HF 4346

High and Low Blood Glucose (Sugar) Reactions

Low Blood Sugar (Hypoglycemia)This is when blood sugars are less than 70 mg/dL. It can happen suddenly and may progress quickly without treatment.

Causes may include:

  • Late/skipped meal or smaller than usual meal

  • Too much diabetes medicine

  • More activity than usual

  • Drinking alcohol (especially without food; best to limit to 0-2 drinks/day)


What to Do

Get treatment quickly. Take 15 grams of quick-acting carbohydrate (sugar) if able to swallow safely. Avoid chocolate since the fat slows down the rise in blood sugars.


  • 4 oz. (½ cup) juice or regular (non-diet) soda

  • Glucose liquid or gel (amount varies)

  • 4 glucose tablets (chew them)

  • Soft, chewable candy like Skittles, jellybeans (amount varies)

  • 1 tablespoon sugar, honey, (if 1 year old or older) regular syrup

  • Pureed fruit pouch(amount varies)

Glucagon is an option if you cannot swallow safely. Someone else would need to give this to you.

Check your blood glucose 15 minutes after treatment. If your glucose is still below 70 mg/dL, repeat treatment. When your blood sugar is greater than 70, if possible, eat your next meal within an hour. If that is not possible, eat a light snack.

Call 911 if you get more sleepy and less alert or if the glucose levels stay below 70 mg/dL after treatment.

Tell Others

Wear a Medical Alert bracelet or necklace that is easy to see by others. Carry a wallet card that states that you have diabetes. It should include your current list of medicines.

High Blood Sugar (Hyperglycemia)

This is when blood sugars are more than 140-180 mg/dL.

  • Causes may include:

  • Overeating

  • Inactivity

  • Too little diabetes medicine

  • Illness or stress (physical or emotional)

  • Certain medicines, like steroids


What to Do

Check your glucose levels often. Don’t miss your diabetes medicines. Talk with your doctor about changing your medicine plan. Talk with a dietitian about your meal plan. Stay active. Call your doctor if you are sick.

Sick Days

If you get sick with a cold or flu or if you have an infection, you may need to check your blood glucose levels as often as every 2 hours. Stay in close contact with your health care team during these times.

  • Keep taking your diabetes pills or insulin unless your doctor tells you to stop.

  • Drink at least 4 oz (1/2 cup) of fluids every 30 minutes. If you cannot eat a meal, then fluids should contain sugar.

  • If you have type 1 diabetes or history of diabetic ketoacidosis (DKA), check for ketones every 4-6 hours if you are sick.

When to Call Your Doctor

  • If you have had vomiting or diarrhea for more than 6 hours

  • If your glucose stays above 300 mg/dL for more than 6 hours or below 70 mg/dL after repeated treatment

  • If you have moderate to large ketones

Other Tips

Prevent Hypoglycemia During or After Activity

Extra activity such as raking the lawn or exercising, burns more sugar as fuel. This lowers blood sugar levels. Since insulin also lowers blood sugar levels, insulin dose changes may be needed. This can help to prevent hypoglycemia (a low blood sugar reaction).

Ways to Prevent Hypoglycemia

Option 1: Take a smaller dose of mealtime insulin before your exercise or activity.

How much you lower the dose is usually based upon the intensity of the activity.

  • Reduce your mealtime insulin by ________ for moderate activity like fast paced walking or cleaning your garage.

  • Reduce it by ________ for more intense exercise such as biking or splitting/loading wood.

Remember, even walking during a shopping trip may require a lower insulin dose.

Option 2: Have a snack before (or during) the exercise or activity.

Your snack does not need to be a large amount of food. Examples might be:

  • an apple with 1 teaspoon peanut butter

  • a small handful of whole grain crackers with low fat cheese

The combination of a carbohydrate along with a protein should keep your blood sugar safe during the time you are exercising or are more active.

Never start your exercise or activity, without having a fast-acting source of sugar in your pocket, such as your glucose tablets.