What is diabetes?
Diabetes, also called diabetes mellitus, is a health condition in which an individual has too much sugar in the blood. It is caused by the body’s inability to metabolize glucose (sugar) from food as energy. Every cell in the body needs glucose to function properly. Insulin, a hormone produced by the pancreas, delivers glucose to the body’s cells via the bloodstream. When there is either a lack of insulin or the body can not use insulin properly, glucose builds up in the bloodstream, causing blood sugar to rise. In some cases, the body does not make insulin on its own (Type 1 diabetes). In other cases, the body does not make enough insulin or becomes resistant to its effects (Type 2 diabetes).According to a 2017 report by the Centers for Disease Control and Prevention (CDC), over 100 million Americans have diabetes or prediabetes. Ninety to ninety-five percent of those with diabetes have Type 2 diabetes. There is no cure for diabetes, but treatments include maintaining a healthy lifestyle, diabetes medication (oral agents and non-insulin injectables), and insulin therapy, depending on the type of diabetes, risk factors, and blood sugar control.
Some common symptoms of diabetes include frequent urination, unquenched thirst, and weight loss or gain. The symptoms of diabetes may occur for many years before diagnosis. Therefore, it’s important to understand who is at risk for diabetes diagnosis.
Diabetes diagnosis
Adults and children who are overweight or obese and individuals with a family history of diabetes have a higher risk of developing Type 2 diabetes. Risk factors for developing Type 1 diabetes include a family history of Type 1 diabetes. Although a diagnosis of Type 1 diabetes is most common in children and a diagnosis of Type 2 diabetes is most common in adults, that is not always the case.The exact cause of both Type 1 and Type 2 diabetes is unknown. However, it is widely accepted that contributing factors for both types include a combination of inherited genetic risk factors and environmental triggers. Type 1 diabetes can be diagnosed at any age but is typically diagnosed in children. Type 2 diabetes is often referred to as “adult-onset” diabetes. However, as child obesity becomes more common, so does the diagnosis of Type 2 diabetes in children.
Frequently experiencing any of the above symptoms may be a sign that you have diabetes. However, your healthcare provider must conduct a blood test to confirm the diagnosis. One or more of the following blood tests may occur (or be ordered) during your doctor’s office visit:
- Glycated hemoglobin (A1c) test: The HbA1c blood test is one of the most common tests for diabetes. Test results display a patient’s average blood sugar level over the past three months.
- Normal results: less than 5.7%
- Prediabetic results: 5.7% to 6.4%
- Diabetic results: 6.5% or higher
- Fasting blood sugar test: This test involves taking a blood sample after a 12-hour fasting period.
- Normal results: less than 100 mg/dL
- Prediabetic results: 100 to 125 mg/dL
- Diabetic results: 126 mg/dL or higher (may be tested twice to confirm, depending on the situation)
- Random blood sugar test: The random blood sugar test is conducted the same way as the fasting test. The difference is that it can be conducted regardless of when you last ate. Therefore, the readings are slightly different.
- Diabetic results: 200 mg/dL or higher
- Oral glucose tolerance test: This test is regularly used during pregnancy to diagnose gestational diabetes. The test consists of an overnight fast, followed by having a fasting blood sugar level drawn at the lab or your doctor’s appointment the next day, immediately followed by consuming a sugary drink. Then your blood sugar levels are tested one, two, and possibly three hour later. At the two-hour mark:
- Normal results: less than 140 mg/dL
- Prediabetic results: 140 to 199 mg/dL
- Diabetic results: 200 mg/dL or higher
If your physician suspects Type 1 diabetes, they may order additional lab tests, including autoantibodies.
Once your blood test results come in, your physician may refer you to a diabetes specialist, known as an endocrinologist, to help manage your diabetes. Endocrinologists specialize in hormone-related conditions, including diabetes. Individuals with a less severe diagnosis may not need to see an endocrinologist and can work with their primary care doctor to discuss management and treatment plans.
Questions you should ask your diabetes specialist after diagnosis
- What other health risks are associated with diabetes?
- How do I test my blood sugar?
- How often should I test my blood sugar and report the results to my medical team?
- What types of medications and treatment plans could help my diabetes?
- Will exercising help my diabetes?
- How should my diet change as a result of my diabetes diagnosis?
- Will losing weight help my diabetes? If so, how much do I need to lose?
- Are my children at risk for diabetes?
The
American Diabetes Association recommends routine screening—at least every three years—for Type 2 diabetes in individuals age 45 years and older, as well as adults of any age who have overweight (BMI greater than 25) or obesity (BMI greater than 30) with one or more risk factors.
