High Blood Sugar: What You Need to Know

This brochure can help you learn more about high blood sugar. It doesn’t replace regular medical check-ups or your health care provider’s advice. Talk with your health care provider about what your blood sugar should be.

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INTRODUCTION

WHAT IS HIGH BLOOD SUGAR?

Prediabetes—sometimes called high blood sugar—and type 2 diabetes are common. There are 26 million people living with type 2 diabetes today. Another two million people will learn that they have it every year. Type 2 diabetes can be serious. If it‘s not treated, it can lead to heart, nerve, and kidney disease. The good news is that it can be controlled.

When you eat, your body turns the food into sugar (glucose). The body uses insulin to turn the sugar into energy. Insulin is a hormone that you make. It helps keep your blood sugar at a normal level.

High Blood Sugar

Prediabetes is a condition in which your blood sugar level is higher than normal but not high enough to be type 2 diabetes. This condition puts you at risk for developing type 2 diabetes. When you have type 2 diabetes, the body does not make enough insulin or does not use it in the right way.

Without insulin, the sugar from the foods stays in the blood. This makes your blood sugar too high:

Insulin takes the sugar from the blood to the cells:

You may have a greater chance of getting prediabetes or type 2 diabetes if you: Are overweight Are 45 years old or older Don’t get enough exercise Have a parent, brother, or sister

with type 2 diabetes Are African American, American

Indian, Asian American, Pacific Islander, or Latino

Have high blood sugar levels Have high blood pressure

WHAT ARE THE RISK FACTORS FOR PREDIABETES OR TYPE 2 DIABETES?

Have high cholesterol (lipid) levels

Had type 2 diabetes when you were pregnant (“gestational diabetes”) or gave birth to a baby that weighed more than 9 pounds

Have polycystic ovarian disease

Have blood vessel problems affecting the heart, brain, or legs

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It can be hard to tell whether you have type 2 diabetes. As many as one out of four people who have type 2 diabetes don’t even know it! That’s because the symptoms can seem harmless. If you have any risk factors talk with your health care team. There is a simple blood test you can have done to check. The test will tell you if your blood sugar is too high. Your health care provider may perform one of the following:

Test Result Fasting Plasma Glucose Test (FPG)

This is a simple blood test taken after you have not had anything to eat or drink for at least 8 hours (except for water).

• Less than 100 mg/dl is normal • 100-125 mg/dl is high blood sugar or prediabetes • 126 or higher is considered type 2 diabetes

The Oral Glucose Tolerance Test (OGTT)

This blood test is taken before and 2 hours after you have been given a special glucose beverage to drink.

• Less than 140 mg/dl is normal • 140-199 mg/dl is high blood sugar or prediabetes • 200 or higher is type 2 diabetes

The A1C Blood Test

This test is taken to see the average amount of sugar in your blood over time.

• Less than 5.7% is normal • 5.7-6.4% is high blood sugar or prediabetes • 6.5% or higher is type 2 diabetes

How Do You Know If You Have Prediabetes or Type 2 Diabetes?

What are the Complications of Type 2 Diabetes?

High blood sugar levels in your blood can cause problems over time. High blood sugar can cause heart and blood vessel disease, which can lead to heart attacks and strokes. It can also cause damage to the eyes and can lead to blindness. Additionally, nerve damage may occur and poor blood flow may lead to foot problems and even amputations.

You can prevent or delay type 2 diabetes problems by keeping your blood sugar, blood pressure, and cholesterol under control.

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What If Your Blood Sugar is Too High?

It’s important to know the signs of high blood sugar. A person with high blood sugar may:

Be very thirsty or hungry a lot Feel very tired and worn out Have to urinate a lot Have blurry eyesight Lose weight (without trying) Feel shaky

Checking Your Blood Sugar Levels

Your blood sugar levels can be checked using a small machine. This machine is called a glucose monitor. It can be used to check your blood sugar levels at any time. It can help you to be aware of how physical activity, food, or your medicine is affecting your blood sugar levels. You can then use that information to make choices on how much medicine to take, foods to eat, or level of exercise. There are many monitors available. Your health care team can help you decide which one is best for you. Always take your monitor and blood sugar logs with you when you see your health care provider. Keep a log of:

Your blood sugar readings What you ate What you did that day How much medicine you took

The main goal for treating high blood sugar is good blood sugar control. Your health care provider will suggest a range that is good for you. Keep your blood sugar level as close to your target range as possible. This will help keep you healthy.

