Why Is My Blood Sugar Still High? Common Reasons and Solutions

If you're managing diabetes or prediabetes, persistently high blood sugar levels can be frustrating and concerning. Understanding why your blood sugar is still high despite your efforts is crucial for effective management and preventing long-term complications. This article explores common reasons behind elevated blood glucose and provides practical solutions to help you regain control.

What is High Blood Sugar?

Before diving into the causes, let’s clarify what constitutes high blood sugar, also known as hyperglycemia. Generally:

• For people with diabetes, a blood sugar level consistently above 180 mg/dL two hours after eating or a blood sugar level greater than 130 mg/dL before eating is considered high.
• Target ranges can vary, so consult with your healthcare provider for personalized recommendations.

Common Reasons for Persistently High Blood Sugar

Several factors can contribute to elevated blood sugar levels, even when you're diligently following your diabetes management plan. Let's break down some of the most common reasons:

1. Dietary Factors: What you eat significantly impacts your blood sugar.

   • Carbohydrate Intake: Consuming excessive carbohydrates, especially refined carbs like white bread, sugary drinks, and processed snacks, can lead to rapid spikes in blood glucose.
   • Portion Sizes: Even healthy carbs can raise blood sugar if you eat too much at one sitting.
   • Timing of Meals: Irregular meal schedules or skipping meals can disrupt blood sugar control.
   • Hidden Sugars: Processed foods often contain hidden sugars that can unknowingly contribute to hyperglycemia.

2. Medication Issues: Your diabetes medication regimen is a critical part of blood sugar management.

   • Incorrect Dosage: The dosage of your insulin or oral medications might need adjustment based on your current needs and blood sugar patterns. This needs to be assessed by a medical professional.
   • Timing of Medication: Taking medications at the wrong time can impact their effectiveness. Insulin needs to be given before or after meals based on the type of insulin.
   • Expired or Improperly Stored Medication: Medications can lose their potency if they're expired or not stored correctly (e.g., insulin exposed to extreme temperatures).
   • Drug Interactions: Certain medications, such as steroids or decongestants, can interfere with blood sugar control.

3. Lack of Physical Activity: Exercise helps your body use glucose for energy, reducing blood sugar levels.

   • Inactivity: A sedentary lifestyle contributes to insulin resistance and higher blood sugar.
   • Inconsistent Exercise Routine: Sporadic exercise may not provide consistent blood sugar control.
   • Type of Exercise: Different types of exercise (e.g., aerobic vs. resistance training) affect blood sugar differently.

4. Stress and Illness: Stress hormones and illness can significantly impact blood sugar levels. Top 5 Breakfast Ideas To Help Manage Type 2 Diabetes

   • Stress: When you're stressed, your body releases hormones that increase blood sugar.
   • Illness: Infections and illnesses can cause hormonal changes and inflammation, leading to hyperglycemia. Even mild colds can temporarily elevate blood sugar.
   • Sleep Deprivation: Lack of adequate sleep can disrupt hormones and impair glucose metabolism.

5. Dehydration: Dehydration can make blood sugar levels higher because there is less water in your blood to dilute the glucose.

6. The Dawn Phenomenon: This is a natural rise in blood sugar that occurs in the early morning hours, likely due to hormonal changes. It affects many people with diabetes.

7. Somogyi Effect (Rebound Hyperglycemia): This occurs when a blood sugar drop at night leads to a rebound rise in blood sugar in the morning. It can be caused by taking too much insulin or skipping a meal.

8. Underlying Medical Conditions: Certain medical conditions can also impact blood sugar levels.

   • Pancreatic Problems: Conditions affecting the pancreas (e.g., pancreatitis, cystic fibrosis) can impair insulin production.
   • Hormonal Disorders: Conditions like Cushing's syndrome (excess cortisol) can lead to hyperglycemia.
   • Gestational Diabetes: High blood sugar developing during pregnancy can increase risk of type 2 diabetes later in life.

9. Inaccurate Monitoring: Errors in blood glucose monitoring can lead to inaccurate readings and difficulty in managing blood sugar. Recognizing Hyperglycemia 9 High Blood Sugar Symptoms You Shouldn T Ignore

   • Using Expired Test Strips: These will likely give inaccurate results.
   • Faulty Monitoring Device: Ensure that the monitor is in proper working condition
   • Inadequate Blood Sample: Insufficient blood for testing can lead to inaccuracies.

Solutions for Managing High Blood Sugar

Addressing persistently high blood sugar requires a multi-faceted approach. Here are some effective strategies: The Link Between Blood Sugar And Weight Loss How Balance Is Key

1. 

   Dietary Adjustments:

   • Carbohydrate Counting: Learn how to count carbohydrates in your meals to better manage your intake. A registered dietitian can provide guidance.
   • Prioritize Complex Carbs: Choose whole grains, fruits, and vegetables over refined carbs.
   • Control Portion Sizes: Be mindful of portion sizes, especially for carbohydrate-rich foods. Use measuring cups and spoons to ensure accuracy.
   • Balanced Meals: Combine carbs with protein and healthy fats to slow down glucose absorption.
   • Limit Sugary Drinks and Processed Foods: Reduce or eliminate sugary sodas, juices, sweets, and processed snacks.

