Methods For Delivering And Monitoring Blood Sugar: Fill & Download for Free

I have had Type 1 diabetes since I was 15 years old. Interestingly my high school years were the easiest years for me in terms of diabetes management/coping with the disease, being an undergraduate and to a lesser extent a graduate student were both much more challenging, for reasons which I will mention later in my answer.Challenge 1: Learning the basic rules for managing diabetes, especially carb counting (figuring out what is in the food you are eating) and how to deal with factors like exercise, sickness, and stress. To manage diabetes successfully you have to imitate your own pancreas, and do so with tools that are inferior to a pancreas. It is easy to learn the very basics, but to achieve a high quality of life and have good control so that you have good health later you need to know how to deal with all the subtleties. The body is incredibly complicated and the blood sugar/insulin/pancreas system is no exception.Challenge 2: Being disciplined and careful after some of the things from challenge 1 have become second nature. Once you learn the basics it is easy to stop learning and just coast. It is also easy to get lazy once you have internalized things. It can be very tough to convince children to pay more attention to these things, especially since the consequences of failure don't seem that important to you.Challenge 3: Being disciplined when you are extremely busy and have lots of stress. This was by far the hardest thing for me, but only became a problem when I was a college student. This is a disease where a single mistake can be fatal and it is much easier to make mistakes when you have a lot of things going on, and I think that this is by far the toughest challenge that diabetes has presented to me (and that I think diabetes can present in terms of management). When I was an undergraduate I had to have the paramedics revive me multiple times, crashed my car twice (which could have been fatal had the circumstances been slightly different each time), acted completely insane and paranoid in front of my friends, bombed an exam due to low blood sugar, and had a very large number of other low blood sugar incidents that were close calls (during one of which I ordered "double meat cookies" at a Subway restaurant, much to the delight of everyone in said restaurant). All of these were caused by performing some diabetes management action by muscle memory and doing it slightly wrong, and then getting absorbed in some activity that was really intense and distracted me from the signs that my blood sugar was dropping too low. These incidents happened regularly despite all my efforts to prevent them. When I left my college for graduate school everything improved (I still had a couple of bad incidents, but much less frequently) and I had nearly perfect blood sugar when I was away from school. I also had friends who were in a similar situation and have similar/worse problems. Naturally all these incidents caused me to try to be careful, which lead to a cycle of having high blood sugar because I was afraid to manage blood sugar as aggressively as I should have. This leads to challenge 4.Challenge 4: Making sure all the numbers are right when you are sleeping. Being woken up by really bad low blood sugar is psychologically bad (and potentially deadly), and having really high bood sugar overnight is bad for your overall health and numbers. The two things pull in opposite directions though. This was a huge source of insomnia for me all the time. It started when I was in high school, I would sort of lie awake in bed for an hour to make sure my sugar wasn't dropping too much. I also would tend to way underdose myself before going to sleep to prevent lows, this lead to lots of highs.Challenge 5: Dealing with low blood sugar. Making sure that you do not put yourself in a dangerous or deadly situation (such as passing out while driving a car), having a plan that will keep you from screwing up in these situations. Dealing with hypoglycemia unawareness. For those not on an insulin pump dealing with random highs and lows caused by long acting insulin. This challenge is aided greatly with technology.Challenge 6: Learning all the things that your doctor does not tell you before they cause you problems. The one thing that I was not told was what happens if you get extremely drunk and have very low blood sugar at the same time. This compromises your liver's ability to save your life by dumping in glucose when your sugar goes low. This is one of the easiest ways for a diabetic to die or get brain damage from a low blood sugar episode and may not be something that your doctor teaches you, and I only learned about it incidentally through talking to another diabetic while a graduate student (and reading about a student who died this way in the student paper). Generally doctors just give you a set of instructions which are usually quite simple to follow but don't teach you all of the complicated things about the disease.Challenge 7: Dealing with giving yourself injections and blood tests. Giving up things that are unhealthy like sugar drinks. Dealing with the idea that you have an uncurable disease with potentially serious consequences. For me it took a few weeks to get used to giving shots and checking. Every once in a while a shot/insulin pump site change will be really painful, but this is not a huge deal since it doesn't last long.Things