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High Blood Sugar No Ketones

Hyperglycemic / Hyperosmolar States

Hyperglycemic / Hyperosmolar States

Hyperglycemia means very high blood sugar. Symptoms include: HHS is a life-threatening emergency associated with very high blood sugars (greater than 600 mg/dl), that occurs in people with type 2 diabetes. It is an uncommon, but life threatening situation. Acute: Hyperglycemic Hyperosmolar States (HHS) HHS is a vicious cycle of high sugars that lead to excessive urination and dehydration. The dehydration causes the blood to become more concentrated and the blood sugar to rise even more. The higher the blood sugar the more the body tries to dispose of the excess sugar in the urine, which just worsens the dehydration. There is usually just enough insulin produced by the pancreas to keep fat in fat cells and prevent ketone formation, so ketone levels are normal or only slightly elevated in HHS. Ultimately the person has very high blood sugars and is very dehydrated and is confused or in a coma (unconscious). This is a serious medical emergency that can lead to death. Immediate hospitalization is required. HHS usually happens to people who don’t know they have diabetes. It also happens to people who know they have diabetes and are sick with something else and don’t check their blood sugars or drink enough fluid. Symptoms: Greatly increased urination Thirst Extreme fatigue Confusion Seizure Coma Blood glucose over 600 mg/dl No ketone or low ketone levels Treatment: HHS is a life-threatening medical emergency requiring hospitalization. Treatment often includes IV fluids, low dose insulin and close monitoring and treatment in a hospital setting. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Diabetes Complications, take our self assessment quiz when you have completed this section. Continue reading >>

Must Read Articles Related To High Blood Sugar (hyperglycemia)

Must Read Articles Related To High Blood Sugar (hyperglycemia)

A A A High Blood Sugar (Hyperglycemia) Whenever the glucose (sugar) level in one's blood rises high temporarily, this condition is known as hyperglycemia. The opposite condition, low blood sugar, is called hypoglycemia. Glucose comes from most foods, and the body uses other chemicals to create glucose in the liver and muscles. The blood carries glucose (blood sugar) to all the cells in the body. To carry glucose into the cells as an energy supply, cells need help from insulin. Insulin is a hormone made by the pancreas, an organ near the stomach. The pancreas releases insulin into the blood, based upon the blood sugar level. Insulin helps move glucose from digested food into cells. Sometimes, the body stops making insulin (as in type 1 diabetes), or the insulin does not work properly (as in type 2 diabetes). In diabetic patients, glucose does not enter the cells sufficiently, thus staying in the blood and creating high blood sugar levels. Blood sugar levels can be measured in seconds by using a blood glucose meter, also known as a glucometer. A tiny drop of blood from the finger or forearm is placed on a test strip and inserted into the glucometer. The blood sugar (or glucose) level is displayed digitally within seconds. Blood glucose levels vary widely throughout the day and night in people with diabetes. Ideally, blood glucose levels range from 90 to 130 mg/dL before meals, and below 180 mg/dL within 1 to 2 hours after a meal. Adolescents and adults with diabetes strive to keep their blood sugar levels within a controlled range, usually 80-150 mg/dL before meals. Doctors and diabetes health educators guide each patient to determine their optimal range of blood glucose control. When blood sugar levels remain high for several hours, dehydration and more serious complicat Continue reading >>

Diabetes Urine Tests

Diabetes Urine Tests

Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>

Hyperglycaemia (high Blood Sugar)

Hyperglycaemia (high Blood Sugar)

Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don't have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia shouldn't be confused with hypoglycaemia, which is when a person's blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Is hyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you're likely to experience hyperglycaemia at some point. It's important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes aren't usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts Continue reading >>

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a serious condition characterized by high blood sugar (hyperglycemia), low insulin, and the presence of moderate to large amounts of ketones in the blood. It's a medical emergency that requires treatment in a hospital. If not treated in a timely fashion, ketoacidosis can lead to coma and death. While diabetic ketoacidosis (or DKA) is much more common among people with type 1 diabetes, it can also occur in people with type 2 diabetes, so ketone monitoring is something everyone with diabetes should understand. Diabetic Ketoacidosis Symptoms Signs and symptoms of ketoacidosis include: Thirst or a very dry mouth Frequent urination Fatigue and weakness Nausea Vomiting Dry or flushed skin Abdominal pain Deep breathing A fruity breath odor What Are Ketones? Ketones, or ketone bodies, are acidic byproducts of fat metabolism. It's normal for everyone to have a small amount of ketones in the bloodstream, and after a fast of 12 to16 hours, there may be detectable amounts in the urine. As is the case with glucose, if blood levels of ketones get too high, they spill over into the urine. An elevated level of ketones in the blood is known as ketosis. People who follow low-carbohydrate diets often speak of ketosis as a desirable state — it's evidence that their bodies are burning fat, not carbohydrate. But the level of ketosis that results from low carbohydrate consumption isn't harmful and is much lower than the level seen in diabetic ketoacidosis. When Should Ketones Be Monitored? Ketone monitoring is less of a concern for people with type 2 diabetes than for those with type 1 diabetes. This is because most people with type 2 diabetes still make some of their own insulin, making diabetic ketoacidosis less likely to develop. Nonetheless, people with type 2 d Continue reading >>

