Hyperglycemia in diabetes

Description

High blood sugar, also called hyperglycemia, which affects people who have diabetes. Several factors may play a role in the hyperglycemia in people with diabetes. These include the food and physical activity, illness, and medications not related to diabetes. Skipping doses or not taking sufficient amount of insulin or other medications to reduce the sugar in the blood can also lead to hyperglycemia.

It is important for the treatment of hyperglycemia. If not treated, hyperglycemia can become severe and cause serious health problems that require emergency care, including a diabetic coma. The hyperglycemia that lasts, even if it is not severe, it can lead to health problems that affect the eyes, kidneys, nerves, and heart.

Symptoms

The hyperglycemia usually notn not cause symptoms until the blood sugar (glucose) levels are high — above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 11.1 millimoles per liter (mmol/L).

The symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar lev- els stay high, the more serious symptoms can become. But some people who have had type 2 diabetes for a long time may not show any symptoms despite high levels of sugar in the blood.

The first signs and symptoms

Recognize the early symptoms of hyperglycemia can help to identify and treat immediately. Observe:

  • Frequent need to urinate
  • Increased thirst
  • Blurred vision
  • A feeling of weakness or unusually tired

Later, the signs and symptoms

If hyperglycemia is not treated, it can cause toxic acids, called ketones, build up in the blood and in the urine. This condition is called ketoacidosis. The symptoms include:

  • Fruity odor on the breath
  • Dry mouth
  • Abdominal Pain
  • Nausea and vomiting
  • Shortness of breath
  • The confusion
  • Loss of consciousness

When to see a doctor

Seek immediate help from your health care provider or call 911 if:

  • You have ongoing diarrhea or vomiting, and you can't keep any food or liquid
  • Your blood glucose levels stay above 240 milligrams per deciliter (mg/dL) (13.3 millimoles per liter (mmol/L)) and has the symptoms of the presence of ketones in your urine

Causes

During digestion, the body breaks down carbohydrates from foods such as bread, rice and pasta — in sugar molecules. One of the molecules of a sugar called glucose. It is one of the main sources of energy. The glucose is absorbed and passes directly into the bloodstream after eating, but can't enter the cells of most tissues of the body without the help of insulin. Insulin is a hormone made by the pancreas.

When the level of glucose in the blood rises, the pancreas releases insulin. Insulin unlocks the cells so that the glucose can enter. This provides the fuel that the cells need to function properly. Excess glucose is stored in the liver and muscles.

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

Diabetes dramatically reduces the effects of insulin in the body. This may be because the pancreas is unable to produce insulin, as in type 1 diabetes. Or it may be because your body is resistant to the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels, as in type 2 diabetes.

In people who have diabetes, the glucose tends to accumulate in the bloodstream. This condition is known as hyperglycemia. You can reach dangerously high levels if it is not treated properly. Insulin and other medications are used to reduce the levels of sugar in the blood.

Risk factors

Many factors can contribute to hyperglycemia, including:

  • Not using enough insulin or other medicines for diabetes
  • Do not inject insulin properly, or the use of insulin expired
  • Do not follow your meal plan for diabetes
  • Be inactive
  • You have a disease or infection
  • The use of certain medications, such as steroids or immunosuppressive
  • Being injured or have surgery
  • Experience the emotionof stress, such as family problems or problems of the place of work

Illness or stress can lead to hyperglycemia. This is due to the hormones that the body produces to fight the illness or stress can also cause the blood sugar to rise. You may need to take more medicine for diabetes keep in blood glucose in the target range during illness or stress.

Complications

The long-term complications

Keep your blood sugar in a healthy range can help to prevent many of the complications associated with diabetes. The long-term complications of hyperglycemia that is not include:

  • Cardiovascular disease
  • Damage to the nerves (neuropathy).
  • Kidney damage (diabetic nephropathy) or renal failure
  • Damage to the blood vessels of the retina (diabetic retinopathy), which might lead to blindness
  • Feet of the problems caused by nerve damage or poor blood flow that can lead to serious infections of the skin, ulceration, and, in some severe cases, amputation
  • Bone and joint problems
  • Teeth and gum infections

Emergency complications

If the blood sugar rises too high or if the high levels of sugar is not treated, it can lead to two severe conditions.

