Hyperglycemia in diabetes
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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.
Hyperglycemia doesn’t cause symptoms until glucose values are significantly elevated — usually above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 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 sugar levels.
Recognizing early signs and symptoms of hyperglycemia can help you treat the condition promptly. Watch for:
If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include:
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.
Many factors can contribute to hyperglycemia, including:
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.
Keeping tight control of your blood sugar can help prevent many diabetes-related complications. Long-term complications of untreated hyperglycemia can include:
If blood sugar rises high enough or for a prolonged period of time, it can lead to two serious conditions.
Diabetic ketoacidosis. Diabetic ketoacidosis develops when you don’t have enough insulin in your body. When this happens, sugar (glucose) can’t enter your cells for energy. Your blood sugar level rises, and your body begins to break down fat for energy.
This process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually “spill over” into the urine. Left untreated, diabetic ketoacidosis can lead to a diabetic coma and be life-threatening.
Hyperglycemic hyperosmolar state. This condition occurs when people produce insulin, but it doesn’t work properly. Blood glucose levels may become very high — greater than 600 mg/dL (33 mmol/L). Because insulin is present but not working properly, the body can’t use either glucose or fat for energy.
Glucose is then spilled into the urine, causing increased urination. Left untreated, diabetic hyperglycemic hyperosmolar state can lead to life-threatening dehydration and coma. Prompt medical care is essential.
The following suggestions can help keep your blood sugar within your target range:
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Hyperglycemia in diabetes
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