How Does Dehydration Affect Blood-glucose Levels?
Water is important for your health and staying well-hydrated may help you reduce your blood-glucose levels, which helps you better manage the hormone insulin. This is especially important for diabetics and some evidence suggests that proper hydration may help you from getting type 2 diabetes. Video of the Day Blood Glucose Basics Glucose is a form of sugar your body uses for energy. When you eat carbohydrates, your body converts carbohydrates to glucose. Foods that are absorbed more rapidly, such as refined sugar and white flour, result in a greater spike in blood glucose, whereas less-refined foods such as whole-grain bread result in a slower, steadier blood-glucose rise. As glucose levels increase, your body releases insulin, which prompts your cells to store glucose and reduces the amount in your bloodstream. Diabetes occurs when people become resistant to insulin, causing blood-glucose levels to remain high. The Hydration Factor If you're concerned about blood glucose, proper hydration should be a top priority. When you're dehydrated, your body produces a hormone called vasopressin, according to "The New York Times." Vasopressin causes your kidneys to retain water and also prompts your liver to produce blood sugar, which may lead to elevated blood-glucose levels. Over time, this effect may lead to insulin resistance, notes the "New York Times." Although more studies are needed to confirm this effect, dehydration may eventually lead to chronic hyperglycemia, or high blood glucose, which may indicate diabetes, according to a study published in "Diabetes Care" in 2011. The study followed 3,615 adults over nine years and found that those who drank the greatest amount of water were the least likely to develop hyperglycemia, while those who drank the least amount of water Continue reading >>
Hyperglycemic Crisis: Regaining Control
CE credit is no longer available for this article. Expired July 2005 Originally posted April 2004 VERONICA CRUMP, RN, BSN VERONICA CRUMP is a nurse on the surgical unit of Morristown Memorial Hospital in Morristown, N.J. She's also a subacute care nurse in the hospital's rehabilitation division. KEY WORDS: hyperosmolar hyperglycemic syndrome (HHS), diabetic ketoacidosis (DKA), hepatic glucose production, proteolysis, hepatic gluconeogenesis, ketone bodies, metabolic acidosis, hyperkalemia, hypokalemia When a patient presents with markedly high blood glucose levels, the consequences can be fatal. Here's how to get your patient through the crisis. Edith Schafer, age 71, has just been admitted to your ICU with pneumonia, which she developed at home. She has a history of Type 2 diabetes. In addition to a temperature of 102° F (38.9° C), she has rapid, shallow breathing and dry, flushed skin. Her blood pressure is 96/70 mm Hg, and she's so lethargic that she's unable to keep her eyes open. Her lab results show a serum glucose level of 900 mg/dL. In addition to the pneumonia, Mrs. Schafer is suffering from hyperosmolar hyperglycemic syndrome (HHS). Severe hyperglycemia is a complication of both Type 1 and Type 2 diabetes. It can indicate HHS or diabetic ketoacidosis (DKA), another life-threatening condition. HHS tends to occur in patients with Type 2 diabetes, like Mrs. Schafer, while Type 1 diabetics are more likely to develop DKA. However, DKA can occur in Type 2 diabetes as well.1 HHS and DKA can be set off by infection, stress, missed medication, and other causes. In Mrs. Schafer's case, the trigger was pneumonia, a common cause of hyperglycemia in patients with diabetes. No matter what the cause, though, a case of HHS or DKA can turn deadly if not caught in time. The m Continue reading >>
How Water Impacts Blood Sugars
This article was originally from the weekly Diabetes Daily Newsletter. To receive your copy, create a free Diabetes Daily account. Picture a glass of water. Mix in a little sugar and stir until it dissolves. Now place it outside on a hot, sunny day. As the water evaporates, the remaining water gets sweeter and sweeter. If you have diabetes, this happens to your blood when you’re dehydrated. Because your blood is 83% water, when you lose water, the volume of blood decreases and the sugar remains the same. More concentrated blood sugar means higher blood sugars. The lesson: stay hydrated to avoid unnecessary high blood sugars. How Much Water Should I Drink? The average person loses about 10 cups of water per day through sweat and urination. At the same time, you gain fluid from drinking liquids and eating food. So how much you need to drink is a tricky question. You may have heard