If you check your blood sugar level:

Your blood sugar should be:

Before a meal 70-130 mg/dl After a meal Less than 180 mg/dl

Treating High Blood Sugar

The American Diabetes Association

suggests

Blood sugar level can increase when:

You are sick―you have a cold, an infection, the flu, or any other illness

You are stressed You eat more than you

planned You exercised less than

you planned

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What If Your Blood Sugar is Too Low?

Tell your health care provider if you have low blood sugar often, especially at the same time of the day or night several times in a row.

Low blood sugar or hypoglycemia (HY-poh-gly-SEE-mee-uh) can happen to anyone. It is important to know the signs of low blood sugar. You also need to know how to treat it. Check your blood sugar level to see if it is low.

• You take too much high blood sugar medicines • Too much exercise • Skipping a meal or eating less than normal • Drinking too much alcohol

The quickest way to treat low blood sugar is to eat something with sugar. Many people with high blood sugar carry glucose (sugar) tablets. You can get glucose tablets from any pharmacy or general store. Other sources of sugar can also work well to treat low blood sugar. Eat at least 15-20 grams of sugars or carbohydrates. A food's nutrition label can tell you how much carbohydrates it has.

• 4 oz. (1/2 cup) of juice or regular soda • 2 tablespoons of raisins • 4 or 5 saltine crackers • 4 teaspoons of sugar • 1 tablespoon of honey or corn syrup

Things that can make your blood sugar too low:

Some foods with 15 grams carbohydrates:

• Shakiness • Dizziness • Sweating • Hunger • Headache • Pale skin color

• Sudden moodiness or behavior changes, such as anger, stubbornness, or sadness for no reason

• Clumsy or jerky movements • Seizure • Hard time being focused, or confusion • Tingling feeling around the mouth

Symptoms of low blood

sugar can be

Action Steps If You Use Insulin

• Tell your health care provider if you've passed out from low blood sugar.

• Ask your health care provider about glucagon. Glucagon is a medicine that raises blood glucose. If you pass out from low blood sugar, someone should call 911 and those who have been trained on how to administer glucagon should give you a glucagon shot.

Action Steps If You DO NOT Use Insulin

• Be sure to tell your health care provider about other medicines you are taking.

• Some diabetes pills can cause low blood sugar. Ask your health care provider whether your pills can cause low blood sugar.

Watch your weight

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Eat foods that are lower in fat such as low-fat dairy products, lean meats, fresh fruits, vegetables, whole grains, and beans.

Lose weight slowly if you are overweight. Lose about 1 to 2 pounds a week. Be sure to talk with your health care provider about a weight goal that is right for you.

Make a meal plan that works The foods you eat will affect your blood sugar level. Foods that have natural or added sugar or starch (carbohydrates) will make your blood sugar levels higher than foods that are made of protein or fat. Skipping meals is a not a good idea. This is especially true if you are taking medicines for your high blood sugar. People with high blood sugar don’t need to eat special foods. The foods on your meal plan are good for everyone in your family.

What Can You Do to Stay Healthy If You Have High Blood Sugar?

Eat healthy foods. Find out what a good diet includes. Work with a dietitian to come up with a meal plan that

keeps your blood sugar under control.

Be physically active

Be active 30 to 60 minutes most days. Take a walk most days of the week. Start out slowly and build up to

at least half an hour. Sign up for an exercise or swimming class. Ask a friend to go with

you. Always check with your health care provider before starting any new

exercise program. If you have eye problems, talk with your health care provider about how to stay active without hurting your eyes.

If you smoke―quit

Smoking can increase blood sugar levels. Ask your health care provider for ideas that can help you quit.

Take your medicines

Take your medicines or insulin the right way, each day, as your health care provider prescribed. Keep taking your medicines unless your health care provider tells you to stop.

Check your blood sugar

Ask your health care provider about how often you should check your blood sugar with a blood glucose meter. Write down your blood sugar results. Follow the treatment plan you and your health care provider decide on. Ask you health care provider what you should do if your blood sugar goes too low or too high.

Reaching Your “ABC” Goals

A stands for the A1C test—a measure of what your blood sugar has been for the last three months.

B is for blood pressure—Keep your blood pressure under control. If it is too high, ask your health care provider if you should change what you eat, exercise more, or take medicine.

C is for cholesterol—keep your cholesterol under control. Eat foods that are low in fat and high in fiber such as beans, fruits, vegetables, and grains. If your cholesterol is too high, talk to your doctor.

