Hyperglycemia. This reference summary helps you better understand hyperglycemia. It discusses symptoms, causes, treatment and prevention.

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1 Hyperglycemia Introduction Hyperglycemia is high blood sugar. Several factors can cause hyperglycemia in people with diabetes. People who do not have diabetes may develop hyperglycemia during a severe illness. If left untreated, hyperglycemia can become severe. It can lead to serious complications requiring emergency care. Long term hyperglycemia, even if not severe, can also lead to complications. It can harm your eyes, kidneys, nerves and heart. This reference summary helps you better understand hyperglycemia. It discusses symptoms, causes, treatment and prevention. Blood Sugar and Diabetes The body is made of millions of cells that need energy to work. The food we eat is turned into sugar, called glucose. The body also uses hormones to make glucose in the liver and muscles. Glucose is one of the most important substances the cells need to make energy. It is the body's main fuel source. All parts of the body need glucose to work normally, especially the brain. The brain can be damaged very fast if it does not get the glucose it needs. The blood carries glucose to all of the cells in the body. For glucose to enter a cell, 2 conditions must be present. 1. The cell must have enough doors, called receptors. 2. A substance called insulin unlocks the receptors. 1

2 With enough receptors and enough insulin available, glucose enters the cell and is used to make energy. Without energy, all cells die. Insulin is a chemical hormone the pancreas makes. In a person without diabetes, insulin levels in the blood change depending on how much glucose is in the blood. Diabetes is a common condition that affects millions of people every year. It is a disease that makes it hard for cells to get the glucose they need to make energy. When glucose cannot get into the cells, it collects in the blood. This leads to hyperglycemia. Lab tests can measure the level of sugar in the blood. There are two types of diabetes: 1. Type 1 diabetes happens when the body does not make insulin. 2. Type 2 diabetes happens when the body makes insulin, but in spite of this, cells are unable to use glucose. In type 1 diabetes, the body s immune system attacks and destroys the pancreatic cells that make insulin. Therefore, people with type 1 diabetes do not have enough insulin in their bodies, which causes their blood sugar to get extremely high. Type 1 diabetes is most common in children and young adults and can occur at any age. Diabetes is not contagious. Type 2 diabetes is when a body has enough insulin, but there are not enough receptors on the cells to allow glucose to enter. This results in high levels of glucose in the blood because it cannot enter the cells. Symptoms Hyperglycemia does not cause symptoms until glucose levels are much higher than normal. Hyperglycemia develops slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. Symptoms of hyperglycemia include: Blurry vision. Dry, itchy skin. Fatigue or drowsiness. 2

3 Frequent urination. Headache. Increased thirst and dry mouth. Weight loss and increased appetite. Causes Some factors increase blood sugar levels in people with diabetes. These include: Eating food high in carbohydrates. Not making enough insulin. Stress. Low levels of exercise. Infection, illness or surgery. People who do not have diabetes may develop hyperglycemia during a severe illness. People with diabetes may need to take extra diabetes medicine to keep blood glucose near normal during illness or stress. Complications If hyperglycemia is not recognized or treated for several years, it can cause problems. Even mild hyperglycemia can harm the brain, kidneys and arteries. Severe hyperglycemia could lead to dehydration. Other symptoms may develop, such as: Difficulty breathing. Dizziness upon standing. Increased drowsiness and confusion. Rapid weight loss. Unconsciousness or coma. Dehydration is a condition caused by the loss of too much water from the body. If hyperglycemia goes untreated, it can cause ketoacidosis. This is a condition caused by toxic acids known as ketones. It causes ketones to build up in your blood and urine. 3