the “drink 8 glass of water a day” rule. Where did this rule come from? As Barbara Rolls, a nutrition research at Pennsylvania State University says: “I can’t even tell you that, and I’ve writen a book on water!” It turns out that there’s no basis for this in the medical literature. The easiest way to tell is looking at your urine. If it’s a little yellow, you’re probably hydrated. If it’s darker, then you need to drink more fluids. You can also go with your own intuition. Are you thirsty? Drink! If you’re busy or stuck at a desk for long periods, make sure you have a water bottle so you can easily answer when your body calls for water. Does Coffee or Tea Count? Yes! Although consuming caffeine can cause your body to shed some water, you still gain more water than you shed. And studies have shown that this effect is partically non-existent for people who drink caffeine re Continue reading >>
Everyday Dehydration Is Having A Major Effect On Your Blood Sugar Levels
Stop and think for a second: Are you dehydrated right now? Are you sure? According to the Institute of Medicine, 75 percent of Americans live with a condition called chronic dehydration. This means that even though you’re drinking fluids throughout the day, your body still isn’t getting the amount it needs to thrive. In fact, chronic dehydration is so common that our bodies get used to it. That’s why you may not feel thirsty, even when your cells are craving some much-needed H2O. People with diabetes are especially prone to daily dehydration. As glucose builds up in the bloodstream, your kidneys are forced to work extra hard to filter out the excess sugar. If they can’t keep up, that sugar is flushed out of your system through urine. High blood sugar can also cause your body to pull fluids from important tissues, such as the lenses of your eyes, muscle tissue, and brain tissue. If left untreated, everyday dehydration can take a pretty serious toll on your blood glucose levels. When your body is lacking fluids, it creates a hormone called vasopressin, which causes your kidneys to retain as much fluid as possible. By keeping in those liquids, your kidneys are also hoarding unwanted glucose. On top of that, high levels of vasopressin in your bloodstream can also cause the liver to produce additional blood sugar. Over time, this can lead to consequences like insulin resistance and chronic hyperglycemia. The good news is that dehydration is one of the fastest, easiest, and cheapest health problems to overcome: Just drink more water! Most people are familiar with the 8×8 rule–everyone should drink eight ounces of water, eight times a day. However, experts at the Mayo Clinic say it isn’t so simple. The amount of water your body needs depends on a variety of factor Continue reading >>
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High Blood Sugar And Diabetes
Blood sugar control is at the center of any diabetes treatment plan. High blood sugar, or hyperglycemia, is a major concern, and can affect people with both type 1 and type 2 diabetes . There are two main kinds: Fasting hyperglycemia. This is blood sugar that's higher than 130 mg/dL (milligrams per deciliter) after not eating or drinking for at least 8 hours. Postprandial or after-meal hyperglycemia. This is blood sugar that's higher than 180 mg/dL 2 hours after you eat. People without diabetes rarely have blood sugar levels over 140 mg/dL after a meal, unless it’s really large. Frequent or ongoing high blood sugar can cause damage to your nerves, blood vessels, and organs. It can also lead to other serious conditions. People with type 1 diabetes are prone to a build-up of acids in the blood called ketoacidosis. If you have type 2 diabetes or if you’re at risk for it, extremely high blood sugar can lead to a potentially deadly condition in which your body can’t process sugar. It's called hyperglycemic hyperosmolar nonketotic syndrome (HHNS). You’ll pee more often at first, and then less often later on, but your urine may become dark and you could get severely dehydrated. It's important to treat symptoms of high blood sugar right away to help prevent complications. Your blood sugar may rise if you: Eat too many grams of carbohydrates for the amount of insulin you took, or eat too many carbs in general Have an infection Are ill Are under stress Become inactive or exercise less than usual Take part in strenuous physical activity, especially when your blood sugar levels are high and insulin levels are low Early signs include: Increased thirst Trouble concentrating Frequent peeing Fatigue (weak, tired feeling) Blood sugar more than 180 mg/dL Ongoing high blood sugar Continue reading >>