Ketones — The 6 Must-knows

Ketones — The 6 Must-knows

WRITTEN BY: Kyla Schmieg, BSN, RN Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and Type 1 Diabetic, working on the same unit she was diagnosed at 26 years ago. 1 – What are ketones? Ketones are chemicals that build up when your body starts to burn fat for energy. The most common cause of ketones in diabetics is insulin deficiency. Without enough insulin, glucose builds up in the blood stream and can’t enter cells. The cells then burn fat instead of glucose. This results in ketones forming in the blood and eventually spilling into urine. 2 – Why can ketones be dangerous? Having ketones can indicate that your body needs more insulin. (Always monitor your blood sugar levels to know how much insulin you need.) If you have a build up of ketones, this can lead to Diabetic Ketoacidosis (DKA). Signs of DKA include moderate or large ketones, nausea, vomiting, abdominal pain, fruity or acetone (think nail polish remover) breath, rapid breathing, flushed skin, and lack of energy. If left untreated, it can lead to a serious and life-threatening diabetic coma or death. High levels of ketones are toxic to the body and if you’re experiencing these, you should seek out medical attention. 3 – When should you check for ketones? You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold. 4 – Can you get ketones with a high blood sugar? Ketones typically accompany high blood sugar. They indicate that your body needs more insulin. Most often if your body needs more insulin, it means you probably have a high blood sugar. Also, when an illness is present, your body releases hormones in response to the stress. These hormones Continue reading >>

High Blood Sugar Emergencies

High Blood Sugar Emergencies

Blood sugar levels that are too high (hyperglycemia) can quickly turn into a diabetic emergency without quick and appropriate treatment. The best way to avoid dangerously high blood sugar levels is to self-test to stay in tune with your body, and to stay attuned to the symptoms and risk factors for hyperglycemia. Extremely high blood sugar 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. Diabetic Ketoacidosis (DKA) Ketoacidosis (or DKA) occurs when blood sugars become elevated (over 249 mg/dl, or 13.9 mmol/l) over a period of time and the body begins to burn fat for energy, resulting in ketone bodies in the blood or urine (a phenomenon called ketosis). A variety of factors can cause hyperglycemia (high blood glucose), including failure to take medication or insulin, stress, dietary changes without medication adjustments, eating disorders, and illness or injury. This last cause is important, because if illness brings on DKA, it may slip by unnoticed, since its symptoms can mimic the flu (aches, vomiting, etc.). In fact, people with type 1 diabetes are often seeking help for the flu-like symptoms of DKA when they first receive their diagnosis. Symptoms of diabetic ketoacidosis may include: fruity (acetone) breath nausea and/or vomiting abdominal pain dry, warm skin confusion fatigue breathing problems excessive thirst frequent urination in extreme cases, loss of consciousness DKA is a medical emergency, and requires prompt and immediate treatment. A simple over-the-counter urine dipstick test (e.g., Keto Continue reading >>

Diabetes: Short Term Problems

Diabetes: Short Term Problems

Complications Diabetes can cause other health problems. Sometimes these problems are referred to as complications (COM-pli-KAY-shuns). Short-term problems can happen at any time when you have diabetes. Long-term problems may develop when you have diabetes for a long time. In case of emergency, you should always wear a form of medical identification (ID). Examples are ID bracelets and necklaces. To reduce your risk of getting other health problems from diabetes, you need good control of your blood glucose (sugar). Good control means keeping blood glucose at certain levels. To learn more about good control and healthy blood glucose numbers, see the UPMC patient education page Diabetes: Your Management Plan. This patient education sheet tells you about short-term problems, what to do for them, and how to prevent them: Low blood glucose High blood glucose with ketones High blood glucose without ketones Low Blood Glucose Low blood glucose is also called hypoglycemia (HI-po-glice-EE-me-uh). Blood glucose numbers under 70 mean you have low blood glucose. Several things can cause low blood glucose: Too much insulin Too much sulfonylurea (SULL-fon-ilyour-EE-uh) medicine Not enough food Too much exercise Symptoms of low blood glucose include: Hunger Feeling nervous Heavy sweating Weakness Shaking (tremors) Confusion Seizures Coma If you get low blood glucose If you get low blood glucose and you are awake and able to swallow, eat or drink something with sugar. Here is a list of some suggested foods: 4 ounces of fruit juice 4 to 6 ounces of sugary (non-diet) soft drink 3 to 4 glucose tablets (or 1 tube of glucose gel) 1 cup of skim milk 6 to 7 hard candies (not sugar-free), such as Lifesavers Wait for 10 to 15 minutes. Test your blood glucose again. If your blood glucose is above 7 Continue reading >>

