ALTHOUGH anyone with diabetes is going to have a bad day now and again with blood glucose control — which often corresponds with a known slip-up, such as eating too much at a party or foregoing exercise — sometimes, blood glucose levels can rise above your target range and you don’t understand the reason behind this, or how to get them back within your goal range, says the May 2013 issue of the Mayo Clinic Health Letter.

If blood glucose levels rise high enough, you may experience symptoms, such as a dry mouth, thirst, frequent urination, blurred vision and fatigue.

If your blood glucose level is above 240 milligrams per deciliter (mg/dL) and you have tested and found ketones in your urine, call your doctor promptly.

(Ketones are a toxic byproduct created when your body can’t get energy from glucose.)

Often, blood glucose levels are elevated, yet not high enough to cause symptoms that you can feel.

However, even though you feel fine, excess blood glucose is slowly eroding the health of your nerves, blood vessels, organs, and other tissues — over time, this leads to complications, such as kidney disease, loss of vision, nerve damage, heart attack and stroke, explains the health letter.

Sometimes, it is also possible for blood glucose levels to rise above your desired range between the times that you test — thus, it is recommended that all individuals with diabetes also have a glycated hemoglobin (A1C) blood test at their doctor’s office at least two times a year — this test measures your average blood glucose level over the past three months.

An A1C measurement of 7 percent or lower is a common treatment target for individuals with diabetes — the target may be slightly higher for some.

A list of factors that can cause an elevated blood glucose includes:

• Changes in what you eat - Around holidays or during special occasions, you may be eating more food without realizing it, or begin consuming extra calories from a hidden source, such as a sugary beverage.

• Changes in exercise habits - Exercise helps lower blood glucose levels - if the amount of exercise you get declines from your usual routine, your body may not use as much glucose, leaving more in your bloodstream.

• Medications - To keep your diabetes in good control, keep these in mind: a) The time of day you take diabetes medication and the dose needed to keep your blood glucose within the desired range may vary and require adjustment from time to time; b) Medications stored improperly or used after their expiration date lose their potency and, therefore, can affect blood glucose; and c) Medications taken for other conditions can also affect blood glucose - any time you start to take a new drug, or discontinue taking a drug, ask your doctor if it will affect your blood glucose control.

• Infections - Colds, the flu or other bacterial infections cause your body to produce hormones that increase blood glucose - thus, if you’re sick, you may need to monitor your blood glucose more carefully and make adjustments. Also, at times, you may have an infection that you are not aware you have or a festering infection that is not being adequately treated, which can cause high glucose levels.

• Medical care or major medical problem - Since surgery, a heart attack, major emotional stress, an injury from an accident or a hospital stay can affect glucose-altering hormones and may involve medications or treatments that affect blood glucose, tell your medical caregivers about your diabetes or consider wearing a medical identification bracelet in case you can’t communicate, the health letter advises. Also, treatments involving steroids - including a steroid injection for back or joint pain, chemotherapy for cancer or treatment for autoimmune diseases, such as rheumatoid arthritis - often affect glucose levels.

• The “dawn effect” - This is an abnormal early-morning increase in blood glucose thought to be related to the release of hormones while you sleep - monitor your blood glucose through the night to determine if you experience the dawn effect, or if elevated morning glucose is due to another cause.

The health letter offers these steps, with the help of your doctor, to regain control of your blood glucose levels:

• Anticipate potential problems - such as might be caused by travel, starting a new medication, or simply getting sick - so that you can respond promptly and according to your plan.

• An A1C test can alert you and your doctor to problems, if your fasting blood glucose levels are persistently high - even though you’ve been following your diet and taking your medications as directed.

• Identify changes in your lifestyle or medication to determine why your blood glucose levels are high, so you can help get it under control, concludes the health letter.

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