that make life easier for a diabetic:Thing 1: Reducing mental stress. This gives one more mental energy to devote to diabetes management. This may be impossible to achieve for college students, but usually high school students and earlier can manage this.Thing 2: Having a regular regimented schedule. This helps you build experience dealing with your own condition. It is difficult to learn if you do different things every day. A lot of diabetic technology, especially insulin pumps, is geared to give diabetics a more flexible life. Flexibility is great, but it helps to have structure.Thing 3: Exercise. Exercise improves insulin sensitivity which leads to a lower insulin requirement. Most of the methods for delivering insulin are more effective if you are in better shape and if you have to use less insulin. Insulin injections work more slowly than insulin from the pancreas, mainly due to absorption issues. Having insulin absorb faster significantly helps reduce blood sugar spikes from food and also helps blood sugar get corrected more quickly leading to better control overall.Thing 4: Technology. Insulin pumps represent a huge improvement over injections because they allow you to use fast acting insulin for your basal insulin requirements. The long acting insulin that is used by people who take injections does not act at a constant rate (this used to be true, but as alluded to in the comments by Olga Pustovalova, modern long acting insulins act at a much more constant rate and are thus much safer) leading to all sorts of problems. Having dosing that can vary with time of day is also nice. A continuous monitor is also enormously useful. It helps prevents lows and warns you of highs. Given that problems with lows can be deadly, and given that there is a mental cost associated with being stressed about low blood sugar I think this equipment is a must have if you can get it. It could be even more useful for young children who are less able to take care of themselves successfully. Indeed I strongly recommend both pieces of technology if you can get them.Thing 5: Organization. If you keep a written or electronic record of your interactions with diabetes you will learn better how to treat yourself. This requires discipline.Thing 6: Knowledgeable friends that you can trust. If you screw up you can get low blood sugar. This might cause you to act crazy, and it is important for the people around you to know what is happening and what to do about it. It is unreasonable to expect people to know how to help/save you if you are in trouble unless you explain it to them carefully (and multiple times, it is your responsible to make sure someone knows). It goes without saying that you should have things on your person that will help them if something goes wrong, for instance different forms of sugar.Thing 7: Education. You should become an expert in your disease. There are many subtleties that need to be learned, and it is much easier to manage once you have a good understanding. Also you need to have motivation, it is essential to learn about the consequences of mismanaging diabetes. Education can also help you avoid land mines like the one I already mentioned involving alcohol. It is especially a tricky issue for children since they have no idea what they don't know about the disease and have less means of getting this knowledge. They are also more trusting of authority figures and thus less likely to look into themselves (at least I was).I had previously written a ridiculously long answer to this question with tons of details about everything. I can write this information up if it is desired by people here.

When your blood sugar level gets too high — known as hyperglycemia or high blood glucose — the quickest way to reduce it is to take fast-acting insulin. Exercising is another fast, effective way to lower blood sugar.In some cases, you should go to the hospital instead of handling it at home.Very high blood sugar levels can result in diabetic ketoacidosis (DKA) when insulin levels are low. This is a medical emergency.Click here to see how i did itSymptoms of DKA include:shortness of breathbreath that smells fruitynausea and vomitinga very dry mouthIf you aren’t sure what to do, call your doctor to get instructions on administering a dose of insulin, and for advice about whether to go to the emergency room.This article looks at ways to lower your blood sugar quickly, when to go to the emergency room or see a doctor, and tips for managing high blood sugar.We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission.Best ways to lower blood sugar quicklyWhen treated early, you can bring high blood sugar levels down and prevent complications, including DKA.Some sources suggest that drinking water or eating a high protein snack can quickly lower your blood sugar levels, though there isn’t enough research to support this.If you have high blood sugar and need to lower it fast, try the following methods:Take your insulin as prescribedHigh blood sugar occurs when your body has too little insulin, or your body can’t use insulin properly. Administering insulin can bring your blood sugar levels down.Talk to your doctor about how much rapid-acting insulin you should administer when your blood sugar is high.You may want to check your blood sugar about 15–30 minutes after taking insulin to make sure your blood sugar is going down and that it’s not dropping too low.ExerciseExercise is a fast and effective way to lower your