By Dr. Loretta Lanphier, ND, CN, HHP, CH

The ways that our bodies take raw ingredients from our food and turn them into energy never cease to amaze me. We are truly an awesome example of engineering at its best. However, sometimes these incredible organisms we call our bodies break down, and are unable to perform the way they were designed. We call this disease, and hyperglycemia is one example of this. Hyperglycemia is all about too much of a good thing:  blood sugar.

What is Hyperglycemia?

Hyperglycemia, also known as hyperglycaemia, is a term that comes from the Greek (hyper meaning “excessive”, glyc meaning “sweet”, and emia meaning “of the blood.”) In laymen’s terms it means “high blood sugar.” When you have hyperglycemia, there is an abnormally high amount of sugar in your blood. The illness diabetes mellitus, or diabetes as most of us know it by, could actually be called chronic hyperglycemia, because an ongoing hyperglycemic state that needs to be consistently managed is the defining characteristic of diabetes.

Chances are if you don’t have diabetes or are not developing the disease, you will never personally have to worry about hyperglycemia. The vast majority of hyperglycemia cases are related to diabetes. There are, however, some exceptions. The most common causes for non-diabetic hyperglycemia are:

  • Eating disorders:  Sometimes people who binge eat, as in the case of bulimia nervosa patients, will experience hyperglycemia after eating large amounts of food in a short period of time, especially if the foods are high in carbohydrates. A bulimic person can develop chronic hyperglycemia if their illness is extensive enough.
  • Certain medications:  Some drugs will raise blood sugar levels as a side effect. These include corticosteroids, beta blockers (for treating heart disease), some diuretics, niacin, and some antipsychotic drugs.
  • Acute stress:  Many victims of such events as a heart attack or stroke will develop acute and sudden hyperglycemia, even if they are not diabetic. In fact, a large percentage of deaths from major heart attacks and strokes is due to hyperglycemia and not the event itself.

How Does Hyperglycemia Relate to Diabetes?

Perhaps a little background information on diabetes will help us understand hyperglycemia better. Diabetes, in a nutshell, is a condition that results in too much sugar in the blood (hyperglycemia). A substance normally produced by the pancreas called insulin normally regulates the amount of glucose in our bloodstream. Diabetes occurs when either the pancreas fails to produce enough insulin, or the insulin cannot be properly utilized.

Diabetes is broken down into two major groups:  Type 1, or insulin dependent diabetes, and Type 2, or non-insulin dependent diabetes. Type 1 patients must take insulin injections, along with exercise and a controlled diet, to manage their diabetes. Type 2 diabetes is usually less serious, and can typically be controlled with exercise, diet, and oral insulin medications if necessary. However, if left unchecked, it can easily develop into the more critical type 1 diabetes.

Some diabetes is inherited, especially Type 1, but the vast majority of Type 2 diabetes is the result of obesity and poor lifestyle and dietary choices. Type 2 diabetes is being seen in epidemic proportions, especially amongst overweight children and teens in the United States. The combination of junky foods and an inactive lifestyle is a terrific breeding ground for Type 2 diabetes.

What Are the Symptoms of Hyperglycemia?

In general, the most common signs of hyperglycemia include:

  • Increased thirst
  • Increased frequency of urination
  • Dry mouth
  • Lack of concentration
  • Blurred vision
  • Fatigue
  • Weight loss
  • Nausea
  • Increased hunger
  • Dry or itchy skin

Diabetics must consistently monitor their blood sugar levels in order to manage their disease. The range of normal readings for most people is between 80-120 mg/dL, but “normal” can vary from person to person. Any reading greater than 130 mg/dL (milligrams/deciliter) is considered hyperglycemic, while any reading less than 70 mg/dL is considered “hypoglycemic” (too little blood sugar). Blood glucose levels are typically tested before and after meals, and at bedtime. There are many home test devices on the market. Most of them involve a pinprick on the fingertip in order to supply blood for testing. The blood is analyzed with a glucose meter, which then gives the results.

There is now a whole new generation of high-tech glucose monitoring devices that may soon make the old-fashioned finger prick ones obsolete. These “continuous glucose sensor” machines can be embedded into the skin and give a constant running report of glucose levels in digital form, graphical form, or both. They must be initially correlated with several finger prick readings, but can then run for several days before needing to be reset. Some even have alarms to warn users when levels are outside preset parameters. This type of machine is a welcome improvement to most diabetics, if they are able to afford them, that is. The continuous readouts are especially helpful when changes are being made in the treatment plan, such as dietary or exercise adjustments. The need for less finger pricks is also a great improvement.

