Low Blood Sugar (hypoglycemia)
Low blood sugar, also known as hypoglycemia, can be a dangerous condition. Low blood sugar can happen in people with diabetes who take medicines that increase insulin levels in the body. Taking too much medication, skipping meals, eating less than normal, or exercising more than usual can lead to low blood sugar for these individuals. Blood sugar is also known as glucose. Glucose comes from food and serves as an important energy source for the body. Carbohydrates — foods such as rice, potatoes, bread, tortillas, cereal, fruit, vegetables, and milk — are the body’s main source of glucose. After you eat, glucose is absorbed into your bloodstream, where it travels to your body’s cells. A hormone called insulin, which is made in the pancreas, helps your cells use glucose for energy. If you eat more glucose than you need, your body will store it in your liver and muscles or change it into fat so it can be used for energy when it’s needed later. Without enough glucose, your body cannot perform its normal functions. In the short term, people who aren’t on medications that increase insulin have enough glucose to maintain blood sugar levels, and the liver can make glucose if needed. However, for those on these specific medications, a short-term reduction in blood sugar can cause a lot of problems. Your blood sugar is considered low when it drops below 70 mg/dL. Immediate treatment for low blood sugar levels is important to prevent more serious symptoms from developing. Explaining low blood sugar in layman's terms » Symptoms of low blood sugar can occur suddenly. They include: rapid heartbeat sudden nervousness headache hunger shaking sweating People with hypoglycemic unawareness do not know their blood sugar is dropping. If you have this condition, your blood sugar Continue reading >>
What Is Hyperglycemia?
Hyperglycemia, a high level of sugar in the blood, is a hallmark of diabetes. Your blood sugar levels fluctuate over the course of a day: Levels are higher right after meals, as carbohydrates are broken down into glucose (sugar), and lower after exercise, when glucose has been burned to fuel the activity. In someone who doesn't have diabetes, blood sugar levels stay within a narrow range. Between meals, the concentration of sugar in the blood ranges from about 60 to 100 mg/dl (milligrams per deciliter). After meals it may reach 120 to 130 mg/dl, but rarely goes higher than 140 mg/dl. But if you have type 2 diabetes, blood sugar levels can go much higher — to 200, 300, or even 400 mg/dl and beyond — and will go much higher unless you take the necessary steps to bring them down. Hyperglycemia Symptoms High blood sugar doesn't always produce symptoms, so it's important to check your blood sugar regularly, as indicated by your doctor. Hyperglycemia symptoms include: Frequent urination Extreme thirst Feeling tired and weak Blurry vision Feeling hungry, even after eating Causes of Hyperglycemia If you've been diagnosed with type 2 diabetes, a treatment plan is put in place to lower blood sugar and keep it as close to the normal range as possible. But even after you start treatment, you may still develop hyperglycemia at times. When you have diabetes, it's almost impossible not to have hyperglycemia — and high blood sugar can happen for no identifiable reason. Some of the reasons blood sugar may go too high include: Missing prescribed medicines or taking medication at the wrong times or in the wrong amounts High food intake or larger consumptions of carbohydrate than expected or intended Lack of sleep Emotional stress Intense exercise Illness is another important — and Continue reading >>
Hyperglycemia In Diabetes
Print Diagnosis Your doctor sets your target blood sugar range. For many people who have diabetes, Mayo Clinic generally recommends target blood sugar levels that are: Between 80 and 120 mg/dL (4 and 7 mmol/L) for people age 59 and younger who have no other underlying medical conditions Between 100 and 140 mg/dL (6 and 8 mmol/L) for people age 60 and older, those who have other medical conditions, such as heart, lung or kidney disease, or those who have a history of low blood sugar (hypoglycemia) or who have difficulty recognizing the symptoms of hypoglycemia Your target blood sugar range may differ, especially if you're pregnant or you develop diabetes complications. Your target blood sugar range may change as you get older, too. Sometimes, reaching your target blood sugar range is a challenge. Home blood sugar monitoring Routine blood sugar monitoring with a blood glucose meter is the best way to be sure that your treatment plan is keeping your blood sugar within your goal range. Check your blood sugar as often as your doctor recommends. If you have any signs or symptoms of severe hyperglycemia — even if they're subtle — check your blood sugar level. If your blood sugar level is 240 mg/dL (13 mmol/L) or above, use an over-the-counter urine ketones test kit. If the urine test is positive, your body may have started making the changes that can lead to diabetic ketoacidosis. You'll need your doctor's help to lower your blood sugar level safely. Glycated hemoglobin (A1C) test During an appointment, your doctor may conduct an A1C test. This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. An A1C level of 7 perc Continue reading >>
