Hyperglycemia: symptoms, causes and treatment

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Definition

What is hyperglycemia?

Hyperglycemia is a condition of high blood sugar levels that generally occurs in people with diabetes mellitus. The condition of high blood sugar levels occurs when the body is deficient or unable to use the hormone insulin properly.

Blood sugar that continues to be high and is left unchecked can lead to diabetes complications that require emergency care, such as diabetic ketoacidosis, hyperosmolar hyperglycemia syndrome (HHS), and diabetic coma.

In the long term, hyperglycemia that is left untreated (although not severe) can lead to complications that damage the eyes, kidneys, nerves, and heart.

Some of the factors that contribute to the risk of hyperglycemia in diabetics are an unhealthy lifestyle, use of drugs, stress, or not undergoing diabetes treatment as recommended by a doctor.

However, hyperglycemia is not always associated with diabetes. The condition of a normal rise in blood sugar levels can also occur in people who have malfunctioning of the pancreas or thyroid gland.

Signs & symptoms

What are the signs and symptoms of hyperglycemia?

Hyperglycemia often shows no significant symptoms until blood glucose actually rises to more than 200 mg / dL, or 11 mmol / L. The longer the blood sugar level remains high, the more serious the symptoms will be.

Symptoms of hyperglycemia generally improve slowly over a few days or weeks. However, some people who have had type 2 diabetes for a long time may not show any symptoms even though their blood sugar levels are elevated.

Recognizing the early signs and symptoms of hyperglycemia is the best way to help manage the condition. The following are various symptoms of high blood sugar, namely:

• Urinating frequently
• Increased thirst
• Blurred vision
• Fatigue
• Headache

When should I go to the doctor?

Hyperglycemia can lead to conditions that require emergency medical attention. For that, consult a doctor immediately if you experience any of these things:

• You have persistent diarrhea or vomiting, but can still eat some food or drink.
• You have a fever that lasts more than 24 hours.
• Your blood sugar level is more than 240 mg / dL (13 mmol / L) even after taking diabetes medication.
• You have trouble keeping your blood glucose levels within the desired range.

You should also visit the nearest hospital emergency room immediately if hyperglycemia causes any of these:

• You are sick and you cannot eat food or fluids.
• Your blood glucose level is constantly above 240 mg / dL (13 mmol / L) and you have ketones in your urine.

Cause

What are the causes of hyperglycemia?

The cause of hyperglycemia is the disruption of blood sugar stability which is influenced by disturbances in the production process and function of the insulin hormone.

After eating, the body will break down carbohydrates from food into simpler molecules, namely glucose (blood sugar) as the main source of energy for the body.

Glucose is then absorbed directly into the bloodstream making blood sugar levels rise. The body signals the pancreas to release the hormone insulin to help absorb glucose into the body's cells to be processed into energy.

In this way, insulin helps to keep blood sugar levels within normal limits. However, diabetics will find it difficult to do this process. In type 1 diabetes, the pancreas cannot provide an adequate supply of insulin.

Meanwhile, according to a study published by the American Diabetes Association, the condition of high blood sugar in type 2 diabetes occurs when the liver continues to increase the supply of glucose into the blood, but insulin does not work effectively when it helps the absorption of glucose into the body's cells (insulin resistance).

As a result, glucose will build up in the stream and cause high blood sugar levels.

Risk factors

What are the risk factors for high blood sugar?

Diabetics are very susceptible to hyperglycemia because their bodies do not have enough insulin hormone or cannot use insulin optimally.

In addition to insulin hormone disorders, here are various other factors that can increase the risk of diabetes sufferers developing hyperglycemia, namely:

• Don't take diabetes medication regularly
• Not injecting insulin properly or using expired insulin
• Excessive consumption of high-carbohydrate foods
• Have certain chronic diseases
• Experiencing certain infectious diseases
• Using drugs that cause blood sugar to rise, such as steroids
• Have a wound or are undergoing surgery
• Experiencing emotional stress, such as family conflicts or work challenges

Apart from diabetes, there are several conditions that can increase a person at risk of developing uncontrolled high blood sugar, including:

• Pancreatitis (inflammation of the pancreas) and pancreatic cancer
• Hyperthyroidism (an overactive thyroid gland)
• Cushing's syndrome (an increase in blood cortisol)
• Tumors that produce certain hormones, for example glucagonoma (tumors in the pancreas) and pheochromocytoma (tumors in the cells of the adrenal glands).

Complications

What are the complications of hyperglycemia?

Untreated hyperglycemia can lead to complications of diabetes. In the long term, complications of hyperglycemia that may occur are:

• Cardiovascular disease
• Nerve damage (diabetic neuropathy)
• Kidney damage (diabetic nephropathy) or kidney failure
• Damage to the blood vessels of the retina (diabetic retinopathy), which can lead to blindness
• Diabetic foot
• Bone problems and joint problems
• Skin problems, including bacterial infections, fungal infections and wounds that don't heal
• Tooth and gum infections

The complications of high blood sugar that are not treated properly are very dangerous. There are two complications of hyperglycemia that are very emergency in nature, namely:

1. Diabetic ketoacidosis

Diabetic ketoacidosis occurs when insulin levels in your body are too low and unable to burn excess sugar for energy. As a result, your blood sugar levels rise and your body starts breaking down fat into energy.

