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Hyperglycemic Attack

Hyperglycemic Crises

Hyperglycemic Crises

What They Are and How to Avoid Them One type results in about 100,000 hospitalizations a year with a mortality rate of under 5%. The other is thought to cause fewer hospitalizations, yet the mortality rate is about 15%. Severe hyperglycemic conditions, known as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), involve very serious imbalances in blood chemistry and usually require that a person be hospitalized until normal blood chemistry is restored. Because they can occur in anyone with diabetes, everyone should know what causes them, how to prevent them, how they are treated, and when to seek medical attention. The body in balance Glucose metabolism is a complex balancing act. In people who don’t have diabetes, a number of interconnected processes help the body to use glucose and keep blood glucose levels in the normal range. The body constantly balances glucose extracted from foods and produced by the liver with glucose utilization by the body’s tissues. When there is ample glucose in the bloodstream, the liver converts some of it into glycogen for storage. When the body needs more energy, such as during a prolonged period of fasting or activity, the liver converts stored glycogen back into glucose so that it can be used by the body’s tissues. The liver also can create glucose from amino acids and fats. Insulin lowers blood glucose levels both by slowing down the liver’s glucose production and by helping the body’s tissues to use glucose for energy. If the blood glucose level goes too low, other hormones, called counterregulatory hormones, work against the action of insulin to raise blood glucose levels. These hormones include glucagon, epinephrine, growth hormone, and cortisol. All work by prodding the liver to release glucose and by Continue reading >>

Hyperglycemia (high Blood Sugar)

Hyperglycemia (high Blood Sugar)

Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for 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 the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>

Hyperglycemia In Diabetes

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 >>

Diabetic Attack Symptoms

Diabetic Attack Symptoms

A person with diabetes may experience blood sugar that is too low, known as hypoglycemia, or blood sugar that is too high, known as hyperglycemia. Diabetes is a disease in which the body is not able to properly use insulin, a hormone responsible for regulating blood sugar. Blood sugar fuels the body, and an imbalance of blood sugar and insulin may lead to health complications. A person experiencing a diabetes attack may have a variety of symptoms. Video of the Day Mental changes are the first symptoms of blood sugar imbalance. Mental changes happen quickly and can progressively worsen with delayed treatment. Blood sugar that is too low or too high can trigger confusion and problems with memory. A person may seem unusually confused and have trouble recalling recent events or personal information. As blood sugar imbalance worsens, additional physical symptoms may appear while mental changes get worse. Dizziness may also occur, along with feeling weak. Without treatment, a diabetic may lapse into unconsciousness. He may be difficult or impossible to rouse or engage, and immediate medical attention is needed to prevent further complications. Thirst and Hunger High or low blood sugar changes how the body utilizes food for fuel. During high blood sugar states, the body pulls fluid from the cells, leaving tissues without proper hydration. A person with high blood sugar may experience increased thirst in response. Urination may also increase. Left untreated, high blood sugar can progress into ketoacidosis, a potentially life-threatening condition. Low blood sugar triggers the body to crave additional food for fuel, resulting in increased hunger. MedlinePlus suggests that eating foods with about 15 g of carbohydrates can help prevent even lower blood sugar until medical help can Continue reading >>

Hyperglycemia

Hyperglycemia

Definition Hyperglycemia is a complex metabolic condition characterized by abnormally high levels of blood sugar (blood glucose) in circulating blood, usually as a result of diabetes mellitus (types 1 and 2), although it can sometimes occur in cystic fibrosis and near-drowning (submersion injury). Description Hyperglycemia, also known as diabetic ketoacidosis, is a condition that develops over a period of a few days as the blood glucose levels of a type 1 or type 2 diabetic gradually rise. Ketoacidosis occurs when increasing glucose levels are met by a lack of sufficient or effective insulin production, starting a sequence of physiologic events as follows: The combination of excess glucose production and low glucose utilization in the body raises levels of blood glucose, which leads to increased urinary output (diuresis) followed quickly by a loss of fluid and essential mineral salts (electrolytes) and, ultimately, dehydration . The loss of fluid may finally result in dehydration. If the entire process is severe enough over several hours (serum glucose levels over 800mg/dL), swelling can occur in the brain (cerebral edema), and coma can eventually result. In a metabolic shift to a catabolic (breaking down) process, cells throughout the body empty their electrolytes (sodium, potassium, and phosphate) into the bloodstream. Electrolytes control the fluid balance of the body and are important in muscle contraction, energy generation, and almost all major biochemical reactions in the body. As a result of electrolyte imbalance, many functions can become impaired. Free fatty acids from lipid stores are increased, encouraging the production of ketoacids in the liver, leading to an over-acidic condition (metabolic acidosis) that causes even more disruption in body processes. Wit Continue reading >>

