Table of ContentsView AllTable of ContentsTake InsulinTake Missed MedicationExerciseDrink WaterWatch Your CarbohydratesWhen to Get HelpWhen to Go to the ER
Table of ContentsView All
View All
Table of Contents
Take Insulin
Take Missed Medication
Exercise
Drink Water
Watch Your Carbohydrates
When to Get Help
When to Go to the ER
When you have type 1 or type 2 diabetes, dangerous spikes in blood glucose (severe hyperglycemia) may mean you need to reduce blood sugar levels quickly. If you don’t, you could be at risk for potentially life-threatening complications. Some keyhyperglycemia symptomsinclude extreme thirst, frequent urination, and nausea.
Generally speaking, a blood glucose level of 180 milligrams per deciliter (mg/dL) is too high, but any blood glucose level (BGL) above your target range is cause for concern. Your healthcare provider should tell you what your upper limit is, as it may be different for different people.
Verywell / Theresa Chiechi
The preferred—and quickest—method of lowering your glucose level is to take rapid-actinginsulinsuch as Humalog, Novolog, or Apidra.If you havetype 1 diabetes, you may be able to get a correction dose through yourinsulin pump, as well.
Slow-acting insulin, such as NPH, does not lower blood sugars quickly. It takes several hours to work. Therefore, it’s not an appropriate treatment when you urgently need to bring down your BGL.
When the body doesn’t have enough insulin (type 1 diabetes) or doesn’t use it efficiently (type 2 diabetes), it can lead to short-term symptoms and complications, likediabeticketoacidosis(DKA) andhyperosmolar hyperglycemicstate(HHS).
Be sure you talk to your healthcare provider about how much rapid-acting insulin you should take to bring down dangerously high BGL.
Once you’ve had the shot, re-check your levels in 15-30 minutes to see whether they’re coming down and how fast. Sometimes, levels will go too low and you’ll end up withhypoglycemia(low blood sugar levels).
If your BGL doesn’t drop right away or doesn’t come down as fast as you’d like, resist the urge to take more insulin too soon; this could lead tohypoglycemia. Rapid-acting insulin may start working in 15 minutes, or it may take up to an hour.
A BGL of 240 mg/dL puts you at risk for DKA. Regular readings of 600 mg/dL or higher could lead to HHS. Both of these conditions can be fatal and require emergency medical treatment.
Intramuscular Injections
Injecting your insulin directly into a muscle can help your body absorb it more quickly. However, it’s also more likely to lead to hypoglycemia, which may become severe. It can also cause a potentially fatal insulin overdose.
Talk to your healthcare team about whether intramuscular injections are a good idea during hyperglycemic episodes. They can also tell you where and how to give yourself this kind of injection.
Many people with diabetes take prescription medications other than or along with insulin. These medications help keep your blood sugar within the normal range.
However, many diabetes drugs only work if they’re takenbeforeyou eat. They won’t help lower a dangerously high BGL. These include biguanides such asmetforminand alpha-glucosidase inhibitors like acarbose and Glyset (miglitol).
Diabetes medications that can bring down your BGL quickly include:
Timing of a Makeup Dose
When in doubt, check the medication packaging for guidance, contact your healthcare provider, or talk to a pharmacist. If you miss several doses, contact your practitioner about the best course of action.
Treating the Lows of HypoglycemiaBGL between 55 mg/dL and 69 mg/dL: Eat 15 grams of carbohydrates and re-check BGL in 15 minutes.BGL below 55 mg/dL: Call 911. Inject Glucagon (glucagon hydrochloride) if available. If conscious, drink juice or a sugary soda, then eat carbohydrates with protein (e.g., cheese and crackers).
Treating the Lows of Hypoglycemia
BGL between 55 mg/dL and 69 mg/dL: Eat 15 grams of carbohydrates and re-check BGL in 15 minutes.BGL below 55 mg/dL: Call 911. Inject Glucagon (glucagon hydrochloride) if available. If conscious, drink juice or a sugary soda, then eat carbohydrates with protein (e.g., cheese and crackers).
Physical activity is the fastest way to lower your blood sugar without medication.Exerciselowers insulin resistance and helps your body convert glucose into energy.
During muscle contractions, your cells take glucose from your bloodstream and use it for energy. This lowers your blood sugar for 24 hours or more after you exercise.
Check Ketones Before ExercisingIf your blood sugar is above 240 mg/dL, check your ketone levels and don’t exercise if they’re elevated. Exercise can increase ketone levels, which can raise blood sugars and put you at a greater risk of ketoacidosis.
Check Ketones Before Exercising
If your blood sugar is above 240 mg/dL, check your ketone levels and don’t exercise if they’re elevated. Exercise can increase ketone levels, which can raise blood sugars and put you at a greater risk of ketoacidosis.
Everyone responds differently to exercise, so there’s no perfect formula for how much to exercise to lower your BGL. In general, though:
It’s a good idea to doregular blood sugar checksbefore and after working out. That way, you’ll have an idea of how your body responds under normal circumstances; this can help guide your decisions the next time you have a dangerously high BGL.
Making a Type 2 Diabetes Exercise Plan
When you have an episode of severe hyperglycemia, water and other unsweetened fluids can help your kidneys flush out excess sugars through your urine.While it may not be as fast as rapid-acting insulin or exercise, it can help get you to a safe BGL.
Staying hydratedmay help you prevent hyperglycemic episodes as well. Most people need about 4 to 6 cups of water each day. If you work out frequently or tend to sweat a lot, you may need more. If you take medications that cause fluid retention, you may need less.
Ask your healthcare provider about your daily water needs and about how much to drink if you have a spike in blood sugar.
