What is hyperglycemia?
Hyperglycemia is excess sugar (glucose) in the blood. The endocrine system regulates the amount of sugar that is stored and used for energy, which is needed for the cells to function.
Sugar consumed in a diet is used or stored, but certain conditions and disorders can cause difficulty in processing and storing glucose, which can result in hyperglycemia or hypoglycemia.
An important hormone for normal sugar storage and processing is insulin. Insulin is a hormone produced by the pancreas that is responsible for maintaining “normal” blood sugar levels. If there is a problem in the pancreas, blood sugar levels may be high.
Video Hyperglycemia – Causes, symptoms and treatment of hyperglycemia
Normal blood glucose (sugar) levels are 60 to 110 mg/dL. Normal values may vary depending on the laboratory. Levels above these may indicate hyperglycemia.
Causes of hyperglycemia may include
Diabetes. About 90% of people can develop diabetes by adulthood (type 2 diabetes). There is a greater risk of developing diabetes with age, if you are overweight (obese), if there is a family history of diabetes (parents, children), and if you are of African-American, Hispanic-American or Native American descent.
People with diabetes have a low production of the hormone insulin, which lowers blood sugar levels. If you have diabetes, you will have problems with high blood sugar levels.
If you develop type 2 diabetes and are an adult, your doctor may prescribe medication in pills that allow your body to produce the insulin needed to maintain “normal” blood glucose levels. It is likely that your pancreas is producing enough insulin, but your body is resistant to insulin and unable to process that hormone effectively, resulting in hyperglycemia.
If you have diabetes and are hypoglycemic, your physician will also treat you to increase your blood sugar levels. You will need to follow a special diet to maintain good control of your blood sugar.
Exercise is recommended, as it helps lower your sugar levels and promote blood circulation throughout your body.
If you cannot control your blood sugar levels with diet, exercise and medication (in pill form), your doctor may prescribe insulin injections.
While your insulin requirements are being determined, you should take your blood sugar levels at home. Your physician will inform you of this and tell you how to care for yourself during this time.
Insulin is not given by mouth because stomach acid makes it inactive (does not work).
You may be taking corticosteroids, such as dexamethasone (Decadron®)
or prednisone. These medications promote gluconeogenesis, which results in high blood sugar levels.
Many people who take steroids and develop high blood sugar levels (hyperglycemia) return to normal after treatment is completed.
You may be receiving intravenous nutrition (Total Parenteral Nutrition (TPN)). The solution for intravenous nutrition has very high levels of glucose.
Many times, your body will be able to regulate your blood glucose levels, but in some cases, these levels may increase while you are receiving TPN.
If you have kidney or liver disease, your blood sugar levels may be high. The same thing can happen if you have an infection in your pancreas that controls your blood insulin levels.
If you have an infection, your blood sugar may be a little high during the time you are sick, which means you may have temporary high blood sugar.
If you are pregnant, you may develop gestational diabetes. This means that you have diabetes while you are pregnant. This form of diabetes usually disappears after delivery.
Prolonged hyperglycemia can lead to kidney failure and damage to the eyes, cardiovascular system and other internal organs. In addition, there are many long-term complications due to prolonged hyperglycemia, such as heart problems and problems with blood circulation.
This is why it is important to maintain good control of the disease.
The foods we recommend below help lower your blood sugar, have a low glycemic index, and are high in fiber, helping to control blood glucose levels. Including them in your diet is key to managing diabetes, and if you’re not diabetic they help prevent you from developing it.
How do I know if my hyperglycemia is due to diabetes?
Your doctor or members of your medical team may order certain blood tests to determine if you have diabetes.
As you have been treated before and certain conditions may cause temporary increases in blood sugar levels (hyperglycemia). You will not be a “true” diabetic and your blood sugar may return to normal after your disease resolves or treatment ends.
