What is hyperglycemia in diabetes? How is it diagnosed and treated? Explore the details of managing high blood sugar levels and preventing complications.

Understanding Hyperglycemia in Diabetes

Hyperglycemia, or high blood sugar, is a common occurrence in individuals with diabetes. It arises when the body is unable to properly regulate blood glucose levels, leading to an excess buildup of sugar in the bloodstream. This condition can have serious implications if left untreated, potentially leading to a range of complications such as nerve damage, kidney disease, and cardiovascular problems.

Diagnosing Hyperglycemia

The first step in managing hyperglycemia is to establish a target blood sugar range with your healthcare provider. For many people with diabetes, the recommended target range is between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals, and less than 180 mg/dL (10 mmol/L) two hours after meals. However, these targets may vary depending on factors such as age, overall health, and the type of diabetes.

To monitor your blood sugar levels, your healthcare provider may recommend regular home testing with a blood glucose meter. If you experience symptoms of severe hyperglycemia, such as excessive thirst, frequent urination, or blurred vision, it’s important to check your blood sugar immediately and take appropriate action.

In addition to routine self-monitoring, your healthcare provider may also conduct an A1C test, which measures your average blood sugar level over the past 2-3 months. An A1C level of 7% or less is generally considered a healthy target, but your individual goal may be different based on your specific circumstances.

Managing Hyperglycemia with Home Treatment

If your blood sugar levels are consistently high, your healthcare provider may recommend the following strategies to help keep them within your target range:

Get Physical

Regular exercise can be an effective way to control blood sugar levels. However, it’s important to avoid exercise if you have ketones in your urine, as this can further drive up your blood sugar.

Take Medications as Directed

Adhering to your prescribed medication regimen, whether it’s oral medications or insulin, is crucial for managing hyperglycemia. Your healthcare provider may adjust the dosage or timing of your medications if you frequently experience high blood sugar levels.

Follow Your Diabetes Eating Plan

Maintaining a balanced and portion-controlled diet, avoiding sugary beverages, and limiting frequent snacking can all help keep your blood sugar within a healthy range. If you’re struggling to stick to your meal plan, consult with your healthcare provider or a registered dietitian for additional support.

Monitor Your Blood Sugar

Regularly checking your blood glucose levels, as recommended by your healthcare provider, is essential for identifying and addressing hyperglycemia. Be sure to check more often if you’re feeling unwell or are concerned about severe hyperglycemia or hypoglycemia (low blood sugar).

Adjust Insulin Doses

If you use insulin to manage your diabetes, your healthcare provider may recommend adjusting your insulin program or taking additional short-acting insulin to help correct high blood sugar levels.

Emergency Treatment for Severe Hyperglycemia

In cases of severe hyperglycemia, characterized by conditions like diabetic ketoacidosis or hyperosmolar hyperglycemic state, emergency medical treatment may be necessary. This typically involves:

Fluid Replacement

Intravenous fluid administration to replace the fluids lost through excessive urination and help dilute the elevated blood sugar levels.

Electrolyte Replacement

Replenishing essential minerals, such as sodium, potassium, and chloride, which can become depleted due to the body’s response to severe hyperglycemia.

Insulin Administration

Rapid-acting insulin may be given to quickly lower blood sugar levels and address the underlying metabolic imbalances.

By working closely with your healthcare team and incorporating these strategies into your daily management plan, you can effectively manage hyperglycemia and minimize the risk of serious complications.

Hyperglycemia in diabetes – Diagnosis & treatment

Diagnosis

Your health care provider sets your target blood sugar range. For many people who have diabetes, Mayo Clinic generally recommends the following target blood sugar levels before meals:

• Between 80 and 120 milligrams per deciliter (mg/dL) (4.4 and 6.7 millimoles per liter (mmol/L)) for people age 59 and younger who have no medical conditions other than diabetes
• Between 100 and 140 milligrams per deciliter (mg/dL) (5.6 and 7.8 millimoles per liter (mmol/L)) for:
  • People age 60 and older
  • Those who have other medical conditions, such as heart, lung or kidney disease
  • People who have a history of low blood sugar (hypoglycemia) or who have difficulty recognizing the symptoms of hypoglycemia

For many people who have diabetes, the American Diabetes Association generally recommends the following target blood sugar levels:

• Between 80 and 130 mg/dL (4. 4 and 7.2 mmol/L) before meals
• Less than 180 mg/dL (10 mmol/L) two hours after meals

Your target blood sugar range may differ, especially if you’re pregnant or you have other health problems that are caused by diabetes. Your target blood sugar range may change as you get older. Sometimes, reaching your target blood sugar range can be a challenge.