First Aid For People With Diabetes

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 >>

Diabetic Reaction

Diabetic Reaction

A A A There are two main forms of diabetes: Type 1 diabetes: Absent or low insulin levels prevent cells from taking up and using sugar for energy, thus requiring insulin injections Type 2 diabetes: Cellular resistance to insulin reduces glucose uptake, often requiring medication to improve the sensitivity of cells to insulin Low blood sugar (hypoglycemia) is the most common form of diabetic reaction. A low blood sugar reaction is caused by increased exertion or increased demand for glucose. The body may "run out" of stored glucose more quickly, thus bringing on a hypoglycemic attack. Persistent intake of excessive alcohol may cause this reaction, because alcohol decreases glucose stores in the liver. High blood sugar (hyperglycemia) is a common problem for people with diabetes. High blood sugar can be brought on by infections or other significant stresses that cause the body to decrease cell uptake of glucose. A decrease in cell uptake of glucose leads to high blood sugar levels as well as the alternative use of fats by starving cells for energy. Fat breakdown increases the acidity of the blood and worsens symptoms of high blood sugar. Symptoms of diabetic reaction depends on the type of reaction. rapid onset of cool, pale, moist, and clammy skin; dizziness; headache; rapid pulse; and shallow breathing. If untreated, symptoms may progress to confusion, nonsensical behavior, coma, and death. Symptoms occur gradually over several days. The person with high blood sugar develops increasing thirst and urination due to large amounts of unused glucose being lost in the urine. Skin feels warm and dry; respirations may be shallow; pulse is rapid and weak, and breath may have a sweet odor (due to ketoacidosis from fat breakdown). The person with high blood sugar may become confus Continue reading >>

Hyperosmolar Hyperglycemic State: A Historic Review Of The Clinical Presentation, Diagnosis, And Treatment

Hyperosmolar Hyperglycemic State: A Historic Review Of The Clinical Presentation, Diagnosis, And Treatment

The hyperosmolar hyperglycemic state (HHS) is the most serious acute hyperglycemic emergency in patients with type 2 diabetes. von Frerichs and Dreschfeld described the first cases of HHS in the 1880s in patients with an “unusual diabetic coma” characterized by severe hyperglycemia and glycosuria in the absence of Kussmaul breathing, with a fruity breath odor or positive acetone test in the urine. Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be <1% of hospital admissions of patients with diabetes. The reported mortality is between 10 and 20%, which is about 10 times higher than the mortality rate in patients with diabetic ketoacidosis (DKA). Despite the severity of this condition, no prospective, randomized studies have determined best treatment strategies in patients with HHS, and its management has largely been extrapolated from studies of patients with DKA. There are many unresolved questions that need to be addressed in prospective clinical trials regarding the pathogenesis and treatment of pediatric and adult patients with HHS. The hyperosmolar hyperglycemic state (HHS) is a syndrome characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of ketoacidosis. The exact incidence of HHS is not known, but it is estimated to account for <1% of hospital admissions in patients with diabetes (1). Most cases of HHS are seen in elderly patients with type 2 diabetes; however, it has also been reported in children and young adults (2). The overall mortality rate is estimated to be as high as 20%, which is about 10 times higher than the mortality in patients with diabetic ketoacidosis (DKA) (3 Continue reading >>

High Blood Glucose: What It Means And How To Treat It

High Blood Glucose: What It Means And How To Treat It

What is high blood glucose? People who do not have diabetes typically have fasting plasma blood glucose levels that run under 100 mg/dl. Your physician will define for you what your target blood glucose should be — identifying a blood glucose target that is as close to normal as possible that you can safely achieve given your overall medical health. In general, high blood glucose, also called 'hyperglycemia', is considered "high" when it is 160 mg/dl or above your individual blood glucose target. Be sure to ask your healthcare provider what he or she thinks is a safe target for you for blood glucose before and after meals. If your blood glucose runs high for long periods of time, this can pose significant problems for you long-term — increased risk of complications, such as eye disease, kidney disease, heart attacks and strokes and more. High blood glucose can pose health problems in the short-term as well. Your treatment plan may need adjustment if the blood glucose stays over 180 mg/dl for 3 days in a row. It is important to aim to keep your blood glucose under control, and treat hyperglycemia when it occurs. What are the symptoms of high blood glucose? Increased thirst Increased urination Dry mouth or skin Tiredness or fatigue Blurred vision More frequent infections Slow healing cuts and sores Unexplained weight loss What causes high blood glucose? Too much food Too little exercise or physical activity Skipped or not enough diabetes pills or insulin Insulin that has spoiled after being exposed to extreme heat or freezing cold Stress, illness, infection, injury or surgery A blood glucose meter that is not reading accurately What should you do for high blood glucose? Be sure to drink plenty of water. It is recommended to drink a minimum of 8 glasses each day. If yo Continue reading >>

