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When you have diabetes it helps to understand what might make your glucose rise or fall so you can take steps to stay in the target range.

When you eat any type of carbohydrate – such as pasta, fruit, bread, or sugar – your body breaks it down into glucose. Glucose is absorbed into the bloodstream and insulin helps remove it from your blood into your cells to be used for energy. Without diabetes, the body usually makes just the right amount of insulin to match the food and activity, and glucose levels naturally rise and fall in response.

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When diabetes develops, the process is disrupted, either because the body stops producing insulin altogether (Type 1 diabetes) or because the insulin it produces becomes less effective (Type 2 diabetes).

The main aim of treating diabetes is to keep your glucose levels within a target range you agree with your diabetes care team. This is to prevent short-term and long-term health problems that can occur when the glucose falls too low (hypoglycemia) or too high (hyperglycemia).

What can make my glucose rise?

  • eating a bigger portion of carbohydrates than usual
  • being less active than usual
  • a reduced dose of insulin or diabetes medications
  • taking certain medications
  • having an infection, virus or surgery
  • changes in hormone levels, such as during periods or pregnancy
  • stress
  • dehydration

What can make my glucose fall?

  • eating a smaller portion of carbohydrates than usual or missing a meal or snack
  • taking too much insulin or diabetes medication
  • being more active than usual
  • taking certain medications
  • drinking alcohol

How can I track my glucose levels?


If your diabetes is treated with insulin or medications that lower glucose or stimulate insulin production, your care team will advise you to test your glucose regularly. Regular testing helps you learn how your glucose levels respond to different foods, medication and activity, so you can spot patterns and trends. This can help you fine-tune your diabetes routine to stay well and prevent your glucose levels from falling too low or rising too high.

What is hypoglycemia?

Hypoglycemia (also called a hypo) means your glucose level is low, usually below 4mmol/L. When this happens there may not be enough glucose to provide your body with energy. Hypos are hard to avoid altogether, but they shouldn’t happen often, get worse, or become severe enough for you to pass out. Having more than three or four hypos a week is a sign your diabetes routine isn’t working, so talk to your care team.

How do I know I’m having a hypo?

Symptoms of a hypo usually occur when the glucose falls to below 4mmol/L. Typical early warning signs that your glucose level is going low include:

  • trembling
  • sweating
  • feeling hungry or tired
  • blurred vision

More severe symptoms include confusion or difficulty concentrating, and it’s even possible to lose consciousness. Some people though don’t have any warning signs or become less ‘hypo-aware’ overtime.

Can I have a hypo while I’m asleep?

You can have a hypo when you are asleep, which can cause excess sweating, disturbed sleep, and feeling tired when you wake up. The easiest way to find out is to test your glucose level during the night. If you suspect or discover you’re having night-time hypos, it’s important to discuss how to prevent them with your diabetes care team.

How do I treat a hypo?

Hypoglycemia can happen suddenly and it can usually be treated quickly and easily by taking a small amount of glucose, such as:

  • a small glass of sugary (non-diet) drink
  • 3 glucose or dextrose tablets
  • a small carton of pure fruit juice
  • Have this fast-acting glucose snack even if you are about to eat a meal.

After 15-20 minutes, re-test your glucose levels; if you are still below 4mmol/L have another portion of high-glucose food or drink.

Once your glucose level is above 4mmol/L, you could have a longer-acting starchy carbohydrate food, such as a sandwich, to keep your glucose from dropping again.

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What is hyperglycemia?

Hyperglycaemia happens when your glucose level goes too high. The symptoms are similar to the symptoms of untreated or undiagnosed diabetes and include:

  • feeling thirsty
  • urinating often, especially at night
  • feeling tired
  • overtime there may be other symptoms including weight loss and blurred vision

If your blood glucose is over 13.9mmol/L and does not drop over the next two hours, or if you are ill, you may be at risk of developing diabetic ketoacidosis, which is a medical emergency. Test your blood for ketones and contact your diabetes care team.

How do I treat hyperglycemia?

If your glucose level is too high, it’s important to bring it down within your target range, but without lowering it so much that you have a hypo. This may mean something simple like taking some exercise or taking a little more insulin. If your glucose level is persistently too high it’s a sign your diabetes routine isn’t working, so talk to your diabetes care team.

What do I need to know about insulin?

Everyone who has Type 1 diabetes, and some people with Type 2 diabetes, need insulin to manage their condition. Most people inject insulin using a pen with a fine needle, or if you have Type 1 diabetes you may be offered an insulin pump. All insulin supplies used to be sourced from animals such as cows or pigs, but synthetic insulins that mimic human insulin were developed in the 1980s and most people now use these. Some people who found it difficult to switch to synthetic insulins use older, animal-based products.

Different types of insulin serve different purposes and many people use more than one type in a ‘basal-bolus’ routine. This means taking long-acting insulin to manage glucose levels through the day and night, and a faster-acting dose at mealtimes.

It can take time to get insulin timing and doses right. Testing your glucose regularly and working with your diabetes care team can help you find a routine that works around your lifestyle.

Source: freestylediabetes.co.uk

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