry, fish, beans, and tofu.
- Protein helps stabilize blood sugar levels and promote satiety.
Incorporate Healthy Fats:
- Include healthy fats in your diet, such as those found in avocados, nuts, seeds, and olive oil.
- Healthy fats can improve insulin sensitivity and help manage blood sugar levels.
Stay Hydrated:
- Drink plenty of water throughout the day to stay hydrated.
- Dehydration can increase blood sugar levels.

Example Meal Plan for Managing Blood Sugar:

| Meal | Food | Portion Size | Carbohydrate Count (Approx.) | |--------------|-------------------------------------------------------------------------------------------------------|---------------------------------------------|-------------------------------| | Breakfast | Oatmeal with berries and a sprinkle of nuts | 1/2 cup cooked oatmeal, 1/2 cup berries, 1 tbsp nuts | 30-45 grams | | Lunch | Grilled chicken salad with mixed greens, avocado, and a vinaigrette dressing | 4 oz grilled chicken, 2 cups salad, 1/4 avocado | 15-30 grams | | Dinner | Baked salmon with roasted vegetables (broccoli, carrots, and bell peppers) and quinoa | 4 oz salmon, 1 cup vegetables, 1/2 cup quinoa | 30-45 grams | | Snacks | Small apple with a tablespoon of almond butter, or a handful of almonds | 1 apple, 1 tbsp almond butter, 1/4 cup almonds | 15-30 grams | Morning Blood Sugar Spikes Here S Why And How To Manage It

The Role of Physical Activity in Blood Sugar Management

Regular physical activity is an integral component of diabetes management. Exercise helps lower blood sugar levels, improve insulin sensitivity, and promote overall health.

Benefits of Exercise for Managing Blood Sugar:

Lowers blood sugar levels: During exercise, your muscles use glucose for energy, which helps lower blood sugar levels.
Improves insulin sensitivity: Exercise makes your cells more responsive to insulin, allowing glucose to enter them more easily.
Helps maintain a healthy weight: Physical activity burns calories and helps you maintain a healthy weight, which can improve blood sugar control.
Reduces stress: Exercise can help reduce stress levels, which can have a positive impact on blood sugar.
Improves cardiovascular health: Regular physical activity reduces the risk of heart disease, a common complication of diabetes.

Recommended Types of Exercise:

Aerobic exercise: Activities that increase your heart rate and breathing, such as walking, jogging, swimming, and cycling.
Strength training: Activities that build muscle mass, such as lifting weights or using resistance bands.
Flexibility exercises: Activities that improve your range of motion, such as stretching and yoga.

Exercise Guidelines:

Frequency: Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, spread out over at least three days.
Strength training: Include strength training exercises at least two days per week, working all major muscle groups.
Timing: Check your blood sugar before, during, and after exercise to see how your body responds.
Precautions:
- Talk to your healthcare provider before starting any new exercise program.
- Carry a source of fast-acting carbohydrates with you in case your blood sugar drops too low during exercise.
- Stay hydrated by drinking plenty of water before, during, and after exercise.

Example Exercise Routine:

| Day | Activity | Duration | Intensity | |---------|----------------------|----------|--------------| | Monday | Brisk walking | 30 minutes| Moderate | | Tuesday | Strength training | 30 minutes| Moderate | | Wednesday| Swimming | 30 minutes| Moderate | | Thursday | Rest | | | | Friday | Cycling | 30 minutes| Moderate | | Saturday | Yoga | 45 minutes| Light | | Sunday | Brisk walking | 30 minutes| Moderate |

Medications for Managing High Blood Sugar

In addition to lifestyle modifications, medications are often necessary to manage high blood sugar. Your healthcare provider will prescribe medications based on your individual needs and blood sugar goals.

Common Types of Diabetes Medications:

Insulin: Used to replace or supplement the insulin your body is not producing.
- Types: Rapid-acting, short-acting, intermediate-acting, and long-acting.
- Administration: Injected via syringe, pen, or pump.
Metformin: Reduces glucose production in the liver and improves insulin sensitivity.
- Administration: Oral tablet.
Sulfonylureas: Stimulate the pancreas to release more insulin.
- Examples: Glipizide, glyburide, and glimepiride.
- Administration: Oral tablet.
DPP-4 Inhibitors: Help increase insulin release and decrease glucose production.
- Examples: Sitagliptin, saxagliptin, and linagliptin.
- Administration: Oral tablet.
GLP-1 Receptor Agonists: Mimic the effects of a natural hormone to increase insulin release and decrease glucose production.
- Examples: Exenatide, liraglutide, and semaglutide.
- Administration: Injected via pen.
SGLT2 Inhibitors: Increase glucose excretion in the urine.
- Examples: Canagliflozin, dapagliflozin, and empagliflozin.
- Administration: Oral tablet.