2. Medication Management:

   • Consult Your Doctor: Discuss your high blood sugar levels with your doctor or endocrinologist. They may need to adjust your medication dosage or timing.
   • Proper Medication Technique: If you're using insulin, ensure you're injecting it correctly and rotating injection sites to prevent lipohypertrophy (fatty lumps).
   • Medication Storage: Store medications as directed to maintain their effectiveness.
   • Consistency: It's important to take medications as prescribed, consistently.

3. Regular Exercise:

   • Aim for 150 Minutes per Week: The American Diabetes Association recommends at least 150 minutes of moderate-intensity aerobic exercise per week.
   • Include Resistance Training: Incorporate resistance training (e.g., weightlifting) at least two days per week to improve insulin sensitivity.
   • Monitor Blood Sugar Before and After Exercise: This will help you understand how different types of exercise affect your blood sugar.
   • Plan Ahead: Have a small snack available if your blood sugar drops too low during exercise.

4. Stress Management:

   • Practice Relaxation Techniques: Engage in activities that reduce stress, such as meditation, yoga, deep breathing exercises, or spending time in nature.
   • Prioritize Sleep: Aim for 7-8 hours of quality sleep each night.
   • Seek Support: Talk to a therapist or counselor to address underlying stress or anxiety.

5. Hydration

   • Aim for at least 8 glasses of water per day.
   • Monitor urine color to ensure you're staying hydrated (it should be pale yellow).

6. Address the Dawn Phenomenon/Somogyi Effect:

   
   • Monitor blood glucose throughout the night: To identify the presence of the phenomena.
   • Adjust Medication: Discuss with your doctor adjusting the time or dose of medication if these are causing morning highs.
   • Avoid Late Night Snacks: Consuming snacks late can cause spikes in blood glucose overnight.

7. Monitor Blood Sugar Regularly:

   • Check Regularly: Monitor your blood sugar as often as your doctor recommends. This helps you identify trends and adjust your management plan accordingly.
   • Keep a Log: Record your blood sugar readings, meals, exercise, and medications to help your doctor identify patterns and make informed decisions.

8. Regular Checkups

   • Consult Your Healthcare Provider: If lifestyle changes and medication adjustments aren't improving your blood sugar levels, your doctor may investigate underlying medical conditions. Regular checkups will allow your doctor to catch potential problems early.

When to Seek Immediate Medical Attention

While managing high blood sugar is typically a long-term process, certain situations warrant immediate medical attention:

• Very High Blood Sugar: Blood sugar levels above 300 mg/dL, especially if accompanied by symptoms like excessive thirst, frequent urination, blurred vision, or nausea.
• Symptoms of DKA (Diabetic Ketoacidosis): DKA is a serious complication of diabetes that can be life-threatening. Symptoms include fruity-smelling breath, abdominal pain, vomiting, rapid breathing, and confusion.
• Symptoms of HHS (Hyperosmolar Hyperglycemic Syndrome): HHS is another severe complication that can occur with very high blood sugar. Symptoms include extreme thirst, dry mouth, confusion, seizures, and coma.

The Role of Continuous Glucose Monitoring (CGM)

A Continuous Glucose Monitor (CGM) can be a valuable tool for understanding your blood sugar patterns. CGMs provide real-time glucose readings throughout the day and night, allowing you to see how your blood sugar responds to meals, exercise, stress, and other factors. This data can help you and your healthcare provider make more informed decisions about your diabetes management plan.

How to Properly Clean and Maintain Your Glucose Meter

The proper cleaning and maintenance of your glucose meter ensures accurate readings. Here are the guidelines to follow:

Step	Instruction
1. Consult User Manual	Always refer to the user manual for your specific meter model. It provides specific cleaning and maintenance instructions recommended by the manufacturer.
2. Cleaning Solution	Use a soft, lint-free cloth slightly dampened with isopropyl alcohol (70% concentration) or a mild disinfectant wipe approved by the manufacturer.
3. Cleaning the Meter	Gently wipe the exterior of the meter with the dampened cloth or wipe. Avoid getting moisture inside the meter ports or test strip slot.
4. Cleaning the Lancing Device	Clean the lancing device regularly, especially the area that comes into contact with the skin. Use the same cleaning solution as for the meter. Replace the lancets after each use to maintain hygiene and prevent infection.
5. Drying the Meter	Allow the meter and lancing device to air dry completely before using or storing them. Do not use a hair dryer or other heat source to speed up the drying process, as this can damage the meter.
6. Storage	Store the meter and testing supplies in a clean, dry place, away from extreme temperatures, humidity, and direct sunlight. Keep them out of reach of children and pets.
7. Calibration	Some glucose meters require calibration using a control solution to ensure accuracy. Follow the manufacturer’s instructions for calibration procedures.
8. Handling Test Strips	Store test strips in their original container with the lid tightly closed. Avoid exposing test strips to moisture, heat, or humidity. Check the expiration date on the test strip container and discard any expired strips.
9. Disposal of Lancets and Strips	Dispose of used lancets and test strips properly in a sharps container to prevent injury and the spread of infection. Follow local regulations for the disposal of medical waste.

Conclusion

Persistently high blood sugar can be a complex issue with multiple contributing factors. By identifying the potential causes and implementing appropriate solutions, you can regain control of your blood sugar and reduce your risk of long-term complications. Remember to work closely with your healthcare team to develop a personalized management plan that meets your individual needs. With consistent effort and a proactive approach, you can achieve better blood sugar control and improve your overall health and well-being. Remember to have open communication with your medical team and seek professional advice when you're not sure.

By Marisol S. Lance, D.O.