Treating Diabetes Emergencies
Blood sugar levels that are too high or too low can quickly turn into a diabetic emergency without quick and appropriate treatment. The best way to avoid dangerously high or low blood glucose levels is to self-test to stay in tune with your body and to stay attuned to the symptoms and risk factors for hypoglycemia, diabetic ketoacidosis, and hyperglycemic hyperosmolar nonketotic syndrome. Low Blood Sugar Emergencies (Hypoglycemia) Hypoglycemia is sometimes called insulin reaction because it is more frequent in people with diabetes who take insulin. However, it can occur in either type 1 or type 2 diabetes, and is also commonly caused by certain oral medications, missed meals, and exercise without proper precautions. The typical threshold for hypoglycemia is 70 mg/dl (3.9 mmol/l), although it may be higher or lower depending on a patient's individual blood glucose target range. Symptoms include erratic heartbeat, sweating, dizziness, confusion, unexplained fatigue, shakiness, hunger, and potential loss of consciousness. Once a low is recognized, it should be treated immediately with a fast-acting carbohydrate such as glucose tablets or juice. High Blood Sugar Emergencies (DKA or HHNS) Extremely high blood glucose levels can lead to one of two conditions diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS; also called hyperglycemic hyperosmolar nonketotic coma). Although both syndromes can occur in either type 1 or type 2 diabetes, DKA is more common in type 1 and HHNS is more common in type 2. Continue reading >>
Hyperglycemic Emergencies
Lana Kravarusic Doctor of Pharmacy Candidate, University of Florida Introduction Diabetes mellitus, if uncontrolled, may lead to serious hyperglycemic emergencies. The two most serious hyperglycemic emergencies are diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). (Hyperglycemic hyperosmolar state is synonymous with hyperosmolar syndrome and hyperglycemic hyperosmolar nonketotic state which are both older names.) DKA most commonly occurs in patients with Type 1 diabetes mellitus or pancreatic disease, while HHS occurs more frequently with Type 2 diabetes. The presentation of the two syndromes can be distinguished by several factors. Both DKA and HHS patients present with hyperglycemia, but DKA is characterized by ketonemia, ketonuria, and metabolic acidosis while HHS involves dehydration without significant ketoacidosis. It is also possible that a patient presents with a mixture of DKA and HHS.1 The incidence of DKA is estimated to be 4-8 per 1000 diabetic patients, but is likely an underestimation. Up to 25% of cases in the United States are discovered at diagnosis, especially in younger children. The current mortality rate is 2-5% with treatment, and is usually a result of the underlying associated illnesses rather than DKA itself.2 For example elderly patients (>65 years) may have a mortality rate as high as 20% due to comorbid conditions. In some rare cases, however, mortality is a result of a DKA complication such as cerebral edema which is estimated to occur in 0.7-1% of DKA cases in young adults and children. Therefore, children less than 5 years of age and elderly over the age of 65 are considered high-risk DKA patients.1 Currently, the incidence of HHS in the United States is thought to be less than 1 per 1000-person years, making HHS much Continue reading >>
Quick And Dirty Guide To Diabetic Emergencies
Diabetes Mellitus Diabetes Mellitus is a systemic disease of the endocrine system resulting from the insufficiency/dysfunction of the pancreas. It is a complex disorder of fat, carbohydrates, and protein metabolism. Diabetes mellitus is potentially lethal, putting the patient at risk for several types of medical emergencies. It is characterized by a lack of insulin, or a persons inability to use insulin. In order to properly manage the numerous calls for diabetics, it is important for EMS professionals to have a basic knowledge of diabetes (DM) before dealing with the associated emergencies that may arise as a result of the disease. Diabetes is the seventh leading cause of death in the US, as well as, it is estimated that 5 + million US citizens become diabetic annually and don't realize they have the disease until an emergency arises. To truly understand the signs and symptoms of the various related conditions, we must first, comprehend some basic pathophysiology. The primary energy fuel for cells is glucose. Glucose is a simple sugar that accounts for approximately 95 percent of the sugar in the bloodstream after gastrointestinal absorption. Thus, it is the blood glucose level that EMS and other health care practitioners are most interested in determining. The key function of insulin (A hormone secreted by the beta cells in the pancreas) is to move glucose from the blood into the cells, where it can be used for energy. However, insulin does not directly carry glucose into the cell, it triggers a receptor on the plasma membrane to open a channel allowing a protein helper (through the process of facilitated diffusion), to carry the glucose molecule into the cell. As long as any insulin is available in the blood, is active, is effective, and is able to stimulate the rece Continue reading >>