Medication Management Tips:

Take medications as prescribed: Follow your healthcare provider's instructions carefully and take your medications at the recommended times.
Monitor blood sugar levels: Regularly check your blood sugar to see how your medications are working.
Be aware of side effects: Understand the potential side effects of your medications and report any concerns to your healthcare provider.
Do not skip doses: Skipping doses can lead to high blood sugar levels.
Store medications properly: Store your medications according to the manufacturer's instructions.
Refill prescriptions on time: Make sure you have enough medication on hand to avoid running out.

| Medication Type | Primary Action | Administration | Potential Side Effects | |-----------------------|-----------------------------------------------------|----------------|-----------------------------------------------------------------| | Insulin | Replaces/supplements body's insulin | Injection | Hypoglycemia, weight gain | | Metformin | Reduces glucose production in the liver | Oral Tablet | Gastrointestinal upset (nausea, diarrhea) | | Sulfonylureas | Stimulates pancreas to release more insulin | Oral Tablet | Hypoglycemia, weight gain | | DPP-4 Inhibitors | Increases insulin release, decreases glucose prod. | Oral Tablet | Joint pain, upper respiratory infections | | GLP-1 Receptor Agonists| Mimics natural hormones to increase insulin | Injection | Nausea, vomiting | | SGLT2 Inhibitors | Increases glucose excretion in urine | Oral Tablet | Urinary tract infections, dehydration |

Managing Stress and its Impact on Blood Sugar

Stress can significantly impact blood sugar levels. When you are stressed, your body releases hormones that can raise blood glucose. Managing stress through various techniques is crucial for maintaining stable blood sugar levels.

How Stress Affects Blood Sugar:

Stress hormones: When you're under stress, your body releases hormones like cortisol and adrenaline, which can increase blood sugar levels.
Lifestyle changes: Stress can also lead to unhealthy lifestyle choices, such as overeating, skipping meals, and reduced physical activity, which can further impact blood sugar control.

Stress Management Techniques:

Relaxation techniques: Practice relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation.
Exercise: Regular physical activity can help reduce stress levels and improve overall well-being.
Hobbies: Engage in hobbies and activities that you enjoy to take your mind off stressors.
Social support: Connect with friends and family for emotional support.
Proper sleep: Ensure you get adequate sleep, as sleep deprivation can increase stress levels.
Mindfulness: Practice mindfulness by focusing on the present moment and accepting your thoughts and feelings without judgment.
Time management: Improve your time management skills to reduce feelings of overwhelm.
Professional help: Consider seeking professional help from a therapist or counselor if you're struggling to manage stress.

Practical Tips for Stress Reduction:

Deep Breathing Exercise:
- Find a quiet place and sit comfortably.
- Close your eyes and focus on your breath.
- Inhale slowly through your nose, filling your lungs with air.
- Hold your breath for a few seconds.
- Exhale slowly through your mouth, releasing all the air from your lungs.
- Repeat for 5-10 minutes.
Mindful Walking:
- Take a walk in a park or natural setting.
- Focus on your senses: the sounds of nature, the sights around you, and the feel of your feet on the ground.
- Let go of any thoughts or worries and simply be present in the moment.

| Stress Management Technique | How it Helps Blood Sugar | Practical Application | |----------------------------|--------------------------|--------------------------------------------------------------------------| | Deep Breathing | Reduces cortisol levels | Practice daily for 5-10 minutes, especially during stressful situations | | Regular Exercise | Improves insulin sensitivity | Engage in aerobic and strength training activities at least 3 times a week | | Mindfulness Meditation | Promotes relaxation | Spend 10-15 minutes each day focusing on the present moment |

Dealing with Emergency Situations: High Blood Sugar

Recognizing and responding appropriately to emergency situations related to high blood sugar is crucial for preventing serious complications.

Hyperglycemic Crisis:

A hyperglycemic crisis, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), is a life-threatening condition that requires immediate medical attention.