blood sugar levels.Exercise can lower your blood sugar for 24 hours or more after you’ve finished. This is because it makes your body more sensitive to insulin.Physical activity causes the body to demand glucose for energy. As a result, the cells deliver glucose to the muscles and blood sugar levels usually drop.For this to work, you need a form of exercise that gets your heart pumping faster than usual. This can include walking at a quick pace.Importantly, if your blood sugar is above 240 mg/dl, you should check your urine for ketones. If ketones are present, do not exercise, because this can make your blood sugar rise even higher.Exercising when you have ketones in your urine increases your risk of complications from high blood sugar.If you have type 1 diabetes, your doctor will likely recommend you check your blood sugar before exercising. You can do this with at-home urine ketone testing kits, which areavailable online.While exercise is an effective way to lower your blood sugar throughout the day, some types of exercises — particularly short bursts of strenuous activity — can briefly increase blood sugar levels.This is because strenuous activity activates the body’s stress response, causing a release of glucagon to power the muscles.If your ketone levels are high, avoid strenuous exercise and try some light exercise, like walking, instead.SUMMARYExercising can usually bring down high blood sugar levels, but don’t exercise if there are ketones in your urine. Talk to your doctor about whether you should take insulin to treat hyperglycemia.When to go to the ERHigh blood sugar can be very concerning because your body can start burning fat for energy instead of blood glucose.This can cause conditions such as DKA and hyperglycemic hyperosmolar syndrome (HHS). These conditions are medical emergencies and can be fatal if left untreated.DKA is a serious complication of type 1 diabetes. It’s rare in people with type 2 diabetes, but can occur.Symptoms that can indicate you should go to the emergency room include:ketones in your urine, as diagnosed using a urine dipstick testconfusionexcessive thirstfrequent urinationnauseashortness of breathstomach painvomitingHigh blood sugar levels can cause a fluid imbalance in the body and can cause the blood to become acidic in a manner that doesn’t support life.Medical treatments for these conditions include administering intravenous insulin on a continuous basis and IV fluids to correct dehydration.SUMMARYHigh blood sugar can become a medical emergency. Go to the ER if you suspect DKA or HHS.When to see a doctorAccording to the University of Michigan, blood sugar levels of 300 mg/dL or more can be dangerous. They recommend calling a doctor if you have two readings in a row of 300 or more.Call your doctor if you’re worried about any symptoms of high blood sugar. They can offer advice and reassurance.See your doctor if you have consistently high blood sugar levels. Symptoms of this include:consistently high blood sugar readingsfrequent urinationincreased thirsthigh levels of sugar in urineAsk your doctor how often to check your blood sugar and about your ideal blood sugar levels.If you don’t currently see a doctor who specializes in diabetes, known as an endocrinologist, you can find one by searching the American Association of Clinical Endocrinologists‘ website.You can find a certified diabetes educator by visiting the American Diabetes Association’s website and searching by zip code.SUMMARYTalk to your doctor if you have consistently high blood sugar readings or symptoms of chronic hyperglycemia.Complications of high blood sugarChecking your blood sugar and then treating hyperglycemia early will help prevent any complications.Health problems can arise when someone has high blood sugar regularly and without treatment.Examples of complications include:nerve damage, called diabetic neuropathy, that may affect sensations in the feet and handsdiabetic retinopathy, or damage to the blood vessels in the eyes that affects visionincreased risks for kidney problemsincreased risks for heart problemsTaking steps to keep your blood sugar at target levels can help to minimize the likelihood that these complications will occur.Find several tips for avoiding blood sugar spikes here.SUMMARYHaving high blood sugar frequently and without treatment can raise the risk of diabetes-related health problems, including neuropathy and retinopathy.Blood sugar chartTalk to your doctor about your blood sugar levels and when you should seek emergency medical attention.Here are some general guidelines for blood sugar ranges:Blood sugarWhat to know70 mg/dL or lowerHypoglycemia, or low blood sugar. Eat a snack to raise blood sugar (e.g. 1/2 cup fruit juice, 1 tbsp. honey, or 2 tbsp. raisins).80–130 mg/dLIdeal preprandial range (before a meal).180 mg/dL or lowerIdeal postprandial range (1–2 hours after beginning a meal).240 mg/dL or higherCheck your urine for ketones. Call your doctor if you find moderate amounts of ketones after more than one test.Sometimes, doctors recommend that a person maintains higher blood sugar goals than others. That’s why it’s important to talk with your doctor about goals for your glucose levels.Read more about blood sugar monitoring here.SUMMARYIdeally, your blood sugar will be 80–130 mg/dL before a meal and less than 180 mg/dL after a meal.Tips for healthful living with diabetesMost people can manage their diabetes in a way that stops their blood sugar levels from ever