4 Ketoacidosis is also known as diabetic ketoacidosis or diabetic coma. Ketoacidosis happens because the body cannot make glucose into fuel. The body instead breaks down fats to use for energy. When the body breaks down fat, ketones are made as byproducts. Signs and symptoms of ketoacidosis are: Abdominal pain. Coma. Confusion. Dry mouth. Fruity smelling breath. Nausea and vomiting. Shortness of breath. Weakness. Diabetic hyperosmolar syndrome is another severe complication. It happens when the body makes insulin, but it does not work properly. Blood glucose levels may become very high. Because insulin is present but not working properly, the body cannot use glucose or fat for energy. The unused glucose is present in the urine. This causes increased urination. If it is not treated, diabetic hyperosmolar syndrome can lead to coma and life threatening dehydration. Untreated hyperglycemia can also cause long term complications, including: Bone and joint problems. Cataracts. Damage to the blood vessels of the retina. Foot problems caused by damaged nerves or poor blood flow. Cataracts are clouding of the lens of your eye. The lens is normally clear. The retina changes light signals into electrical signals. These electrical signals are sent through the optic nerve to the brain. The brain translates these signals into the images we see. 4

5 Other complications of hyperglycemia include: Heart disease. Kidney and nerve damage. Skin problems, including infections and wounds that do not heal. Tooth and gum infections. Diagnosis To diagnose hyperglycemia, your health care provider will perform a physical exam. He or she will ask questions about your medical history and your symptoms. If your health care provider suspects hyperglycemia, he or she will conduct a blood test to check your blood sugar level. An A1C test can be used to check your average blood sugar level for the past two to three months. Prevention and Treatment To prevent hyperglycemia, talk to your health care provider about managing your blood sugar. Different treatments can help keep your glucose levels within your goal range. Your health care provider sets your target blood sugar range. Your target blood sugar range may differ if you are pregnant. It may change as you get older, too. Monitor your blood sugar with a blood glucose meter. This is the best way to be sure that your treatment plan is keeping your blood sugar in your goal range. Check your blood sugar as often as your health care provider recommends. To prevent and treat hyperglycemia, your health care provider may suggest the following: Exercise. Medicine. A diabetes eating plan. Adjusting your insulin to control hyperglycemia. Regular exercise is often an effective way to control your blood sugar. But you should not exercise if ketones are present in your urine. This can drive your blood sugar even higher. 5

6 Your health care provider may adjust the dose or timing of your medication if you have frequent episodes of hyperglycemia. If you have diabetes, you should avoid beverages and foods with sugar. If you're having trouble sticking to your diabetes meal plan, ask your health care provider or dietitian for help. Monitor your blood glucose as directed by your health care provider. Check more frequently if you are ill or stressed. Watch your levels if you are concerned about severe hyperglycemia or low blood sugar, also known as hypoglycemia. Adjusting your insulin program or taking an extra dose of short acting insulin can help control hyperglycemia. The extra dose is used to help temporarily correct a high blood sugar level. Seek medical care if you have very high blood sugar. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes: Fluid replacement. Electrolyte replacement. Insulin therapy. Electrolytes are minerals in your blood that carry an electrical charge. You will receive fluids either orally or intravenously until you are rehydrated. Intravenously means through a vein. The fluids replace those you have lost through increased urination. They also help manage the excess sugar in your blood. Not having enough insulin in your blood can lower the level of electrolytes. You will receive electrolytes through your veins to help keep your heart, muscles and nerve cells working normally. Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you will receive insulin therapy, usually through a vein. Your health care provider will consider what may have triggered the severe hyperglycemia. Depending on the cause, you may need additional treatment. 6

7 Summary Hyperglycemia is high blood sugar. Several factors can cause hyperglycemia in people with diabetes. It could be caused by food, lack of exercise or illness. It could also be caused by certain medications or not taking enough glucose-lowering drugs. Symptoms of hyperglycemia include: Blurry vision. Dry, itchy skin. Fatigue or drowsiness. Frequent urination. Headache. Increased thirst and dry mouth. Weight loss and increased appetite. If left untreated, hyperglycemia can become severe. It can lead to serious complications requiring emergency care. Long term hyperglycemia, even if not severe, can also lead to complications. It can harm your eyes, kidneys, nerves and heart. Talk to your health care provider about managing your blood sugar. Different treatments can help keep your glucose levels within your goal range. 7