HYPERGLYCEMIA

What is Hyperglycemia?

Hyperglycemia, or high blood glucose (sugar), is a serious health problem for those with diabetes. Hyperglycemia develops when there is too much sugar in the blood. In people with diabetes, there are two specific types of hyperglycemia that occur:

* Fasting hyperglycemia is defined as a blood sugar greater than 90-130 mg/dL (milligrams per deciliter) after fasting for at least 8 hours.

* Postprandial or after-meal hyperglycemia is defined as a blood sugar usually greater than 180 mg/dL. In people without diabetes postprandial or post-meal sugars rarely go over 140 mg/dL but occasionally, after a large meal, a 1-2 hour post-meal glucose level can reach 180 mg/dL. Consistently elevated high post-meal glucose levels can be an indicator that a person is at high risk for developing type 2 diabetes

When a person with diabetes has hyperglycemia frequently or for long periods of time as indicated by a high HbA1c blood test, damage to nerves, blood vessels and other body organs can occur. Hyperglycemia can also lead to more serious conditions, including ketoacidosis -- mostly in people with type 1 diabetes -- and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) in people with type 2 diabetes or in people at risk for type 2 diabetes.

It's important to treat the symptoms of hyperglycemia promptly to prevent complications from diabetes.




What Causes Hyperglycemia in Diabetes?

Hyperglycemia in diabetes may be caused by:

* Skipping or forgetting your insulin or oral glucose-lowering medicine

* Eating too many grams of carbohydrates for the amount of insulin administered or just eating too many grams of carbohydrates in general

* Eating too much food and having too may calories

* Infection

* Illness

* Increased stress

* Decreased activity or exercising less than usual

* Strenuous physical activity

What Are the Symptoms of Hyperglycemia in Diabetes?

It is important to know the early signs of hyperglycemia. If hyperglycemia is left untreated, it may develop into an emergency condition called ketoacidosis (if you have type 1 diabetes) or HHNS (if you have type 2 diabetes).

Early signs of hyperglycemia in diabetes include:

* Increased thirst

* Headaches

* Difficulty concentrating

* Blurred vision

* Frequent urination

* Fatigue (weak, tired feeling)

* Weight loss

* Blood glucose more than 180 mg/dL

Prolonged hyperglycemia in diabetes may result in:

* Vaginal and skin infections

* Slow-healing cuts and sores

* Decreased vision

* Nerve damage causing painful cold or insensitive feet, loss of hair on the lower extremities, and/or erectile dysfunction

* Stomach and intestinal problems such as chronic constipation or diarrhea





How Is Hyperglycemia in Diabetes Treated?

If you have diabetes and have any of the early signs of hyperglycemia, be sure to test your blood glucose several times. You will need to have a record of several blood glucose readings before you call your health care provider. He or she may recommend the following changes:

* Drink more water. Water helps remove the excess glucose from your urine and helps you avoid dehydration.

* Exercise more. Exercise will help to lower your blood glucose. Caution: If you have type 1 diabetes and your blood glucose is over 240 mg/dL, you need to check your urine for ketones. When you have ketones, do NOT exercise. If you have type 2 diabetes and your blood glucose is over 300 mg/dL, even without ketones, do NOT exercise.

* Change your eating habits. You may need to meet with the dietitian to change the amount and types of foods you are eating.

* Change your medications. Your health care provider may change the amount, timing, or type of diabetes medications you take. Do not make adjustments in your diabetes medications without first talking with your health care provider.

If you have type 1 diabetes and your blood glucose is more than 250 mg/dL, your doctor may want you to test your urine or blood for ketones.

Call your doctor if your blood glucose is consistently greater than 180 mg/dL 1-2 hours after a meal or if you have two consecutive readings greater than 300 mg/dL.

How Can Hyperglycemia in Diabetes Be Prevented?

Make sure you are following your meal plan, exercise program and medicine schedule.

* Know your diet, count the total amounts of carbohydrate that you are consuming

* Test your blood glucose regularly.

* Know when to contact your health care provider if you have repeated abnormal blood glucose readings.

* Make sure you always wear medical identification that states you have diabetes so you can receive proper treatment in the event of an emergency.