Home blood sugar monitoring

Routine blood sugar monitoring with a blood glucose meter is the best way to be sure that your treatment plan is keeping your blood sugar within your target range. Check your blood sugar as often as your health care provider recommends.

If you have any symptoms of severe hyperglycemia — even if they seem minor — check your blood sugar level right away.

If your blood sugar level is 240 mg/dL (13. 3 mmol/L) or above, use an over-the-counter urine ketones test kit. If the urine test is positive, your body may have started making the changes that can lead to diabetic ketoacidosis. Talk to your health care provider about how to lower your blood sugar level safely.

Hemoglobin A1C test

During an appointment, your health care provider may conduct an A1C test. This blood test shows your average blood sugar level for the past 2 to 3 months. It works by measuring the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells, called hemoglobin.

An A1C level of 7% or less means that your treatment plan is working and that your blood sugar was consistently within a healthy range. If your A1C level is higher than 7%, your blood sugar, on average, was above a healthy range. In this case, your health care provider may recommend a change in your diabetes treatment plan.

For some people, especially older adults and those with certain medical conditions, a higher A1C level of 8% or more may be appropriate.

How often you need the A1C test depends on the type of diabetes you have and how well you’re managing your blood sugar. Most people with diabetes receive this test 2 to 4 times a year.

More Information

Treatment

Home treatment

Talk to your health care provider about managing your blood sugar. Understand how different treatments can help keep your glucose levels within your target range. Your health care provider may suggest the following:

• Get physical. Regular exercise is often an effective way to control blood sugar. But don’t exercise if you have ketones in your urine. This can drive your blood sugar even higher.
• Take your medication as directed. If you develop hyperglycemia often, your health care provider may adjust the dosage or timing of your medication.
• Follow your diabetes eating plan. It helps to eat smaller portions and avoid sugary beverages and frequent snacking. If you’re having trouble sticking to your meal plan, ask your health care provider or dietitian for help.
• Check your blood sugar. Monitor your blood glucose as directed by your health care provider. Check more often if you’re sick or if you’re concerned about severe hyperglycemia or hypoglycemia.
• Adjust your insulin doses. Changes to your insulin program or a supplement of short-acting insulin can help control hyperglycemia. A supplement is an extra dose of insulin used to help temporarily correct a high blood sugar level. Ask your health care provider how often you need an insulin supplement if you have high blood sugar.

Emergency treatment for severe hyperglycemia

If you have signs and symptoms of diabetic ketoacidosis or hyperosmolar hyperglycemic state, you may be treated in the emergency room or admitted to the hospital. (4p4) Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes:

• Fluid replacement. You’ll receive fluids — usually through a vein (intravenously) — until your body has the fluids it needs. This replaces fluids you’ve lost through urination. It also helps dilute the extra sugar in your blood.
• Electrolyte replacement. Electrolytes are minerals in your blood that are necessary for your tissues to work properly. A lack of insulin can lower the level of electrolytes in your blood. You’ll receive electrolytes through your veins to help keep your heart, muscles and nerve cells working the way they should.
• Insulin therapy. Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you’ll receive insulin therapy — usually through a vein.

As your body returns to normal, your health care provider will consider what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional tests and treatment.

Preparing for your appointment

If you have trouble keeping your blood sugar within your target range, schedule an appointment to see your health care provider. Your provider can help you make changes to better manage your diabetes.

Here’s information to help you get ready for your appointment and know what to expect from your health care provider.

What you can do

• Be aware of any pre-appointment restrictions. If your health care provider is going to test your blood sugar, you may need to stop eating or drinking anything but water for up to eight hours before your appointment. When you’re making an appointment, ask if there are any restrictions on eating or drinking.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements you take.
• Create a record of metered glucose values. Give your health care provider a written or printed record of your blood glucose values, times and medication. Using the record, your health care provider can recognize trends and offer advice on how to prevent hyperglycemia or adjust your medication to treat hyperglycemia.
• Write down questions to ask your health care provider. If you need more information about your diabetes management, be sure to ask.
• Check if you need prescription refills. Your health care provider can renew your prescriptions while you’re at the appointment.

For hyperglycemia, questions you may want to ask include:

• How often do I need to monitor my blood sugar?
• What is my target range?
• How do diet and exercise affect my blood sugar?
• When do I test for ketones?
• How can I prevent high blood sugar?
• Do I need to worry about low blood sugar? What are the symptoms I need to watch for?
• Will I need follow-up care?

Sick-day planning

Illness or infections can cause your blood sugar to rise, so it’s important to plan for these situations. Talk to your health care provider about creating a sick-day plan. Questions to ask include:

• How often should I monitor my blood sugar when I’m sick?
• Does my insulin injection or oral diabetes pill dose change when I’m sick?
• When should I test for ketones?
• What if I can’t eat or drink?
• When should I seek medical help?

