Hyperglycemic Hyperosmolar Nonketotic Syndrome
Hyperglycemic hyperosmolar nonketotic coma is an extremely serious complication which can happen in those with type 1 or type 2 diabetes. It most often occurs in those who are non-insulin dependent .
HHNKC is characterized by dangerously high blood sugar over 600 mg/dL. It is typically brought on by an infection such as pneumonia, a urinary tract infection, or uncontrolled blood sugar. If left untreated, it can result in coma and even death.
Signs and symptoms include:
- Weakness or paralysis on one side of the body
The best way to prevent HHNKC is to take your medications as directed and to keep in contact with your healthcare team when your blood sugar is consistently over 300 mg/dL.
Managing Blood Sugar Levels
must check their blood sugar levels daily with a glucose meter. This device takes a drop of blood, usually from a finger, and displays the sugar level within a few seconds.
People with type 1 diabetes will need to take insulin as their doctor recommends, usually several times a day.
Those with type 2 diabetes or gestational diabetes may need to change their diet and exercise habits. They may also need to take oral medications or insulin.
Various strategies hyperglycemia.
- Check their blood sugar levels as their doctor advises and take the correct amount of insulin if they have type 1 diabetes.
- Speak with a doctor or dietitian about which foods to eat or avoid, how much to eat, and how often.
- Take precautions to avoid infections, for example, through regular handwashing, as illness, such as a cold, can trigger an increase in blood sugar levels.
- Plan their food intake and exercise to balance blood sugar levels.
- Minimize stress as far as possible, for example, through exercise, getting enough sleep, and stress-reducing activities such as meditation or yoga.
Low blood sugar, or hypoglycemia, can occur when a person:
- has certain medical conditions
- does a lot of exercise
- skips meals or eats too little
It can also be a side effect of diabetes medicines. Taking too much insulin can result in low blood sugar levels.
Symptoms of low blood sugar may include:
- feeling weak or shaky
- fast heart rate, or palpitations
- consult doctor regularly
How Is Hyperglycemia Diagnosed
If you have diabetes and notice a sudden change in your blood sugar levels during your home monitoring, you should alert your doctor of your symptoms. The increase in blood sugar may affect your treatment plan.
Regardless of whether you have diabetes, if you begin experiencing any symptoms of hyperglycemia, you should speak to your doctor. Before going to your appointment, you should note what symptoms youre experiencing. You should also consider these questions:
- Has your diet changed?
- Have you had enough water to drink?
- Are you under a lot of stress?
- Were you just in the hospital for surgery?
- Were you involved in an accident?
Once at your doctors appointment, your doctor will discuss all of your concerns. Theyll perform a brief physical exam and discuss your family history. Your doctor will also discuss your target blood sugar level.
If youre age 59 or younger, a safe blood sugar range is generally between 80 and 120 milligrams per deciliter . This is also the projected range for people who dont have any underlying medical conditions.
People who are age 60 or older and those who have other medical conditions or concerns may have levels between 100 and 140 mg/dL.
Your doctor may conduct an A1C test to determine what your average blood sugar level has been in recent months. This is done by measuring the amount of blood sugar attached to the oxygen-carrying protein hemoglobin in your red blood cells.
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Symptoms Of Low Blood Sugar Level
Hypoglycemia is a condition in which your blood sugar levels are too low. It can occur if you dont eat for a while or have diabetes and take too much insulin.
Symptoms of hypoglycemia can include:
- Having a fast heartbeat
If you have diabetes and think you might be experiencing hypoglycemia, its essential to check your blood sugar levels immediately. Furthermore, if theyre low, eat or drink something that will raise your blood sugar levels quickly, such as fruit juice, hard candy, crackers with peanut butter, or milk.
If an individual has diabetes, they need to keep their blood sugar levels. One can do this by managing their blood glucose, blood pressure, and cholesterol levels.
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HealthifyMe addresses the underlying issue. By examining your medical history, evaluating your medications, and analysing diagnostic test results, we get to the bottom of the problem and give you more insight into your situation.