However, you can be treated as if you were a diabetic, with frequent blood sugar monitoring, diet modifications and exercise, until your lab values return to normal. Normal blood sugar levels are between 60 and 110 mg/dL (normal values may vary by laboratory).
If you have a fasting blood sugar level between 110 and 125 mg/dL, you will be diagnosed with glucose intolerance. This is a major risk factor for developing diabetes.
With a good diet and exercise, you can prevent the progression to type 2 diabetes.
If you have a blood sugar level greater than 126 mg/dl while fasting, you will be diagnosed with diabetes.
If you have had two blood sugar tests over 200mg/dl, you will also be diagnosed with diabetes.
For the diagnosis, you may be given a glucose tolerance test (GOT). You will need to drink a solution with a high glucose level and have several blood samples taken for 2 hours after drinking it to determine your blood sugar level.
This was the traditional method of diagnosing diabetes, but is now done less often.
A blood test, called hemoglobin A1C (also called glycated hemoglobin), measures average blood sugar levels over 90 days. If you suspect diabetes, your doctor may order this test to make the diagnosis and then every 3 months for control.
What are some of the signs and symptoms of hyperglycemia that should be considered?
The symptoms of hyperglycemia are the same as those of type 2 diabetes.
They include being overly or excessively thirsty. You may urinate more than usual.
You may be tired and lose weight without wanting to.
You may develop fungal infections.
Some late symptoms of high and prolonged blood sugar levels are blurred vision and possible numbness in your fingers and toes.
Very high blood sugar levels can cause confusion or coma.
What you can do about hyperglycemia
If you have high blood sugar levels from diabetes, an infection or pregnancy, your doctor may prescribe pills, insulin, diet, exercise and blood sugar monitoring. Follow all of your doctor’s directions.
Exercise. As part of your routine, take a walk every day, alone or with a friend or family member.
Walking or light aerobic activity can help promote the flow of oxygen to the lungs (oxygenation), lower blood sugar levels and help prevent long-term complications of hyperglycemia. In addition, consistent diet and exercise will help your doctor determine the doses of insulin and other diabetes medications that will best help you manage your disease.
Take the recommended diet. A diabetic diet may be suggested, even if your blood sugar is elevated only for a short period of time due to infection or steroid use.
The right diet can reduce symptoms.
If you are diagnosed with diabetes, either type 2 or gestational, you will most likely be referred to a nutritionist to determine an appropriate diet. This will help you control your disease or the condition that is causing your blood sugar levels to rise.
Reading food labels is helpful in knowing what types of calories, fats and proteins you are eating. Some general recommendations include
Limit carbohydrates, whether simple (like fruit and sugar) or complex (like pasta and cereals), because they have the greatest impact on blood sugar levels.
Carbohydrates should give you 50% of the calories you receive from your diet. Avoid sugar and instead use artificial sweeteners such as Nutrasweet, aspartame or saccharine.
Protein: Protein should give you 15-20% of the calories you receive from the diet. If you are diabetic, long-term damage to the kidneys can be corrected by restricting protein.
Increase your intake of fresh vegetables and fiber: it is recommended that you eat up to 55 grams of fiber per day. Fiber and fresh vegetables help lower blood sugar levels, maintain regular bowel habits and may prevent certain types of cancers.
There are many types of “good and bad” fats. The easiest thing to remember is to limit the intake of saturated fats and oils in your diet.
You will most likely be asked to get a blood sugar monitor, especially if you have diabetes, and your doctor will ask you to monitor your blood sugar levels at home.
At first, you should monitor your blood sugar levels up to 4 or more times a day to make sure they are kept at normal levels, without being extremely high or low.
Finally, with diet, exercise and the right medications, you can monitor your blood sugar levels less frequently.
Although blood sugar levels may increase, a small snack before bedtime can help prevent low blood sugar levels at night.
Tell your friends, family and loved ones about your condition. Tell them that if they see you sweating, shaking and confused, these can be serious symptoms of low blood sugar.
