Hyperglycaemia
Hyperglycaemia is the term used when there is a raised concentration of sugar in the blood. It has a much slower onset than hypoglycaemia. It is present when diabetes is just diagnosed but can also happen when diabetes is not well enough controlled. This may be for a number of reasons:
- Not enough insulin
- Medication not working as well as before
- Too much sugar or carbohydrate in the diet
- During illness
- With some drugs e.g. steroids
Is hyperglycaemia serious?
In people with type 1 diabetes, where no insulin is produced in the body, hyperglycaemia (that is a very raised blood sugar), if left unchecked, can develop into a serious condition called diabetic ketoacidosis or DKA for short. This is a state of severe uncontrolled diabetes caused by insulin deficiency, which requires emergency treatment in hospital with insulin and intravenous fluids.
What are the symptoms of hyperglycaemia?
There may be no symptoms at first, but persistent and prolonged high blood sugars can cause:
- Thirst and a dry mouth
- Excess urine production
- Tiredness
- Blurred vision
- Mood changes
- Fast deep breathing
- And eventually drowsiness and coma
How can I avoid hyperglycaemia?
- Monitor your blood sugars regularly
- Never miss your tablets or insulin
- If taking insulin you may need to increase the dose of insulin when you are ill
- Follow a healthy diet and take regular exercise
Remember – a few high blood sugar readings are inevitable sometimes, but if your sugars stay high this can cause problems – so if you are worried about high blood sugars – seek help! Contact your doctor or diabetes nurse.
Tell me more about the ‘sick day’ rules?
Having diabetes means there are extra things to think about and do when you are sick in order to prevent your diabetes getting out of control. This is especially important if you have type 1 diabetes. Part of the body's natural response to the stress of an illness (such as an infection) is to make more sugar. In people with type 1 diabetes this may lead to very high blood sugar levels and the condition known as diabetic ketoacidosis. During periods of illness you may experience a loss of appetite and then reduce your intake of food. Many insulin treated patients reduce or stop their insulin due to concerns about hypoglycaemia during illness. This is not the right thing to do. Instead you must follow the ‘sick day’ rules ...
- Never stop taking your insulin or omit doses. Your blood sugar levels may continue to rise even if you do not eat.
- If your blood sugar levels are higher than 10 mmol/l you may need to take more insulin or an additional dose of insulin.
- Test your blood glucose more often. If your levels are unstable increase the frequency of your tests to every 4 hours or more.
- If blood glucose readings are higher than 13 mmol/l, and you are unwell or vomiting, check your urine for ketones. Use 'Ketostix' strips to test your urine. Your Diabetes Nurse will advise you on how to get hold of these strips. Ketones indicate a lack of insulin. The ongoing presence of ketones in the urine may be a warning of developing ketoacidosis and should be acted upon.
- Drink lots of fluids. It is easy to become dehydrated when you are ill especially if you have a temperature, vomiting or diarrhoea. If you are unable to keep fluids down call your doctor. Aim to drink at least 3 litres of fluid a day.
- Stick to your normal diet as far as possible. If unable to eat solids take liquids and even sugary drinks if necessary. If you don't feel like eating, replace your solid food with soup, milk, ice cream, fruit juice, sugar, honey, fruit juice.
You or a relative should seek assistance if you are:
- Unable to eat or drink
- Losing fluids due to repeated vomiting or diarrhoea
- Recording a very high blood sugar level (higher than 25 mmol/l) despite taking more insulin
- Showing persistent ketones or 'large' ketones (more than ++)
- Recording blood glucose levels that are low
- If you become drowsy or confused
- If you are worried!
If in doubt get in touch – better to be safe than sorry.