Symptoms of DKA:

High blood sugar levels (above 250 mg/dL)
Ketones in the urine
Excessive thirst
Frequent urination
Nausea, vomiting, and abdominal pain
Fruity-smelling breath
Rapid, deep breathing
Confusion or loss of consciousness

Symptoms of HHS:

Very high blood sugar levels (above 600 mg/dL)
Excessive thirst
Frequent urination
Dry mouth and skin
Warm, flushed skin
Confusion or loss of consciousness
Vision problems
Weakness on one side of the body

What to Do in Case of a Hyperglycemic Crisis:

Check blood sugar levels: Use a blood glucose meter to check blood sugar levels.
Check for ketones: If you have symptoms of DKA, check your urine for ketones using a home test kit.
Stay hydrated: Drink plenty of water to help flush out excess glucose and ketones.
Contact your healthcare provider or seek immediate medical attention: If you suspect you are experiencing DKA or HHS, call your healthcare provider or go to the nearest emergency room immediately.
Administer insulin (if prescribed): If you have been prescribed insulin for high blood sugar, administer it as directed by your healthcare provider.

Prevention Tips:

Monitor blood sugar levels regularly: Check your blood sugar as often as recommended by your healthcare provider.
Follow your diabetes management plan: Adhere to your prescribed diet, exercise, and medication regimen.
Stay hydrated: Drink plenty of water throughout the day.
Manage stress: Use stress management techniques to reduce stress levels.
Be aware of sick-day management: Follow your healthcare provider's guidelines for managing blood sugar when you are sick.
Educate yourself: Learn about the symptoms of DKA and HHS and how to prevent them.

| Emergency Situation | Key Symptoms | Immediate Actions | Prevention Strategies | |-----------------------------|-----------------------------------------------------|-------------------------------------------------------------------|-----------------------------------------------------------------------| | Diabetic Ketoacidosis (DKA) | High blood sugar, ketones, fruity breath, nausea | Check blood sugar, check ketones, hydrate, seek medical attention | Regular monitoring, follow management plan, stay hydrated, manage stress | | Hyperosmolar Hyperglycemic State (HHS) | Very high blood sugar, confusion, dehydration | Check blood sugar, hydrate, seek medical attention | Regular monitoring, follow management plan, stay hydrated |

Working with Your Healthcare Team

Effective management of high blood sugar requires a collaborative effort between you and your healthcare team. Regular communication and consultations with your healthcare team are essential for developing and adjusting your treatment plan to meet your individual needs.

Key Members of Your Healthcare Team:

Endocrinologist: A physician specializing in diabetes and other endocrine disorders.
Primary Care Physician: Your main healthcare provider who oversees your overall health.
Certified Diabetes Educator (CDE): A healthcare professional who provides education and support on diabetes management.
Registered Dietitian: A nutrition expert who can help you develop a healthy eating plan.
Pharmacist: A healthcare professional who can answer questions about your medications and potential side effects.
Ophthalmologist: An eye doctor who screens for diabetic retinopathy.
Podiatrist: A foot doctor who provides care for diabetic foot problems.

Tips for Effective Communication with Your Healthcare Team:

Prepare for appointments: Write down your questions and concerns before your appointment.
Be honest: Provide accurate information about your blood sugar levels, diet, exercise, and medication adherence.
Ask questions: Don't hesitate to ask questions if you don't understand something.
Take notes: Write down the information and instructions provided by your healthcare team.
Follow up: If you have any questions or concerns after your appointment, contact your healthcare team.
Schedule regular check-ups: Attend regular appointments to monitor your blood sugar levels and overall health.

Questions to Ask Your Healthcare Team:

What are my target blood sugar levels?
How often should I check my blood sugar?
What should I do if my blood sugar is high?
What medications are you prescribing, and what are the potential side effects?
What lifestyle changes can I make to improve my blood sugar control?
How often should I see you for follow-up appointments?
Who should I contact if I have an emergency?

| Healthcare Provider | Role in Diabetes Management | Key Questions to Ask | |----------------------------|----------------------------------------------------------------|-----------------------------------------------------------------------------| | Endocrinologist | Specializes in diabetes management | What are my A1C goals? How can we adjust my medication for better control? | | Certified Diabetes Educator| Provides education and support on diabetes management | How can I better manage my blood sugar with diet and exercise? | | Registered Dietitian | Helps develop a healthy eating plan | What foods should I focus on, and what should I limit? |

By actively engaging with your healthcare team and following their recommendations, you can effectively manage high blood sugar, prevent complications, and improve your overall quality of life.

In conclusion, managing high blood sugar is a continuous process that requires knowledge, dedication, and proactive management. By understanding the causes and symptoms of high blood sugar, adopting healthy dietary habits, engaging in regular physical activity, managing stress, and working closely with your healthcare team, you can effectively control your blood sugar levels and lead a healthier, more fulfilling life with diabetes. Always remember that managing diabetes is a marathon, not a sprint. Stay informed, stay consistent, and stay positive.