Causes Of Blood Sugar
Your blood sugar may rise if you:
- Skip or forget your insulin or oral glucose-lowering medicine
- Eat too many grams of carbohydrates for the amount of insulin you took, or eat too many carbs in general
- Have an infection
- Are under stress
- Become inactive or exercise less than usual
- Take part in strenuous physical activity, especially when your blood sugar levels are high and insulin levels are low
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What Is High Blood Sugar
High blood sugar occurs when theres a buildup of excess glucose in the bloodstream. This is more often a concern for someone with diabetes than it is for someone without it. Our bodies are typically pretty great at keeping our blood sugar in perfect balance, Deena Adimoolam, M.D., assistant professor of endocrinology at the Icahn School of Medicine at Mount Sinai, tells SELF. But in some situations, like when a person has diabetes, high blood sugar can happen.
Blood sugar is measured in milligrams per deciliter , and a fasting blood sugar of greater than 125 mg/dL is considered hyperglycemic, the Cleveland Clinic says. A person can also be considered to have hyperglycemia if their blood glucose level is higher than 180 mg/dL one to two hours after eating, the Cleveland Clinic says.
How Are High Blood Sugar Levels Treated
Treating high blood sugar levels involves fixing what caused them in the first place. Your diabetes health care team will give you specific advice on how to keep your blood sugar levels in a healthy range. But here are some ways to manage the common causes of high blood sugar levels:
|Reason for High Blood Sugar Level
|What to Do
|Not getting enough insulin or other diabetes medicine
|Not following the meal plan
|Not getting enough exercise
|Use of other medicines that can increase blood sugar
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Oral Glucose Tolerance Test
Youll be given a special sweetened drink prior to this blood test. A test result of 11.1 mmol/L or greater taken two hours after having the sweet drink indicates diabetes.
A second test must be done in all cases . Once diabetes has been diagnosed, ask your doctor to refer you for diabetes education. Diabetes Canada also has many resources to help you understand diabetes better and live a long and healthy life. Being diagnosed with type 2 diabetes and managing the disease is not easy. But it is important to know that you can live a long and healthy life by taking a number of steps including keeping your blood sugar levels in target range.
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What Are The Dangers And Complications Of High Blood Sugar
Long-term complications of prolonged hyperglycemia or high blood sugar can be severe. These occur in people with diabetes and are worse when the condition is poorly controlled. The long-term complications of diabetes tend to develop slowly over time.
Some of the complications of hyperglycemia in poorly controlled diabetes are:
- Heart and blood vessel disease can increase the risk of heart attack, stroke, and peripheral artery disease
- Poor kidney function eventually leads to kidney failure
- Nerve damage can lead to burning, tingling, pain, and changes in sensation
- Eye diseases, including damage to the retina, glaucoma, and cataracts
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How Is Diabetes Diagnosed
The fasting blood glucose test is the preferred way to diagnose diabetes. It is easy to perform and convenient. After the person has fasted overnight , a single sample of blood is drawn and sent to the laboratory for analysis. This can also be done accurately in a doctors office using a glucose meter.
- Normal fasting plasma glucose levels are less than 100 milligrams per deciliter .
- Fasting plasma glucose levels of more than 126 mg/dl on two or more tests on different days indicate diabetes.
- A random blood glucose test can also be used to diagnose diabetes. A blood glucose level of 200 mg/dl or higher indicates diabetes.
When fasting blood glucose stays above 100mg/dl, but in the range of 100-126mg/dl, this is known as impaired fasting glucose . While patients with IFG or prediabetes do not have the diagnosis of diabetes, this condition carries with it its own risks and concerns, and is addressed elsewhere.
The oral glucose tolerance test
For the test to give reliable results:
- The person must be in good health .
- The person should be normally active , and
- The person should not be taking medicines that could affect the blood glucose.
- The morning of the test, the person should not smoke or drink coffee.
Evaluating the results of the oral glucose tolerance test
Glucose tolerance tests may lead to one of the following diagnoses:
Nausea Vomiting Confusion And More
These seemingly disparate symptoms are all signs of a rare and life-threatening state called diabetic ketoacidosis , according to the U.S. National Library of Medicine. DKA can cause the symptoms above, as well as stomach pain, trouble breathing, dry or flushed skin, fruity-smelling breath, or difficulty paying attention. It usually occurs in people with type 1 diabetes and is sometimes the first sign they are sick, according to the U.S. National Library of Medicine. DKA happens when the liver is unable to use the sugar in the blood for energy without insulin and begins to break down body fat into a type of fuel called ketones at such a high rate that they become toxic and make the blood acidic, the U.S. National Library of Medicine explains. DKA can be fatal if left untreated, so anyone experiencing these symptoms should seek care immediately.
