Hyperglycemia refers to high levels of sugar, or glucose, in the blood. It occurs when the body does not produce or use enough insulin, which is a hormone that absorbs glucose into cells for use as energy.

High blood sugar is a leading indicator of diabetes. If a person with diabetes does not manage the sugar levels in their blood, they can develop a severe complication called diabetic ketoacidosis (DKA).

If a person does not get treatment for ketoacidosis, they can fall into a diabetic coma, which a dangerous complication of diabetes.

In this article, we look at how to recognize hyperglycemia, ways to treat it, and possible causes and complications.

Causes

Most people will experience an increase in blood sugar levels after eating an unusually large high-glucose meal, but people who experience consistent hyperglycemia may have problems with producing or using insulin.

Insulin is a hormone produced in the pancreas that allows cells to use glucose for generating energy and functioning normally. When insulin is low or inefficient, diabetes may develop.

There are two types of diabetes:

• Type I diabetes occurs when the body does not produce insulin.
• Type 2 diabetes occurs when the body does not use insulin effectively. As a result, glucose remains in the blood and circulates the body.

Overeating and not doing enough exercise can lead to continuously high amounts of sugar in the blood. This can reduce the efficiency of insulin by giving it more glucose than it can process.

Stress in work, life, and relationships can also release hormones that keep glucose at high levels in the blood. One study statistically linked stress with high blood sugar.

An illness, such as flu, might also lead to stress that causes a spike in blood sugar.

Dawn phenomenon

A common cause of hyperglycemia in people with diabetes is the dawn phenomenon.

This condition occurs in the early morning when certain hormones, such as epinephrine, glucagon, and cortisol, cause the liver to release glucose into the blood.

This phenomenon occurs typically around 8 to 10 hours after an individual with diabetes goes to sleep.

Not all high blood sugar levels in the morning are the result of the dawn phenomenon, however. They can also occur as a result of eating sugary or high-carbohydrate snacks before bed, taking an incorrect dose of medication, or not taking enough insulin.

Waking up during the night and testing blood sugar can be an effective way to determine whether these peaks are a result of the dawn phenomenon or down to other causes.

Symptoms

Hyperglycemia causes symptoms that a person will either detect during self-monitoring or notice in other ways, including:

• blood glucose levels higher than 130 milligrams per deciliter (mg/dl) before eating a meal or above 180 mg/dl 2 hours after the start of a meal
• frequently needing to pass urine
• feeling thirsty more often
• a higher than average volume of glucose in the urine

While noticeable symptoms of hyperglycemia do not often occur at a level below 250 mg/dl, people with diabetes should self-monitor regularly enough to catch glucose levels before they reach the stage where they cause symptoms.

Complications

If a person with diabetes does not take steps to control their blood sugar levels, ketones can build up in the body, leading to complications.

Ketones are the waste product of the breakdown of fats. When there is insufficient insulin in the body and glucose cannot reach the cells, the body uses fats for energy instead.

The body cannot handle a high level of ketones, and while it can get rid of some in the blood, ketones may eventually build up, causing complications, such as DKA.

Anyone with diabetes who experiences the following symptoms should seek immediate emergency treatment:

• breathlessness
• fruity-smelling breath
• vomiting and feeling sick
• parched mouth

Treatment

While managing diabetes is an ongoing and often lifelong requirement, a person with diabetes can take steps to reduce spikes of high blood glucose.

These include:

• Exercise: Physical activity can use excess glucose in the blood. However, if a person with severe hyperglycemia finds ketones in their urine, they should avoid exercise, as this breaks down more fats and might speed up ketoacidosis.
• Moderating the diet: Eating less during mealtimes and snacking less, as well as focusing on low-sugar foods, helps keep the amount of glucose at a level that the body can handle. A dietitian can help a person adapt their diet in gradual and healthful ways.
• Altering medications: A doctor may recommend changing the timings or types of medication and insulin a person is taking if they are not reducing blood sugar as they should.

A doctor will often be able to look at a person's self-monitored results, identify issues, and help individuals find ways to prevent severe spikes occurring.

Medical ID

A person who has hyperglycemia should consider wearing a necklace or bracelet that provides information about their condition, as it might impact on the administration of other treatments.

A medical ID contains essential information, such as whether the individual has diabetes, any allergies, or needs to take insulin.

The information contained in a medical ID can be life-saving in situations where an individual cannot speak themselves, for example after a vehicle accident or if they have severe DKA.

Takeaway

Hyperglycemia is high blood glucose that can occur as a result of insufficient or ineffective insulin and a sedentary lifestyle.

Hormone spikes due to stress and the dawn phenomenon can also lead to periods of hyperglycemia.

Symptoms include frequent urination, intense thirst, and high blood sugar readings during self-monitoring. If a person does not address high blood glucose, they might develop ketoacidosis, a dangerous buildup of waste products that can lead to diabetic coma.

Treatment includes adjustments in diabetes medication, physical exertion, and eating less during meals. Wearing a medical ID is essential for people who have hyperglycemia as this can impact on other treatments.