Hyperglycaemia: Monitoring Blood Glucose

High blood glucose levels (hyperglycaemia) may occur if you have diabetes and do not manage it properly.

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High blood glucose levels or blood sugar levels (hyperglycaemia) may occur if you have diabetes and do not manage it properly. It can be caused by:
Forgetting to take medication, or taking too little medication
Not taking proper care with insulin injections 
Not following meal plans
Illness and/or infection

Blood glucose levels should be checked with a blood glucose meter regularly, but high levels will provide the following warning symptoms:
Frequent passing of urine 
Increased thirst and hunger
Tiredness
Difficulty in seeing clearly
Weight loss

Why Monitor Blood Glucose

Checking your blood glucose levels helps you see how your food, exercise, activities, stress, medication and insulin doses are affecting them. Knowing this helps you make any necessary changes to your lifestyle.

How to Check Blood Glucose 

There are many different meters available and each of them works differently. Follow the specific instructions that come with the blood glucose monitor. Your doctor or diabetes care team will help you decide which one to use. Most meters require the following steps to be taken when carrying out a blood sugar test.
1. Wash hands well with soap and water. Dry them.
2. Insert a test strip into the reader.
3. Squeeze your fingers.
4. Prick the side of your finger with the lancet.
5. Squeeze out a drop of blood.
6. Place the drop of blood onto a test strip, ensuring the drop is big enough.
7. Take the blood glucose reading and record it.
8. Throw used lancets in a puncture-resistant plastic container or metal tin.

Regular Blood Glucose Monitoring

Your doctor can advise the best time — and how often — to check your blood glucose.

Generally, the best times to check are:
Before/two hours after meals
When you feel giddy/confused/sweaty/very hungry
Before/after exercise
When you are sick or not eating well

How to Read a Blood Glucose Meter 

The meter shows a number that indicates the amount of glucose in the blood. The table below explains what the figures mean.
  
A reading in the “poor” range indicates that your blood glucose level is too high. You should:
Drink lots of water
Cut down on carbohydrates (sugars) until your blood glucose level comes down — but do not fast
Do further blood tests every four hours
Keep taking your medications but consult your doctor to adjust them if the readings remain high. Ask your doctor if you need an extra dose of fast-acting insulin to help temporarily correct high blood glucose; and how often you need it
Get active. Regular exercise is a good way to control your blood glucose. However, do not exercise when you have ketones as it can worsen the condition
Follow your meal plan as directed. If you find it hard to stick to your meal plan, ask your dietician for help
Plan ahead. Talk to your doctor about handling high blood glucose so that you are prepared if it happens to you

 

A reading in the “poor” range indicates that your blood glucose level is too high. You should:
Drink lots of water
Cut down on carbohydrates (sugars) until your blood glucose level comes down — but do not fast
Do further blood tests every four hours
Keep taking your medications but consult your doctor to adjust them if the readings remain high. Ask your doctor if you need an extra dose of fast-acting insulin to help temporarily correct high blood glucose; and how often you need it
Get active. Regular exercise is a good way to control your blood glucose. However, do not exercise when you have ketones as it can worsen the condition
Follow your meal plan as directed. If you find it hard to stick to your meal plan, ask your dietician for help
Plan ahead. Talk to your doctor about handling high blood glucose so that you are prepared if it happens to you

Related: Blood Sugar Diary

Seeking Medical Help

See a doctor immediately if your blood glucose is higher than your goal for three consecutive days or if you have any of these symptoms:
Shortness of breath
Vomiting
Very dry mouth

Left untreated, high blood glucose can lead to a serious condition called ketoacidosis, or diabetic coma, which requires hospitalisation. This is a life-threatening condition.

HbA1c (Glycated Haemoglobin)

To track how well your blood glucose levels have been maintained over a period of time, your doctor will test your HbA1c level. This reflects how high your blood glucose levels have been over the last two to three months.

 

Discuss with your doctor what your HbA1c should be, as it depends on your age and other illnesses, if any. If your results are not within your target levels, you will need to do more to manage your blood glucose level.

Tips from Other Patients on Checking Blood Sugar Levels
I used to think I could tell what my blood sugar was without checking it. But really, the only way I can tell is by using my meter.
Pricking my finger used to hurt. The nurse showed me how to prick it on the side instead of in the middle. That made a big difference.
Once I check my blood sugar in the morning, I know what I need to do for the rest of the day. It gives me peace of mind and helps me keep control of my life.

Related: Blood Glucose Meters

Blood Pressure and Cholesterol 

Diabetics need to keep their blood pressure and cholesterol level under control. If not, complications from diabetes can be much worse. If you have high blood pressure and/or high blood cholesterol levels:
Ensure that you are taking the medications your doctor has prescribed for you
Eat healthily 
Exercise
Don’t smoke
Drink moderately
Keep your medical appointments
Go for regular check-ups

Foot Care and Eye Screening 

Diabetes damages and affects the blood vessels and nerves of the whole body, including the eyes and the limbs. People with diabetes are at risk of serious eye and foot problems due to poor blood flow and/or nerve damage.

Bleeding in the eyes can occur very suddenly, so go for annual eye screening. Eye problems can be detected and treated early. Also, take good care of your feet. This will help you to pick up early signs of damage and prevent foot complications. 

Ketones 

Ketones are harmful chemicals which the body produces when there is too little or no insulin. They are a warning sign that your blood glucose level is too high and needs to be reduced immediately.

Checking for Ketones

The easiest way to check for ketones is to use a urine or blood ketone test. Your doctor or nurse can advise you on which ketone test to use. Most test kits come in packages of strips or individually wrapped strips (which can be kept longer).

To get accurate results from ketone tests, follow the instructions carefully. If you are unsure, always ask your doctor or nurse to show you.

Here’s how to use most urine ketone tests:
1. First, check that the strips are not beyond their expiry date.
2. Collect a sample of your urine in a clean container.
3. Place a strip in the urine sample. Alternatively, pass it through your urine stream.
4. Shake off excess urine from the strip.
5. Wait for the strip to change colour.
6. Compare the strip to the colour chart on the strip bottle to get an indication of the amount of ketones in your urine.
7. Record your results.

Check for ketones if you have any of these symptoms:
A blood glucose level of 14mmol/L or higher
Fatigue
Constant thirst or a dry mouth
Frequent urination
Blurred vision 
Vomiting
Diarrhoea
Difficulty in breathing

Reading the Ketone Test Results

If the ketone test shows small or trace amounts of ketones, it could mean that ketones are starting to build up in your body. Repeat the ketone test once every three to four hours to monitor the progress. 

Moderate or large amounts of ketones indicate that your blood glucose is out of control. See a doctor or go to the hospital immediately as this can lead to ketoacidosis (diabetic coma), which has serious consequences.

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