Over time, untreated high blood sugar can cause additional symptoms, such as:
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Things To Know About High Blood Sugar
- Low high blood sugar is abnormally high blood levels of insulin in the blood. Hyperglycemia is a hallmark sign of diabetes and prediabetes, and diabetes is the most common cause of it. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome .
- The primary symptom of hyperglycemia is excessive amounts of sugar in the urine. Other symptoms and signs of high blood sugar levels in the blood are blurred vision, hunger , and headaches.
- Other conditions that can cause high blood sugar are pancreatitis, Cushing’s syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses.
- Insulin is the treatment for people with type 1 diabetes, and life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for elevated glucose.
Microvascular Damage Of Eyes Kidneys Toes Etc
Microvascular damage is defined as damage to small blood vessels, and its a common consequence of high blood sugar. Evidence confirms that acute hyperglycemia causes microvascular damage and leads to poor functional recovery, especially in patients who have sustained myocardial infarction.
For example, numbers show that more than 661,000 Americans have kidney failure, but high blood pressure and diabetes are the most common risk factors for this serious health problem. Almost half of the patients with chronic kidney disease have diabetes. This isnt such a surprise if we bear in mind that poor glycemic control is associated with microvascular disease development.
High blood sugar damages nerves and interferes with their ability to send signals, which causes diabetic neuropathy. Damage of this kind usually affects eyes, kidneys, toes, and other parts of a patients body.
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When Is Blood Sugar Considered To Be Too High Or Too Low
Slight fluctuations in blood sugar levels are completely normal, and also happen every day in people who dont have diabetes, in response to the food they eat. Between around 60 and 140 milligrams of sugar per deciliter of blood is considered to be healthy. This is equivalent to a blood sugar concentration of between 3.3 and 7.8 mmol/l. Millimoles per liter is the unit that blood sugar is measured in. It describes the amount of a certain substance per liter.
If someone has readings over 7.8 mmol/l , they are considered to have hyperglycemia. These high blood sugar levels mainly occur if there isnt enough insulin or the insulin doesnt work properly. Without the effect of insulin, the organs cant make good use of the sugar in the blood, so the sugar builds up. If type 1 diabetes is left untreated, blood sugar levels can increase to over 27.8 mmol/l . Such high levels tend to be uncommon in type 2 diabetes.
Blood sugar levels below 3.3 mmol/l are considered to be too low. But, as you can see in the illustration below, there are no clear-cut borders between normal blood sugar levels and too high or too low blood sugar levels.
Blood sugar: Normal range between hyperglycemia and hypoglycemia
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High Blood Sugar Levels
If you have diabetes, you can find out if your blood sugar level is high by having a blood sugar test.
You may have regular tests by your care team or GP surgery, or you may have tests you can do at home.
|Type of test
|Test done by a health professional to check your blood sugar level over the last 2 or 3 months
|48 mmol/mol or over
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What You Can Do Now
Your doctor will provide you with clear steps to follow aimed at lowering your blood sugar levels. Its important that you take their recommendations to heart and make any necessary lifestyle changes to improve your health. If left untreated, hyperglycemia can lead to serious, and sometimes life-threatening, complications.
Your doctor may recommend that you buy a blood glucose meter to use at home. This is a simple and effective way to monitor your blood sugar and act quickly if your levels have spiked to an unsafe level. Being aware of your levels can empower you to take charge of your condition and live a healthy lifestyle.
Nighttime Low Blood Sugar
While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:
- Having an active day.
- Being physically active close to bedtime.
- Taking too much insulin.
- Drinking alcohol at night.
Eating regular meals and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think youre at risk for low blood sugar overnight, have a snack before bed.
You may wake up when you have low blood sugar, but you shouldnt rely on that. A continuous glucose monitor can alert you with an alarm if your blood sugar gets low while youre sleeping.
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How To Prevent It
If you work to keep your blood sugar under control — follow your meal plan, exercise program, and medicine schedule — you shouldnât have to worry about hyperglycemia. You can also:
- Know your diet — count the total amounts of carbs in each meal and snack.
- Test your blood sugar regularly.
- Tell your doctor if you have repeated abnormal blood sugar readings.
- Wear medical identification to let people know you have diabetes in case of an emergency.