Hyperglycemia: Treat It Early

Written by Amy Hess Fischl, MS, RD, LDN, BC-ADM, CDE

According to the Concise Oxford English Dictionary, hyperglycemia is “an excess of glucose in the bloodstream”.  Depending on who you are and whether you have diabetes or not, hyperglycemia (or high blood sugar) will have a different answer.  For example, without diabetes, hyperglycemia is >100 mg/dL before meals and >140 ,g/dL after meals.  For diabetes, these blood sugar goals are individualized, but typically it is considered high blood sugar if your pre-meal blood sugar stays above 130 mg/dLand after meal stays above 180 mg/dL. It is natural for blood sugar levels to rise, but if they remain high consistently, then action must be taken.  Being able to recognize the signs and symptoms of hyperglycemia early is helpful.  Remember, that signs and symptoms may not always be present and you may not have symptoms due to high blood sugars ever.

If your blood sugar rises and STAYS up too high, it can be dangerous—and it can possibly lead to an emergency room visit, especially if you are having trouble breathing, which may be a sign of diabetic ketoacidosis. That particular topic is covered in another article. When in doubt, contact your healthcare provider to find out what to do.

Also, if your blood sugar is continually in the high range, your likelihood of developing long-term diabetes complications such as nerve damage, kidney failure, and heart disease rises dramatically. So it is important to detect when your blood glucose reaches unacceptable levels.

Early Signs and Symptoms of Hyperglycemia
How people generally discover that they have diabetes is due to certain symptoms that are typically associated with prolonged high blood sugar.  Those include:

It is also important to realize that sometimes, there will not be symptoms at all.

Blood glucose monitoring is the best tool we have to identify when hyperglycemia is occurring and if there is a pattern of it consistently happening at any particular time.  For those not taking diabetes medications, you could test occasionally after meals.  This can help you figure out how the meals you eat are affecting your blood sugar – if the level is above the goal that is right for you (generally <180 mg/dL at 1 hour and <140 mg/dL at 2 hours) then meal adjustments can be made.  For those taking insulin, the after meal blood sugar can help them identify the correct per-meal insulin dose that is right for them. Talk to your healthcare team to create a goal of how often and when to test blood sugars.

What Can Cause Hyperglycemia?
It is unrealistic to expect blood sugar levels to remain within recommended levels all the time.  Various situations can cause hyperglycemia:

There are MANY factors that can affect blood sugars, so sometimes the actual cause may not be evident.

Hyperglycemia Treatments
If your blood glucose is consistently high (based on your individualized  target levels) then adjustments need to be made. Work with your healthcare team to problem solve a plan that is right for you.

Diabetes self-management education (DSME) is the ongoing process of facilitating the knowledge, skill, and ability necessary for diabetes self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. Diabetes education and ongoing resources provide the foundation to help people with diabetes navigate their everyday lives by providing tools they need to be successful in managing their diabetes. The overall objectives of DSME are to support informed decision making, self-care behaviors, problem solving, and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life. Working with a diabetes educator who provides answers to diabetes questions, discusses blood sugar goals and problem solving tips to maintain better overall blood sugar improvements have been shown to improve health outcomes.  Since hyperglycemia is a common problem with diabetes, it is important to note that goal setting is individualized.  What may work for one person, may not work for another.  So, sitting down with a diabetes educator and receiving ONGOING diabetes education can help you understand WHY your blood sugars may rise, give you tips on how to help maintain blood sugars within your goal ranges and help create a plan of what to do if the blood sugars start to rise in the future.  We know that receiving advice may work for a little while, but lives change, our needs change and that means a new plan must be created to help what is happening NOW.

Some tried and true ways to help reduce blood sugars:

How to Prevent Prolonged Hyperglycemia
Diabetes is a long-term condition which requires frequent adjustments to maintain blood glucose levels within a healthy range.

Working with a diabetes educator on an ongoing basis can help hone in on trends that affect blood sugar levels.  Remember, those on Medicare receive up to two hours of diabetes self-management education and two hours of nutrition education every year through a recognized diabetes education program.  Take advantage of it!

To find a program near you, click here.

Continue Reading

How to Avoid Diabetic Ketoacidosis