This process produces blood acids known as ketones. Excess ketones build up in the blood and can make diabetics urinate continuously so that the body loses a lot of fluids.

2. Nonketotic Hyperosmolar Hyperglycemia

Nonketotic Hyperglycemic Syndrome or also known as HHS occurs when the body produces insulin but does not work properly.

As a result, the body cannot burn fat for energy. This causes blood sugar levels to spike very high — more than 600 mg / dL (33 mmol / L).

As with diabetic ketoacidosis, your body then channels excess high blood sugar into the urine.

HHS can also cause severe dehydration which can lead to life-threatening coma, which requires immediate medical attention.

Diagnosis & Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the usual tests for this condition?

The only way to know if uncontrolled high blood sugar levels are to do a blood sugar test. In diabetic patients, recommended targets for normal blood sugar before meals include:

• Between 80-120 mg / dL (4.4 and 7 mmol / L) for people 59 and younger who have no other underlying medical conditions.
• Between 100-140 mg / dL (6 and 8 mmol / L) for people over 60 and those who have heart, lung, kidney disease, or have had hypoglycemia.

In addition, your doctor will ask you to do an HbA1c test. This test can show your average blood sugar level over the past two or three months.

What are the drug options for hyperglycemia?

If the HbA1c result shows the blood sugar level is above the target, the doctor will change the diabetes treatment plan so that the blood sugar level is not high continuously. These changes can change the type and amount of drug doses and the time of consumption.

In emergency cases, which have caused complications of hyperglycemia such as diabetic ketoacidosis and HHS, you may need to undergo treatment in the hospital. The goal is to quickly lower blood sugar.

As described in the study at Clinical Therapeutics Treatment for emergency hyperglycemia usually includes:

1. Fluid replacement

You will receive replacement fluids, either orally or through a vein (IV) until you are no longer dehydrated. This treatment aims to prevent the body from becoming dehydrated and at the same time helping to reduce high blood sugar.

2. Electrolyte replacement

Hyperglycemia treatment is done by increasing the intake of minerals in the blood so that cells and tissues can function properly again. Electrolyte fluid will be given through a vein.

3. Insulin therapy

Giving insulin by injection can help reduce the buildup of ketones in the blood. Insulin therapy is usually performed together with fluid and electrolyte replacement.

Home remedies

What are some home remedies and lifestyle changes that can be taken to prevent hyperglycemia?

Talk to your doctor about home treatments to control blood sugar levels. Some things you can do at home to prevent hyperglycemia are:

1. Exercise

Exercise is the most effective way to control high blood sugar. Exercise can help lower your blood sugar levels. However, choose sports that are safe for diabetes.

It is important to know that if you have type 1 diabetes and your blood sugar is high, you will need to check for ketones in your urine. If you have ketones, don't exercise.

If you have type 2 diabetes and high blood sugar, you should also make sure that there are no ketones in your urine and that you are well hydrated.

2. Take medication as directed

Hyperglycemia can occur due to the habit of taking diabetes medication irregularly or injecting insulin therapy that is not appropriate. So that this condition does not occur, always take medication regularly and in accordance with the drinking rules prescribed by the doctor.

Your doctor can change the amount, time, or type of diabetes medication you take. Don't make changes without talking to a doctor.

3. Maintain a diet

High blood sugar levels can be triggered by improper eating habits. Therefore, you need to rearrange your diet. Follow the recommendations of your doctor or nutritionist regarding a diet plan and a healthy diet for diabetes.

4. Diligently check blood sugar

Unstable blood sugar requires you to regularly check your blood sugar at home. Monitoring blood sugar can prevent hyperglycemia and its complications.

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

First aid to deal with high blood sugar levels

If you have diabetes and experience any of the early signs of hyperglycemia, get a blood sugar test and call your doctor.

The doctor will ask for the results of the test and recommend you some simple changes, especially to drink more water.

Water helps remove excess sugar from your blood through urine, and prevents you from becoming seriously dehydrated.

Emergency Care for Severe Hyperglycemia

If you have signs and symptoms of diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome, you may need to be admitted to the emergency room at the hospital immediately. Emergency treatment aims to lower your blood sugar to a normal range so that no dangerous complications occur.

Prevention

How can you prevent hyperglycemia?

To prevent various complications of diabetes, including hyperglycemia, the most effective and effective way is to regularly check blood sugar every day. This is done so that diabetics can know immediately if their blood sugar increases at any time.

In addition, be consistent in adopting a healthier diet, exercising diligently, and regularly taking medications prescribed by doctors to control blood sugar levels.

If you have done the various methods above but your blood sugar levels are still out of control for more than 3 days, and you don't know why this is happening, do a urine test immediately. A urine test is done for ketones and then contact your doctor or nurse right away.

If you have trouble keeping your blood sugar within the desired range, don't hesitate to consult a doctor immediately. Your doctor can help you make a better diabetes treatment plan.