RELATED: How many types of diabetes are there?
Complications of diabetes
There are many
health risks associated with untreated high blood sugar. Some of these risks include:
- Stroke
- Heart attack
- Heart disease
- Kidney damage that can lead to kidney failure, including dialysis and transplant
- Nerve damage that can lead to amputations
- Eye damage that can lead to vision loss and blindness
- Skin conditions such as bacterial and fungal infections
- Alzheimer’s disease
- Depression
To prevent, minimize, or delay your diabetes from causing additional health complications, it’s important to know your treatment options so you can keep your blood sugar in the target range as much as possible.
Diabetes treatment options
There is currently no cure for diabetes, but it can be managed. Treatment options for diabetes vary depending on the type of diabetes, other medical conditions, and blood sugar levels. Patients with Type 2 diabetes are often advised to make diet and exercise changes, take prescription medications, and will sometimes require insulin. Patients with Type 1 diabetes always require insulin.
People with diabetes can help manage their condition with lifestyle modifications such as increased exercise and improved diet that leads to weight loss (when weight loss is needed). Weight management is especially important for patients with prediabetes (who have overweight or obesity) because they have a higher likelihood of developing diabetes. If you have diabetes or are at risk for a diabetes diagnosis, create an action plan for maintaining a healthy lifestyle with your doctor.
Type 1 diabetes treatments
Treatment for Type 1 diabetes always requires insulin, either through multiple daily injections or the use of an insulin pump. Patients with Type 1 diabetes also require frequent blood sugar monitoring.
Type 2 diabetes treatments
Most patients with Type 2 diabetes are treated with medications that boost insulin production, in combination with lifestyle adjustments that help lower blood sugar levels. One of the most popular types of drugs for those with Type 2 diabetes currently on the market is a class of medications called GLP-1 receptor agonists, which induce insulin production and suppresses glucagon (a hormone that keeps blood sugar levels from dropping too low) secretion from the liver. GLP-1 receptor agonists are available as injectable medications as well as oral medication.
Diabetes medications
For some diabetes patients, lifestyle modifications such as improved diet and physical activity can help achieve
target blood sugar levels. Others may need diabetes medication or insulin therapy to manage blood glucose levels.
There are several classes of diabetes medications. Below we outline each class of diabetes drugs, how they work, popular brands, potential benefits, and possible side effects.
Biguanides
Biguanides are a class of medications that decrease the production of glucose in the liver, thus reducing the amount of sugar in the blood. They are also known as insulin sensitizers, which lower insulin resistance and allow your body to properly use its own insulin. The only biguanide is metformin, which comes in immediate-release and extended-release versions—metformin and metformin ER. Metformin is usually taken two times per day and metformin ER once per day. Metformin may be taken alone or in combination with other diabetes medications.Drug in this class: metformin
Popular brand names:
- Glucophage
- Glucophage XR (extended-release metformin)
- Glumetza
- Fortamet
- Riomet
How it’s taken: Orally
Potential Benefits: Lowers blood sugar and aids in weight management
Possible Side Effects: Gastrointestinal stress, which includes diarrhea, cramping, nausea, vomiting, and increased flatulence.
Sulfonylureas
Known as insulin secretagogues, sulfonylureas work by causing the pancreas to increase the release of insulin. They are typically taken once or twice a day with a meal. Sulfonylureas are taken on their own or in conjunction with other diabetes medications.Drugs in this class:
- Amaryl (glimepiride)
- DiaBeta (glyburide)
- Glipizide XL (extended-release glipizide)
- Glucotrol (glipizide)
- Glucotrol XL (extended-release glipizide)
- Glynase PresTab (glyburide micronized)
- Micronase (glyburide)
How it’s taken: Orally
Potential benefits: Lowering blood glucose levels
Possible side effects: Weight gain, hypoglycemia (low blood sugar), and itchy skin/rashes
AGIs (Alpha glucosidase inhibitors)
Nicknamed starch blockers, alpha glucosidase inhibitors reduce blood glucose levels after food consumption by slowing down the digestion of carbs. AGIs specifically work by blocking enzymes in the small intestine that break down carbs to prevent high blood sugar levels.Drugs in this class:
- Glyset (miglitol)
- Precose (acarbose)
How it’s taken: Orally
Potential benefits: Lowers post-meal blood sugar and decreases appetite, preventing weight gain.