Hyperglycemia (high Blood Sugar)

Hyperglycemia (high Blood Sugar)

Parents of children with diabetes quickly discover that, no matter how hard they try to get excellent blood sugar results, the levels will be high from time to time. This is to be expected. Sometimes the reasons are obvious: a test done too soon after the last meal or snack; a lazy rainy day; an extra treat at a birthday party; or some insulin leakage from an injection site. Often, however, there is no obvious reason for the high level. This will seem unfair to those who invest a lot of time and effort in controlling blood sugar. But its no ones fault. Rather, it is the result of an imperfect way of replacing insulin. Injecting insulin even 3 or 4 times a day does not give the automatic blood sugar regulation that people without diabetes take for granted. There will be occasional highs even if you are very careful. Blood sugar results alone do not tell the whole story. You should also be aware if your child: has any symptoms of hyperglycemia, such as thirst, increased urination, or fatigue is showing signs of being sick, such as a cough or fever One isolated high blood sugar leveleven in the high teens or twenties (300 to 400 mg/dL)is no cause for concern, as long as your child feels well and there are no ketones in the urine. If high blood sugar levels last, even without symptoms or ketones, an insulin adjustment is needed. Immediate action is needed if there is a high blood sugar level and either ketones in the urine or the signs and symptoms of high blood sugar. Additional short-acting or rapid-acting insulin (Regular or Humalog or NovoRapid) should be injected. The diabetes team will help you decide how much insulin to give. If you do not take action when the blood sugar level is high and ketones are present, it can lead to diabetic ketoacidosis (DKA). This is a li Continue reading >>

Ketone Testing: What You Need To Know

Ketone Testing: What You Need To Know

What are ketones? Ketones are produced when the body burns fat for energy or fuel. They are also produced when you lose weight or if there is not enough insulin to help your body use sugar for energy. Without enough insulin, glucose builds up in the blood. Since the body is unable to use glucose for energy, it breaks down fat instead. When this occurs, ketones form in the blood and spill into the urine. These ketones can make you very sick. How can I test for ketones? You can test to see if your body is making any ketones by doing a simple urine test. There are several products available for ketone testing and they can be purchased, without a prescription, at your pharmacy. The test result can be negative, or show small, moderate, or large quantities of ketones. When should I test for ketones? Anytime your blood glucose is over 250 mg/dl for two tests in a row. When you are ill. Often illness, infections, or injuries will cause sudden high blood glucose and this is an especially important time to check for ketones. When you are planning to exercise and the blood glucose is over 250 mg/dl. If you are pregnant, you should test for ketones each morning before breakfast and any time the blood glucose is over 250 mg/dl. If ketones are positive, what does this mean? There are situations when you might have ketones without the blood glucose being too high. Positive ketones are not a problem when blood glucose levels are within range and you are trying to lose weight. It is a problem if blood glucose levels are high and left untreated. Untreated high blood glucose with positive ketones can lead to a life-threatening condition called diabetic ketoacidosis (DKA). What should I do if the ketone test is positive? Call your diabetes educator or physician, as you may need additional Continue reading >>

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Having a sick child can be challenging—getting time off work and securing a last-minute doctor's appointment isn't always easy. But when your sick child also happens to have type 1 diabetes, it presents a separate set of complications relating to insulin and blood glucose (blood sugar) management. This article covers some important considerations to keep in mind the next time your child with type 1 diabetes feels under the weather. Checking Blood Glucose and Ketones Even the most common ailments, such as a cold or flu, can cause your child's blood glucose levels to rise. Plus, some over-the-counter medications can cause blood glucose levels to increase even more. Complicating matters, your child's blood glucose levels may actually drop too low if he or she is vomiting or has stopped eating. You just can't be certain how an illness will affect your child's blood glucose—that's why it's important to check their levels more often than you normally would. A general guideline to shoot for is to check their blood glucose every 2 to 3 hours, but remember—that's a guideline. Your child may require more or fewer checks, depending on your health care professional's recommendations. In addition to checking blood glucose levels, you also need to check for the presence of ketones in the urine. In people with type 1 diabetes, common illnesses can lead to diabetic ketoacidosis, a condition characterized by acidic blood caused by the release of too many ketones. Ketones are released when your body doesn't have enough insulin, so it's important to check your child's urine regularly (usually every 4 hours) until there are no ketones detected. If ketones are still present, that's a sign that your child needs more insulin. There are 2 ways to check ketones: using urine ketone strips Continue reading >>

When To Worry About Ketones

When To Worry About Ketones

“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>

Ketones: Clearing Up The Confusion

Ketones: Clearing Up The Confusion

Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>

What Are Ketones And Their Tests?

What Are Ketones And Their Tests?

A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>

Urine Tests For Diabetes: Glucose Levels And Ketones

Urine Tests For Diabetes: Glucose Levels And Ketones

The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>

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