Regardless of whether you have diabetes or not, you’re going to feel the effects of a spike in your blood sugar levels. For people without diabetes, symptoms will pass—but for those with diabetes, prolonged high blood sugar (also known as hyperglycemia) can be dangerous. That’s why having strategies for how to lower blood sugar immediately is so critical.
“In the short-term, if you let your sugar stay too high, you run the risk of it getting worse and becoming something serious like diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome—both of which could land you in the hospital,” said Beatrice Hong, M.D., an endocrinologist and assistant professor of medicine at Duke University. “On the long-term side, the longer your sugars stay high, the more likely you are to have long-term complications. Diabetes is such a systemic disease that having high blood sugars can be cumulative over time so you run the risk of eye problems, kidney problems, nerve problems, foot problems, or heart problems.”
Meet the experts: Beatrice Hong, M.D., an endocrinologist and assistant professor of medicine at Duke University; Lorena Wright, M.D., an endocrinologist at the UW Diabetes Institute and an associate professor at the University of Washington.
How can you tell if your blood sugar is high and you need to act? The easiest way is to use a glucometer, which uses a drop of blood to measure your blood glucose levels. But there will likely be some physical symptoms of high blood sugar as well. “Usually if blood sugar is very high, the kidney is trying to eliminate all that sugar and in order to eliminate all that sugar, we need water to get rid of things,” explained Lorena Wright, M.D., an endocrinologist at the UW Diabetes Institute and an associate professor at the University of Washington. “That causes increased urination.” You might also experience thirst as your body gets more dehydrated from the loss of fluid. “Other patients, they describe that they might feel dizzy or sometimes they feel like their hands are tingly and that’s when they know that their blood sugars are high,” added Dr. Wright. Unfortunately, diabetes affects nearly every body part so symptoms can vary greatly. “Other signs could be fatigue, just really not having the energy that you would expect you should have at that time,” said Dr. Hong. “And then more severely, things like nausea and vomiting or even abdominal pain can be signs of hyperglycemia.”
Those are all acute issues, but if blood sugars stay high for a while, particularly in patients who have newly diagnosed diabetes or those who don’t even know they have it yet, there might be blurry vision or unexplained weight loss, according to Dr. Wright. “It is very important to check blood sugar regularly, because by the time patients have symptoms like that, then blood sugar is already really, really high,” she said. “Ideally we don’t really want to get to that point.”
Read on for best strategies you can use to lower your blood sugar quickly and safely, plus the most common causes of high blood sugar and when you should seek medical care.
How to lower your blood sugar quickly
Go for your insulin
First, if you’ve missed an insulin dose or your pump is not working, the first thing to do is correct the underlying problem, according to Dr. Wright. “Insulin is a hormone in our body that’s normally produced by the pancreas and what insulin does is it acts as a shuttle and it shuttles glucose from the blood and into the cells so that it can be used as fuel,” explained Dr. Hong. “So, for people with diabetes, if they have high blood glucose, by giving themselves more insulin they’re essentially helping to facilitate the movement of glucose into the cells so that the blood glucose levels drop and the cells receive more fuel or glucose.”
Take any medication you missed
“Typically, diabetes medications are meant to be taken on a daily basis or in a scheduled way,” said Dr. Hong. (Insulin is different in that you can schedule doses and also use it in response to high blood sugar.) Still, accidents can happen and life can get in the way. “If you forget to take your medication, then absolutely, your blood sugars can go up, and then if you take it again, the sugars will certainly come back down,” said Dr. Hong. Just keep in mind that medications (like Metformin) won’t work as quickly as insulin, especially if it’s been a while since you had your last dose or if you haven’t been taking it as often as you should. Dr. Hong also stressed that she does not generally recommend taking diabetes medication on an as-needed basis; this fix is only for situations in which you miss a dose.
