Highs and Lows

Lows:

Symptoms:

Hunger

Shakiness

Sweaty

Pale face

Headache

Confusion

Drowsiness

Behavior changes

Double vision

Loss of consciousness

Seizure or convulsion

How to treat it:

For a mildly low glucose (below 70): give 2-8 oz sugary fluid. Recheck blood glucose in 10-20 min.  If BG is still below 70, repeat sugary fluid and recheck in 10-20 min. When BG is above 70, give a solid snack (10-20g complex carb. Crackers with peanut butter work great)

* The above treatment is a good rule of thumb but many diabetes know exactly what they need to take in order treat their lows. Just ask the patient what they normally use to treat their lows! *

I know oftentimes the first thing you want to do is start shoving sugar down the person’ throat! Beware, that if you over treat with sugar, your patient’s blood sugar will rise quickly then drop again.

*The most important thing I was taught about treating a low blood glucose is to treat, then wait a full 15 min to retest and re-treat if needed. Often, the body just needs enough time to replenish its glucose after being treated for a low blood sugar reading.*

The problem with lows:  The reason low blood sugar is bad is because your brain’s main source of nutrients comes from sugar.  Low sugar = low brain function.  If severe lows happen often, this can result in brain damage.

Highs:

Symptoms:

Hot

Irritable

Headache

Stomache ache

If a patient has a high blood glucose, they should take insulin to correct it as directed by their physician if they are prescribed insulin.  Many Type II Diabetics do not take insulin and therefore would just need to watch their blood sugars more often if they experience hyperglycemia.

In the pain procedure setting, we often cancel patients if they have a high blood sugar.  The reason for this is the steroid that we often use.  Steroids will increase the blood glucose even more which can be very dangerous for the patient.  Educating your patient on this is very important.  This can help them understand why their blood sugar is higher after they have a procedure.

A great resource that I used for this post is called Understanding Diabetes by H. Peter Chase, MD from the University of Colorado