Hyperglycemia in diabetes
Hyperglycemia in diabetes
High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia, including food and physical activity choices, illness, or not taking enough glucose-lowering medication.
Hyperglycemia causes symptoms — such as increased thirst, urination and fatigue — when blood sugar (glucose) values are significantly elevated. In many cases you can treat such elevations on your own through steps such as adjusting your medications or the foods you eat.
It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications, such as diabetic ketoacidosis, hyperosmolar syndrome and diabetic coma. These conditions require emergency medical assistance. In the long term, persistent hyperglycemia, even if not severe can lead to diabetes related complications affecting your eyes, kidneys, nerves and heart.
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.
Early signs and symptoms
Later signs and symptoms
When to see a doctor
Make an appointment with your doctor if:
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.
For people with diabetes, the effects of insulin on your body are drastically diminished, either because your pancreas doesn't 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 and may reach dangerously high levels (hyperglycemia) if not treated properly. Insulin or other drugs are used to lower blood sugar levels.
Factors that contribute to hyperglycemia
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.
Preparing for your appointment
If you have trouble keeping your blood sugar within the desired range, schedule an appointment to see your doctor. He or she can help you make changes to better manage your diabetes.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
For hyperglycemia, questions you may want to ask include:
Sick day planning
Tests and diagnosis
Your doctor sets your target blood sugar range. For many people who have diabetes, target levels are:
Your target blood sugar range may differ, especially if you're pregnant or you develop diabetes complications. Your target blood sugar range may change as you get older, too. Sometimes reaching your target blood sugar range is a challenge. But the closer you get, the better you'll feel.
Home blood sugar monitoring
If you have any signs or symptoms of severe hyperglycemia — even if they're subtle — check your blood sugar level. If your blood sugar level is 240 mg/dL (13 mmol/L) or above, use an over-the-counter urine ketones test kit. If the urine test is positive, your body may have started making the changes that can lead to diabetic ketoacidosis. You'll need your doctor's help to safely lower your blood sugar level.
Glycated hemoglobin (A1C) test
An A1C level of 7 percent or less means that your treatment plan is working and that your blood sugar was consistently within the normal range. If your A1C level is higher than 7 percent, your blood sugar, on average, was above the normal range. In this case, your doctor may recommend a change in your diabetes treatment plan.
Keep in mind that the normal range for A1C results may vary somewhat among labs. If you consult a new doctor or use a different lab, it's important to consider this possible variation when interpreting your A1C test results.
How often you need the A1C test depends on the type of diabetes you have and how well you're managing your blood sugar. Most people with diabetes, however, receive this test between two and four times a year.
Treatments and drugs
Emergency treatment for severe hyperglycemia
As your body chemistry returns to normal, your doctor considers 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.
The following suggestions can help keep your blood sugar within your target range:
Last Updated: 2010-03-23
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