Drink a lot of water
While you get your insulin and/or medication on track, you also need to focus on hydration. “Don’t drink juice,” said Dr. Wright. “Drink water and hydrate aggressively.” Water is so important because dehydration is a key component of diabetic ketoacidosis (DKA). “When your blood sugars are high, your body is desperately trying to get rid of [the excess sugar] and so what it does is it dumps it into your urine and along with it, a lot of water because it’s trying to flush it out of your system,” explained Dr. Hong. “So people who have high blood sugars are generally always dehydrated. Drinking a lot of water actually helps you flush the system and also helps dilute the amount of glucose in the blood.”
Move around
If you have insulin in your body and you’re not feeling nauseous, try taking a stroll around the neighborhood. “Any type of aerobic exercise can absolutely help with your blood glucose,” said Dr. Hong. In fact, she pointed out, “there are several studies out there that demonstrate that taking a moderate intense walk for about 20 minutes after a meal can decrease your blood glucoses by 20 to 30% easily. The way that works is that you’re actually having your muscles use more fuel and their fuel is glucose.” The result? Less glucose is left floating around in your bloodstream. However, it’s important to note that exercise only helps if you have insulin in your system. “It would be a terrible idea for someone who is almost in diabetic ketoacidosis to go for a walk and not use insulin,” said Dr. Wright. But if there is insulin and you’re not feeling sick, a walk or some gentle exercise like squats should help lower your blood sugar.
Possible causes of high blood sugar
To better manage hyperglycemia, it’s helpful to know potential triggers. “Probably the first thing most people think about is food–in particular, carbohydrates—and I would say even more specifically, simple carbohydrates would be the most likely culprit,” said Dr. Hong. Foods that have a high glycemic index (meaning the body breaks them down into sugar very quickly, leading to a blood sugar spike) include things like white bread, potatoes, or rice.
Beyond that, a common cause for a rise in blood sugar is a missed insulin dose, but it’s not always a matter of forgetting an injection. “For example, in patients who are using an insulin pump, if the pump malfunctions or if there is a kink in the tubing or the infusion site is lodged and they are not aware that the insulin is not infusing, then that may happen,” said Dr. Wright. Insulin that is exposed to heat (like in a hot car) won’t work as well either. “It’s not toxic, but it’s just not as effective,” Dr. Wright said. That means your typical dose might not be as potent as you’re used to, making the insulin less effective.
“The other situation is illness,” said Dr. Wright. “If patients are getting a cold or the flu or a stomach bug and they are throwing up and not eating and not feeling well, then that might precipitate an episode of diabetic ketoacidosis. Or, sometimes a patient might have a heart attack or a stroke and in patients with type 1 diabetes, that might precipitate diabetic ketoacidosis as well.” You’ll also want to consider any non-diabetes medications you’re taking. Research shows that commonly prescribed medications such as glucocorticoids, antipsychotics, statins, beta blockers, and others can raise your blood sugar.
What about stress or hormone fluctuations? “Yes, absolutely, stress can certainly cause a rise in blood sugars,” said Dr. Hong. “In regards to hormonal fluctuations, some female patients with type 1 diabetes will experience differences in their blood glucoses depending on where they are in their menstrual cycle but this effect is not often seen in patients with type 2 diabetes.”
When to see a doctor
While it’s possible to effectively manage occasional spikes in blood sugar with the strategies above, chronic hyperglycemia and complications like DKA can be serious and even life-threatening. Fortunately, there are tests for both that can tell you when it’s best to seek medical care.
“I would say that anybody with type 1 diabetes, first of all, they should always carry ketone sticks with them,” said Dr. Hong. “So, if blood sugars were to run high or they were to feel sickly, they should test their urine for ketones and if that is positive, they should seek care from a doctor or an emergency room.” Ketones in the urine are the surest sign of DKA, per the Mayo Clinic.
Dr. Hong added that anyone (whether they have type 1 or type 2 diabetes) should seek care if they feel very sick, have nausea, vomiting, severe abdominal pain, confusion, or trouble thinking clearly. “And then, if they are checking blood glucoses and they notice that their sugars are running significantly higher than what they’re used to and it’s not responding to any of their usual care such as drinking water or taking their insulin, they should absolutely seek care and speak to the doctor as well,” Dr. Hong said.
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