High Blood Sugar Symptoms And Information
What is high blood sugar? High blood sugar means that the level of sugar in your blood is higher than normal. It is the main problem caused by diabetes. The medical term for high blood sugar is hyperglycemia. Blood sugar is also called glucose. How does it occur? Blood sugar that stays high is the main problem of diabetes. If you have type 1 diabetes, high blood sugar happens because your body is not making insulin. Insulin moves sugar from the blood into your cells. It is normally made by the pancreas. If you have type 2 diabetes, high blood sugar usually happens because the cells have become unable to use the insulin your body is making. In both cases high levels of sugar build up in the blood. Sometimes people with diabetes can have high blood sugar even if they are taking diabetes medicine. This can happen for many reasons but it always means that your diabetes is not in good control. Some reasons why your sugar might go too high are: skipping your diabetes medicine or not taking the right amount of medicine if you are using insulin: a problem with your insulin (for example, the wrong type or damage to the insulin because it has not been stored properly) if you are using an insulin pump: a problem with the pump (for example, the pump is turned off or the catheter has come out) taking medicines that make your blood sugar medicines work less well (steroids, hormones or water pills) eating or drinking too much (that is, taking in too many calories) not getting enough physical activity emotional or physical stress illness, including colds and flu, especially if there is fever infections, such as an abscessed tooth or urinary tract infection Even if you don’t have diabetes, you may have high blood sugar for a brief time after you eat a food very high in sugar. For exam Continue reading >>
First Aid For People With Diabetes
The prevalence of diabetes increased 382% from 1988 to 2014. According to the National Diabetes Statistics Report, this growth correlates with the upsurge of visits to the emergency room from people in a life-threatening diabetic crisis. As the condition continues to rise so does the likelihood of providing first aid for someone with diabetes. Understanding Diabetes First-aid providers have important choices to make before providing care to a diabetic. The best way to effectively manage a diabetic emergency is through understanding the mechanisms behind the medical condition. Every cell in the body requires glucose as a foundation of energy. People with diabetes, though needing glucose, have an inability to process, or metabolize, it efficiently because the pancreas is either producing too little insulin or none at all—either way, glucose can accumulate to dangerously high levels. A healthy pancreas regulates the production of insulin proportionate to the amount of glucose in the blood. Classification of Diabetes Type 1 diabetes is primarily an autoimmune condition manifesting in children and young adults. These people do not produce insulin; they require routine injections of insulin to aid in glucose metabolism. Without insulin injections type 1 diabetics cannot use the sugar in their blood for energy. People with Type 2 diabetes produce small amounts of insulin, or they cannot properly use the insulin hormone, also known as insulin resistance. This condition usually develops later in life. Many people with type 2 diabetes use diet, exercise, and other non-insulin medications. Some Type 2 diabetics however, may require supplemental insulin. What is a Diabetic Emergency? With six million people using insulin in the United States, the incidence of too much or too litt Continue reading >>
Hyperglycemia In Diabetes
Diseases and Conditions Home treatment Talk to your doctor about managing your blood sugar and understand how different treatments can help keep your glucose levels within your goal range. Your doctor may suggest the following treatments: Get physical. Regular exercise is often an effective way to control your blood sugar. However, don't exercise if ketones are present in your urine. This can drive your blood sugar even higher. Take your medication as directed. If you have frequent episodes of hyperglycemia, your doctor may adjust the dosage or timing of your medication. Follow your diabetes eating plan. It helps to eat less and avoid sugary beverages. If you're having trouble sticking to your meal plan, ask your doctor or dietitian for help. Check your blood sugar. Monitor your blood glucose as directed by your doctor. Check more frequently if you're ill or you're concerned about severe hyperglycemia or hypoglycemia. Adjust your insulin doses to control hyperglycemia. Adjustments to your insulin program or a supplement of short-acting insulin can help control hyperglycemia. A supplement is an extra dose of insulin used to help temporarily correct a high blood sugar level. Ask your doctor how often you need an insulin supplement if you have high blood sugar. Emergency treatment for severe hyperglycemia If you have signs and symptoms of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome, you may be treated in the emergency room or admitted to the hospital. