If your blood glucose level exceeds 400 mg/dL, it is considered severe hyperglycemia and requires immediate caution.
This article explains what to do if your blood sugar level is above 400 mg/dl.
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What is considered severe hyperglycemia?
Most people with diabetes begin to feel symptomatic of hyperglycemia between 180-200 mg/dL. If you have an insulin dependence, blood glucose levels above 200 mg/dL should be treated with insulin.
If your blood glucose level exceeds 250 mg/dL (13.89 mmol/L), you should have a ketone urine test to rule out diabetic ketosidosis (DKA). DKA is a dangerous complication of diabetes and can be fatal if not treated immediately.
If you are experiencing blood glucose levels above 250 mg/dL for several hours along with mild, moderate or high ketones, seek immediate medical attention.
People with diabetes are at risk of becoming diabetic coma if their blood sugar levels reach 600 mg/dL or more in ketones. High blood sugar levels usually require immediate medical consultation in a hospital setting.
What causes hyperglycemia?
Hyperglycemia levels are a direct result of not having enough insulin in the body (cells).
Several factors can contribute dangerously to hyperglycemia levels:
Missed insulin administration: Skip it, or you may not take enough insulin, or your blood sugar levels may rise. Malfunction Device: A malfunction of an insulin pump or continuous glucose monitor (CGM) may result in missing early warning signals or not being ingested. Disease or infection: The body's response to illness can increase blood sugar levels. Dietary choice: Consumes large amounts of carbohydrates without proper insulin coating. Stress: Emotional or physical stress can cause hormonal changes that increase blood sugar levels. Drug interactions: Certain drugs and steroids can affect glycemic control.
What should I do if my blood sugar level is above 400 mg/dl?
If your blood sugar level is above 400 mg/dL, there are several immediate steps to quickly lower your blood sugar level.
Test your blood sugar again
Sometimes, the continuous glucose monitoring (CGM) system and blood glucose meter readings may be incorrect.
Wash your hands and test your blood sugar again before making any drastic measurements (if you're reading high CGM, test your blood sugar manually).
Sometimes sugar or another substance is misreading first. So it's always best to double check to make sure your blood sugar levels are actually high.
Ketone Test
Ketones are a type of chemical that the liver produces to break down fat for energy when the body lacks insulin to use glucose for energy.
Your body resorts to doing this after prolonging your high blood sugar levels, and using ketones is extremely dangerous.
You can test ketones with simple home urine or blood tests.
If you have ketones, this usually indicates that you need to take extra insulin to lower your blood sugar levels (most people who develop ketones have type 1, insulin-dependent diabetes).
If you have ketones, talk to your doctor about how insulin correction factors will change.
If you have an insulin dependency, take insulin
If you retest your blood glucose, test your ketones (whether you have or not), and test for insulin dependence, the next thing you do if your blood glucose is above 400 mg/dL is to take insulin immediately.
You'll want to take fast-acting insulins like Humanlog, Novolog, Fiasp, Lyumjev, and long-acting insulins like Lantus and Levemir. This should start to make your blood sugar levels faster.
If you are using an insulin pump and think that the insulin pump may be malfunctioning, try replacing the insulin pump site after a manual corrective injection of insulin.
Malfunction of the insulin pump site can quickly lead to hyperglycemia levels, especially if it occurs overnight during sleep.
This is because insulin pumps use only short-acting insulin, so when you stop working, your body will quickly run out of insulin onboard, unlike when you have multiple daily injections using long-acting insulin.
I drink a glass of water
Hyperglycemia levels can lead to dehydration and may contribute to diabetic ketoacidosis (DKA). If your blood sugar level is high, you may urinate more than usual. This makes drinking water even more important.
For these reasons, you need to maintain hydration.
Don't resort to drinking soda or juice. It's just going to raise your blood sugar level. Stick to water and diet drinks.
20 minutes on foot
After hydrating with insulin, you can help jump-start your blood sugar by taking light exercise for 20 minutes.
If you have ketones, exercise is not recommended as hyperglycemic levels with ketones cause dehydration. Exercise can get worse. This could lead to even higher blood sugar levels.
If your blood sugar levels don't drop after a few hours, call your doctor.
If you have tried all of the above strategies but still haven't dropped after a few hours, call your doctor (especially if you're mild, moderate, or high ketones or illnesses).
Your doctor can advise on additional strategies to employ. They may even recommend going to the hospital for intravenous fluid and insulin to prevent dehydration and the development of DKA.
What is the fastest way to defeat high blood sugar?
If you are insulin-dependent, the fastest way to lower your blood sugar levels is to take insulin.
If you're not insulin addiction, maintaining hydration and exercise with water is the fastest way to quickly defeat blood sugar levels.
What if I can't lower my blood sugar level?
If you are unable to lower your blood sugar levels, call your doctor or 911 and seek emergency medical attention immediately. Hyperglycemia levels are damaged and can quickly develop into DKA.
If your blood sugar levels are high for several hours and you have mild, moderate, or high ketones, you should seek medical attention.
The signs and symptoms to note are:
Nausea Vomiting Confusing Body pain Shortness, Fruity scented breathing stomach pain