Hyperglycemia

Hyperglycemia

Not to be confused with the opposite disorder, hypoglycemia. Hyperglycemia, or high blood sugar (also spelled hyperglycaemia or hyperglycæmia) is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 15–20 mmol/l (~250–300 mg/dl). A subject with a consistent range between ~5.6 and ~7 mmol/l (100–126 mg/dl) (American Diabetes Association guidelines) is considered slightly hyperglycemic, while above 7 mmol/l (126 mg/dl) is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time. Signs and symptoms[edit] The degree of hyperglycemia can change over time depending on the metabolic cause, for example, impaired glucose tolerance or fasting glucose, and it can depend on treatment.[1] Temporary hyperglycemia is often benign and asymptomatic. Blood glucose levels can rise well above normal and cause pathological and functional changes for significant periods without producing any permanent effects or symptoms. [1] During this asymptomatic period, an abnormality in carbohydrate metabolism can occur which can be tested by measuring plasma glucose. [1] However, chronic hyperglycemia at above normal levels can produce a very wide variety of serious complications over a period of years, including kidney damage, neurological damage, cardiovascular damage, damage to the retina or damage to feet and legs. Diabetic n Continue reading >>

Hyperosmolar Hyperglycemic Nonketotic Syndrome

Hyperosmolar Hyperglycemic Nonketotic Syndrome

Tweet Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), also known as Hyperosmolar Hyperglycaemic State (HHS) is a dangerous condition resulting from very high blood glucose levels. HHNS can affect both types of diabetics, yet it usually occurs amongst people with type 2 diabetes. Usually, HHNS is brought on by an illness or infection. What are the major warning signs of HHS for people with diabetes? Elevated blood sugar levels Extreme thirst Warm skin without sweat Fever Confusion or feeling sleepy Vision loss Hallucinations Nausea Weakness down one side of the body Who is at risk of Hyperosmolar Hyperglycaemic State? Periods of illness can significantly raise blood glucose levels, which could lead to Hyperosmolar Hyperglycaemic State (HHS) if medication is not sufficient to lower sugar levels. Having blood glucose levels above 33 mmol/l (600 mg/dl) for extended periods of time presents a risk of HHS occurring. Some serious complications of diabetes, such as Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), usually manifest themselves amongst older people, who may be less aware of high blood glucose levels and how to treat them. What happens to diabetics who get HHNS? When HHNS affects a person with diabetes, blood sugar levels rise and the body passes excess sugar into the urine. This causes regular bathroom trips, and over time this affects the colour of the liquid. Dehydration can occur if you do not drink liquid regularly, and this can become severe and lead to coma, seizures and even death. What is the best way for people with diabetes to avoid HHNS? If you keep on top of your blood sugar levels, it is possible to avoid HHNS. By checking blood glucose regularly, people with diabetes can take action if a reading falls outside their target blood glucose ra Continue reading >>

Controlling Hyperglycemia In The Hospital: A Matter Of Life And Death

Controlling Hyperglycemia In The Hospital: A Matter Of Life And Death

IN BRIEF Six million U.S. hospitalizations per year are accompanied by hyperglycemia. The degree of hyperglycemia may be an important predictor of morbidity and mortality among patients with myocardial infarction or stroke and those undergoing surgical procedures, including coronary artery bypass. Hyperglycemia should be aggressively controlled from the time of admission regardless of patients' primary medical problem or previous diabetes status. New methodologies for identifying, monitoring, and treating hyperglycemia are needed. The data on the importance of controlling glucose in hospital settings spans diverse disciplines of medicine. Studies in the areas of stroke, myocardial infarction (MI), bypass surgery, and wound and nosocomial infections all point to the tremendous potential to reduce morbidity and mortality among hospitalized patients with hyperglycemia. It is essential to identify hyperglycemia at the time of hospital admission and to implement therapy to achieve and maintain glucose levels as close to normal as possible, regardless of a patient's primary reason for admission or previous diabetes status. In the United States, there are more than 4.2 million hospitalizations annually among people with diabetes.1 Additionally, as many as 1.5 million hospitalized individuals have significant hyperglycemia but no history of diabetes.2 Identification of and therapeutic interventions to treat hyperglycemia must be initiated in tandem with treatment of the presenting medical problem rather than days after admission when many of the acute issues have been addressed. The data presented strongly suggest that an early and aggressive approach to the management of hyperglycemia may reduce mortality, morbidity, excessive hospital stays, and added costs. Why is hyperglyce Continue reading >>