getting too high. The following tips can help:Eat a consistent dietMaintain a steady carbohydrate intake, avoiding “empty calorie” foods, such as processed foods, whenever possible.Foods high in dietary fiber help keep your blood sugar levels steady.For a balanced diet, eat plenty of the following:whole grainsfruitsvegetableslean proteinsGet consistent exerciseEngage in physical activity that gets your heart pumping for at least 30 minutes a day, most days of the week.Read about how exercise can benefit people with diabetes.Reduce stressHigh stress levels can increase your blood sugar. Try out some relaxation methods to keep stress in check. These might include:meditationjournalinglistening to musictaking a short walkany other activity you especially enjoyRead about ways to reduce stress and anxiety.Stay hydratedDrink plenty of water. If your urine is yellow, you’re likely dehydrated. Avoid drinking too many sugary soft drinks or sugary juices as well.Get a good night’s restHigh quality restorative sleep can help reduce stress and balance blood sugar levels.Turn off your electronic devices an hour before bed and sleep in a cool, dark, and quiet room for a better night’s rest.See your doctorMake sure you see your doctor to test your A1C levels at recommended intervals.This is a measure of how consistent your blood sugar is over a 3-month period. Knowing your A1C can provide clues as to how effectively you’re managing your diabetes.Maintain a healthy weightLosing excess fat can reduce the amount of metabolically active tissue in your body. This makes blood sugar levels easier to maintain.If you’re having difficulty managing your weight, talk to your doctor or consider seeing a dietitian for tips specific to your dietary needs.Stick to your medication and insulin regimenSkipping a dose of medication or insulin can be harmful to your body and increase your blood sugar levels.It’s important to stick to your treatment plan and follow your doctor’s instructions for taking your medication.SUMMARYHealthful lifestyle habits can help people manage their blood sugar levels over the long term, such as eating a balanced diet, getting regular exercise, staying hydrated, and getting good sleep.The bottom lineAdministering insulin and exercising are two of the most common ways to get blood sugar levels down.However, if someone has ketones in their urine or symptoms of excessively high blood sugar, they may need to go to the emergency room.If you’re having difficulty managing with your diabetes, you can call the American Diabetes Association’s helpline at 1-800-342-2383 for referrals and advice.Last medically reviewed on August 12, 202011 sourcescollapsed

I am not a doctor. I am a diabetic. It runs in my family. I have figured out my own way to control it.In 2008 (when I was 57 years old), I was diagnosed with diabetes. My readings were sky-high. Fasting sugar was 200. Whew! And my A1C was around 9.8. Walking wounded.My wife and I decided to try to control it by a three-pronged approach: medicine, diet, and exercise (with associated weight loss). I met an excellent specialist, who explained diabetes to me professionally and clearly. Of course, I had already everything available on the internet.I asked him to prescribe the starter dose - what they prescribe for people with fairly low readings, or even pre-diabetes. I said I will handle the rest. He said, “I don’t believe you, but I trust your wife, who is sitting next to you.”The starter dose was 2 tablets a day of 500MG ER Metformin (Glucophage). Today, nine years later, I am still at this level. In between, I had gone down to 1 tablet, and may be able to move down to 1.5 tablets per day.Diet. I experimented quite a bit with various foods, keeping track of my sugar. The conclusion is that for me the amount and type of carbs I eat is critical. Pasta, pizza, french fries, samosas, bananas - my sugar goes sky high. If I eat a low carb, low glycemic index meal, sugar is quite reasonable.Exercise. I devised a method of lowering my sugar quickly. This is through high intensity interval training exercise. I call it huff-and-puff exercise. Exercise for 7 minutes. Within this time, have three bursts of 20–30 seconds each in which you huff and puff - work hard. The rest of the time - just low level. [For the technically inclined, in the huff-and-puff, I hit 8 or higher METS; rest of the time 5 METS).This 7 minute exercise usually drops my sugar reading in the range of 15–30 points. So, if I am at 150, it will drop to 135 or less.I do this at home. On a treadmill. Or even just walking fast up my staircase.In contrast, if I walk normally, it takes me 30 minutes to drop 20–25 points.Some days, I cannot control my eating. So, my sugar may touch 200 at 2 hours after eating. Now, I know I need three sessions of my huff-and-puff. I will be at 120 or so at the end.I am lucky in some ways. I sleep well. Exercise at night does not keep me awake. I sometimes even drink normal black tea after late night exercise, and then go to sleep.Make it personal. You need to figure it out for yourself. You need to experiment with different foods to see what makes your sugar go high, and which foods don’t. You need to find for your self what type of exercise you can do, and how many points of sugar drop with different exercises. It’s specially important you figure out your evening meal - never go to sleep with a “high” sugar level. For me, anything over 150 at night is not acceptable - I will