Dr. Horton answers the question: 'Normal Range For Blood Sugar Levels?' — -- Question:What is the normal range for blood sugar levels, and what blood sugar level constitutes a true emergency? Answer:Now, in a normal individual we measure blood sugar under different circumstances. What we call fasting blood sugar or blood glucose levels is usually done six to eight hours after the last meal. So it's most commonly done before breakfast in the morning; and the normal range there is 70 to 100 milligrams per deciliter. Now when you eat a meal, blood sugar generally rises and in a normal individual it usually does not get above a 135 to 140 milligrams per deciliter. So there is a fairly narrow range of blood sugar throughout the entire day. Now in our diabetic patients we see both low blood sugar levels that we call hypoglycemia, or elevated blood sugars, hyperglycemia. Now, if the blood sugar drops below about 60 or 65 milligrams per deciliter, people will generally get symptoms, which are some shakiness, feeling of hunger, maybe a little racing of the heart and they will usually be trenchant or if they eat something, it goes away right away. But if blood sugar drops below 50 and can get down as low as 40 or 30 or even 20, then there is a progressive loss of mental function and eventually unconsciousness and seizures. And of course that is very dangerous and a medical emergency. On the other side, if blood sugar gets up above 180 to 200, then it exceeds the capacity of the kidneys to reabsorb the glucose and we begin to spill glucose into the urine. And if it gets way up high, up in the 400s or even 500s, it can be associated with some alteration in mental function. And in this situation, if it persists for a long time, we can actually see mental changes as well. So either too low or very exceedingly high can cause changes in mental function. Next: What Does Fasting Blood Sugar (FBS) Mean And What Does FBS Tell You? Previous: How Often Must I Exercise And What Kind Of Exercise Should I Do To Lower My Risk Of Developing Type 2 Diabetes?
Diabetes is a chronic condition where the blood sugar level is too high. Insulin, a hormone produced by the pancreas, removes sugar from the blood and moves it into cells for the body to use. In people with type 1 diabetes, their pancreas doesn’t make any insulin; in those with type 2 diabetes, it doesn’t make enough. Healthy blood sugar levels are between 60 and 140 mg/dL. A blood glucose of above 140 mg/dL is considered too high, and one that’s below 60 mg/dL is too low. Having high blood sugar for a long period of time puts people with diabetes at risk for other health problems, such as kidney disease, heart disease, stroke, and nerve damage. Another common issue that people living with diabetes face is diabetic emergencies. A diabetic emergency happens when blood sugar is too high or too low for too long. This is a life-threatening condition that requires immediate medical treatment. There are a few types of diabetic emergencies, and some conditions may increase the risk of a diabetic emergency. Diabetic ketoacidosis (DKA) occurs when the body begins burning fat, instead of sugar, for fuel. This happens when there isn’t enough insulin to deliver sugar to cells for energy. To make up for this, the liver begins breaking down fat too quickly for the body to process. This can lead to a buildup of ketones (a type of acid) in the blood, which can become poisonous. Symptoms of DKA can include:
DKA is most common in individuals with type 1 diabetes. It can sometimes be the first sign of type 1 in those who are not diagnosed. Causes of DKA in type 1 diabetes include infection, injury, serious illness, missed insulin doses, or stress due to surgery. DKA is less common in people with type 2 diabetes. If it occurs, it is typically less severe. Causes of DKA in type 2 diabetes include uncontrolled high blood sugar for a long period of time, missing medicine doses, or a severe illness or infection. When you eat too much sugar, the excess is stored in the muscles and liver. When blood sugar decreases, the liver releases what it has stored, raising the amount of sugar in the blood. For some, especially those with diabetes, their blood sugar doesn’t go up enough and is below 70 mg/dL, causing hypoglycemia, or low blood sugar. Possible symptoms of hypoglycemia include:
Hypoglycemia can happen to anyone, but for people with diabetes, hypoglycemia can occur as a side effect of the medicine they’re taking. Eating foods high in carbohydrates usually helps raise your blood sugar to normal levels. If hypoglycemia happens too often, they need to consult with their healthcare provider to see if they need to change their treatment plan. Hyperglycemia is blood glucose greater than 125 mg/dL while fasting, which is defined as not eating for at least eight hours. It can occur in people with diabetes if they’re eating too many carbohydrates, taking their medicine incorrectly, or if their medication is not as effective as it should be. Stress and the dawn phenomenon (a surge of hormones that lead to high blood sugar in the morning), could also lead to hyperglycemia. Symptoms of hyperglycemia can include:
Hyperglycemic hyperosmolar syndrome (HHS) can occur if you have a high blood sugar level for a long time. Signs of HHS can include:
HHS usually develops in people who do not have their type 2 diabetes under control and who have an infection, stopped taking their medications, have a heart attack or stroke, or take medicine that can cause this condition, such as steroids and diuretics. High blood sugar can negatively affect the immune system. It can lower the ability of white blood cells to come to the site of an infection and kill what is causing the infection. Nerve damage and difficulty breaking down and storing fats can contribute to an increased risk of infection. People with type 1 or type 2 diabetes are vulnerable to infections that can become life threatening, including:
Signs of infection can include fever, chills, sore throat or mouth sores, redness or swelling, or pain with urination. A diabetic coma, where a person passes out due to extremely low or high blood sugar, is an emergency that requires immediate medical attention. Extreme hypoglycemia or hyperglycemia can cause a diabetic coma, so symptoms of these two conditions could be warning signs of this diabetic emergency. Other circumstances can also increase the risk of diabetic coma, such as:
Diabetic ketoacidosis or hypoglycemia are more likely to cause a diabetic coma in those with type 1 diabetes, while HHS places people with type 2 diabetes more at risk of this condition.
You should call your healthcare provider or 911 if you have diabetes and the following:
Preeclampsia is pregnancy-induced high blood pressure (hypertension) and liver or kidney damage. It often occurs after the 20th week of pregnancy. The risk of preeclampsia is two to four times higher among people with type 1 or type 2 diabetes. Gestational diabetes, a type of diabetes that occurs during pregnancy, also increases your risk of developing preeclampsia. The exact cause of preeclampsia is unknown. It is estimated to occur in about 3% to 7% of all pregnancies. Women with preeclampsia often do not feel sick, but symptoms in the early stages could include:
Even when diabetes is controlled, high blood sugar can still damage the blood vessels and nerves of the heart over the years. The longer you have diabetes, the higher the chances that you will develop heart disease. This increases the risk of heart attack or stroke. Signs of a heart attack can include:
Women are more likely to experience nausea or vomiting, back or jaw pain, and shortness of breath as heart attack symptoms. Signs of a stroke are:
If you experience any of these symptoms, call 911 immediately. To avoid a diabetic emergency, you must manage your diabetes as well as possible. Check your blood sugar often, and get into the habit of recognizing the early signs that levels are rising or dropping toward a dangerous range. Other tips to prevent a diabetic emergency include:
It’s also a good idea to carry snacks that you can eat to quickly get sugar into your blood to treat hypoglycemia. These might include raisins, candy, or glucose tablets. For hyperglycemia, exercise will lower your blood sugar, but if your blood sugar is above 240 mg/dL, you need to check your urine for ketones. Exercising with a high ketone level will raise your blood sugar even higher. If you are pregnant, your healthcare provider may recommend that you take daily low-dose aspirin to help prevent preeclampsia and its related complications. It is started between 12 to 28 weeks of pregnancy, but it is best to start before 16 weeks of pregnancy. Managing diabetes and the possibility of diabetic emergencies can feel overwhelming, but these emergencies are largely preventable by keeping your condition under control. Eating healthy, taking medicines as prescribed, exercising regularly, and recognizing the early signs of rising or falling blood sugar levels can help you keep these emergencies at bay and become prepared in the event that they do occur. |