Diabetic Emergencies: Warning Signs And Steps To Save Someone’s Life

Diabetic Emergencies: Warning Signs And Steps To Save Someone’s Life

A diabetic can develop hyperglycemia (raised blood sugar) or hypoglycemia (low blood sugar). Giving sugar will be lifesaving if blood sugar is low, and is unlikely to do harm if sugar levels are raised. Diabetics usually know how to control their condition, but even people who’ve had diabetes for years or decades may be susceptible to an attack. Low Blood Sugar (Hypoglycemia) Symptoms: This can occur if the blood sugar-insulin balance is incorrect. A person with diabetes often recognizes the warning signs: Feels shaky and weak Skin is pale and feels cold and clammy Confused, irritable, and behaving irrationally Rapid, but full and pounding pulse; patient may tell you that his heart is pounding Patient will quickly lose consciousness if he is not given some sugar If you know a patient has diabetes and he fails to respond to sugar or his condition begins to worsen, call for medical help immediately. A person recently diagnosed with diabetes is more susceptible to a “hypo” attack, especially while he is becoming used to balancing his sugar-insulin levels. What to Do for Hypoglycemia 1. Sit patient down. Reassure him and help him to sit down on a chair or on the floor if he is feeling faint. 2. Give sugar. If the patient is fully conscious and alert, give him a sugary drink, such as fruit juice, or some glucose tablets. People with diabetes often carry a dose of glucose concentrate or have some sugary food on hand as a precaution. 3. Check response. If the patient improves quickly after eating or drinking something, follow this with some slower-release carbohydrate food, such as a cereal bar, a sandwich, a piece of fruit, biscuits and milk, or the next meal if the timing is right. 4. Find medication. Help the patient find his glucose testing kit and medication and let Continue reading >>

Diabetes Mellitus And Infectious Diseases: Controlling Chronic Hyperglycemia

Diabetes Mellitus And Infectious Diseases: Controlling Chronic Hyperglycemia

As the incidence of diabetes mellitus continues to rise, common focus areas for diabetes control are blood glucose levels, diet, and exercise. Addressing and controlling these factors as well as other factors associated with diabetes are essential for a better quality of life; however, awareness of an increased risk of infections is also warranted in diabetes patients with chronic hyperglycemia. The immune system is comprised of two subcategories: innate immunity and adaptive immunity. Innate immunity, the first line of defense, is activated when a pathogen initially presents itself. This portion of immunity is inherited at birth and is not specific in its mechanism of defense. In addition, it serves the overall immune system by alerting specific cells of pathogen invasion to activate the adaptive immune system. The innate immune system has physical and chemical mechanisms of response. These include but are not limited to sneezing, coughing, sweating, maintenance of normal body temperature, and gram-positive normal flora on the skin. Adaptive immunity is a very specific aspect of a properly functioning immune system that provides protection against previous infections experienced by the host. These responses are mediated by lymphocytes, which consist of natural killer (NK) cells, B cells and T cells. Vaccinations and exposure to pathogens benefit the adaptive immune system by establishing immunologic memory. In the event of another attack by the same foreign organism, the adaptive immune system is able to provide a more efficient response. Complications of Chronic Hyperglycemia Patients with uncontrolled diabetes are considered immunosuppressed due to the negative effects of elevated blood sugars on the immune system. Hyperglycemia impairs overall immunity through diffe Continue reading >>

What Happens If My Blood Sugar Gets Really High?

What Happens If My Blood Sugar Gets Really High?

Your blood sugar is high when the numbers are 130 mg/dL or higher. High blood sugar can: Make you thirsty Cause headaches Make you go to the bathroom often to urinate (pee) Make it hard to pay attention Blur your vision Make you feel weak or tired Cause yeast infections The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS. High blood sugars cause the body to slow down. When sugar levels are high, blood thickening occurs which causes a reduction of oxygen in the brain and this lessens responses to stimuli. In turn, chemical synapses don’t function properly, reducing the brains ability to process information. This makes it harder to think and process data clearly. It impacts memory recall, attention, concentration, focus, and retention of external information, making learning difficult and in some cases impossible for the child or adult diabetic. Now imagine trying to swim in Jell-O®. For those synapses, the high blood sugar is the same as if you were the Olympic Gold Medalist swimmer Michael Phelps (synapse) and your lane had filled with Jell-O®, causing you not to be able to reach your full potential. If your sugars are normal and your pool (brain) is filled with the proper chemicals and water, you will get to finish (information stored in your brain) faster and sometimes you will win the race (get almost perfect scores on the SAT’s.) This feeling of Jell-O® also causes poor memory recall and prevents new information from assimilating into the memory properly, causing memory loss and poor retention. It hinders the growth of new cells in the brain Continue reading >>

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