High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including

food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.

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It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.

 

SYMPTOMS OF High Blood Sugar

Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars.

 

Early signs and symptoms High Blood Sugar

Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for:

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

Later signs and symptoms

If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include:

• Fruity-smelling breath
• Nausea and vomiting
• Shortness of breath
• Dry mouth
• Weakness
• Confusion
• Coma
• Abdominal pain

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COMPLICATIONS

Untreated hyperglycemia can cause long-term complications. These include:

• Cardiovascular disease
• Nerve damage (neuropathy)
• Kidney damage (diabetic nephropathy) or kidney failure
• Damage to the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness
• Clouding of the normally clear lens of your eye (cataract)
• Feet problems caused by damaged nerves or poor blood flow that can lead to serious infections, and in some severe cases, amputation
• Bone and joint problems
• Skin problems, including bacterial infections, fungal infections and nonhealing wounds
• Teeth and gum infections
• Emergency complications

If blood sugar rises high enough or for a prolonged period of time, it can lead to two serious conditions.

 

Diabetic ketoacidosis. Diabetic ketoacidosis develops when you don't have enough insulin in your body. When this happens, sugar (glucose) can't enter your cells for energy. Your blood sugar level rises, and your body begins to break down fat for energy.

 

This process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually "spill over" into the urine. Left untreated, diabetic ketoacidosis can lead to a diabetic coma and be life-threatening.

 

Hyperglycemic hyperosmolar syndrome. This condition occurs when people produce insulin, but it doesn't work properly. Blood glucose levels may become very high — greater than 600 mg/dL (33 mmol/L). Because insulin is present but not working properly, the body can't use either glucose or fat for energy.

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Glucose is then spilled into the urine, causing increased urination. Left untreated, diabetic hyperglycemic hyperosmolar syndrome can lead to life-threatening dehydration and a coma. Prompt medical care is essential.

 

 

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 goal range. Check your blood sugar as often as your doctor recommends.

 

If you have any signs or symptoms of severe hyperglycemia — even if they're subtle — check your blood sugar level. If your blood sugar level is 240 mg/dL (13 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. You'll need your doctor's help to lower your blood sugar level safely.

 

Glycated hemoglobin (A1C) test

During an appointment, your doctor may conduct an A1C test. This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.

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An A1C level of 7 percent or less means that your treatment plan is working and that your blood sugar was consistently within the target range. If your A1C level is higher than 7 percent, your blood sugar, on average, was above the normal range. In this case, your doctor may recommend a change in your diabetes treatment plan.

 

However, for some people, especially the elderly, people with other medical conditions, or advanced diabetes complications, a higher A1C level of up to 8 percent may be appropriate.

 

Keep in mind that the normal range for A1C results may vary somewhat among labs. If you consult a new doctor or use a different lab, it's important to consider this possible variation when interpreting your A1C test results.

 

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, however, receive this test between two and four times a year.

LIFESTYLE AND HOME REMEDIES

The following suggestions can help keep your blood sugar within your target range:

 

Follow your diabetes meal plan. If you take insulin or oral diabetes medication, it's important that you be consistent about the amount and timing of your meals and snacks. The food you eat must be in balance with the insulin working in your body.

Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Note when your glucose readings are above or below your goal range.

Take your medication as prescribed by your health care provider.

Adjust your medication if you change your physical activity. The adjustment depends on the blood sugar test results and on the type and length of the activity.

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