Causes of Hyperglycemia in DiabetesEating too many carbohydratesNot getting enough physical activityIllness or infectionTaking a corticosteroid, like prednisoneSkipping or not taking enough glucose-lowering medication
Causes of Hyperglycemia in Diabetes
Eating too many carbohydratesNot getting enough physical activityIllness or infectionTaking a corticosteroid, like prednisoneSkipping or not taking enough glucose-lowering medication
The glycemic index measures how different foods affect your blood sugar. High glycemic foods cause your blood sugar to rise quickly. Low glycemic foods have less impact on blood sugar.
Examples of low-glycemic index foods include:
When to See a Healthcare Provider
Contact your healthcare provider for guidance if you have:
They’ll likely want you to make an appointment to go over treatment and lifestyle options for better managing your illness.
Call 911 or get to an emergency room if you have:
Summary
Any blood glucose level above your target range is too high. In general, 180 mg/dL is considered dangerously high and you should take steps to bring it down.
You can lower blood sugars quickly with rapid-acting insulin, taking missed doses of oral medications such as meglitinides or sulfonylureas, exercising, and drinking water. Watching your carbohydrates can help to prevent your blood sugars from rising too fast.
Get emergency medical attention for readings in the danger zone plus high ketone levels, sustained high BGL, or symptoms of DKA or HHS. Contact your healthcare provider if you have consistently high levels, increased thirst, or frequent urination.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cheisson G, Jacqueminet S, Cosson E, et al.Perioperative management of adult diabetic patients. Review of hyperglycaemia: definitions and pathophysiology.Anaesth Crit Care Pain Med. 2018;37 Suppl 1:S5-S8. doi:10.1016/j.accpm.2018.02.019American Diabetes Association.Blood glucose and insulin.U.S. Food and Drug Administration.Insulin.Stephenson L, van den Heuvel C, Humphries M, Byard RW.Characteristics of fatal insulin overdoses.Forensic Sci Med Pathol. 2022;18(4):429-441. doi:10.1007/s12024-022-00511-3American Diabetes Association.Blood glucose and exercise.Centers for Disease Control and Prevention.Manage blood sugar.American Diabetes Association.Caring for people with diabetes in emergency situations.American Diabetes Association.Hyperglycemia (high blood glucose).MedlinePlus.Glycemic index and diabetes.University of Michigan Medical School: Michigan Medicine.High blood sugar (hypoglycemia).Additional ReadingCenters for Disease Control and Prevention.Diabetic ketoacidosis.National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cheisson G, Jacqueminet S, Cosson E, et al.Perioperative management of adult diabetic patients. Review of hyperglycaemia: definitions and pathophysiology.Anaesth Crit Care Pain Med. 2018;37 Suppl 1:S5-S8. doi:10.1016/j.accpm.2018.02.019American Diabetes Association.Blood glucose and insulin.U.S. Food and Drug Administration.Insulin.Stephenson L, van den Heuvel C, Humphries M, Byard RW.Characteristics of fatal insulin overdoses.Forensic Sci Med Pathol. 2022;18(4):429-441. doi:10.1007/s12024-022-00511-3American Diabetes Association.Blood glucose and exercise.Centers for Disease Control and Prevention.Manage blood sugar.American Diabetes Association.Caring for people with diabetes in emergency situations.American Diabetes Association.Hyperglycemia (high blood glucose).MedlinePlus.Glycemic index and diabetes.University of Michigan Medical School: Michigan Medicine.High blood sugar (hypoglycemia).Additional ReadingCenters for Disease Control and Prevention.Diabetic ketoacidosis.National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cheisson G, Jacqueminet S, Cosson E, et al.Perioperative management of adult diabetic patients. Review of hyperglycaemia: definitions and pathophysiology.Anaesth Crit Care Pain Med. 2018;37 Suppl 1:S5-S8. doi:10.1016/j.accpm.2018.02.019American Diabetes Association.Blood glucose and insulin.U.S. Food and Drug Administration.Insulin.Stephenson L, van den Heuvel C, Humphries M, Byard RW.Characteristics of fatal insulin overdoses.Forensic Sci Med Pathol. 2022;18(4):429-441. doi:10.1007/s12024-022-00511-3American Diabetes Association.Blood glucose and exercise.Centers for Disease Control and Prevention.Manage blood sugar.American Diabetes Association.Caring for people with diabetes in emergency situations.American Diabetes Association.Hyperglycemia (high blood glucose).MedlinePlus.Glycemic index and diabetes.University of Michigan Medical School: Michigan Medicine.High blood sugar (hypoglycemia).
Cheisson G, Jacqueminet S, Cosson E, et al.Perioperative management of adult diabetic patients. Review of hyperglycaemia: definitions and pathophysiology.Anaesth Crit Care Pain Med. 2018;37 Suppl 1:S5-S8. doi:10.1016/j.accpm.2018.02.019
American Diabetes Association.Blood glucose and insulin.
U.S. Food and Drug Administration.Insulin.
Stephenson L, van den Heuvel C, Humphries M, Byard RW.Characteristics of fatal insulin overdoses.Forensic Sci Med Pathol. 2022;18(4):429-441. doi:10.1007/s12024-022-00511-3
American Diabetes Association.Blood glucose and exercise.
Centers for Disease Control and Prevention.Manage blood sugar.
American Diabetes Association.Caring for people with diabetes in emergency situations.
American Diabetes Association.Hyperglycemia (high blood glucose).
MedlinePlus.Glycemic index and diabetes.
University of Michigan Medical School: Michigan Medicine.High blood sugar (hypoglycemia).
Centers for Disease Control and Prevention.Diabetic ketoacidosis.National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.
Centers for Disease Control and Prevention.Diabetic ketoacidosis.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.
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