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What's the Big Deal About High Blood Sugars? Does it Matter if My Blood Sugar is High

There is a common lack of knowledge about why diabetes professionals care about high blood sugars. What's the big deal if you have high blood sugar? What does that number represent? Is it causing you problems in the moment? Does it really matter if your blood sugar is high?

In short, for the most part, high blood sugar is a problem when it is chronic. Except in a minority of cases of severe high blood sugar, at the moment of high blood sugar, you won't be in immediate danger. High blood sugar matters because over time it causes other health problems.

person with diabetes checking blood sugars

High Blood Sugars Do Matter: Acute Issues

There are rarer times that high blood sugar can be immediately dangerous. One condition, called diabetic ketoacidosis (DKA,) is more likely to occur in people with type 1 diabetes who have not been taking their insulin than in people with type 2 diabetes. In DKA, blood sugars are usually 300 or higher. Another serious condition, called hyperosmolar hyperglycemic state (HHS,) occurs more often in type 2 diabetes than type 1 diabetes, and in those cases, blood sugars are exceedingly high--often above 600.

High Blood Sugars Do Matter: Chronic Issues

A vast majority of cases of high blood sugars occur in people with type 2 diabetes with blood sugars in 200's-300's range, and A1C's in the 8-13% range. While these situations are unlikely to be DKA or HHS, and are therefore not acutely dangerous, it's the long term risks that are concerning--these high blood sugars matter in the long run.

The the risks of high blood sugar are cumulative. Think of blood sugar values as points. The higher your blood sugar is and the more frequently your blood sugar is high, the more points you accumulate. The more points you have, your risk of diabetes complications increases. There is no exact number of years of diabetes that will lead to any one of the many diabetes complications. Genetics and lifestyle factors also influence which complications a person will get and how soon they will occur.

Sometimes it is hard to take high blood sugar seriously. In the early years after a diabetes diagnosis, often no complications are apparent. And if they are, it is often easy to explain them away. In the moment you see no bad outcomes. Additionally, usually high blood sugar is asymptomatic--you will likely feel fine.

The problems comes over time. The additive effects of high blood sugars over time slowly cause damage to your small and large blood vessels. This damage can be stopped from progressing by improved blood sugar, but usually once damage has occurred, the damage is not fixable. In different organs and systems in the body, the blood vessel damage is at the root of the diseases that are complications of high blood sugar. Because we have blood vessels in every part of the body, there is no area that is immune to diabetes complications.

Complications of High Blood Sugar

Here are some complications of high blood sugar:

  • Kidney disease

  • Vision issues (diabetic retinopathy)

  • Diabetic foot disease and amputations

  • Heart attack

  • Stroke

  • Nerve damage (neuropathy, hearing loss)

What You Can do About High Blood Sugar

The good news about diabetes is that there is a lot you can do. With a combination of medication, nutrition, and physical activity, most people can maintain their blood sugars in their goal range. While I don't want to diminish the challenge of health-related behavior change such as medication adherence and good nutrition, it is possible.

If you are having a hard time making changes that will improve your blood sugar, your diabetes healthcare provider can help you! Schedule an appointment with a dietitian who specializes in diabetes, or ask your doctor for help.

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