> Hyperglycemia And Diabetic Ketoacidosis
When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>
Hyperglycemia In Diabetes
Print Overview High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication. It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart. Symptoms Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars. Early signs and symptoms Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for: Frequent urination Increased thirst Blurred vision Fatigue Headache Later signs and symptoms If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include: Fruity-smelling breath Nausea and vomiting Shortness of breath Dry mouth Weakness Confusion Coma Abdominal pain When to see a doctor Call 911 or emergency medical assistance if: You're sick and can't keep any food or fluids down, and Your blood glucose levels are persistently above 240 mg/dL (13 mmol/L) and you have ketones in your urine Make an appointment with your Continue reading >>
Dehydration is a generally dangerous condition for any animal, in which the tissues are low on water. It is particularly likely in poorly-regulated or hyperglycemic diabetics, and also particularly dangerous for them, because it can quickly trigger diabetic ketoacidosis. Those with diabetes are at risk for dehydration as it is triggered by hyperglycemia. Excessive thirst (medical term polydipsia [pah-lee-DIP-see-uh]; abreviated as PD) is a symptom of diabetes. Diabetic animals often drink incessantly because they are dehydrated from the cell-dehydrating effects of hyperglycemia, plus the effects of their bodies casting off the excess glucose through urination, taking hydration with it. The process also removes electrolytes the body needs to function properly such as potassium, sodium and chloride also. Chronic mild dehydration (common in diabetic cats) can lead to bowel motility problems among other things. One thing to check in the case of constipation is hydration level. To check if your pet is dehydrated, look at their gums and their skin. Skin will not snap back quickly when pinched, gums will be tacky or dry; more signs can be found at the link below. This condition can be deadly or lead to deadly complications, within a day, so it must be remedied immediately. In any case of dehydration, check frequently for ketones. Mild dehydration may be possible to remedy with lots of water; if this isn't working, the next step is subcutaneous fluid injections, usually performed by your vet. (Though some people see this problem enough to have the equipment and fluids at home.) Untreated dehydration can cause the blood to be more hypertonic, which in turn can suck water from the cells causing more dehydration. It's a vicious circle. Continue reading >>
What To Do If You Get Gastroenteritis:
Gastroenteritis causes diarrhea and vomiting, which can lead to dehydration and the loss of sodium and potassium (electrolytes). The disease puts a stress on your body and often causes an increase in blood glucose (sugar) levels. The two main culprits are stress hormones (cortisol, adrenaline) and lack of physical activity when you are ill. In rare cases, blood glucose (sugar) levels will fall. Measure your blood glucose (sugar) frequently; Continue to take your medication or insulin as usual (or as adjusted by your doctor while you are sick), even if your food intake is reduced because you’ve lost your appetite or are vomiting; Modify your diet: if you find it difficult to eat solid foods, try to eat the usual amount of carbohydrates in liquid form or, at the very least, satisfy your body’s minimum carbohydrate requirements of 150 g per day while you are ill. What are the signs of dehydration? Mild to Moderate Dehydration Severe Dehydration Dry, sticky mouth Extreme thirst Unusual sleepiness or tiredness Irritability and confusion Dry and cool skin Sunken eyes Headache Dry skin that doesn't bounce back when you pinch it Dizziness and lightheadedness Low blood pressure Rapid heartbeat and breathing Dark urine in smaller quantity Call a doctor or go to Emergency if: Signs of severe dehydration; Your blood glucose (sugar) levels are higher than 25 mmol / L accompanied by excessive drowsiness (type 2 diabetes), or 20 mmol / L with a moderate to high ketone level in your urine or blood (type 1 diabetes); You are vomiting continuously and unable to keep liquids down; Your fever stays above 38.5 ºC (101.3 ºF) for more than 48 hours; Diarrhea lasts more than 24 hours or occurs more than 5 times per day. How to avoid becoming dehydrated Here are some ways to avoid dehydra Continue reading >>
Why Does Diabetes Cause Dry Skin?