  • Diabetic ketoacidosis.This condition develops when you do not have enough insulin in your body. When this happens, the glucose cannot enter the cells for energy. Your blood sugar level rises, and your body begins to down fat for energy. When fat is broken down for energy in the body, it produces toxic acids called ketones. Ketones accumulate in the blood and eventually spill into the urine. If left untreated, diabetic ketoacidosis can lead to a diabetic coma which can be fatal.
  • Hyperosmolar hyperglycemic state.This condition occurs when the body produces insulin, but the insulin does not work properly. Blood glucose levels may become very high — more than 600 milligrams per deciliter (mg/dL), (33.3 millimoles per liter (mmol/L) without ketoacidosis. If you develop this condition, your body can't use glucose or fat for energy. The glucose then enters into the urine, causing increased urination. If left untreated, diabetic hyperosmolar hyperglycemic state may lead to life-threatening dehydration and coma. It is very important to get immediate medical attention.

Diabetic ketoacidosis. This condition develops when you do not have enough insulin in your body. When this happens, the glucose cannot enter the cells for energy. Your blood sugar level rises, and your body begins to break down fat for energy.

When fat is broken down for energy in the body, it produces toxic acids called ketones. Ketones accumulate in the blood and eventually spill into the urine. If he isn't treated, diabetic ketoacidosis can lead to a diabetic coma which can be fatal.

Hyperosmolar hyperglycemic state. This condition occurs when the body produces insulin, but the insulin does not work properly. Blood glucose levels may become very high — more than 600 milligrams per deciliter (mg/dL), (33.3 millimoles per liter (mmol/L) without ketoacidosis. If you develop this condition, your body can't use glucose or fat for energy.

The glucose then enters into the urine, causing increased urinetion. If left untreated, diabetic hyperosmolar hyperglycemic state may lead to life-threatening dehydration and coma. It is very important to get immediate medical attention.

Prevention

To help keep your blood sugar within a healthy range:

  • Follow your meal plan for diabetes. If you take insulin or oral medications for diabetes, to be consistent with respect to the amount and frequency of your meals and snacks. The foods you eat should be in balance with the insulin working in your body.
  • Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Note when your glucose readings abofive or below your target range.
  • Carefully follow your doctor's instructions on how to take your medication.
  • Adjust medication if you change your physical activity. The setting depends on your blood sugar test results and on the type and the length of the activity. If you have any questions about this, talk to your health care provider.

Hyperglycemia in diabetes

Diagnosis

Your health care provider will set your target blood sugar range. For many people who have diabetes, the Mayo Clinic generally recommends the following target blood sugar levels before meals:

  • Between 80 and 120 milligrams per deciliter (c) (4.4 6.7 millimoles per liter (mmol/L)) to persons of the age of 59 years and younger who do not have medical conditions other than diabetes
  • Between 100 and 1of 40 mg/dL (5.6 to 7.8 mmol/L) to: People 60 years and olderThose who have other medical conditions, such as heart, lung or kidney diseasePeople who have a history of low blood sugar (hypoglycemia), or who have difficulty recognizing the symptoms of hypoglyce- mia
  • For people 60 years and over
  • Those who have other medical conditions, such as heart, lung or kidney
  • People who have a history of low blood sugar (hypoglycemia), or who have difficulty recognizing the symptoms of hypoglycemia
  • For people 60 years and over
  • Those who have other medical conditions, such as heart, lung or kidney
  • People who have a history of low blood sugar (hypoglycemia), or who have difficulty recognizing the symptoms of hypoglycemia

For many people who have diabetes, the American Diabetis the Association generally recommends the following target blood sugar levels:

  • Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals
  • Less than 180 mg/dL (10 mmol/L) two hours after meals

Your target blood sugar range can vary, especially if you are pregnant or have other health problems that are caused by diabetes. Your target blood sugar range can change as you get older. At times, arriving to your destination of sugar in the blood can be a challenge.

Home blood sugar monitoring

Routine monitoring of blood sugar with a blood glucose meter is the best way to be sure that your treatment plan is to keep your blood sugar within your target range. Check your blood sugar as often as your doctor recommends.

If you have any of the symptoms of severe hyperglycemia — even if they seem minor — check your blood sugar level immediately.

If your blood sugar level is 240 mg/dL (13.3 mmol/L) or above, the use of over-the-counter test kit of ketones in the urine. If the urine test is positive, your body may have started to make changes that can lead to diabetic ketoacidosis. Talk with your health care provider about how to lower your blood sugar level safely.

Hemoglobin A1C test

During the appointment, the doctor may perform an A1C test. This blood test shows the average of blood sugar level over the past 2 to 3 months. It works by measuring the percentage of blood sugar attached to the oxygen-carrying protein in the red blood cells called hemoglobin.

