One of the hallmarks of type 1 diabetes is hyperglycemia, or high blood glucose. The obvious reason for glucose levels climb high in type 1 diabetes is lack of insulin. If there is sufficient insulin in the bloodstream, glucose levels return to a safe level. If there is little or no insulin available, the situation becomes serious, both in the short term as well as in long term.
Symptoms of Hyperglycemia
Feeling thirsty
Feeling hungry
Frequent urination
Blurry vision
Feeling very tired and lethargic
Headache
Blood glucose levels can get very high and at this point, you may develop some more serious symptoms, such as:
Nausea or vomiting
Stomach pain
Shortness of breath
Fruity-smelling breath
Confusion
Weakness
What causes Hyperglycemia?
If you have type 1 diabetes, it’s almost inevitable that you will have hyperglycemia at some point. Obviously, the goal is to minimize episodes of hyper and hypoglycemia as much as possible, keeping glucose levels in a safe range for as long as possible. But doing so requires education, support and a lot of detective work on your part.
Some common factors causing hyperglycemia include:
Not enough insulin
Not injecting insulin properly
Changes in food intake, for example, eating too much carbohydrate, eating higher fat foods, eating more often or eating larger amounts of food.
A decrease in your usual level of physical activity.
But other things can also lead to high blood glucose levels and these may not be what initially come to our mind. Like
Being under stress due to any reason
Illness, such as a cold or sinus infection, or something more serious
Injury, such as a sprained ankle
Changes in your sleeping pattern, which in turn may cause hormonal changes that spike glucose levels.
Menstrual cycle. Some women find that hyperglycemia occurs a few days before their period.
Medication. Certain non-diabetes medications can raise blood sugar, especially steroids, thiazide diuretics, some antipsychotic medications, some antibiotics, Hyperglycemia can also occur as a rebound from a low blood sugar. If your blood sugar drops, counter regulatory hormones may kick in, signaling the liver to release glucose.
Psychosocial issues may also lead to hyperglycemia.
How high is “high”?
Hopefully your diabetes care team has discussed your blood sugar goals with you. Your own blood sugar goals may be different based on your age and other health conditions. However, here are general hyperglycemia definitions:
Fasting hyperglycemia
The American Diabetes Association defines a fasting glucose target as 80 to 120 mg/dl. A fasting glucose level above 130 mg/dl is considered to be hyperglycemia.
Postprandial hyperglycemia
A blood glucose level that’s above 200 mg/dl one to two hours after eating a meal (postprandial) is considered to be hyperglycemia.
Symptoms of hyperglycemia usually appear when glucose levels are at least 180 to 200. Keep in mind that you may not have all of the symptoms of hyperglycemia. Checking your blood glucose with a meter is crucial for you to understand how well your diabetes is managed and if your blood glucose is within your target range. Likewise, many people with type 1 diabetes now use CGM (continuous glucose monitoring), which, depending on the type of CGM used, can reduce or practically eliminate the need to do use sugar strips.
Ketones
When blood glucose level go above 250 mg/dl, your healthcare team may advise you to check your urine for ketones. Ketones form when fat, rather than glucose, is used for energy. This can happen when there isn’t enough insulin available. Ketone levels can build up in the blood, making it more acidic; if levels get too high, you’re at risk for developing DKA (diabetic ketoacidosis). DKA is a very serious condition that typically needs to be treated in the hospital. Ask your doctor or diabetes educator about when and how to check for ketones, and what to do if you have moderate to high levels of ketones in your urine.
Treating hyperglycemia
Untreated hyperglycemia has both short- and long-term consequences. The short-term, or “acute,” consequences of hyperglycemia are the typical signs and symptoms, such as thirst, urination and headache that tend to make you feel unwell. However, another acute consequence that is much more dangerous is DKA.
Chronic hyperglycemia can lead to a series of diabetes complications, including:
Treating hyperglycemia really depends on the situation. A few high blood sugar levels here and there may be related to food choices, not doing your usual level of physical activity, or forgetting an insulin injection, for example.
The treatment?
Getting back on track with your eating plan and/or your usual exercise routine, as well as taking your insulin as prescribed.
More specific treatment guidelines are needed if you’re sick or recovering from a medical procedure. In this case, it’s important to have a “sick-day plan” in place. A sick-day plan is developed in conjunction with your doctor or diabetes educator, and includes how often to check your blood sugar, foods to eat, how to adjust your insulin, and when to call the doctor or even go to the hospital based on blood sugar readings and specific symptoms.
Other steps you can take include:
Double-checking your insulin to make sure it hasn’t expired or “spoiled” from being left in a hot car, for example. You may need to use a new vial of insulin or insulin pen; if you use a pump, it’s a good idea to use a new infusion set, as well.
- Drinking plenty of non-caloric fluids, as you may be somewhat dehydrated.
- Cutting back a little on your carb intake (but don’t cut out carbs completely).
- Going for a walkor doing some activity to help lower your blood sugar levels. However, it’s best not to exercise if you have ketones in your urine; if you do, exercise may cause your glucose levels to go even higher.
You might also need to address any other factors that you suspect might be causing your high glucose levels, such as other medications, level of stress, poor sleep and challenges affording your insulin. Talking with your doctor and other members of your diabetes care team can be helpful in dealing with these issues.
Panacea Hospital with its dedicated team is having expertise in managing all types diabetes and related complications.