Prediabetes risks and next steps

Speaking of Health

Monday, November 21, 2022

Topics in this Post

• Diabetes

If you’ve been diagnosed with prediabetes, it means your blood sugar levels are not high enough to be classified as Type 2 diabetes, but are high enough to indicate a need for change.

A normal fasting blood sugar level is below 100; whereas, the level of a person with prediabetes is between 100 and 126. Once levels have surpassed 126, it’s classified as Type 2 diabetes. This indicates that the body resists insulin or doesn’t produce enough of it to maintain normal blood sugar levels. Other names used for prediabetes are impaired fasting glucose, glucose tolerance, impaired glucose tolerance and borderline diabetes.

Foods high in carbohydrates raise blood sugar more than other foods. During digestion, the pancreas produces insulin, which then binds the sugar in the blood and takes it into cells as a source of energy. If you have prediabetes, sugar begins to build up in the bloodstream rather than fuel the cells. This is when insulin resistance occurs, which is believed to be the No. 1 cause of prediabetes.

A healthy weight allows insulin to work more efficiently and can help to keep blood sugars within a normal range. A healthy diet and regular exercise are the best ways to help bring your blood sugar levels back to a healthy range.

What factors increase risk for developing prediabetes?

The same factors that may increase risk of a person of getting Type 2 diabetes also may increase the risk of prediabetes, such as:

• Overweight or obesity
• Excess weight in the abdomen
• Family history of diabetes
• Sedentary lifestyle
• Age 35 or older
• Previous gestational diabetes diagnosis
• High cholesterol
• High blood pressure
• Race or ethnicity, as African American, Hispanic, American Indian and Asian American people are more likely to develop prediabetes

When should someone be tested?

If you’re 35 or older, you should have your fasting blood sugar checked every year during your physical exam. If you’ve had gestational diabetes, it’s important to have your blood sugar checked each year as this increases your risk of developing prediabetes or Type 2 diabetes.

What are prediabetes symptoms?

People often don’t know they have prediabetes because they may not experience any symptoms.

People with prediabetes or especially Type 2 diabetes may experience some of these symptoms:

• Fatigue
• Blurred vision
• Frequent urination
• Increased thirst
• Increased hunger

What are next steps?

After diagnosis, you may be referred to a diabetes educator who can customize a plan to help you manage your health and well-being.

You also will learn lifestyle skills to manage prediabetes and Type 2 diabetes. This may include meal planning, exercise, medication management, stress management and sleep hygiene. People with prediabetes may be able to prevent or delay the development of Type 2 diabetes significantly through lifestyle changes including achieving and maintaining a healthy weight.

It’s important to know that most prediabetes treatment plans do not include medications or routine monitoring of blood sugar.

What are the consequences of diabetes?

Diabetes can have long-term health consequences.

Your risk of developing Type 2 diabetes is higher if you have prediabetes, and this increases your health risk for:

• Heart disease
• Stroke
• Eye damage, including blindness
• Limb amputation
• Kidney failure

Talk to your health care team if you have any questions or concerns about your blood sugar level, or if you develop any Type 2 diabetes symptoms.

Tara Wilde is a certified diabetes educator in La Crosse, Wisconsin.

Topics in this Post

• Diabetes

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How to live well with diabetes

Take a general blood test for glucose

Glucose is one of the main sources of energy for the body. The concentration of glucose in the blood is regulated by various hormones (insulin, glucagon), and depends on the rate of its formation and utilization. The content of glucose in the blood can change significantly with metabolic disorders in the body.
The concentration of glucose in the blood increases after eating and decreases during fasting, intense physical work, and stress. Elevated glucose levels can be a sign of type 1 or type 2 diabetes.

Recently, great importance has been attached to the metabolic syndrome – a state of glucose tolerance, which can later lead to obesity, type II diabetes mellitus, PCOS in women, a significant increase in the risk of stroke and heart attack. In order to timely diagnose this condition, it is important to regularly check the level of glucose in the blood.

Also, glucose tolerance increases during pregnancy, so it must be determined when registering at the beginning of the third third trimester.
Glucose is the main source of nutrition for cells. It is formed by the breakdown of carbohydrates that a person consumes with food. The cells of the nervous system (including the brain) also require Glucose to regulate their activity. They are able to perform their functions normally only if the glucose level does not fall below an acceptable level.

The body is able to effectively use glucose as an energy source only in combination with a special hormone – insulin. It is responsible for regulating the transport of sugar from the blood into the cells. Energy that cannot be used at the moment is stored in the body in the form of glycogen in the liver and muscles, as well as in adipose tissue, after which it is consumed as needed. To maintain the normal functioning of the body, a balance of glucose and insulin is required. In a healthy person, it is maintained naturally.

