A reading this high requires a calm and methodical response to ensure your safety. Follow these immediate steps while you get in touch with your healthcare provider.
Test Your Blood Sugar Again
If you get a reading over 400 mg/dL, recheck your blood sugar to rule out a false reading, especially if you don’t have other symptoms like frequent urination or extreme thirst. An inaccurate result can occur if your hands are not clean, you use expired test strips, or you’ve not kept test strips in the correct storage conditions.
Contact Your Doctor Immediately
If a second test confirms your blood sugar is over 400 mg/dL, call your doctor or endocrinologist right away. Follow the specific treatment plan they have given you for high blood sugar, which may include taking extra insulin or drinking more water, while you wait for their guidance.
Test Your Urine for Ketones
The ADA recommends checking for ketones when your blood sugar level is 240 mg/dL or higher.
“In our clinic, if a person has blood sugar levels of over 300 mg/dL, we will check for urine ketones,” says Susan Spratt, MD, an endocrinologist and professor of medicine at Duke University School of Medicine in Durham, North Carolina.
“If their blood sugar levels are over 300 mg/dL — and certainly over 400 mg/dL — we’re concerned that they may be going into diabetic ketoacidosis,” says Dr. Spratt.
If ketones are present, your doctor will give you further instructions, which may include going to the emergency room. Do not exercise if you have ketones, as this can make your blood sugar spike even higher.
Know When to Call 911
Untreated hyperglycemia can lead to DKA, which can progress rapidly. According to the Centers for Disease Control and Prevention, you should seek immediate medical help if you experience DKA symptoms like:
- Unusually rapid, deep breathing
- A flushed face
- Breath that has a distinct fruity smell
- Feeling nauseous or vomiting
- Abdominal pain
- A parched mouth and dry skin
- Feeling exhausted
- Headache
- Muscle aches or stiffness
Without immediate treatment, DKA can lead to diabetic coma and death. Diabetes is the seventh leading cause of death in the United States, so getting medical care right away is critical if you have symptoms of DKA.
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