‘What do I do when blood sugar level is 278?’

Blood sugar levels can fluctuate through the day depending on factors such as meals, medication, physical activity, illness and stress. However, a reading that is considerably above the usual range is enough to put you in panic mode.

One such internet user took to Quora seeking answers: “What do I do when blood sugar level is 278?”

We reached out to Dr Aarti Ullal, Physician and Diabetologist, Gleneagles Hospital Parel, to understand what such a reading means and what a person should do next.

“A blood sugar level of 278 mg/dL is significantly high and indicates hyperglycaemia.” Dr Ullal confirms this, clarifying that although one isolated reading does not provide the complete picture, it should not be ignored. The reading should be rechecked and considered along with the person’s symptoms and diabetes history.

What should you do immediately?

“Confirm the reading by washing and drying the hands and repeating the test with a fresh strip if possible,” the diabetologist recommends.

If the reading is confirmed, drink water to stay hydrated, unless a doctor has advised restricting fluids. Avoid sugary foods and drinks, and monitor glucose again as advised.

“If the reading remains very high or symptoms develop, contact a doctor promptly.”

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The timing of the reading also matters. A post-meal reading needs to be considered in relation to how long after the meal it was checked. Consider the person’s usual glucose pattern and medication plan.

That being said, “A level of 278 mg/dL is high whether it is fasting, before a meal or, after eating, although the interpretation can vary.”

Screenshot of the query posted on Quora

When does high blood sugar need urgent medical attention?

A high reading becomes more concerning when accompanied by symptoms such as severe thirst, frequent urination, vomiting, abdominal pain, marked weakness, confusion, drowsiness or difficulty breathing.

“If the person is unable to keep fluids down or becomes confused or unusually sleepy, urgent medical care is needed,” says Dr Ullal. People with type 1 diabetes should be particularly alert to symptoms of “diabetic ketoacidosis.”

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It is also important not to blindly follow online hacks. Busting common high blood sugar myths, Dr Ullal says that exercise is not automatically the answer to a very high glucose reading. In fact, it should particularly be avoided if ketones are present or the person feels unwell.

Similarly, eating additional carbohydrates is generally not appropriate when blood sugar is already this high unless a healthcare professional has specifically advised it.

People taking diabetes medication or insulin should also not take an extra dose on their own unless they have been given a specific correction-dose plan. They should follow their prescribed treatment and correction instructions and contact their diabetes care team if the sugar remains high.

“Taking additional medication without guidance can cause blood sugar to fall too low.”

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Why can blood sugar suddenly rise to 278?

A sudden rise can have several causes, including illness, infection, physical or emotional stress, missed medication, dietary changes, reduced physical activity, dehydration and changes in insulin requirements. Certain medicines, particularly steroids, can also increase blood sugar.

If readings around 278 mg/dL keep occurring, the person should discuss them with their doctor. The review may include fasting and post-meal glucose patterns, HbA1c, medication, diet, activity levels and possible infections or other triggers.

Keeping a record of glucose readings, meal timing, medicines and symptoms can help the doctor assess the pattern.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.