In a healthy person , the blood sugar level increases after eating. This increases the production of insulin, which reduces sugar. Its level directly depends on the diet. If it decreases too much (for example, after a significant physical exertion or because the body does not receive food for a long time), the pancreas synthesizes the hormone glucagon. Under its action, the liver converts glycogen into sugar, and the amount of glucose increases.
Maintaining the sugar level within the normal range is provided by a feedback mechanism. In case of imbalance, the glucose content rises. The body is trying to bring sugar levels back to normal levels. To do this, it produces a large amount of insulin and removes excess sugar in the urine.
A significant excess or lack of sugar poses a threat to human life. In this case, the work of internal organs may be disrupted, brain damage and coma are possible. With an increased level of sugar for a long time, blood vessels and some internal organs (for example, the retina) are damaged. Chronic lack of glucose causes damage to the nervous system and brain.

The results of a blood glucose test, during which glucose in plasma is determined, can only be interpreted by a doctor.

Prevention of diabetes mellitus – Blood Transfusion Station of the Ministry of Health of the Krasnodar Territory (GBUZ SPK)

Prevention of diabetes

Diabetes mellitus is a serious disease of the endocrine system. To date, the pace of its spread cannot but frighten: for example, according to statistics, about 6% of the world’s population suffer from this disease.

What is diabetes mellitus?

Diabetes is manifested by high blood sugar levels due to inadequate insulin action. This hormone, which our pancreas secretes, regulates metabolism, primarily carbohydrates. In diabetes, due to insufficient exposure to insulin, a complex metabolic disorder is manifested, as a result of which the content of sugar and ketone bodies (products of improper fat combustion) in the blood increases, sugar is excreted in the urine.

The symptoms of diabetes are:

• constant intense thirst;
• frequent urination;
• dehydration;
• strong feeling of hunger;
• exhaustion;
• visual impairment;
• muscle weakness;
• itching and skin irritation.

There are two main types of diabetes mellitus:

1) In type I disease, insulin in the body is catastrophically lacking, so daily injections of this hormone are an obligatory part of therapy. Only 10% of diabetics have type I. The disease usually develops in people under 20 years of age. So far, science does not know methods for the prevention of type 1 diabetes.

2) In type II diabetes, insulin is secreted, but not enough for the body’s needs. The disease develops rather slowly and its course is mild. Most often, type II diabetes occurs in obese people. If the disease is diagnosed in time, it is possible to stop it without medical treatment. Prevention of diabetes can significantly reduce the risk of this dangerous disease.

Causes of diabetes mellitus

The main factor that predisposes to the development of the disease is heredity. If any of the next of kin suffers from diabetes, the risk of damage is high.

The second cause of diabetes is obesity. With excess body weight and sufficiently large amounts of adipose tissue, the body’s sensitivity to insulin decreases, which facilitates the development of the disease. Contributes to the occurrence of disease and malnutrition. That is why diet is an important part of diabetes prevention.

Chronic stress can also cause diabetes. The fact is that the state of nervous excitement is accompanied by an increased release of catecholamines and glucocorticoids into the blood, which can cause diabetes.

Finally, some diseases contribute to the development of the disease: autoimmune thyroiditis, arterial hypertension, atherosclerosis, coronary heart disease, and others.

Prevention of diabetes mellitus

Modern methods of diabetes prevention will allow you to lead a normal life and at the same time significantly reduce the risk of developing this dangerous disease.

So, the main methods of preventing diabetes are:

1) Proper nutrition. You need to try to reduce your carbohydrate intake so as not to overload the pancreas (which, remember, secretes insulin), and also reduce the number of calories consumed daily in order to stay in good shape. To prevent diabetes, you need to minimize or completely remove easily digestible carbohydrates from the menu, such as sugar and any products containing sugar (cookies, unnatural juices).

The basis of nutrition should be complex carbohydrates and foods that include vegetable fibers. In general, the diet should look like this: 60% complex carbohydrates, 20% fats (with 50-70% of them vegetable oils), 20% proteins. Preference should be given to poultry, low-calorie fish, vegetables, unsweetened juices. You should limit the consumption of pasta and flour products, spicy, spicy and smoked dishes. Fried food should be replaced with boiled, baked or stewed. You can fill the deficit of sweet foods with the help of sweeteners – the best choice would be stevioside.

2) Daily exercise. Prevention of diabetes will be effective only if you carve out at least half an hour every day for physical education. Physical activity has a beneficial effect on metabolic processes, thanks to them, the breakdown of fats is enhanced, the fatty composition of the blood improves, and body weight is significantly reduced.