Common Health Issues

Solving Diabetes Hyperglycemia Problems

• By Rich Health Editorial Team
• November 01, 2021

If you have diabetes, your body either doesn’t produce enough insulin or doesn’t respond to insulin as it should. Insulin helps glucose get into the cells that need it. Without it, glucose remains in your blood and your blood glucose levels climb too high. This can result in a host of problems. High blood glucose levels over time can affect the way the blood does its job. As a result, you can develop many of the complications of diabetes such as heart disease, eye disease and kidney disease. 

 

In the short term, having high blood glucose levels can make you feel bad. If your glucose levels remain too high for too long and you fail to recognize what is happening, life-threatening situations can develop. It is important to recognize the warning signs of hyperglycemia so you can take action to get your blood glucose levels down to normal.

 

HYPERGLYCEMIA (HIGH BLOOD GLUCOSE)

No matter how hard you try, it is unlikely you can maintain perfect blood glucose control. There will be times when your blood glucose level may rise a little above normal or fall too low. But if your blood glucose level is always or often higher than it should be or if you frequently have abnormally high blood glucose levels, you will be more likely to develop diabetes complications and you could put yourself at risk for life-threatening situations, including seizures, coma or even death.

 

HYPERGLYCEMIA SYMPTOMS

The symptoms of high blood glucose may be subtle. You may feel unusually thirsty or feel the need to urinate more frequently. You may even experience blurry vision. 

Sometimes, if your blood glucose levels are too high, you just don’t feel quite right. You may feel tired and have no energy. The only way to know for sure is to test your blood glucose level. If it is higher than 250mg/dl, you have hyperglycemia. (Some people will experience symptoms at lower blood glucose levels)

 

HYPERGLYCEMIA RISKS

Chronically high blood glucose levels over time can trigger and worsen many of the complications of diabetes. These include retinopathy (eye disease), heart disease, nephropathy (kidney disease), neuropathy (nerve disease) and infection. In the short term, extremely high levels of blood glucose could lead to two especially dangerous conditions, diabetic ketoacidosis or hyperglycemic hyperosmolar state. Both of these conditions, if left untreated, can cause coma and even death.

 

WHAT TO DO

If you feel any of the symptoms listed above, test your blood glucose level. If it is above 350mg/dl, call a member of your health care team right away. If your blood glucose levels are lower (250-350mg/dl) and you have any symptoms of diabetic ketoacidosis or hyperglycemic hyperosmolar state, call your health care team immediately. If your blood glucose level is over 500mg/dl, call for emergency help or have someone drive you to an emergency room at once

 

HYPERGLYCEMIA TREATMENT

What to do about hyperglycemia depends on the severity of the situation and whether you have ketones in your urine. If your blood glucose is borderline high and you have no other symptoms, you may be advised to exercise a little or just wait out the situation and focus on prevent it from happening in the future. If your blood glucose levels are above 250mg/dl, your health care team member may advise taking extra insulin and drinking plenty of fluids. 

 

You should discuss with your health care team in advance what steps to take should your blood glucose levels fall within this range. If your blood glucose levels are dangerously high (over 500mg/dl), you will require emergency treatment.

 

HYPERGLYCEMIA PREVENTION

To prevent hyperglycemia, you need to identify the events that causes it and take steps to ensure that it doesn’t happen again. Eating too much food, taking too little insulin, skipping insulin doses or oral agents, or delaying insulin injections are likely culprits.

 

UNEXPLAINED HYPERGLYCEMIA

If you don’t know what caused your hyperglycemia, you may have unexplained hyperglycemia. Sometimes you know why your blood glucose levels are high (over 250mg/dl). Maybe you ate too much of a high-carbohydrate meal. Or maybe you skipped a dose of insulin because you weren’t feeling well. It is important to figure out why your blood glucose levels may rise unexpectedly, especially if this happens often.

Preventing unexplained hyperglycemia requires a little detective work. After all, if you knew the cause, it wouldn’t be happening in the first place. If your bouts of hyperglycemia occur frequently, you may first want to track your patterns of eating, activity and insulin or medication use to see how they affect your blood glucose levels. 

 

If your hyperglycemia occurs an hour after meal, then you may want to allow more time between your insulin injection and eating. If your blood glucose levels are high before mealtime, you may want to exercise before you eat. If your blood glucose levels are high when you wake up, you may be experiencing the dawn phenomenon or the Somogyi effect. To prevent this, your health care team may suggest eating less at breakfast or the night before, or adjusting your insulin dose.

 

Unexplained hyperglycemia can also be due to problems with insulin and insulin delivery, especially if you are using an insulin pump. First, check your insulin. If it is expired or has been subjected to extremes in temperature, it may be inactive and unable to do its job. Check the bottle to see if it looks clumped or filled with little particles. If the vial is nearly empty or you have used it for more than 1 month, it may be time to open a fresh bottle.

 

Problems with the insertion site or injection site can also affect insulin action. If you placed the needle near a scar or mole, or into an area that is red and swollen, insulin absorption could be delayed. This can result in high blood glucose levels. 

If you are using an insulin pump, check to make sure that the needle has not come out of the infusion site and that the infusion line has not come loose from the pump. If insulin is leaking, it cannot get to where it needs to go. Also check for blood, air or kinks in the infusion line. If you have noticed any of these things or if the infusion set has been in place for more than 2 days, think about changing the infusion line.

 

Also, check to see that the basal rate is set correctly on your insulin pump. Check the battery. If it has run down, insulin cannot be pumped efficiently. Make sure the insulin cartridge is not empty and has been placed correctly. Always make sure to prime the pump with insulin when inserting a fresh cartridge. If the pump is not working correctly, insulin will not be delivered at the correct dose and blood glucose levels will rise.

 

Other factors can also affect blood glucose levels. Illness, stress, medications, level of physical activity, or any change in your normal routine can also lead to changes in hormonal action and blood glucose levels. If you are female, your blood glucose may be more difficult to control at certain phase of your menstrual cycle. If you are going through menopause, this could also affect your blood glucose levels. If you still can’t figure out what is causing your hyperglycemia, check with a member of your health care team.

Sources and References

• The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

 

• Type 2 diabetes: principles of pathogenesis and therapy by Michael Stumvoll, Barry Goldstein and Timon van Haeften

 

 

• Stress-induced hyperglycemia by K C McCowen, A Malhotra and B R Bistrian

 

• Unexplained hyperglycemia in continuous subcutaneous insulin infusion: evaluation and treatment by Stephen Ponder, Jay Skyler, David Kruger et al