Possible side effects: Flatulence and diarrhea
Amylin analogues
Amylin analogues, also known as agonists, are used in both Type 1 and Type 2 diabetes patients and are designed to mimic the hormone amylin, an amino acid produced by the pancreas that aids in blood sugar management after food consumption. Amylin agonists are injected before meals.Drug in this class:
How it’s taken: Injection
Potential benefits: Lower blood sugar; possible weight loss
Possible side effects: Hypoglycemia (low blood sugar), nausea, vomiting, abdominal pain
Meglitinides
Also known as prandial glucose regulators or glinides, meglitinides prevent spikes in blood sugar levels after eating by stimulating the release of insulin. This is done by binding to proteins in the pancreas that secrete insulin hormone. They are similar to sulfonylureas but have a more rapid onset and last for a shorter period.Drugs in this class:
- Prandin (repaglinide)
- Starlix (nateglinide)
How it’s taken: Orally
Potential benefits: Lower blood sugar
Possible side effects: Hypoglycemia, respiratory tract infections, headaches
Thiazolidinediones (TZDs)
Also known as glitazones, thiazolidinediones (TZDs) work to lower blood sugar by reducing the body’s resistance to insulin. A thiazolidinedione can be used as a single treatment (monotherapy) or with other diabetes drugs.Drug in this class:
Potential benefits: lower blood glucose levels without causing hypoglycemia, increase lipid metabolism which increases the amount of good cholesterol in the bloodstream, may slightly lower blood pressure
Possible side effects: Weight gain, headache, muscle pain
DPP-4 inhibitors (Gliptins)
Dipeptidyl peptidase-4 (DPP-4) inhibitors, also known as gliptins, are prescribed to Type 2 diabetes patients who don’t respond well to other diabetes drugs such as metformin. They are typically the second line of defense.These medications work by inhibiting an enzyme called DPP-4 from destroying hormones in the intestines called incretins that stimulate insulin production after a meal. DPP-4 inhibitors also slow down digestion and decrease appetite.
Drugs in this class:
- Januvia (sitagliptin)
- Onglyza (saxagliptin)
- Tradjenta (linagliptin)
- Nesina (alogliptin)
How it’s taken: Orally
Potential benefits: Lower blood sugar, reduce appetite leading to weight loss
Possible side effects: Headache, gastrointestinal discomfort, joint pain, flu-like symptoms, and skin rashes
SGLT2 inhibitors (Gliflozins)
SGLT2 is an abbreviation for sodium-glucose co-transporter-2. These inhibitors, also known as gliflozins, lower blood glucose levels by helping the kidneys urinate out excess sugar.Drugs in this class:
- Steglatro (ertugliflozin)
- Farxiga (dapagliflozin)
- Invokana (canagliflozin)
- Jardiance (empagliflozin)
How it’s taken: Orally
Potential benefits: Lower blood sugar, weight loss, may slightly lower blood pressure
Possible side effects: Hypoglycemia, increased risk of UTIs and yeast infections, and in rare cases, lead to diabetic ketoacidosis or cause necrotizing fasciitis of the genitals (also called Fournier’s gangrene)
GLP-1 receptor agonists (Incretin mimetics)
Incretin mimetic drugs, also called glucagon-like peptide-1 receptor agonists or GLP-1 analogues, are injectable drugs used to help control blood sugar and as a side effect, promote weight loss. GLP-1 analogues work by mimicking the hormone incretin which lowers post-meal blood sugar levels by increasing the release of insulin after eating, reducing the release of glucagon, and slowing stomach emptying.Drugs in this class:
- Bydureon BCise (exenatide extended-release) injection
- Byetta (exenatide) injection
- Ozempic (semaglutide) injection
- Rybelsus (semaglutide) oral
- Trulicity (dulaglutide) injection
- Victoza (liraglutide) injection
Saxenda (liraglutide) and Wegovy (semaglutide) are injectable GLP-1 agonists, but are approved by the FDA for weight management only. They are not approved for blood sugar control in patients with diabetes.
How it’s taken: Injection (except for Rybelsus which is taken orally)
Potential benefits: Lower blood sugar, weight loss
Possible side effects: Gastrointestinal problems (diarrhea, nausea, vomiting, indigestion, constipation, etc.)