Advanced symptoms of prolonged hyperglycemia include:

  • Slow-healing cuts and sores
  • Vision problems
  • Intestinal dysfunction, such as chronic constipation or diarrhea
  • Skin infections
  • Vaginal infections
  • Erectile dysfunction
  • Nerve damage causing cold or insensitive feet (can sometimes lead to amputation)
  • Nerve damage that can lead to failure of the associated organs, such as the kidney.

Critical complications of hyperglycemia include:

  • Ketoacidosis:  Also known as “diabetic coma,” is a life threatening condition that necessitates immediate emergency care. This occurs when the body does not have enough insulin, and therefore cannot convert glucose into energy. It attempts to use fats as fuel for energy, and this process produces acids in your blood and urine called “ketones.” Eventually the ketones will have a poisonous effect. Symptoms include: fruity breath, nausea and vomiting, shortness of breath, and unconsciousness. Ketoacidosis is most often a threat to Type 1 diabetics.
  • Hyperglycemic hyperosmolar nonketotic syndrome (HHNS):  This is a potentially fatal condition that can take days or even weeks to develop. It is most common in Type 2 diabetics, but can occur in Type 1 as well. It is also more common in senior citizens. HHNS is also a medical emergency. Typical symptoms of HHNS include:
    • Blood glucose levels of greater than 600 mg/dL
    • Warm, dry skin with no perspiration
    • Fever greater than 101F
    • Extreme sleepiness
    • Confusion
    • Parched mouth
    • Hallucinations
    • Vision difficulties
    • Weakness on one side of the body

What Causes Diabetic Hyperglycemia?

Diabetes is a complex disease that must be managed differently for every patient. So the way that most diabetics get hyperglycemic is by neglecting to take the proper steps involved with their own personal management of the disease. Possible causes include:

  • Forgetting to take medication, either insulin injections for Type 1, or oral medications for Type 2. Not only is the dosage important, but the timing of the medications is also carefully planned and individualized to each patient.
  • Too many grams of carbohydrates: This error can be total grams of carbos, or grams of carbos in relation to the amount of insulin taken.
  • Eating too much: Too many calories at one sitting can also lead to excess blood sugar.
  • Too little exercise: Part of diabetic management is regulating physical activities. Neither too much nor too little is good.
  • Strenuous physical activity: Sometimes an unplanned strenuous activity can throw off the balance as well.
  • Stress: Increased levels of either physical or emotional stress can trigger hyperglycemia as well.
  • Illnesses or infections: When your body is fighting off disease or infections, sometimes blood sugar levels can be affected.

How Can Hyperglycemia Be Avoided?

It is important for diabetics to keep excellent records of their glucose levels, especially if hyperglycemia becomes an issue. If you are having early symptoms of hyperglycemia, be sure to take several glucose readings at different times of the day before talking with your health care team. Management of diabetes can be quite tricky, and the more information you are armed with, the better. As the illness progresses, changes in the treatment plan must be considered. It is vitally important that you are very clear on what your management plan is, and that you stick to it religiously. Failing to follow the prescribed plan is how most diabetics run into trouble with hyperglycemia and other complications of diabetes.

Here are some suggestions to help correct hyperglycemia, but remember to discuss any changes with your health care team before implementing them:

  • Drink more water: You usually can’t go wrong with this choice. Drinking ample amounts of pure, filtered water will help remove excess glucose from your urine, and boost your over all health as well. It will also help prevent dehydration.
  • Increase exercise: This advice comes with some precautionary measures. Additional exercise can help to lower blood glucose levels. However, if you are Type 1 diabetic and your blood glucose is greater than 240 mg/dL, have your urine checked for ketones before increasing exercise. If you have ketones in your urine, DO NOT exercise, as this can be very dangerous. If you exercise with ketones in your urine, it can cause your blood glucose to go even higher. If your blood sugar is greater than 300 mg/dL, do not exercise regardless if you have ketones present or not.
  • Dietary changes: Do not attempt to make these adjustments on your own, but consult with your dietician to see if changes in your illness necessitate changes in the amount or types of food you are consuming. Frequency of eating is also a factor to be considered.
  • Medication changes: Check with your health team regarding possible changes in the type, dosage, and timing of your medications. As the diabetes changes the ways it affects your body, your medication needs often change as well. Again, please do not make these determinations on your own.

Folks who are diabetic and struggle with hyperglycemia or other complications of their illness may feel sorry for themselves from time to time. However, diabetes can at least be controlled and managed by following a strict, and at times demanding regimen. But that is more than can be said for some conditions.

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