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes: Fluid replacement. You'll receive fluids — either orally or through a vein (intravenously) — until you're rehydrated. The fluids replace those you've lost through excessive urination, as well as help dilute the Continue reading >>
Diabetics Need Immediate First Aid For Low Blood Sugars
Diabetics, diagnosed as someone with extraordinarily high blood sugars, sometimes experience quite the opposite. And when they do, it is important to treat low blood sugar conditions promptly. Hypoglycemia can happen when diabetics take too much insulin, don’t consume enough calories or expend more energy than planned. A blood glucose level of less than 70 mg/dl is generally considered low, according to the Joslin Diabetes Center. Severely low blood sugar levels can lead to a coma or could be fatal. If detected quickly, low blood sugars can be treated at home without having to make a trip to the doctor or emergency room. That is why it is important for family members, friends or caretakers to recognize the signs of hypoglycemia and know how to respond.Many diabetics “get a certain feeling” when their blood sugars are dropping. They are able to consume some extra carbohydrates and protein to raise their levels. However, blood sugars sometimes drop suddenly – and diabetics are in distress without realizing it. Common signs of hypoglycemia are shakiness, dizziness, difficulty speaking, confusion, fatigue, sweating and anxiety. The behavior can be similar to someone who has consumed too much alcohol. If you notice a diabetic experiencing these symptoms, check their level with a blood sugar monitor. If the diabetic is unresponsive or you are unable to administer any treatment, you should immediately call 911 and get the patient to a hospital as soon as possible. If the reading is 70 or lower and the person is conscious, doctors recommend following the 15-15 Rule of first aid: Eat or drink 15 grams of a carbohydrate (which metabolizes into sugar). Four to six ounces of fruit juice or regular soda (Coke, Mountain Dew) will infuse the system with instant sugar. Don’t Continue reading >>
Diabetes-related High And Low Blood Sugar Levels - Home Treatment
When you have diabetes, whether it is type 1 diabetes, type 2 diabetes, or gestational diabetes, one of the most important skills you will learn is how to manage your blood sugar level. Following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise will help you avoid blood sugar problems. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. It may be hard for a parent of a young child to distinguish the difference between high and low blood sugar symptoms in a child. When you have learned to recognize high or low blood sugar levels, you can take the appropriate steps to bring your blood sugar level back to your target blood sugar levels. People who keep their blood sugar levels under control with diet, exercise, or oral diabetes medicines are less likely to have problems with high or low blood sugar levels. Do not drink alcohol if you have problems recognizing the early signs of low blood sugar. Be sure to know the steps for dealing with high blood sugar and how fast your insulin medicine will work to bring your blood sugar down. Some insulins work very fast while regular insulin takes a little longer to bring the sugar level down. Knowing how fast your insulin works will keep you from using too much too quickly. Because you have diabetes and can have low blood sugar levels, you need to keep some type of food with you at all times that can quickly raise your blood sugar level. These should be quick-sugar foods (about 15 grams of carbohydrate). Be sure to check your blood sugar level again 15 minutes after eating a quick-sugar (carbohydrate) food to make sure your level is getting back to your target range. If you continue to have low blood sugar, take another 15 grams of carbohydrate. Wh Continue reading >>
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Patients With Diabetes Are Treated Differently In The Er
