Hyperglycemia (high blood sugar) occurs when your body doesn’t have enough insulin or can’t use insulin properly. High blood sugar is a major cause of diabetes complications.
Early symptoms of high blood sugar include:
- increased thirst
- frequent urination
- blurry vision
The best way to avoid hyperglycemia is to check your blood sugar often. Treating high blood sugar may involve exercising regularly or making changes to your diet or medication regimen. If left untreated, high blood sugar can turn into a diabetic emergency. Extremely high blood sugar levels can lead to Diabetic Ketoacidosis (DKA) or Hyperosmolar Hyperglycemic State (HHS).
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Diabetic Ketoacidosis (DKA)
Ketoacidosis (or DKA) occurs when blood sugars become elevated (over 249 mg/dl, or 13.9 mmol/l) over a period of time and the body begins to burn fat for energy, resulting in ketone bodies in the blood or urine (a phenomenon called ketosis). A variety of factors can cause hyperglycemia (high blood glucose), including failure to take medication or insulin, stress, dietary changes without medication adjustments, eating disorders, and illness or injury. This last cause is important, because if illness brings on DKA, it may slip by unnoticed since its symptoms can mimic the flu (aches, vomiting, etc.). In fact, people with type 1 diabetes are often seeking help for the flu-like symptoms of DKA when they first receive their diagnosis.
Symptoms of diabetic ketoacidosis may include:
- Fruity (acetone) breath
- Nausea and/or vomiting
- Abdominal pain
- Dry, warm skin
- Breathing problems
- Excessive thirst
- Frequent urination
- In extreme cases, loss of consciousness
DKA is a medical emergency, and requires prompt and immediately treatment. A simple over-the-counter urine dipstick test can check for ketones (i.e., Ketostix); anyone who has blood glucose levels above 240 mg/dl (13.3 mmol/l) should test their urine for ketones. There is also at least one glucose meter on the market that tests blood ketone levels. It’s normal to occasionally have trace amounts of ketones in the urine, but you should call your healthcare provider immediately if you experience moderate to heavy ketones. Treatment for DKA involves administering insulin to lower blood glucose levels and restoring fluid balance to the bloodstream with an intravenous (IV) saline drip. Electrolytes may also be given via IV.
Hyperglycemic Hyperosmolar Syndrome (HHS)
Hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes that can occur when blood glucose levels exceed 600 mg/dl (33.3 mmol/l), but ketosis (ketone bodies in the blood) is small or not present. With such high blood sugars, the body becomes severely dehydrated. HHS occurs most often in the elderly, who are either newly diagnosed with diabetes or are unaware of having high blood glucose levels, and those who are not able to tell they are thirsty (impaired thirst mechanism). If you or a loved one are elderly or have a decreased thirst mechanism, it is important to always have water within reach and to drink plenty of fluids. Impaired kidney function and infections are also risk factors.
HHS is a life-threatening condition. If you experience any of the following symptoms of the syndrome, seek emergency medical care immediately:
- Excessive thirst
- Disorientation and confusion
- Sudden hypotension, or low blood pressure (as evidenced by faintness, or dizziness when changing positions, especially lying or sitting to standing up)
- Visual problems
- Extreme, unexplained fatigue
- In advanced cases, coma, seizure, and/or hemiplegia (paralysis on one side of the body)
Treatment for HHS involves administering intravenous fluids (i.e., saline and sometimes electrolyte solutions) to restore fluid balance. Insulin therapy may also be required.
Over time, high blood sugar can cause damage to the vessels that supply blood to vital organs. This can increase the risk of heart disease and stroke, kidney disease, vision problems, nerve problems, and other health problems in people with diabetes.
A single high blood sugar reading usually isn’t cause for alarm. It happens to everyone with diabetes from time to time. However, if you’re having high blood sugar levels a lot, let your diabetes health care team know. Extremely high blood sugar levels can lead to an emergency such as DKA (diabetic ketoacidosis) or hyperglycemic hyperosmolar syndrome (HHS, previously known as hyperglycemic hyperosmolar nonketotic state [HHNS] or hyperosmolar nonketotic coma [HHNC]). Learn to recognize the signs and symptoms of blood sugar highs and treat them early to prevent emergencies.
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