5 Ways to Handle Unexpected Blood Glucose Levels

Recently I went to bed with a blood glucose level of 7 mmol and set my alarm on my phone, as I do every night, for 3am. Sometimes I set it for midnight or 1 am as well, if I am uncertain about what they are going to do, but I had a fresh well working pump site, and had been steady on 7 mmol all night. This seemed a perfectly reasonable place to go to bed, as long as I woke up at some point to check, which I usually do.

I tossed and turned a bit after a few hours and at 3am I woke up and checked, feeling like my mouth was as dry a desert and a bit off….my blood glucose was 15 mmol! What? How? Why?

There is no reasonable explanation other than insulin pump site issues, of which I have quite often due to scar tissue…so I turn on the light, change my site with groggy eyes in the light of the bedside lamp, hoping I am getting the needle in correctly. I get up for some water and a wee, and head back to bed with a bolus on board. I get up at 5.30 am but set the alarm for 4 am, so I can check the new site is ok and things are going in the right direction. At 4am it is now 12 mmol and on the way down and by 5.30 when I get up, 7 mmol. I have avoided getting up in the morning with ketones and a rough day. But still I feel rough, worn out, buffeted about by my body which turns on me like this sometimes.

Have you experienced something similar?  It is easy to let it get to you and destroy your day or week, or even longer.

Here are 5 ways to handle unexpected blood glucose levels:

Here are 5 ways to handle unexpected blood glucose levels:

  1. Deal with the immediate issue – seek medical advice if you are at risk of any danger, whether high or low – treat the low and the high as you usually would.
  2. Problem solve – what may have led to the high or low levels? Can you try to avoid it happening again?
  3. Tell someone – share what happened so you can let your emotions about it loose and let them go.
  4. Be gentle on yourself – it is all too easy to move on and do whatever you would usually after a very high or low blood glucose level – and that is cool, I always do, but sometimes you need to stop and take some TLC time and remember you are dealing with a very difficult condition and may need a little down time today, especially if you are feeling unwell or washed out after the event.
  5. Put it into perspective – don’t beat yourself up, don’t think you did something wrong. Diabetes management is still an imperfect science and we are expected to master the art of mastering it, with these imperfect tools. You are a human being first and you happen to have a faulty pancreas – really not your fault.

Most of us have crappy days with diabetes, it is par for the course. Take it in your stride but also notice it, recognise the impact it has on your physically and emotionally and cut yourself a little slack

How do you handle unexpected BGL’s?





  1. ashillam on April 2, 2016 at 7:08 pm

    This is right on the money. Just about every time I have fish and chips this is the result. Increasing the bolus causes a hypo and then the seesaw begins again. There are times when I’ve not eaten in the evening just to get a consistency through the night and wake up in the normal range. It is very frustrating and exasperating at times.

  2. AnnieHendley on April 22, 2016 at 8:55 am

    The middle of the night hypers are horrible. Check, bolus, water, wait…..check, bolus, water, wait,…and I am so tired. You certainly don’t wake up refreshed! I notice they usually occur after a high carbohydrate dinner. I go to bed with a pretty OK blood sugar (so don’t bolus) then sugar goes up when I am sleeping instead of down, like it usually does. Very frustrating.
    Middle of the night hypos are equally horrible. Fortunately I do usually wake up when they occur. Check, eat, wait…..
    The worst is waking up in the morning, hypo, just about able to help yourself, then go to work. I have looked at people in the locker room and thought “I was virtually semi conscious a couple of hours ago, and here I am, admittedly with a bad headache and feeling rough…..but I’m still here!…….and of course, no one can tell or has any idea!
    Thinking like that sometimes makes me feel a bit sorry for myself, but then I think, no, actually, what you have done is really quite awesome!!

    • Helen-Edwards on May 5, 2016 at 5:22 pm

      oh yes all of that! The overnight stuff is the worst. I had a waking at 2 am 19 mmol for no reason the other day and it was awful changing my pump site at 2.30 am all blurry eyed! It is ok to feel sorry for yourself sometimes!

  3. Sandra Williams on July 7, 2017 at 9:52 pm

    I agree – middle of the night highs and lows are terrible and so very draining – both physically and emotionally! I use the temporary basal feature on the pump all the time. If my level goes up I put one on straight away – the higher the BGL the more temporary basal I use. At night, I am more cautious with the amount of temporary basal I use but even a small amount helps to quickly get the control again. It does help to take the edge off the BG quickly. I can often go low in late afternoons so I set the alarm for 3.00pm to check my BGL and often I reduce the basal amount to avoid having to eat just to stop a hypo. The big thing to remember is that the temporary basal insulin does not show on the insulin on board feature so I test often and am always ready to eat if I have too much insulin on board. It takes a bit of experimenting but it works for me. My DE
    always comments that she wishes that everyone used the temporary basal feature like I do. I can bring a very high BGL down very quickly.

    • Helen Edwards on July 10, 2017 at 6:39 am

      Hi Sandra – thanks for those tips! I have an alarm each night to check – the issue for me is the unpredictability – I am not sure that would work for me. It is great when you have a process that works so well for you!