It’s not so much that diabetes itself causes dry skin -- it’s the dehydration that results from poor blood sugar control. When your blood sugar level is high, that causes your body to lose fluid. In turn, that causes you to become dehydrated. The solution, of course, is to keep your blood sugar in check -- which you want to do for many other reasons besides dry skin. So, control your diabetes, and you can control your dry skin! [There are good tips here if you want to add more: Diabetes may dry your skin because having high sugar levels in your blood causes your body to lose fluid, including moisture from your skin. Also, nerve damage caused by diabetes may interfere with your ability to perspire normally, lessening the amount of moisture on your skin. Dry skin can crack and become more prone to infection. To help keep your skin moist, avoid very hot showers and baths, use mild cleansers and apply moisturizer to your skin while it is still damp. Examine your skin daily, and if you notice any signs of infection, such as red or sore spots, see your doctor. Dry skin is a complication of diabetes. It is caused by high blood glucose (high blood sugar) levels in the blood which zap moisture away from the tissues such as the skin. Another cause of dry skin for a diabetic is due to poor circulation. Poor circulation can cause the sweat glands to slow down or even shut down. Without sweat to cool the skin, the skin becomes dry. Continue reading >>
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Vertigo is the sensation of spinning, while lightheadedness is typically described as near fainting, and weakness. Some of the conditions that may cause lightheadedness in a patient include low blood pressure, high blood pressure, dehydration, medications, postural or orthostatic hypotension, diabetes, endocrine disorders, hyperventilation, heart conditions, and vasovagal syncope. Vertigo is most often caused by a problem in the balance centers of the inner ear called the vestibular system and causes the sensation of the room spinning. It may be associated with vomiting. Symptoms often are made worse with position changes. Those with significant symptoms and vomiting may need intravenous medication and hospitalization. Vertigo is also the presenting symptom in patients with Meniere's Disease and acoustic neuroma, conditions that often require referral to an ENT specialist. Vertigo may also be a symptom of stroke. Most often, dizziness or lightheadedness is a temporary situation that resolves spontaneously without a specific diagnosis being made. Introduction to dizziness (feeling dizzy) Dizziness is one of the most common symptoms that will prompt a person to seek medical care. The term dizziness is sometimes difficult to understand since it means different things to different people. It is either the sensation of feeling lightheaded as if the individual is weak and will pass out, or it describes vertigo or the sensation of spinning, as if the affected person just got off a merry-go-round. Lightheadedness is often caused by a decrease in blood supply to the brain, while vertigo may be caused by disturbances of the inner ear and the balance centers of the brain. Continue reading >>
Hyperglycemia - Symptoms, Causes And Treatments
Hyperglycemia is a term referring to high blood glucose levels - the condition that often leads to a diagnosis of diabetes. High blood glucose levels are the defining feature of diabetes, but once the disease is diagnosed, hyperglycemia is a signal of poor control over the condition. Hyperglycemia is defined by certain high levels of blood glucose:1 Fasting levels greater than 7.0 mmol/L (126 mg/dL) Two-hours postprandial (after a meal) levels greater than 11.0 mmol/L (200 mg/dL). Chronic hyperglycemia usually leads to the development of diabetic complications.2 Symptoms of hyperglycemia The most common symptoms of diabetes itself are related to hyperglycemia - the classic symptoms of frequent urination and thirst.2,3 Typical signs and symptoms of hyperglycemia that has been confirmed by blood glucose measurement include:1,3,4 Thirst and hunger Dry mouth Frequent urination, particularly at night Tiredness Recurrent infections, such as thrush Weight loss Vision blurring. Causes of hyperglycemia Hyperglycemia often leads to the diagnosis of diabetes. For people already diagnosed and treated for diabetes, however, poor control over blood sugar levels leads to the condition. Causes of this include:1,3,4 Eating more or exercising less than usual Insufficient amount of insulin treatment (more commonly in cases of type 1 diabetes) Insulin resistance in type 2 diabetes Illness such as the flu Psychological and emotional stress The "dawn phenomenon" or "dawn effect" - an early morning hormone surge. The video below from Diabetes UK explains the dawn phenomenon and offers practical tips. Treatment and prevention of hyperglycemia Prevention of hyperglycemia for people with a diabetes diagnosis is a matter of good self-monitoring and management of blood glucose levels, including ad Continue reading >>
