My Blood Sugar Is High: What You Need to Do Right This Second

You wake up, prick your finger or glance at your CGM, and there it is. A number that makes your heart sink. Maybe it’s 180, maybe it’s 350. Seeing that my blood sugar is high feels like a personal failure, even though it’s usually just biology doing its thing. It’s frustrating. It’s scary.

Honestly, the first thing you need to do is breathe. Stress triggers cortisol, and cortisol tells your liver to dump even more glucose into your bloodstream. You’re literally fueling the fire by panicking.

Hyperglycemia isn't just a "diabetic thing" either. While it’s the hallmark of Type 1 and Type 2 diabetes, plenty of people experience spikes due to illness, extreme stress, or certain medications like steroids. If you're looking at a high reading right now, we need to talk about why it happened and how to bring it down without crashing into a hypoglycemic mess.

Is This an Emergency or Just a Bad Day?

Before you go chugging a gallon of water, you have to triage the situation. There is a massive difference between "I ate too much pizza" high and "my body is entering ketoacidosis" high.

If your meter says 240 mg/dL or higher, you need to check for ketones. This is non-negotiable for Type 1s and highly recommended for Type 2s on SGLT2 inhibitors (like Jardiance). According to the American Diabetes Association, if you have moderate to large ketones, you don't go for a jog. You don't wait it out. You call your doctor or head to the ER. High blood sugar plus high ketones equals Diabetic Ketoacidosis (DKA), and that’s a life-threatening medical emergency.

Look for the red flags. Are you vomiting? Does your breath smell like fruit or nail polish remover? Are you confused? If you’re nodding yes to any of these, stop reading this and get help.

Now, if you’re just sitting at 200 and feeling sluggish and thirsty, let’s get to work.

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The "Why" Behind the Spike

It’s easy to blame the bagel you had for breakfast. But blood sugar is a fickle beast. Sometimes my blood sugar is high for reasons that have absolutely nothing to do with food.

1. The Dawn Phenomenon: Your body releases hormones early in the morning to help you wake up. These hormones tell the liver to release glucose. You haven't eaten in ten hours, yet you're at 160. It’s annoying, but it’s a normal evolutionary survival mechanism.

2. Hidden Infections: You might feel fine, but your immune system is fighting a cold or a urinary tract infection. Illness causes insulin resistance. Sometimes a high reading is the first sign that you're about to get the flu.

3. Dehydration: When you're dehydrated, your blood volume drops, but the amount of sugar stays the same. This makes the concentration of glucose higher. It’s basic math.

4. Poor Sleep: A single night of bad sleep can spike insulin resistance the next day. If you stayed up late scrolling or had a bout of insomnia, your morning numbers will reflect that stress.

5. The "Pizza Effect": This is also known as delayed gastric emptying. High-fat, high-carb meals (like Chinese food or pizza) slow down digestion. The carbs hit your system hours later, often while you're sleeping.

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How to Bring It Down Safely

You want it down now. I get it. But "stacking" insulin—taking dose after dose because the number isn't moving fast enough—is the fastest way to end up unconscious on the floor from a low.

Hydration is Your Best Friend

Water is the most underrated tool in your kit. It helps your kidneys flush out excess glucose through your urine. Don't go overboard and drink two gallons in an hour, but steady sipping is key. Skip the "sugar-free" sports drinks if they contain electrolytes you don't need; plain old water is usually the gold standard here.

Movement (With a Warning)

If your blood sugar is high but you don't have ketones, a 15-minute brisk walk can work wonders. Muscle contractions allow your cells to take up glucose even without extra insulin. However—and this is a big however—if your sugar is over 250 and you have ketones, exercise can actually make your blood sugar go up. Your body thinks it’s starving and dumps more fuel into the tank. Check your levels first.

The Correction Dose

If you use insulin, follow your doctor’s prescribed correction factor. This is usually something like "1 unit for every 50 mg/dL over 150." Respect the "insulin on board" (IOB) time. Rapid-acting insulin takes about 15–20 minutes to start working, peaks at two hours, and can stay in your system for five. If you take more insulin one hour after your first dose, you are asking for trouble.

The Emotional Toll of the "High"

We don't talk enough about "hyperglycemia rage." When blood sugar is high, many people become incredibly irritable, anxious, or just plain "off." You aren't being a jerk; your brain is literally bathing in too much sugar.

It’s hard to make good decisions when your brain is foggy. This is why people often "rage bolus" or eat more out of frustration. Dr. William Polonsky, a clinical psychologist specializing in diabetes, often talks about "diabetes distress." It's the burnout that comes from doing everything right and still seeing a high number.

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You have to separate your self-worth from the number on the screen. A glucose meter is a tool, like a speedometer. If you’re going 80 in a 60 zone, you don't call yourself a "bad person." You just take your foot off the gas.

What about the "Rebound"?

Sometimes my blood sugar is high because it was too low earlier. This is the Somogyi effect. If your sugar drops dangerously low in the middle of the night, your body panics and releases glucagon to save you. You wake up at 220 and think, "What happened?" If you keep correcting these morning highs with more insulin, you might be making the nighttime lows worse. This is where a Continuous Glucose Monitor (CGM) like a Dexcom or Freestyle Libre becomes a literal lifesaver. It shows you the "trend" rather than just a snapshot.

Long-Term Strategies That Actually Work

If you’re seeing frequent highs, it’s time to look at the big picture. This isn't about "dieting" in the traditional sense. It’s about management.

• Fiber is the buffer. If you're going to eat carbs, marry them to fiber. Fiber slows down the absorption of sugar. A piece of white bread is a rocket ship; a piece of sprouted grain bread with avocado is a slow-moving train.
• The Order of Eating Matters. Recent studies suggest that eating your vegetables and proteins before your carbohydrates can significantly reduce post-meal spikes. Eat the salad, then the steak, then the potato. It sounds simple, but the data is solid.
• Magnesium and Vitamin D. Many people with chronic high blood sugar are deficient in magnesium. Magnesium plays a role in over 300 biochemical reactions, including insulin sensitivity. Check your levels with your doctor before starting supplements.
• Stress Management. I know, "don't stress" is the most annoying advice ever. But even five minutes of deep breathing can lower your heart rate and help stabilize glucose.

When to Call Your Doctor

You shouldn't be managing this alone if the highs are becoming a pattern. If you’re seeing unexplained spikes for three days in a row, it’s time for a med adjustment.

Your doctor might need to tweak your basal (long-acting) insulin or change your oral medication dosage. Don't wait for your A1c to come back high in three months. Be proactive.

Real-world check: Are you rotating your injection sites? If you always hit the same spot on your stomach, you can develop lipohypertrophy (hardened tissue). Insulin doesn't absorb well through that. It’s a common reason for "unexplained" highs that people overlook.

Immediate Action Steps

If you are high right now:

1. Test for ketones if you’re over 240 mg/dL.
2. Drink 16 ounces of water immediately.
3. Check your last dose. How long ago did you take insulin or medication? If it was less than two hours ago, wait.
4. Take a "low-impact" walk if your ketones are negative. Just 10 to 15 minutes around the block.
5. Wash your hands and re-test. Sometimes a bit of fruit juice or lotion on your finger can give a wildly high reading. Always double-check an outlier.
6. Log it. Write down what you ate, your stress level, and any physical symptoms. Patterns are the only way to solve the mystery of why my blood sugar is high.

Dealing with high blood sugar is a marathon, not a sprint. One high reading doesn't define your health, but how you respond to it does. Stay hydrated, stay calm, and keep tracking the data. You've got this.