What to know about Hyperglycaemia

What’s covered?

Diabetic patients are affected by hyperglycaemia or high blood sugar. Several variables may lead to hyperglycaemia in diabetics, including dietary and physical activity decisions, sickness, and skipping or not taking enough glucose-lowering medication.

It is essential to manage hyperglycaemia since untreated hyperglycaemia may progress to severe problems needing emergency treatment, such as diabetic coma. Even if not severe, continuous hyperglycaemia may result in issues affecting the eyes, kidneys, nerves, and heart over time.

Symptoms

Symptoms of hyperglycaemia do not appear until glucose levels are considerably increased, often between 180 and 200 milligrams per decilitre (mg/dL) or 10 and 11.1 millimoles per litre (mmol/L). Hyperglycaemia symptoms develop gradually over many days or weeks. The severity of symptoms worsens the longer blood sugar levels are elevated. However, some individuals with long-standing type 2 diabetes may exhibit no symptoms despite raised blood sugar levels.

Early symptoms and signals

Determining the early signs and symptoms of hyperglycaemia may aid in the rapid treatment of the illness. These include:

Frequent urination

• Increased thirst
• Impaired vision
• Fatigue
• Headache

Later symptoms and indications

Untreated hyperglycaemia may lead to the accumulation of harmful acids (ketones) in the blood and urine (ketoacidosis). Among the symptoms are:

• Nausea and vomiting
• Shortness of breath
• Mouth dryness
• Weakness
• Confusion
• Coma
• Abdominal discomfort

When to visit a physician or call 999 - Seek medical attention if:

• You’re breathing more quickly than usual or your heart is beating faster than usual
• You’re feeling drowsy or are struggling to stay awake
• Your breath has a fruit smell (like pear drop sweets)
• You feel confused or have difficulty concentrating
• You have persistent diarrhoea or vomiting, but you can still eat and drink.
• You have a fever lasting more than 24 hours.
• Your blood sugar level exceeds 240 mg/dL (13.3 mmol/L) despite having taken your diabetic medication.
• You have difficulty maintaining your blood glucose within the optimal range.

Causes

Your body converts carbohydrates from meals such as bread, rice, and pasta into different sugar molecules during digestion. One of these sugar molecules is glucose, your body's primary source of energy. After eating, glucose is taken immediately into circulation, but it cannot reach the cells of the majority of your tissues without insulin, a hormone generated by the pancreas.

When blood glucose levels rise, they stimulate the pancreas to produce insulin. Insulin unlocks your cells, allowing glucose to enter and supply the energy your cells need to perform correctly. Any excess glucose is stored as glycogen in the liver and muscles.

This procedure reduces blood glucose levels and prevents them from getting dangerously high. As your blood sugar level yields to normal, so does your pancreas' insulin output.

Diabetes significantly diminishes insulin's actions on the body. This may be because your pancreas is incapable of making insulin (type 1 diabetes), because your body is insulin-resistant, or does not create enough insulin to maintain a normal glucose level (type 2 diabetes). Consequently, glucose tends to accumulate in the bloodstream (hyperglycaemia) and may reach dangerously high levels if left untreated. Insulin or other medications are used to reduce blood glucose levels.

Risk Factors

Among the many contributors to hyperglycaemia are:

• Insufficient insulin or oral diabetic medication use
• Not properly administering insulin or using outdated insulin
• Not sticking to your diabetic diet plan
• Being inactive
• Having a disease or an infection
• Utilising certain drugs, like steroids
• Being injured
• Having surgery
• Experiencing emotional stress that may be detrimental to health

Hyperglycaemia may be triggered by illness or stress since the hormones generated to counteract disease or stress can also raise blood sugar levels. During severe illness, even those without diabetes may acquire temporary hyperglycaemia. However, people with diabetes may need to take more diabetes medicine to maintain normal blood glucose levels during illness or stress.

Complications

Keeping your blood sugar within a reasonable range prevents a number of complications connected with diabetes. The following are potential long-term implications of untreated hyperglycaemia:

• Cardiovascular disease
• Nerve injury (neuropathy)
• Kidney damage (diabetic nephropathy) or kidney failure.
• Damage to the retina's blood vessels (diabetic retinopathy) may lead to blindness.
• The clouding of your normally transparent lens (cataract)
• Feet problems caused by injured nerves or poor blood circulation; may result in severe skin infections, ulcers, and, in extreme cases, amputation.
• Bone and joint problems
• Tooth and gum conditions

Emergent difficulties

Two dangerous diseases may develop if blood sugar levels increase excessively or for an extended length of time.

Diabetic ketoacidosis

Diabetic ketoacidosis arises when there is insufficient insulin in the body. When this occurs, glucose cannot reach your cells to provide energy. As your blood sugar increases, your body metabolises fat for energy. This procedure generates acidic by-products known as ketones. Ketones build up in the blood and "spill over" into the urine. Without treatment, diabetic ketoacidosis may result in a diabetic coma and be fatal.

Hyperglycaemic hyperosmolar state

People with insulin resistance make insulin, but it does not function effectively. It is possible for blood glucose levels to exceed 1,000 mg/dL (55.6 mmol/L). Because insulin is present but not functioning correctly, neither glucose nor fat can be used for energy by the body. The glucose then leaks into the urine, resulting in increased urination. A diabetic hyperglycaemic hyperosmolar condition may result in life-threatening dehydration and coma if left untreated. Prompt medical treatment is vital.

Prevention

• The following recommendations will help you maintain a healthy blood sugar level:
• Adhere to your diabetic diet plan. If you use insulin or oral diabetic medicine, it is essential that you maintain a regular meal and snack schedule. The foods you consume must complement the insulin in your body.
• Monitor your glucose levels. Depending on your treatment plan, you may need to monitor and record your blood sugar level many times per week or multiple times per day. Only vigilant monitoring will ensure your blood sugar level stays within the correct range. Notate when your glucose levels exceed or fall below your target range.
• Take your medication according to your doctor's instructions and prescriptions.
• Adjust your medicine if your physical activity changes. The modification relies on the blood sugar test results and the exercise's kind and duration.

Immediately contact your care team or NHS 111 if you suspect you have high blood sugar and:

• You are experiencing nausea, vomiting, or abdominal discomfort.
• You are breathing quicker than normal, or your heartbeat is faster than usual.
• You are tired or having trouble staying awake.
• Your breath smells fruity (like pear drop sweets)
• You are disoriented and have trouble focusing.
• You have a significant amount of ketones in your blood or urine.

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