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Type 2 diabetes medicine should be taken as directed by your health care provider. Make sure to eat on time if you are taking medicine to lower your blood sugar.

Write it down. Make a wall chart with the names of your medicines, the dose, and the time of day you need to take them.

Get a pillbox. It should have the days of the week and times of day. You can get these boxes from your pharmacy or local grocery store. Fill the box at the beginning of the week to help you keep track. Ask a friend or family member to check the box so that you know each medicine is in the right place.

Set an alarm on your clock or cell phone to remind you if a medicine has to be taken at a certain time.

Ask for help. Tell family and friends about your medicine schedule so they can remind you.

Set a daily routine. Combine taking your medicines with something you do at regular times. For example, when you brush your teeth, eat breakfast or dinner. This way, taking your medicines at the right time can become a good habit.

Take it with you. Remember to take your medicines with you when you are away from home. Bring enough medicines with you when you go on trips. Always put them in your carry-on luggage.

Refill your prescriptions on time. Reorder your prescriptions ahead of time to make sure that you never run out.

Inject your insulin as directed by your health care provider.

The place on your body where you inject insulin affects your glucose level. Shots work fastest when they are given in the abdomen, a little slower in the upper arms, and more slowly when given in the thighs or buttocks.

Don't inject the insulin in exactly the same place each time, but move around the same area. This is called site rotation.

To get the steadiest glucose results, each mealtime injection of insulin should be given in the same general area. For example, give your before-breakfast insulin in the abdomen every day and your before-lunch insulin in the thigh every day.

Tips for Taking Insulin

Things You Can Do to Make Sure You Take Your Medicine Every Day

Be sure to keep your needle capped and clean. Do not let it touch anything but your skin and the top of the insulin vial.

Your current bottle of insulin can be stored at room temperature to make injections less painful, but extra vials of insulin should be kept in the refrigerator.

Never share your needle or use someone else's needle or syringe.

Dispose of used needles in safe containers made of heavy plastic or metal, such as empty detergent or bleach bottles. Check medical waste requirements in your area.

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Check your feet every day. Use a mirror to look at the bottom of your feet. Look for changes in your skin, toes, and toenails (for example, blister, discoloration, redness).

Wash your feet every day. Use warm water and mild soap. Dry your feet well, especially between the toes.

Moisten dry skin with lotion after you wash and dry your feet. Do not apply lotion between your toes. Ask your health care provider to suggest a lotion that is right for your skin.

Wear shoes and socks at all times. Do not walk barefoot, even at home.

Keep the blood flowing to your feet. Raise them up when you sit. Wiggle your toes and move your feet several times a day. Do not cross your legs for long periods of time.

Take your shoes and sock off when you see a doctor.

Be sure to ask your health care provider to check your feet during each visit.

Talk to your health care provider if you have foot or leg pain, numbness or tingling.

If you notice a foot problem that gets worse or sores that do not heal, call your health care provider right away.

Giving Foot Problems a Swift Kick

You can use these tips to help prevent foot problems:

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Tests To Remember

If you have type 2 diabetes, there are tests you will need to take. Here’s a list of some of the more important ones. You can see how often you should have the tests. Use this page to write down your results. Talk to your health care provider about what goals are right for you.

Test How Often Goala b Date/

Result Date/

Result Date/

Result Date/

Result A1C Every 3 months A test that measures

blood sugar levels over the past 2 to 3 months. Less than 7% .

Blood Pressure Every routine visit Less than 140-130/80 mm/Hg.

Cholesterol At least every year

LDL: less than 100 mg/dl. HDL: higher than 40 mg/dl for men, higher than 50 mg/dl for women. Triglycerides: less than 150 mg/dl.

Microalbuminuria (my-crow-al-byoo-minyou-REE-ah)

Every year Urine test for kidney problems. Normal reading: less than 30 μg/mg creatinine.

Eye Exam Every year Prevent or delay eye problems related to high blood sugar.

Foot Exam Every visit Done at home and by the doctor to prevent serious foot problems. Take your shoes and socks off.

Oral Exam Dental checkup at least every 6 months

Prevent high blood sugar related gum and other problems.

Flu Shot Every year before flu season

There are different flu vaccines available. Talk with your provider about which one is best for you.

