Blood Sugar and Insulin

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Audrey Crawford
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1 PATIENT & CAREGIVER EDUCATION Blood Sugar and Insulin This information explains high and low blood sugar levels and how to manage them. About Blood Sugar and Insulin Your body uses a sugar called glucose for energy. Glucose comes from the food that you eat. Your blood carries glucose to your cells so that your cells can use it for energy. Insulin is a hormone that helps transport sug ar from your blood into your other cells. It s made by your pancreas, which is an org an located at the back of your abdomen (belly). If your pancreas doesn t make enoug h insulin, your blood sug ar levels will rise above normal. This happens because the sug ar stays in your blood instead of going into your cells. This is called high blood sugar (hyperglycemia). This can happen if you: Have type 1 or type 2 diabetes mellitus. Have had part or all of your pancreas removed. Take steroids like prednisone or dexamethasone (Decadron ). Have a fever (a temperature of F (38 C) or hig her), an infection, or had recent surg ery. Managing your blood sugar levels with insulin If other diabetes medications don t control your blood sug ar levels, you will need to take insulin. You can take insulin only by injection (shot). How much you need will depend on: Your blood sugar level Blood Sugar and Insulin 1/6

2 Your diet Your level of physical activity Your overall health Other medications you take (such as steroids) Measuring your blood sugar level You can check your blood sugar level at home using a blood sugar meter. Your blood sugar target numbers are set by your doctor or diabetes educator. You will have targets for fasting and for other times during the day. Monitoring your blood sug ar: Alerts you when you have high or low blood sugar levels. Lets you know if you re within your targ et rang e. Helps you and your doctor decide how much insulin you need to bring your blood sugar within the target range. You should write down all of your blood sug ar results and doses of insulin in a log book, paper record, or a smartphone application. Controlling your blood sugar level You will be in charg e of controlling your blood sug ar levels. You should: Eat a healthy diet, making sure to stay on your meal plan. Limit the amount of sweet foods you eat. Drink 6 to 8 (8-ounce) g lasses of water or diet, decaffeinated liquids each day. You should do this unless your doctor or nurse gives you other instructions. Increase your physical activity to the level recommended by your doctor or nurse. Check your blood sug ar levels as recommended by your doctor or nurse. Take your diabetes medication or insulin as prescribed by your doctor or nurse. Double check the dose before you inject the insulin. See your doctor or nurse as directed. Blood Sugar and Insulin 2/6

3 We recommend that you get a MedicAlert ID. It should say that you have diabetes and the type of insulin you take. For more information, call or visit Symptoms of Low and High Blood Sugar Levels High blood sugar (hyperglycemia) This happens when you have a blood sugar level above your target range. High blood sug ar can cause many symptoms, such as: Being very thirsty Having a dry mouth A need to urinate (pee) often, especially at nig ht Being very hung ry Having blurry vision Drowsiness, fatig ue, or tiredness Low blood sugar (hypoglycemia) This happens when you have a blood sug ar level below 70 millig rams/deciliter (mg/dl). Low blood sug ar can cause many symptoms, such as: Sweating Shakiness Headaches Feeling faint A fast, forceful heartbeat Weakness Blood Sugar and Insulin 3/6

4 How to Treat Low Blood Sugar If your blood sugar is below 70 mg/dl and you re awake and alert, follow the rule of 15/15: Take 15 grams of sugar. Wait 15 utes, then retest your blood sug ar. Take 15 grams of sugar Choose 1 of these options: Drink 4 ounces of fruit juice or regular soda (not diet soda) Drink 8 ounces of milk Eat 4 larg e marshmallows Chew 6 to 8 Life Savers (not ts) Chew 3 to 4 large glucose tabs Do not eat chocolate or cookies when your blood sugar is below 70 mg/dl. Wait 15 utes then retest your blood sugar Retest your blood sugar 15 utes after eating 15 grams of sugar. If your blood sugar is still less than 70 mg/dl when you retest, take another 15 grams of sugar. Retest 15 utes later. Keep doing this until your blood sugar rises to 70 mg/dl or more. When your blood sugar rises to 70 mg/dl or more, eat half of a sandwich and drink 4 ounces of milk or juice. You can also have your meal instead. Your insulin or diabetes medication may need to be chang ed. Call your doctor or nurse to discuss this. Call Your Doctor or Nurse If You: Have a temperature of F (38 C) or hig her. Have chills. Blood Sugar and Insulin 4/6

5 Have burning or pain when you urinate. Take steroid medications that are being increased, reduced, or stopped. Have signs of high or low blood sugar that don t go away. Have frequent episodes of high or low blood sugar. Have a blood sugar level of 200 mg/dl or more. Have a blood sugar level of 300 mg/dl twice in 1 day. Have a blood sugar level of 70 mg/dl or less. Before calling your doctor, follow the 15/15 rule for treating low blood sug ar explained in the How to Treat Low Blood Sug ar section of this resource. When your blood sugar is back to 70 mg/dl or higher, call your doctor or nurse. Insulin Action Guide These are commonly used insulins at Memorial Sloan Kettering (MSK). T ype Name Onset Peak Dur ation Rapid acting Aspart (NovoLog ) 5 to to 60 3 to 4 Lispro (Humalog ) 5 to to 90 3 to 4 Fast acting Novolin R Regular 30 to 60 2 to 5 6 to 8 hrs Humulin R Regular 30 to 60 2 to 4 6 to 8 Intermediate Novolin N (NPH) 1 to 2 6 to to 14 acting Humulin N (NPH) 1 to 2 6 to to 16 Blood Sugar and Insulin 5/6

6 Long acting Glargine (Lantus ) 1 to 2 No peak Up to 24 Detemir (Levemir ) 1 to 2 injections daily 1 to 2 No peak Up to 24 Combination fast and intermediate acting NovoLog Mix 70/ to 12 (N/Aspart) Novolin 70/30 (N+R) 30 to 60 4 to 12 5 to to 16 T M Humalog Mix 75/25 5 to 15 1 to to 18 (N/Lispro) If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday throug h Friday from 9:00 AM to 5:00 PM at. After 5:00 PM, during the weekend, and on holidays, please call. If there s no number listed, or you re not sure, call Blood Sugar and Insulin 2019 Memorial Sloan Kettering Cancer Center - Generated on January 25, 2019 Blood Sugar and Insulin 6/6

Diabetes: What You Need to Know

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