GIP and GLP-1 receptor agonists
Mounjaro is the first drug in the GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist class. It works by increasing insulin secretion and reducing glucagon secretion. It’s currently FDA-approved for lowering blood sugar but has an FDA Fast Track designation and is being studied for a weight loss indication.Drugs in this class:
How it’s taken: Injectable
Potential benefits: Lower blood sugar, weight loss
Possible side effects: Nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach pain
Combination medications
There are many diabetes medications that combine the pharmacological effects of two medications into one, either orally or through injection. One of the benefits of combined medications is having to take fewer pills or injections. However, this does have its disadvantages as well, including difficulty adjusting medication dosages, as most combined medications have limited options in dosing for the two medications combined, versus when taken separately.
- ActoPlus Met - pioglitazone (TZD) and metformin (biguanide)
- ActoPlus Met XR - pioglitazone (TZD) and extended-release metformin (biguanide)
- Duetact - glimepiride (sulfonylurea) and pioglitazone (TZD)
- Glucovance - glyburide (sulfonylurea) and metformin (biguanide)
- Glyxambi - linagliptin (DPP-4 inhibitor) and empagliflozin (SGLT-2 inhibitor)
- Invokamet - canagliflozin (SGLT-2 inhibitor) and metformin (biguanide)
- Invokamet XR - canagliflozin (SGLT-2 inhibitor) and extended-release metformin (biguanide)
- Janumet - sitagliptin (DPP-4 inhibitor) and metformin (biguanide)
- Janumet XR - sitagliptin (DPP-4 inhibitor) and extended-release metformin (biguanide)
- Jentadueto - linagliptin (DPP-4 inhibitor) and metformin (biguanide)
- Jentadueto XR - linagliptin (DPP-4 inhibitor) and extended-release metformin (biguanide)
- Kazano - alogliptin (DPP-4 inhibitor) and metformin (biguanide)
- Kombiglyze XR - saxagliptin (DPP-4 inhibitor) and metformin (biguanide)
- Oseni - alogliptin (DPP-4 inhibitor) and pioglitazone (TZD))
- Qtern - dapagliflozin (SGLT-2 inhibitor) and saxagliptin (DPP-4 inhibitor)
- Segluromet - ertugliflozin (SGLT-2 inhibitor) and metformin (biguanide)
- Steglujan - ertugliflozin (SGLT-2 inhibitor) and sitagliptin (DPP-4 inhibitor)
- Synjardy - empagliflozin (SGLT-2 inhibitor) and metformin (biguanide)
- Synjardy XR - empagliflozin (SGLT-2 inhibitor) and extended-release metformin (biguanide)
- Xigduo XR - dapagliflozin (SGLT-2 inhibitor) and extended-release metformin (biguanide)
Insulin therapy
Insulin therapy is a common treatment for both Type 1 and Type 2 diabetes. The goal of insulin therapy is to manage blood sugar levels by keeping them within a target range. This type of diabetes treatment is administered most commonly via insulin injections or an insulin pump.
There are multiple types of insulin and each varies based on how long they take to begin working, when they reach maximum effectiveness, and how long their effects last.
People who take multiple daily injections generally take a long-acting insulin (called a basal insulin) such as Lantus or Tresiba to keep blood sugar steady all day and night (when not eating) as well as short-acting insulin that’s taken with food or to correct high blood sugar when needed.
Because a pump can only hold one type of insulin, people who use a pump use a fast-acting insulin such as Humalog or Novolog, given in very tiny doses all day long, to keep blood sugar steady, as well as higher doses for food and to correct high blood sugar when needed.
Insulin types include:
Ultra long-acting insulin/long-acting insulin
- Insulin glargine - Toujeo
- Insulin glargine - Lantus, Basaglar
- Insulin detemir - Levemir
- Insulin degludec - Tresiba
- Concentrated Regular insulin - Humulin R U-500
Intermediate-acting insulin
- NPH (Humulin N, Novolin N, Novolin N ReliOn)
Short-acting insulin
- Regular insulin (Humulin R, Novolin R, Novolin R ReliOn)
Rapid-acting insulin
- Insulin aspart (Novolog, Fiasp)
- Insulin glulisine (Apidra)
- Insulin lispro (Humalog, Admelog)
Mixed insulins
- Humalog Mix 50/50 - 50% insulin lispro protamine and 50% insulin lispro
- Humalog Mix 75/25 - 75% insulin lispro protamine and 25% insulin lispro
- Novolog Mix 70/30 - 70% insulin aspart protamine and 30% insulin aspart
- Humulin 50/50 - 50% NPH, 50% regular
- Humulin 70/30, Novolin 70/30, Novolin ReliOn 70/30 - 70% NPH, 30% regular
Rapid-acting inhalation powder
- Insulin inhaled (Afrezza inhalation powder)
Potential benefits: Improved blood sugars
Possible side effects: Hypoglycemia, cough, headache, diarrhea, fatigue, nausea
Combination insulins (long-acting insulin and GLP-1 agonist)
- Xultophy (insulin degludec and liraglutide)
- Soliqua (insulin glargine and lixisenatide)
Best diabetes medications
There is no “best” diabetes medication. The diabetes medication you are prescribed depends on various factors, such as your blood sugar levels and medical history. Additionally, healthcare providers will consider how a diabetes medication may react with other drugs the patient is taking and how they respond to a specific diabetic treatment.
