What are the risks of high blood sugar?
The potential long-term impacts of diabetes include complications like blindness, kidney failure, and amputation. Avoiding these long-term complications should be the main goal of treatment, not “getting rid” of diabetes.
“Without the complications, it’s diabetes, and you have to do things and lead your life a little bit differently, but you can still lead a fully normal life,” Dr. Coxe said.
How is high blood sugar treated?
To prevent long-term complications, it’s important to understand what causes them. It is not high blood sugar on its own that causes these complications, but elevation in glucose over time. This results in damage to tissue that ultimately leads to the complications.
“What’s more important of the two is not the degree of the elevation, but the duration,” Dr. Coxe said. “The duration of elevation seems to be more important than the degree of elevation.”
So the fi rst step is to know what your blood sugar levels are at various times throughout the day. And since high blood sugar doesn’t cause symptoms the majority of the time, the only way you can know your levels is to monitor them, usually just before and two hours after meals to give you a good idea of how high your blood sugar is following food or beverage intake.
Dr. Coxe said the first way to reduce elevated blood sugar is to get regular exercise, lose weight and maintain weight loss, and control your carbohydrate intake at meals, less or equal to 60 grams per meal.
If these lifestyle changes don’t do the trick, Dr. Coxe said the next step is oral medications, often starting with metformin. If or when you are no longer able to control your blood sugar with oral medications, then you’ll need to move to insulin.
“That’s all determined by what your blood sugar is,” said Dr. Coxe. “Not by what your family history is, not by what your body size is, but by your glucose control when you are maximally doing all of the other things.”