Health Topics for Diabetes

Department of Internal Medicine

Diabetes Services

General Endocrinology and Diabetes Services

Hyperglycemia

Hyperglycemia means high blood sugar or high glucose in the blood. When food is eaten, it breaks down into sugar. The sugar is carried by the bloodstream to the cells. The pancreas gland makes insulin. The body uses the insulin to help move the sugar into the cells. The cells use the sugar as energy.

Hyperglycemia (high blood sugar) happens when the body does not make enough insulin. This leaves extra sugar in the blood stream. It may occur if a diabetic has not taken enough insulin for the food they have eaten or they have eaten the wrong type or amount of food. It can also be caused by lack of exercise, increased stress, illness, or new medications.

The symptoms of hyperglycemia are increased thirst and hunger; frequent or increased urination, blurry vision, high blood sugar, and high levels of sugar (glucose) in the urine. Hyperglycemia can also happen to someone who does not even know they have diabetes. The undiagnosed diabetic may feel tired or fatigued, have unexplained weight loss, or complain of stomach pain, nausea, or vomiting.

If hyperglycemia is not treated, diabetic ketoacidosis can occur. This condition is also known as DKA or diabetic coma. It is an acute, major, life-threatening complication that usually occurs in type 1 diabetics.

When there is not enough insulin, the body cannot use glucose for fuel. So it breaks down fats. These fats produce ketones when they are broken down. The body tries to get rid of the extra ketones through the urine. But if there are too many, they build up in the bloodstream causing ketoacidosis.

The symptoms of ketoacidosis usually develop slowly. The first symptoms are thirst or very dry mouth, frequent urination, high blood sugar, and high levels of ketones in the blood and urine. As the ketones build up, the symptoms become more severe. But once vomiting occurs, ketoacidosis can occur in a matter of a few hours.

A diabetic will usually seek treatment for some of the symptoms of hyperglycemia before ketoacidosis happens. If not, treatment is needed immediately. Ketoacidosis is an emergency. If any of the following occur, call your healthcare provider immediately or have someone take you to the nearest emergency department:

• shortness of breath (slow, deep breathing with a fruity odor to the breath is a key sign since this characteristic odor is caused by ketones)
• ketones in the urine (urine checks are useful in determining the level of acidosis)
• dry or flushed skin
• nausea, vomiting, or abdominal pain, especially vomiting more than twice in 4 hours with high ketones in the urine and
• confusion with eventual loss of consciousness

Treatment is usually done in a hospital. It may require the administration of IV fluids, insulin, glucose, and changes in diet.

It is important for a diabetic to follow a treatment plan for hyperglycemia. If the blood sugar level is below 250 milligrams and there are no ketones in the urine, exercise may bring the blood sugar down. Anytime the blood sugar is over 250 milligrams the urine should be checked for ketones. When ketones are present in the urine, exercise should be avoided, as it can make the blood sugar go higher.

It will be necessary to change the treatment plan, if a diabetic is unable to control the hyperglycemia. For Type 1 diabetics, that may include changes in diet and exercise, as well as insulin. Type 2 diabetics should be able to be controlled with just diet and exercise. But sometimes oral medications, or even insulin, are needed.

Blood sugar levels need to be monitored daily by all diabetics to prevent hyperglycemia. Any time there is a high blood sugar level, the treatment should be changed to keep it within normal levels. There are many types of blood glucose monitors that can be used at home.

Blood glucose monitoring keeps track of blood sugar results each day. But there is another blood test that should also be used. It is called the glycated hemoglobin test or you may also hear it called A1C or HbA1C. This blood test is drawn in the provider's office. The A1C gives the average blood sugar control for the past 2 to 3 months. It helps you know how well your treatment plan is working. The American Diabetes Association recommends keeping the A1C below 7 percent.

People with diabetes have fewer complications when blood sugar is maintained at a normal level. Long-term complications of uncontrolled hyperglycemia include heart and kidney disease, blindness, stroke, blood flow problems, and nerve damage leading to amputations.

Diabetes is a lifelong disease that requires regular monitoring. Careful attention is required to follow the diabetic treatment plan. Blood sugar levels need to be kept as close to normal as possible. It is important to keep tight blood sugar control. It is also important to know the signs of hyperglycemia so it can be treated quickly. Do not let hyperglycemia get out of hand.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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