A trip to the ER is different for patients with diabetes compared to those without. Diabetes can lead to more serious complications doctors would be concerned about, as well as influence diagnostics and potential treatments. Emergency room physician Dr. Troy Madsen explains why it’s important your physicians know your diabetic status early with emergency treatment. Transcript Interviewer: How does a patient with diabetes change the way emergency room physicians would treat you? That's next on The Scope. Announcer: Health tips, medical views, research and more for a happier, healthier life. From the University of Utah Health Sciences, this is The Scope. Interviewer: Dr. Madsen, if somebody comes into the emergency room and you find out they have diabetes, does that change the way that you would treat whatever condition that they're in the ER for? Dr. Madsen: It really does. It affects the way I look at things and it often affects the way I treat things. And the reason for that is, certainly with diabetes, there are the immediate issues where maybe they have a high blood sugar or really low blood sugar. Either they use too much insulin or maybe they haven't been using their insulin, and certainly there's that factor. But diabetes changes a lot of other things as well. So if someone comes in and they say to me, "I'm having chest pain," I mean, this is a 30-year-old otherwise healthy person, I'm like, "Okay, we'll get an EK to do some tests," I'm not too concerned. If this person has diabetes even, maybe in their 30s, that heightens my concern a little bit more for heart disease. And diabetes can cause coronary disease, causes narrowing of the coronary arteries, that's what we call the heart disease, that causes decreased blood flow, that causes heart attacks. So it's goi Continue reading >>
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First Aid For Hyperglycemia
Hyperglycemia refers to a condition that results in high blood glucose levels. It usually occurs in undiagnosed diabetics or diabetics who have not taken their insulin or any other medication to drop glucose levels. This can also be caused by having a heavy meal containing more carbohydrates than the administered amount of insulin can handle. Hyperglycemia is opposite to the condition called, hypoglycemia that results from low blood glucose levels. When your blood glucose levels are drastically lowered down, the body relies on a backup system i.e. burning fats for energy. However, the brain only utilizes glucose as a fuel of energy as it cannot burn fat, thus making the person experience dizziness and confusion. Hyperglycemia on the other hand occurs due to high glucose level, which is often caused due to insufficient insulin produced by the pancreas. Insulin is a hormone responsible for breaking down carbohydrates. Without insulin, carbohydrates cannot be broken down into soluble form that the cells can absorb to generate energy. Therefore, in this case also, fats are burnt down. A diabetic has to take insulin medications to be able to break down carbohydrates. Thus, skipping doses may lead to the symptoms of hyperglycemia. Other causes of hyperglycemia include infections, diseases, stress and reduced physical activity. Symptoms Lethargy Increased thirst as the body is trying to drain out sugar from the system Frequent urination Dry skin Rapid heartbeat Deep yet fatigued breathing Drowsiness Weight loss Skin and breath smell like acetone Treatment Drink plenty of water as it helps prevent dehydration and flush out excess sugar from your system. You should exercise regularly to maintain sugar levels and prevent it from rising. Consult your doctor about the medications, Continue reading >>
Diabetes In The Emergency Department And Hospital: Acute Care Of Diabetes Patients
Go to: Hyperglycemic Crisis: DKA and HHS Diabetic ketoacidosis (DKA) accounts for more than 110,000 hospitalizations annually in the United States, with mortality ranging from 2 to 10%4–6. Hyperglycemic hyperosmolar state (HHS) is much less common but confers a much greater mortality7. Patients with DKA classically present with uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration. On the other hand, HHS is defined by altered mental status caused by hyperosmolality, profound dehydration, and severe hyperglycemia without significant ketoacidosis6,8. Initial evaluation In the Emergency Department, the primary goals are rapid evaluation and stabilization. All patients with severe hyperglycemia should immediately undergo assessment and stabilization of their airway and hemodynamic status, with consideration of administration of naloxone for all patients with altered mentation to reverse potential opiate overdose, and thiamine for all patients at risk for Wernicke’s encephalopathy. In cases requiring intubation, the paralytic succinylcholine should not be used if hyperkalemia is suspected as it may acutely further elevate potassium. Immediate assessment should also include placing patients on oxygen, measure O2 saturation and cardiac monitoring as well as obtaining vital signs, a fingerstick glucose, intravenous (IV) access, and a 12-lead electrocardiogram to evaluate for arrhythmias and signs of hyper-and hypokalemia. Emergency Department evaluation should include a thorough clinical history and physical examination, as well as a venous blood gas,9,10 complete blood count, basic metabolic panel, and urinalysis; a urine pregnancy test must be sent for all women with childbearing potential. An important goal of this evaluation is id Continue reading >>
