Managing Highs and Corrections
Reviewed by CDE Mehandi Sharma · Updated
A single high reading is not an emergency. What matters is why it happened and whether it is staying high.
Common causes are more carbohydrate than usual, a missed or mistimed dose, illness or infection, steroids, poor sleep, or significant stress. Insulin that has been left in the heat can also stop working properly — a genuinely common reason in Indian summers for readings that make no sense.
If you are on insulin and your doctor has given you a correction dose plan, use it as written. The rule that matters most is spacing.
As your insulin production falls, one extra step becomes important: check for ketones if your reading is above about 250 mg/dL, and especially if you also feel nauseated, breathless or unusually unwell. This step matters far less in Type 2 diabetes than it does in LADA.
Get medical help if readings stay above 250 mg/dL despite corrections, if ketones are present, if you cannot keep fluids down, or if you are becoming drowsy or breathing deeply and rapidly.
Persistent highs on a regimen that used to work are not a discipline problem. They usually mean your treatment has been outgrown.