Always keep candy in your pocket in case your blood sugar drops too low and call for emergency help if you don’t know what to do.
Wear a “medical alert” bracelet if you have diabetes or a history of high blood sugar (hyperglycemia or hypoglycemia).
Tell your doctor and health care team members about any medicines you are taking (including over-the-counter medicines, vitamins, or herbal remedies), because they can interact with other medicines you take by mouth and affect your blood sugar levels.
Tell your doctor if you have a history of liver, kidney or heart disease.
Stay well hydrated. Drink two to three liters of water per day, unless otherwise instructed.
Avoid alcohol. Certain forms of alcohol can cause you to have very high or low blood sugar. If alcohol is mixed with “sweet” drinks, it can result in increased blood sugar levels.
Drinking certain liquors “alone” can result in lower blood sugar levels. If you are taking pills to control your hyperglycemia, alcohol use can cause a deadly interaction.
If you have diabetes, it is important to monitor your feet daily. People with high and prolonged blood sugar levels can develop diabetic neuropathy, which has as symptoms a loss of sensation because blood flows less through the feet.
If you have neuropathy, you may not realize if you have an infection or an injury, which you may not be able to heal normally.
Keep your feet clean and dry. Wear white cotton socks.
Watch your feet and toes for cracks, hardened areas, or rashes.
Apply moisturizers every day, but not between the toes.
If you notice wounds or changes, consult a podiatrist or your doctor.
If you have diabetes, you should see an ophthalmologist to check your eyes every year. Any change in vision should be reported as soon as it is detected.
A more serious and long-term side effect of diabetes is kidney disease. You may have your urine tested periodically for protein levels (proteinuria).
If there is damage to the kidneys, you will have protein in your urine. If kidney damage is diagnosed early and there is only a low level of protein in your urine, your doctor can help you prevent further damage with diet, exercise or medication.
Tight control of blood sugar will help prevent proteinuria.
A blood test, called hemoglobin A1C, measures average blood sugar levels over 90 days. If you have diabetes, your doctor will order it every 3 months.
If you have symptoms or side effects, especially if they are severe, discuss them with your doctor or a member of your health care team. They can prescribe medication and/or suggest other effective alternatives for managing these problems.
Keep all your appointments.
Medications that the doctor can prescribe:
If you have high blood sugar levels, your doctor may prescribe it:
Insulin: Insulin is a hormone that is naturally found in the body and regulates blood glucose levels.
Insulin is given intravenously (IV), while you are in the hospital or more commonly, under the skin (subcutaneously). If blood sugar levels are not well controlled, you may be instructed to take insulin alone or as an adjunct to oral hypoglycemics.
Insulin injections may be temporary, when you are first diagnosed with diabetes, or may need to be continued for a prolonged period. This will be determined by your physician.
Oral hypoglycemics: There are many different types of medications that allow the body to process insulin more effectively. These include: metmorphine, glipizide, act or avandia.
Your doctor will suggest the most appropriate one for you. The side effects of these medications can vary, but most include low blood sugar, weight loss and improvement in blood cholesterol levels. Some may cause mild nausea or loss of appetite, or diarrhea and intestinal discomfort. It is important that you follow your doctor’s recommendations.
When to call the doctor:
If you have the following symptoms, consult your doctor:
Increased urinary frequency, painful urination, weight loss.
If you notice symptoms of low blood sugar, such as trembling, sweating and tiredness.
If you develop signs of confusion.
Shortness of breath, chest pain or discomfort; swelling of the lips or throat should be evaluated immediately, especially if you started a new medication.
If you feel your heart beating fast or if you have palpitations.
Nausea that affects your ability to eat and is not relieved by prescription medications.
Diarrhea (4 to 6 episodes in 24 hours) that is not relieved by anti-diarrheal medication or a diet modification.
Note: We recommend that you talk to your doctor about your condition and treatment. The information presented here is for practical and educational purposes only, and does not replace the opinion of your physician.