try my best to do some exercise.It will mean that you need to check your sugar 3–4 times a day, at least initially. My docs have no problem with this. And, I hardly ever check my sugar when I wake up. That reading is not “actionable” - I cannot do anything with it because I cannot exercise until I have had breakfast. So, I take my readings at “actionable times” -when I can do some form of exercise to reduce them. I have worked out different forms of exercise at different times. Even when you are with friends for dinner, you can suggest a 15–20 minute walk, and sometimes people agree. Sometimes not - then you come home and walk.I hope this perspective from an informed diabetic helps you. I did discuss it with my doc - and he said, “You are a model patient.” But, to me, it’s just common sense.Update May 2019More than one year has passed since I wrote this answer. It still holds. However, as I age, eating dessert creates problems. So, I have to mainly skip it, particulalry in the evenings.Update August 2019We now have workable skin patches to monitor sugar levels continuously. I am not yet using them but they are major step forward.Diabetes patients are increasingly using electronic skin patches and their phones, instead of pricking their fingers, to do the complex job of managing a disease that affects more than 30 million Americans.The transformation in blood-sugar testing suggests how harnessing technology and data may drive improvements for disease management—and profits for manufacturers.Many patients now wear coin-sized skin patches on their arms or abdomens that test for blood-sugar levels automatically, then send the data to a patient’s smartphone or even to a wearable insulin pump that delivers the medicine.For Many Diabetes Patients, Skin Patches and Phones Are Replacing Finger PricksAutomatic pumps are also a major breakthrough, though I am not using them right now.Insulin Pump OverviewInsulin pumps are small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate). The device also is used to deliver variable amounts of insulin when a meal is eaten (bolus). The basal insulin rates are usually set up in your pump with your doctor, and you can have one or multiple basal settings programmed in your pump, based on your needs. You program the amount of insulin for your mealtime bolus directly on the pump. Most pumps come with built-in bolus calculators to help you figure out how much insulin you need at mealtime based on your glucose levels and the amount of carbohydrates you are eating.The pump, which is about the size of a smart phone or deck of cards, is worn on the outside of your body and delivers insulin through a tube (catheter), connected to a thin cannula, placed into the layer of fat under your skin, typically around your stomach area. The pump can be worn around your waist in a pump case or attached to a belt or bra, in a pocket, or on an armband. There are a variety of custom-made accessories available so you can carry your insulin pump with style.Update July 2020I was finding it harder to keep my sugar level in control. So, I have now got the option to take 3 Metformin 500 ER tablets instead of only 2 on days when I know there is trouble ahead. For example, I know pizza is a problem food for me. So, when I see we are having pizza for dinner, I take 2 tablets (I took 1 in the morning). But, less than once a week. I am also losing some weight - trying to get rid of the belly fat. For the first time in 25 years, my home scale showed a reading below 150 pounds. Mostly it is just above 150, which is good. But, if even once it showed below 150 - that’s happiness. I am hoping to see below 149 by end August, and never above 151. But, I will keep the third tablet option,Update September 2020I was able to drop to 150 pounds and below. Even saw below 149 pounds one day. The main reason is that I don’t overeat as we don’t out to eat!As I wrote, exercise drops the sugar level. More broadly, as you develop muscles, “muscles eat sugar.” So, if one set of muscles is already developed, shift to another set of muscles. I had been doing treadmill - gave it up, and shifted to stationary bicycle. Different muscles, but still lower body. Now, I am using dumbbells to build arm muscles. This exercise also drops sugar, and makes me fitter.Hoping to drop 1 pound (half kg) per month for next three months, so that my BMI is well-below 25.Update 25 Dec 2020.The exercise routine has worked well. It has long been known that you have to exercise 300 minutes a week to lost weight. The New York Times has reported it again. Exercise for Weight Loss: Aim for 300 Minutes a Week - The New York Times (nytimes.com)Well, I am putting in a hour per day. That makes it at least 400 minutes a week. So, the other day, I saw a weight of 146.6 pounds, which I have not seen in 35 years.Nevertheless, I have upped my Metformin tablets to 3 per day, total 1,500 mg. The reason is that now I don’t want my sugar levels to remain mostly at non-diabetic levels. To get there, I have cut back on some carbs.In short, I have: (i) upped my exercise a bit, (ii) increased my med level a bit, and (iii) cut my carbs a bit. Just preparing to be fitter as I feel older age coming my way.Update Jan 2021My A1C came at 6.3. I had written in July 2020 that I am finding it harder to control my sugar. However, my 3-point approach above has worked. And, this result cam through Thanksgiving and Christmas eating. So, I hope next time the A1C will be lower.