Use the following chart of commonly prescribed medications to understand some of your diabetes treatment options. Always consult your endocrinologist or primary care physician to find the best diabetes medication for you. Your doctor will determine the best diabetes drug for you based on your condition, medical history, and current list of medications.
Best medications for diabetes
Side effects of diabetes medication
The side effects of diabetes medications vary based on drug class and patient. The following list of potential adverse side effects caused by diabetes medications is not exhaustive but covers common side effects associated with popular diabetes treatments. You may not experience any of the following side effects, but if you do, consult your healthcare provider. As with any new medication, read all patient information associated with the drug.
- Hypoglycemia (low blood sugar): May be associated with nearly all anti-diabetic drugs, but is more common with sulfonylureas and insulin.
- Weight gain: Most common with sulfonylureas, meglitinides, TZDs, and insulin.
- Weight loss: Most common with amylin analogues, DPP-4 inhibitors, SGLT-2 inhibitors, GLP-1 agonists, and GIP/GLP-1 agonists.
- Gastrointestinal discomfort: Includes side effects such as diarrhea, nausea, vomiting, indigestion, constipation, and increased flatulence. Most common with GL
P-1 agonists, GIP/GLP-1 agonists, sulfonylureas, metformin, and AGIs.
- Adverse skin reactions: Such as rashes or irritation. Common with sulfonylureas, DPP-4 inhibitors, and meglitinides.
- Ketoacidosis: This is a condition in which there are high levels of byproducts of fatty acids in the blood called ketones and is most common with SGLT-2 inhibitors.
Disclosure: This is not an exhaustive list of all the possible side effects associated with diabetes medications. For a complete list of possible adverse events and drug interactions caused by specific diabetes medications, please talk to a healthcare professional.
Can diabetes be treated naturally?
Although diabetes can’t be cured, some people can manage Type 2 without medications. In fact, with significant lifestyle changes, some patients are able to put their Type 2 diabetes into remission.
Natural treatments for diabetes include:
- Weight loss. Keeping off weight naturally lowers blood glucose. Even losing as little as five to ten percent of your body weight can significantly impact blood sugar levels for the better.
- Improved diet. While there is no official diabetes diet, it’s important for those with diabetes to consume fewer calories, refined carbs, and saturated fats to stabilize blood sugar and maintain a healthy weight.
- Daily exercise. Adults should get at least 150 minutes of moderate-intensity physical activity per week, which can be broken up into 5, 30-minute sessions. Additionally, adults should also add two or more days of strength training exercise. Physical activity helps weight loss, and keeps blood sugar levels down. Consult your doctor before beginning a new exercise program.
- Monitoring blood sugar. The key to diabetes management is to keep track of your blood sugar on a regular basis to make sure it stays within your target range. Discuss how frequently you should check your levels with your doctor. Some people prefer to use a blood glucose meter and finger stick, while others opt to wear a continuous glucose monitor which continuously monitors glucose.
- Vitamins and supplements. There are also a number of natural vitamins and supplements available that may help lower blood sugar. These are not a substitute for prescription medications. Talk with your doctor before starting any supplements.
All patients with diabetes are encouraged to engage in the
natural treatments for diabetes listed above, even if they must take medication or insulin therapy as well.
Diabetes treatment complications
While treatments are very effective in managing blood sugar levels, there are always complications that could arise.
Hypoglycemia, or low blood sugar, is more common with insulin or sulfonylureas (glimepiride, glipizide, glyburide), but can also occur with other diabetes medications. Your healthcare provider will give you an action plan that contains information on monitoring blood sugar, hypoglycemia, and how to manage it.
On the other hand, while monitoring blood sugar, you may find that you have hyperglycemia (high blood sugar). Your action plan will detail what to do in the case of high blood sugar. Generally, people who use insulin will need to inject insulin. People who do not use insulin may be instructed to take diabetes medication, exercise, and drink lots of water.
