About hyperglycemia

What is hyperglycemia?

High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.

It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.



What are the symptoms for hyperglycemia?

Nausea symptom was found in the hyperglycemia condition

Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars.

Early signs and symptoms

Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for:

  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Fatigue
  • Headache

Later signs and symptoms

If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include:

  • Fruity-smelling breath
  • Nausea and vomiting
  • Shortness of breath
  • Dry mouth
  • Weakness
  • Confusion
  • Coma
  • Abdominal pain

When to see a doctor

Call 911 or emergency medical assistance if:

  • You're sick and can't keep any food or fluids down, and
  • Your blood glucose levels are persistently above 240 mg/dL (13 mmol/L) and you have ketones in your urine

Make an appointment with your doctor if:

  • You experience ongoing diarrhea or vomiting, but you're able to take some foods or drinks
  • You have a fever that lasts more than 24 hours
  • Your blood glucose is more than 240 mg/dL (13 mmol/L) even though you've taken your diabetes medication
  • You have trouble keeping your blood glucose within the desired range



What are the causes for hyperglycemia?

During digestion, your body breaks down carbohydrates from foods — such as bread, rice and pasta — into various sugar molecules. One of these sugar molecules is glucose, a main energy source for your body. Glucose is absorbed directly into your bloodstream after you eat, but it can't enter the cells of most of your tissues without the help of insulin — a hormone secreted by your pancreas.

When the level of glucose in your blood rises, it signals your pancreas to release insulin. The insulin, in turn, unlocks your cells so that glucose can enter and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen.

This process lowers the amount of glucose in your bloodstream and prevents it from reaching dangerously high levels. As your blood sugar level returns to normal, so does the secretion of insulin from your pancreas.

Diabetes drastically diminishes the effects of insulin on your body, either because your pancreas is unable to produce enough insulin (type 1 diabetes) or because your body is resistant to the effects of insulin or doesn't produce enough insulin to maintain a normal glucose level (type 2 diabetes). As a result, glucose tends to build up in your bloodstream (hyperglycemia) and may reach dangerously high levels if not treated properly. Insulin or other drugs are used to lower blood sugar levels.

Factors that contribute to hyperglycemia

Many factors can contribute to hyperglycemia, including:

  • Not using enough insulin or oral diabetes medication
  • Not injecting insulin properly or using expired insulin
  • Not following your diabetes eating plan
  • Being inactive
  • Having an illness or infection
  • Using certain medications, such as steroids
  • Being injured or having surgery
  • Experiencing emotional stress, such as family conflict or workplace challenges

Illness or stress can trigger hyperglycemia because hormones produced to combat illness or stress can also cause your blood sugar to rise. Even people who don't have diabetes may develop hyperglycemia during severe illness. But people with diabetes may need to take extra diabetes medication to keep blood glucose near normal during illness or stress.



What are the treatments for hyperglycemia?

Home treatment

Talk to your doctor about managing your blood sugar and understand how different treatments can help keep your glucose levels within your goal range. Your doctor may suggest the following treatments:

  • Get physical. Regular exercise is often an effective way to control your blood sugar. However, don't exercise if ketones are present in your urine. This can drive your blood sugar even higher.
  • Take your medication as directed. If you have frequent episodes of hyperglycemia, your doctor may adjust the dosage or timing of your medication.
  • Follow your diabetes eating plan. It helps to eat less and avoid sugary beverages. If you're having trouble sticking to your meal plan, ask your doctor or dietitian for help.
  • Check your blood sugar. Monitor your blood glucose as directed by your doctor. Check more frequently if you're ill or you're concerned about severe hyperglycemia or hypoglycemia.
  • Adjust your insulin doses to control hyperglycemia. Adjustments to your insulin program or a supplement of short-acting insulin can help control hyperglycemia. A supplement is an extra dose of insulin used to help temporarily correct a high blood sugar level. Ask your doctor how often you need an insulin supplement if you have high blood sugar.

Emergency treatment for severe hyperglycemia

If you have signs and symptoms of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome, you may be treated in the emergency room or admitted to the hospital. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes:

  • Fluid replacement. You'll receive fluids — either orally or through a vein (intravenously) — until you're rehydrated. The fluids replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood.
  • Electrolyte replacement. Electrolytes are minerals in your blood that are necessary for your tissues to function properly. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes through your veins to help keep your heart, muscles and nerve cells functioning normally.
  • Insulin therapy. Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you'll receive insulin therapy — usually through a vein.

As your body chemistry returns to normal, your doctor will consider what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional treatment.

If your doctor suspects a bacterial infection, he or she may prescribe antibiotics. If a heart attack seems possible, your doctor may recommend further evaluation of your heart.



What are the risk factors for hyperglycemia?

Many factors can contribute to hyperglycemia, including:

  • Not using enough insulin or oral diabetes medication
  • Not injecting insulin properly or using expired insulin
  • Not following your diabetes eating plan
  • Being inactive
  • Having an illness or infection
  • Using certain medications, such as steroids
  • Being injured or having surgery
  • Experiencing emotional stress, such as family conflict or workplace challenges

Illness or stress can trigger hyperglycemia because hormones produced to combat illness or stress can also cause your blood sugar to rise. Even people who don't have diabetes may develop transient hyperglycemia during severe illness. But people with diabetes may need to take extra diabetes medication to keep blood glucose near normal during illness or stress.



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