Hyperglycemia – Part 2

I know some stubborn people with diabetes that will not contact their doctor and then often forget about what has happened for the period between appointments. You should make an appointment with your doctor if:

1. You experience ongoing diarrhea or vomiting, but you're able to take some foods or drinks
2. You have a fever that lasts more than 24 hours
3. Your blood glucose is more than 240 mg/dl (13.3 mmol/L) even though you've taken your diabetes medication
4. You have trouble keeping your blood glucose within the desired range

During digestion, your body breaks down carbohydrates from foods, such as bread, rice, and pasta, into various sugar molecules. One of these sugar molecules is glucose, which is the main energy source for your body. Glucose is absorbed directly into your bloodstream after you eat, but it can't enter the cells of most of your tissues without the help of insulin, a hormone secreted by your pancreas.

When the level of glucose in your blood rises, it signals your pancreas to release insulin. The insulin, in turn, unlocks your cells so that glucose can enter and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen.

This process lowers the amount of glucose in your bloodstream and prevents it from reaching dangerously high levels. As your blood sugar level returns to normal, so does the secretion of insulin from your pancreas. Diabetes drastically diminishes the effects of insulin on your body, either because your pancreas doesn't produce enough insulin (type 1 diabetes) or because your body is resistant to the effects of insulin or doesn't produce enough insulin to maintain a normal glucose level (type 2 diabetes). As a result, glucose tends to build up in your bloodstream and may reach dangerously high levels (hyperglycemia) if not treated properly. Insulin or other drugs are used to lower blood sugar levels.

Many factors can contribute to hyperglycemia, including:

1. Not using enough insulin or oral diabetes medication
2. Not injecting insulin properly or using expired insulin
3. Not following your diabetes eating plan
4. Being inactive
5. Having an illness or infection
6. Using certain medications, such as steroids
7. Being injured or having surgery
8. Experiencing emotional stress, such as family conflict or workplace challenges

Illness or stress can trigger hyperglycemia because hormones produced to combat illness or stress can also cause your blood sugar to rise. Even people who don't have diabetes may develop hyperglycemia during severe illness. But people with diabetes may need to take extra diabetes medication to keep blood glucose near normal during illness or stress. Always make sure that you contact your doctor when blood glucose levels are above 200 mg/dl.

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

• Cardiovascular disease
• Nerve damage (neuropathy)
• Kidney damage (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
• Bone and joint problems, such as osteoporosis
• Skin problems, including bacterial infections, fungal infections and nonhealing wounds
• Teeth and gum infections

Concluded in next blog.