The experience of living under lockdown due to COVID-19 has created
new and varied challenges for us all, many of which may be here to
stay as we adapt to life beyond COVID-19. Our lives and daily routines
have been severely affected. We had to learn to work in isolation or
in busy households, look after, and home school our children, and
maintain our physical and mental health all at the same time.
Such disruption to routines can be very stressful, especially for
those living with long-term conditions that require careful
monitoring, such as diabetes
This could result in eating the wrong food, difficulty in being able
to exercise in your usual way or forgetting a dose of your
medication, which can potentially put you at risk of experiencing high
blood glucose levels, also known as hyperglycaemia or ’hypers’.
This article provides information to help you understand the signs
of experiencing a hyper, as well as some ideas for how you can try to
prevent your blood glucose levels from above your optimal range.
Dealing with hyperglycaemia (high blood glucose)
This article provides information to help you understand the signs of
experiencing a hyper, as well as some ideas for how you can try to
prevent your blood glucose levels from getting above your optimal range.
How to spot high blood glucose levels (hyper)
The most common symptoms of experiencing a hyper include:
tiredness and lethargy
passing more urine than usual
(peeing more)
being very thirsty
blurred
vision
headaches
feeling flushed
You may experience one or more of these symptoms when your
blood glucose levels are high, or a family member or friend may
mention that you do not quite seem your usual self.
It may take a few days or weeks for the symptom(s) to develop while
some people may not show any symptoms despite elevated blood glucose
levels, specifically those who have had diabetes for a longer period.
As very high blood glucose levels can lead to serious complications,
it is therefore very important to regularly check your blood glucose
(sugar) at home. This is easy to manage and should only be started
following a discussion with your doctor or nurse. They can advise
whether home monitoring is suitable for you and the available options,
explain what you need to do, and how often. Should you notice that
your blood glucose level is elevated during home monitoring, consult
with your doctor or nurse.
Helping reduce the risk of hypers
Having a daily routine is one of the best ways to help you adapt to
your new life during this unprecedented situation. As you are likely
to be preparing most of your meals at home, you may even find it
easier to manage your mealtimes and the amount of insulin you may need.
Creating a daily routine, planning your mealtimes and trying to
avoid snacking, plus having planned time to check your blood sugar
levels and take your insulin will help you to spend more time within
your ideal blood glucose (sugar) range and help to reduce the risk of hypers.
Try to still exercise at home if you cannot get outside much – even
10 minutes a day of physical activity will be beneficial to your
physical and mental wellbeing. There are many online fitness classes
that you may wish to try. More ideas can be found in the “Exercise
and type 2 diabetes” article.
Coping with stressful times as a person with diabetes
Prolonged periods of emotional stress can also lead to changes in
blood sugar levels. If you’re feeling stressed, your body releases
stress hormones like cortisol and adrenaline. These hormones make it
harder for insulin to regulate blood sugar level properly and can lead
to an increase in your blood glucose (sugar) level.
Therefore, it is recommended to try to manage your stress levels
during this challenging time by doing things you like or that help you
relax, such as reading, meditating, yoga, or perhaps something
creative like drawing and painting. Spending time with any pets you
may have can also help ease any worries and stress.
What to do if you experience a hyper
If you start to feel unwell or notice some of the typical symptoms
of high blood glucose levels – (hypers), first check your
blood glucose levels. If your blood glucose levels are too high, you
will need to consult with your doctor to adjust your medication(s) accordingly.
There are many potential causes for hypers, including:
Not using enough or missing a dose of your insulin or other
diabetes medication(s)
Eating more carbohydrates than your
routine eating plan
Feeling emotionally stressed
Being unwell due to an infection or injury
If you experience frequent high blood glucose levels, you can also
try to remember to:
Check your blood glucose (sugar) more often than usual,
specifically before and after your meals
Look for patterns
in your blood glucose (sugar) results to understand what may be
causing it
If you are having difficulties in controlling your blood sugar
levels and they are regularly too high, it’s important to speak to
your doctor or nurse. They can offer tips and advice, or they may
need to adjust your medication(s).
What to do if you experience a hyper
Don’t panic
It is normal for your blood glucose level
to go up and down in a day
Never miss your insulin
injection(s)
If you have unusually high blood glucose
readings or if you feel unwell, you should contact your nurse or
doctor immediately
Test your blood or urine for ketones if
you have been instructed to do so by your nurse or doctor
Emergency situations
Contact your nurse or doctor or dial 112/999 if:
You are vomiting and unable to hold down fluids
You
have high blood glucose levels and ketones in your blood or
urine
What are ketones?
Normally, with the help of insulin as a ‘key’, the body uses glucose
from food to produce energy. When there is little or no insulin to
allow the conversion of the glucose from food into energy, the body
starts breaking down fat cells for energy. When this occurs, ‘ketones’
form in the blood and spill into the urine. These ketones can make you
ill and if left untreated eventually lead to ‘diabetic ketoacidosis’
or DKA, a potentially life threatening condition.
How do you test for ketones?
You can test for ketones in the blood or urine. Several products are
available for doing this - your nurse or doctor will advise you.
When should you test for ketones?
If your blood glucose level is over 15 mmol/L
When
you are ill / vomiting
If you have taken extra insulin and
your glucose level does not come down
Ketone levels can be checked in two different ways - in blood or in urine.
Acknowledgements:
Novo Nordisk would like to thank the Diabetes Nurse Specialists and
dietician who were instrumental in developing this content
What should you do if the ketone test is positive?
You will need additional insulin - call your nurse or doctor
if you need advice
Ensure that you drink plenty of water or
unsweetened fluids
Continue to test blood glucose levels
and ketones every 1-2 hours until ketone free
Eat a small
amount of carbohydrate if possible
Never stop taking your
insulin
This is general disease awareness and should not be understood as
medical advice. If you experience symptoms of COVID-19 or have
questions, doubts or concerns, you should contact your doctor.
Always follow the advice of local authorities.
In this article you will find links to third-party material not
owned or controlled by Novo Nordisk. We are not responsible for the
content or the accuracy of the information provided and have no
control over the privacy policies or terms of use of such
third-party sites.
Ideas for how to manage your blood sugar during the COVID-19 crisis, to
help you stay within your optimal blood sugar range and reduce the risk
of getting low blood sugar level, which is also called hypoglycaemia or
a “hypo”.