Pneumonia Shot 1 or 2 doses Talk to your doctor about what’s best for you.

a Based on American Diabetes Association and American Heart Association recommendations b The target number for A1C may vary, depending on the type of test your healthcare provider’s laboratory uses

High Blood Sugar: What You Need to Know

What is type 2 diabetes? When you have type 2 diabetes, your body doesn’t make enough insulin. In most cases, it does not use insulin the right way. Without insulin, the sugar from the foods you eat stays in your bloodstream and does not go into your cells. This makes your blood sugar high.

What is prediabetes? Prediabetes occurs when your blood sugar levels are higher than normal, but not high enough to have type 2 diabetes. Many people with prediabetes develop type 2 diabetes.

Too much sugar in your blood can damage different parts of your body. Eyes: Poor vision including glaucoma and cataracts Nerves: Loss of feeling in fingers and feet―can’t

feel injuries Feet: Impaired circulation may lead to loss of toes,

feet, or legs Heart: Heart attack, heart failure Kidneys: Kidney failure Sex organs: Infections in women and erectile

dysfunction in men Mouth: Gum disease Brain: Stroke

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“I knew high blood sugar and diabetes ran in my family, but I never thought I could have it too.”

Take steps today to stay healthy Get a blood sugar test if you have any of the risk factors for type 2 diabetes. You can keep from having problems from type 2 diabetes by taking good care of yourself.

Could you have type 2 diabetes or prediabetes? You may have a greater chance of getting type 2 diabetes or prediabetes if you: Have a parent, brother, or sister with it. Are African American, American Indian, Asian

American, Pacific Islander, or Latino. Are a woman who gave birth to at least one baby

weighing 9 or more pounds, or you had diabetes when you were pregnant.

Have been told you have high blood pressure or if your blood pressure is 140/90 or higher.

Have high cholesterol. Are not physically active. Are overweight. Are 45 years old or older.

A person with high blood sugar may: Be very thirsty or hungry a lot Feel very tired and worn out Have to urinate a lot especially at night Have blurry eyesight Lose weight (without trying) Have cuts/bruises that are slow to heal, Have tingling/numbness in the hands/feet, Have recurring skin, gum, or bladder infections

Even if you don’t have any of these signs, you still may have type 2 diabetes.

As many as 1 out of 4 people who have type 2 diabetes don’t even know it! That’s because the symptoms can seem harmless. If you have any of the type 2 diabetes risk factors or symptoms, talk with your health care provider. There is a simple blood test you can have done. The test will tell you if your blood sugar is too high.

How can you tell if you have type 2 diabetes?

Action Plan for High Blood Sugar

Make a meal plan that works.

Check off items from the list below that you will be able to change or improve. Or you can write in your own action items. Watch your weight.

1. Are the items that you have chosen achievable?

2. What will you do to make these changes? _______________________________________________

_____________________________________________________________________________________________

3. When will you make these changes? ____________________________________________________ ______________________________________________________________________________________________

Yes No

Eat foods that are lower in fat such as: low-fat dairy products, lean meats, fresh fruits, vegetables, whole grains, and beans.

Lose weight slowly if you are overweight. Lose about 1 to 2 pounds a week. Be sure to talk with your health care provider about a weight goal that’s right for you.

Take your medicines.

Other

Get moving each day.

Check your blood sugar.

Take your medications or insulin the right way, each day, as your health care provider prescribed. Keep taking your medications unless your health care provider tells you to stop.

Take a walk most days of the week. Start out slowly and build up to at least half an hour.

Sign up for an exercise or swimming class. Ask a friend to go with you. Always check with your health care provider before starting any new exercise

program. If you have eye problems, talk with your health care provider about how to stay active without hurting your eyes.

Eat healthy foods. Find out what a good diet includes. Work with a dietitian to come up with a meal plan that keeps your

blood sugar under control.

Ask your health care provider how often you need to check your blood sugar with a blood glucose meter.

Write down your blood sugar results. Follow the treatment plan you and your health care provider decide upon. Ask your health care provider what you need to do if your blood sugar goes too low or too high.

Reasons to reach your goal. Did you know...? Two-thirds of people with type 2 diabetes die of some form of heart or blood vessel disease. Close to 27 million people in the United States have type 2 diabetes.

“There was no way around it — I needed to lose weight. My husband and I skipped cake for dessert and ate fresh fruit instead. We even started dance lessons. Now I have more energy!”

NPC612503-01 ©2013 Pfizer Inc. All rights reserved. Printed in USA/November 2013

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