An A1C level of 7% or less means that your treatment plan is working and that your blood sugar was consistently within a healthy range. If your A1C level is above 7%, the sugar in the blood, on average, above a healthy range. In this case, your health care provider may recommend a change in your treatment plan for diabetes.

For some people, especially older adults and people with certain medical conditions, a higher level of A1C of 8% or more, may be appropriate.

How often you need the A1C test depends on the type of diabetes you have and how well you are managing your blood sugar. The majority of peoplewith diabetes receive this proof of 2 to 4 times a year.

Treatment

Treatment in the home

Talk with your health care provider about how to manage your blood sugar. Understanding how the different treatments that can help keep your blood glucose levels within your target range. Your health care provider may suggest the following:

  • The physical. Regular exercise is often an effective way to control sugar in the blood. But do not exercise if you have ketones in the urine. This can lead to your blood sugar even more.
  • Take your medicine as directed. If you develop hyperglycemia often, your doctor may adjust the dose or the duration of the medication.
  • Follow your diabetes meal plan. It helps to eat smaller portions and avoid sugary drinks and snacks frequent. If you are having trouble sticking to your meal plan, ask your doctor or a dietician for help.
  • Check your blood sugar. Monitor your blood glucose as directed by your health care provider. Check more often if you are ill or if you are concerned about the severe hyperglycemia or hypoglycemia.
  • To adjust your dose of insulin. Changes to the programs of insulin or a supplement of short-acting insulin can help control hyperglycemia. A supplement is an extra dose of insulin to help temporarily correct a high blood sugar level. Askr health care provider how often you need a supplement of insulin if you have high blood sugar.

Emergency treatment for severe hyperglycemia

If you have signs and symptoms of diabetic ketoacidosis or hyperosmolar hyperglycemic state may be treated in the emergency room or in the hospital. (4p4) Emergency treatment can reduce the blood sugar in a normal range. Generally, treatment includes:

  • Fluid replacement. You will receive fluids — usually through a vein (intravenously) — until the body has the fluids that you need. This replaces the fluids that have been lost through the urine. It also helps to dilute the excess sugar in the blood.
  • The replacement of electrolytes. Electrolytes are minerals in the blood that are necessary for their tissues to work properly. A lack of insulin may reduce the level of electrolytes in the blood. You will receive electrolytes through the veins to help keep your heart, muscles and nerve cells work the way they should.
  • The insulin therapy. Insulin reverses the processes that cause ketones to build in his blood. Along with fluids and electrolytes, you will receive the therapy of insulin — usually through a vein.

As your body returns to normal, your doctor will take into account what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional tests and treatment.

Preparing for your appointment

If you have trouble keeping your blood sugar within your target range, to schedule an appointment to see your health care provider. Your provider can help you make changes to the better to manage your diabetes.

Here is the information to help you prepare for your appointment and know what to expect from your health care provider.

What you can do

  • Be aware of any pre-appointment restrictions. If your health care provider will test your blood sugar, you may need to stop eating or drinking anything, but water for up to eight hours before your appointment. When you are making an appointment, ask if there are any restrictions on eating or drinking.
  • Write down key personal information,such asng of any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking.
  • Create a log of the glucose values. Give your health care provider a written or printed record of your blood glucose values, and times, and medication. Using the registry, your health care provider can recognize trends and offer advice on how to prevent hyperglycemia or adjust your medication for the treatment of hyperglycemia.
  • Write questions to ask their health care provider. If you need more information about your diabetes management, be sure to ask.
  • Check if you need doctor's prescription. Your health care provider may renew your prescriptions while you're at the appointment.

For hyperglycemia, the questions that you can ask iincludes:

  • How often do I have to control my blood sugar?
  • What is my target range?
  • How diet and exercise affect my blood sugar?
  • When I do the test for ketones?
  • How can I prevent high blood sugar?
  • Do I need to worry about low blood sugar? What are the symptoms I should watch for?
  • I'm going to need follow-up care?

Sick-day planning

Diseases or infections that can cause your blood sugar to increase, so it is important to plan for these situations. Talk with your health care provider about the creation of a plan for when you are sick. Questions include:

  • How often should I check my blood sugar when I'm sick?
  • Do my injection of insulin or oral diabetes pill dosage change when I'm sick?
  • When should I test for ketones?
  • What if I can't eat or drink?
  • When should I seek medical help?
Symptoms and treatment of Hyperglycemia in diabetes