Some patients will experience diabetic ketoacidosis (DKA). This is more common in individuals with Type 1 than those with Type 2 diabetes. When there is not enough insulin in the body, the body starts to break down fat as fuel. This causes acids (ketones) to build up in the blood. If left untreated, DKA can occur. Symptoms may include thirst, frequent urination, nausea, vomiting, stomach pain, weakness, difficulty breathing, confusion, and fruity-smelling breath. Left untreated, DKA can lead to a coma or death. In your treatment plan, your healthcare provider will include information about testing for ketones and what to do if you have ketones.
Consult your healthcare provider for more information about potential complications of diabetes treatment.
Future advances in diabetes treatment
There is continuous research on diabetes treatments and potential cures. In fact, a search of clinicaltrials.gov brings up almost 20,000 studies on diabetes. Some areas of research include:
Frequently asked questions about diabetes
What is the best treatment for diabetes?
For people with Type 1 diabetes, insulin is always required. This can be done through multiple daily injections, or via an insulin pump, which continuously delivers insulin.
For people with Type 2 diabetes, lifestyle changes such as diet and exercise are always recommended. Additionally, prescription medication may be required. The best treatment varies based on individual factors. Often, metformin is recommended as a first choice of treatment for Type 2 diabetes. However, this may vary as there are many drugs available, and one may be more appropriate than another depending on your case. Your healthcare provider can determine which diabetes treatment is best for you.
Can you treat diabetes without medication?
People with Type 1 diabetes will always require insulin. People with Type 2 diabetes are sometimes able to put their condition into remission by making significant lifestyle changes such as a healthy diet and increased exercise. Talk to your healthcare provider for personalized recommendations.
What diabetes drugs cause weight gain?
The following drugs may be associated with weight gain:
- Sulfonylureas
- Meglitinides
- TZDs
- Insulin
Which diabetes medications cause weight loss?
The following drugs are associated with weight loss:
- GLP-1 agonists
- GIP/GLP-1 agonist
- Metformin
- Amylin analogues
- DPP-4 inhibitors
- SGLT2 Inhibitors
What is the safest diabetes medication?
While all drugs come with a risk of side effects, including serious side effects,
metformin is often used as a first choice of treatment because it is considered safe, effective, well-tolerated, and is also very affordable.
What other drugs are taken in conjunction with diabetes medications?
In addition to drugs that target blood glucose levels and insulin resistance and production, diabetes patients may also need to take additional medications for other medical conditions, like high blood pressure and high cholesterol, to prevent heart disease.
Can more than one diabetes drug be taken at once?
Yes, depending on the situation, more than one diabetes medication can be prescribed to lower blood sugar levels.
What is the latest drug for diabetes?
A new drug called Brenzavvy (bexagliflozin) was
FDA-approved in January 2023. It is an oral SGLT-2 inhibitor but is not yet available on the market.
Mounjaro is another new diabetes drug (see section above). It is currently approved to manage blood sugar in people with Type 2 diabetes but has been shown to help people lose a significant amount of weight. It’s currently being studied for a weight-loss indication.
What is a dangerous level of blood sugar?
Low blood sugar: Blood sugar levels below 70 mg/dL are considered low. Low blood sugar, also called hypoglycemia, is often caused by insulin or diabetes medications and if not treated quickly, can lead to seizures, loss of consciousness, and even death.
Your doctor will tell you what blood sugar level is considered dangerous. Generally, if your blood sugar drops below 70, your action plan will instruct you to eat or drink about 15 grams of carbohydrates, preferably fast-acting carbs like Smarties, jelly beans, glucose tablets, or apple juice, right away. (You should have these items available at all times so you can treat low blood sugar right away.) Wait about 15 minutes and then check your blood sugar (or monitor your continuous glucose monitor readings). If your levels remain low, call your doctor right away or call 911 in an emergency. Ask your doctor if you should carry Baqsimi (glucagon nasal spray) with you at all times. This medication can be administered to the patient by family members or first responders in the event of a low blood sugar emergency if you are unable to eat or drink. You should also always wear a medical alert to alert first responders that you have diabetes in the event of an emergency.
High blood sugar: High blood sugar (hyperglycemia) can be dangerous too. Having high blood sugar frequently over a long time can cause long-term complications such as heart attack, kidney failure, and stroke. Your doctor will tell you what your target blood sugars should be and what levels are considered high or dangerous (and what to do in those situations). Hyperglycemia requires long-term management.
Related resources for diabetes:
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