Hyperglycemia: Treat It Early

How to Treat High Blood Glucose

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.

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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 continually remains elevated over a very long period of time (decades), the likelihood of developing long-term diabetes complications such as nerve damage, kidney failure, and heart disease rises dramatically. So it is important to keep track of when your blood sugar reaches consistently elevated levels. Just because your blood sugars have risen a little higher than your current goals, that also does not mean that you will develop long-term complications. The American Diabetes Association publishes The Standards of Medical Care every year to highlight the key recommendations for diabetes care. There are particular recommendations to reduce the risk of long-term complications. Those include: 

  1. Annual dilated eye exam by an ophthalmologist or an optometrist
  2. Dental exam every 6 months
  3. Blood tests annually to make sure cholesterol, overall blood sugar control and kidney function are within range
  4. Annual foot examination

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:

  • Increased thirst
  • Increased urination
  • Increased hunger
  • Sleepiness
  • Blurred vision
  • Infections or injuries that will not heal as quickly as in the past

By following these recommendations, it will help reduce the risk of long-term complications. But, it all starts with trying to keep the blood sugars within your goal ranges.

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

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:

  • Increased thirst
  • Increased urination
  • Increased hunger
  • Sleepiness
  • Blurred vision
  • Infections or injuries that will not heal as quickly as in the past

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:

  • Eating more than you planned to eat (especially carbohydrates, since too many at one time can increase the blood sugars)
  • Not exercising enough or not being active at all
  • Having a cold or the flu, which causes stress on the body
  • Mental stress – having a fight with a friend/spouse/child, preparing for a test or a big project
  • Not getting enough sleep
  • Taking corticosteroids for an illness or treatment
  • The medications that you are taking are not working well enough
  • For those on insulin, not taking enough or skipping a dose

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 the 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:

1. Exercise: Exercise can help your body use the extra glucose since our muscles use sugar for energy, whether you have type 1 diabetes or type 2 diabetes.

But please note, if your blood glucose level is above 250 mg/dL and you have type 1 diabetes, you’ll need to check for ketones before exercising (you can use a ketone strip to test your urine). If you have ketones or if your blood sugar is >300, you should not exercise since exercising with ketones or with very high blood sugars will cause your levels to rise even higher.

2. Drink water:  Since consistently high blood sugars lead to increased urination, this will remove more fluid from the body and lead to mild dehydration. We need to help replace the fluids lost.

3. Adjust what and when you eat: Meeting with a Registered Dietitian Nutritionist (RDN) a few times to better individualize your meal planning needs will help identify how to better spread out meals and understand which foods (and their quantities) may have the biggest impact on blood sugar levels.

4. Adjust your medications or insulin: As with your meal plan, your medications (including insulin) may need an adjustment if your blood glucose readings are not in the range set for you. Speak with your healthcare team to have a plan of how to adjust medications for prolonged hyperglycemia.

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, you can use the American Diabetes Association Program Finder or American Association of Diabetes Educators' Program Finder.

Updated on: August 22, 2019
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How to Avoid Diabetic Ketoacidosis
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