March 18, 2015

Hyperglycemia – Part 1

Hyperglycemia or high blood glucose levels are more common than even I realized. In talking with a doctor recently, he made mention of the number of patients he serves who don't worry about blood glucose readings consistently over 200 mg/dl (11.1 mmol/L). I asked why they are not concerned. He admitted he does not understand why as he has told them about the complications that can develop and losing their eyesight, kidney failure, heart problems, and that readings consistently over 150 mg/dl (8.3 mmol/L) would cause the complications. He said that they even see readings near 300 mg/dl (16.7 mmol/L). HbA1c readings were mostly between 8.0 and 11.9% on a regular basis.

He has tried to educate them, and teach them what testing can tell them, but nothing changes. Other patients are doing excellent and he had no concerns about their developing complications. He is not concerned about patients that have excursions into blood glucose levels above 150 mg/dl. Yes, he is concerned about hyperglycemia and how it affects people with diabetes.

Several factors can contribute to hyperglycemia,
  1. Food
  2. Physical activity choices
  3. Illness
  4. Nondiabetes medications
  5. Too low a dose of glucose-lowering medication
It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as diabetic coma. In the long term, persistent hyperglycemia, even if not severe can lead to complications affecting your eyes, kidneys, nerves, and heart. This is why you should be instructed about testing and why you need to contact your doctor if you have consistent elevated blood glucose readings.

Symptoms of hyperglycemia generally don't happen until blood glucose is elevated above 200 mg/dl (11.1 mmol/L). Then the symptoms can develop slowly over several days or weeks. The longer blood glucose levels remain elevated, the more serious the symptoms become.

Recognizing the early symptoms of hyperglycemia can help you treat the condition promptly. Watch for:
  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Fatigue
  • Headache
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
  • Abdominal pain
  • Coma
If you let hypoglycemia get to the level above, call 911 or emergency medical assistance if:
  1. You're sick and can't keep any food or fluids down, and
  2. Your blood glucose levels are persistently above 240 mg/dl (13.3 mmol/L) with ketones in your urine
Continued in the next blog.


Denise said...

I wonder if folks with those higher blood glucose levels have given up being able to effect change and so put on an air of not caring? I know when my levels were rising and rising, regardless of the medications I took - even insulin! - I was really discouraged. Making the dietary and activity level changes that will help the medication do its work is hard and not everyone has access to the information and support necessary to make those changes; I wish it were so.

Bob Fenton said...

Denise - I believe it is a combination of factors. Age at diagnosis, unwillingness to make changes necessary, belief in too many diabetes myths, desire to continue life as usual, and many more reasons.

Our support group is working with three such individuals presently, but we are being ignored and two have told us to stop working with them. The third person is slowly improving and changing what and how much they eat. Readings have dropped from the lower 300's to mid 100's and the proof as he tells it, is how much better he is feeling.