Whenever you bite into a piece of fruit or eat a bowl of pasta, you’re providing your body with the energy and nutrients it needs to stay healthy. One of the most important nutrients is glucose, a type of sugar. It‘s a main source of energy, and it travels in the bloodstream to cells throughout your body.
Normally, our bodies carefully regulate glucose levels, making sure they don’t get too high or too low. But sometimes, as happens in people with diabetes, the body is unable to effectively control those levels. Hyperglycemia occurs when the level of blood glucose gets too high.
Hyperglycemia can affect people of any age and can cause a range of symptoms, including excessive thirst, hunger, fatigue, and/or an urge to urinate more frequently than usual. If left untreated for a long period of time, it can lead to serious complications such as heart disease, eye damage, and kidney problems, among others. Fortunately, treatments are available that can help prevent hyperglycemia and control blood-glucose levels.
What is hyperglycemia?
Hyperglycemia is a condition in which the level of glucose in the blood is higher than normal. Sometimes called “high blood sugar,” it commonly affects people who have diabetes mellitus, but it can also develop in non-diabetics.
Glucose is the primary source of energy for all cells in our bodies. It comes from the foods we eat, especially carbohydrates. When food reaches the stomach, it is broken down into different parts—one of which is glucose. The intestines absorb the glucose, which then enters the bloodstream and circulates around the body.
Normally, the body uses a hormone called insulin to move glucose from the blood into cells, thereby lowering glucose in the blood and providing cells with energy.
Hyperglycemia can occur when the body does not produce enough insulin—or does not respond to insulin correctly. In both cases, glucose stays in the blood instead of being sent to the cells, and as a result, blood-glucose levels remain elevated. If more glucose enters the bloodstream—if you eat carbohydrate-rich food, for example—the blood-glucose levels climb even higher.
In some cases, people with diabetes who have hyperglycemia can develop a complication called diabetic ketoacidosis (DKA). In this condition, the cells cannot access glucose. Instead, the body gets energy by breaking down fats. This process produces compounds called ketones, which build up in the blood, causing it to become acidic. DKA is a life-threatening condition. (DKA is most commonly associated with type 1 diabetes, but can occur in people with type 2 as well.)
In people with type 2 diabetes, very high blood-glucose levels can lead to a life-threatening condition called hyperosmolar hyperglycemic state (HHS).
What causes hyperglycemia?
Hyperglycemia most commonly affects people who have diabetes. In type 1 diabetes, the body does not make enough insulin. In type 2 diabetes, the body makes an adequate amount of insulin, but the cells do not respond to it properly. This is called insulin resistance.
For people with diabetes, hyperglycemia can be triggered by:
- Eating too much
- Not exercising enough
- Not taking enough insulin medication (for type 1 diabetes) or other medications that regulate blood-glucose levels
Hyperglycemia can also be caused by:
- Medications such as corticosteroids, thiazide diuretics, beta-blockers, and epinephrine
- Certain conditions that affect the pancreas, which produces insulin
- Medical conditions that can cause insulin resistance, such as Cushing’s syndrome and acromegaly
What are the risk factors for hyperglycemia?
Certain factors or conditions increase the risk for hyperglycemia, including:
What are the symptoms of hyperglycemia?
Symptoms of hyperglycemia include:
- Frequent urination
- Excessive thirst
- Feeling tired
- Frequent hunger
- Dry mouth
- Weight loss
- Blurred vision
- Recurrent infections (e.g., bladder infections, skin infections)
- Wounds (cuts, scrapes) that heal slowly
In addition to the symptoms of hyperglycemia, people with DKA may also experience:
- Deep, rapid breathing
- Fruity-smelling breath
- Nausea and vomiting
- Stomach pain
- Difficulty thinking clearly and confusion
- Loss of consciousness, coma
HHS can cause the following symptoms:
- Loss of consciousness, coma
How is hyperglycemia diagnosed?
A diagnosis of hyperglycemia usually involves a review of your medical history, a physical exam, and blood tests.
The doctor will ask about your symptoms and whether you have a family history of diabetes or other risk factors associated with hyperglycemia. He or she will conduct a physical exam to check for symptoms of high blood sugar.
Ultimately, though, blood tests that measure blood-glucose levels are necessary to definitively diagnose hyperglycemia. For what’s called a “fasting blood glucose” (FBG) test, you will need to abstain from eating for 8 hours prior to the test. Other blood tests may include an H1C test (also known as hemoglobin A1C or glycated hemoglobin test) and an oral glucose tolerance test (OGTT).
How is hyperglycemia treated?
The treatment depends on the cause of hyperglycemia, and may include the following:
- Insulin. For people with type 1 diabetes, insulin is the main treatment for hyperglycemia. In some cases, it may also be used to treat people with type 2 diabetes, as well as people who don’t have diabetes.
- Glucose-lowering medications. Various drugs such as metformin may be used to lower blood-glucose levels.
- Glucose monitoring. People with diabetes should monitor their blood glucose levels as instructed by their doctor.
- Lifestyle changes. People with diabetes can reduce the risk of developing hyperglycemia by getting regular exercise, following a nutritious diet, and maintaining a healthy weight.
DKA and HHS are medical emergencies. They are treated with intravenous fluids, electrolytes, and insulin.
What is the outlook for people who have hyperglycemia?
In general, hyperglycemia that occurs infrequently does not cause long-term problems. But if hyperglycemia regularly occurs or becomes a chronic condition, it can lead to serious complications including cardiovascular disease, kidney damage, vision problems, and nerve damage.
But with appropriate treatment and regular monitoring of blood glucose levels, people can reduce the risk of hyperglycemia, lower their chances of having serious complications, and live healthy lives.