Last updated: May 15, 2008
glucose-level-test
Fact is, even "perfect" behavior can't always prevent a blood-sugar surprise.
(SERGEY LAVRENTEV/ISTOCKPHOTO)
Blood sugar is a tricky little beast. Yes, you can get a high reading if you throw caution to the wind and eat several slices of cake at a wedding.


The problem is that you can also have a high blood sugar reading if you follow every rule in the type 2 diabetes handbook.

That's because it's not just food that affects blood sugar. You could have a cold coming on, or stress may have temporarily boosted your blood sugar.

The reading could be wrong, and you need to repeat it. Or it could mean that your medicine is no longer working, and it's time to try a new one.

The point is, it's the pattern that matters, not a single reading.

Whatever you do, don't feel bad or guilty if you have a high blood sugar reading.

A 2004 study found that blood sugar monitoring often amplifies feelings of being a "success" or "failure" at diabetes, and when readings are consistently high, it can trigger feelings of anxiety or self-blame.

This can cause some people to give up on testing completely. Try not to think of blood sugar monitoring as a "test" administered by a sour-faced teacher lurking in your distant past. Blood sugar monitoring is simply a tool that you can use to fight the disease.

If you have a high reading you should:

  • Test before you eat and two hours after. This will tell you how well your medication is controlling your blood sugar. It will also shed light on what food is boosting your sugar too high—and thus should be avoided. "You should consult your health-care provider to develop a plan that works for you," says Donna Rice, immediate past president of the American Association of Diabetes Educators, who notes that the frequency and time of day you test will depend on how controlled your blood glucose is.
  • Look for patterns. If your blood sugar is high in the morning on one day, no big deal. If it keeps happening, though, it's more meaningful. "An isolated high and low you can brush off. Anyone can have a high or low, your body might have been compensating," says Rice. "If they're high every morning, that's important because it means that your liver is producing too much sugar during the night—that might require new or an additional medicine."
  • Make some small changes. You might try to get more exercise, or limit carbs at your next meal, but don't go crazy. "One blood sugar that's high doesn't indicate a need for major changes—that should only be done on a pattern," says Rice, such as "continuing highs despite following a doctor's instructions." If a pattern continues for two to three days or more, then you might want to let your health-care provider know.
  • Think about what's going on. Irene Dunbar, 73, of Durham, N.C., woke up one morning recently to discover her blood sugar was at 119, which is high for her. "I had a cold and had had orange juice yesterday and I normally do not drink orange juice and I thought, 'I better not do that,' " she said. When she gets a high blood sugar reading, she tries to remember if she had anything recently—like bread—that she knows are triggers, and avoids them next time.
  • Relax. It's not just food that can turn your blood sugar into a roller coaster. "My blood sugar will get really wacky if I have a lot of stress," said Carol Mullen, 62, of Sandia Park, N.M. "I try to avoid situations that are stressful, like serving on committees. I like to do volunteer work, but I'll do something I can do by myself." Mullen is an artist, but she avoids doing artwork on commission because she knows the extra stress can be "aggravating." We all know stress is bad—now you have a concrete number that's telling you it's time to relax.
  • Consider talking to your doctor. If you think you've been doing all you can to keep blood sugar in control, but still have high blood sugar readings, it might be time to switch medication. Diabetes is a progressive disease, and over time, the beta cells in the pancreas that produce insulin can stop making the hormone. "So, even if your numbers have held steady for years, that could change if the beta cells change, which is usually a gradual change but can be sudden," says Rice. "That change doesn't mean you've done anything wrong, it's just the nature of the disease. The beta cells can only put out so much insulin, and over time they start to put out less." Your doctor will look at the big picture and do additional testing to find out if there is a bigger problem.