WHAT YOU NEED TO KNOW: What is nondiabetic hyperglycemia? Nondiabetic hyperglycemia means your blood glucose (sugar) level is high even though you do not have diabetes. Hyperglycemia may happen suddenly during a major illness or injury. Instead, hyperglycemia may happen over a longer period of time and be caused by a chronic disease. Why is it important to manage hyperglycemia? Hyperglycemia can increase your risk for infections, prevent healing, and it make it hard to manage your condition. It is important to treat hyperglycemia to prevent these problems. Hyperglycemia that is not treated can damage your nerves, blood vessels, tissues, and organs. Damage to arteries may increase your risk for heart attack and stroke. Nerve damage may also lead to other heart, stomach, and nerve problems. What increases my risk for nondiabetic hyperglycemia? A medical condition such as Cushing syndrome or polycystic ovarian syndrome Surgery or trauma, such as a burn or injury Infections, such as pneumonia or a urinary tract infection Certain medicines, such as steroids or diuretics Nutrition given through a feeding tube or IV A family history of diabetes or gestational diabetes Obesity or a lack of physical activity What are the signs and symptoms of hyperglycemia? You may not have any signs or symptoms, or you may have any of the following: More thirst than usual Frequent urination Blurred vision Nausea and vomiting Abdominal pain How is nondiabetic hyperglycemia diagnosed and treated? Your healthcare provider will measure your blood sugar level with a blood test. You may be given insulin or other medicines to decrease your blood sugar level. How can I help prevent hyperglycemia? Exercise can help lower your blood sugar when it is high. It also can keep your blood sugar levels steady o Continue reading >>
Hyperosmolar Hyperglycemic State
Background Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occurs in patients with diabetes mellitus (DM).  It is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%. (See Epidemiology.) HHS was previously termed hyperosmolar hyperglycemic nonketotic coma (HHNC); however, the terminology was changed because coma is found in fewer than 20% of patients with HHS.  HHS is most commonly seen in patients with type 2 DM who have some concomitant illness that leads to reduced fluid intake, as seen, for example, in elderly institutionalized persons with decreased thirst perception and reduced ability to drink water.  Infection is the most common preceding illness, but many other conditions, such as stroke or myocardial infarction, can cause this state.  Once HHS has developed, it may be difficult to identify or differentiate it from the antecedent illness. (See Etiology.) HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ketoacidosis. Most patients present with severe dehydration and focal or global neurologic deficits. [2, 4, 5] The clinical features of HHS and DKA overlap and are observed simultaneously (overlap cases) in up to one third of cases. According to the consensus statement published by the American Diabetes Association, diagnostic features of HHS may include the following (see Workup) [4, 6] : Effective serum osmolality of 320 mOsm/kg or greater Profound dehydration, up to an average of 9L Detection and treatment of an underlying illness are critical. Standard care for dehydration and altered mental status is appropriate, including airway management, intravenous (I Continue reading >>
Hyperglycemic Crises In Patients With Diabetes Mellitus
Ketoacidosis and hyperosmolar hyperglycemia are the two most serious acute metabolic complications of diabetes, even if managed properly. These disorders can occur in both type 1 and type 2 diabetes. The mortality rate in patients with diabetic ketoacidosis (DKA) is <5% in experienced centers, whereas the mortality rate of patients with hyperosmolar hyperglycemic state (HHS) still remains high at ∼15%. The prognosis of both conditions is substantially worsened at the extremes of age and in the presence of coma and hypotension (1–10). This position statement will outline precipitating factors and recommendations for the diagnosis, treatment, and prevention of DKA and HHS. It is based on a previous technical review (11), which should be consulted for further information. Although the pathogenesis of DKA is better understood than that of HHS, the basic underlying mechanism for both disorders is a reduction in the net effective action of circulating insulin coupled with a concomitant elevation of counterregulatory hormones, such as glucagon, catecholamines, cortisol, and growth hormone. These hormonal alterations in DKA and HHS lead to increased hepatic and renal glucose production and impaired glucose utilization in peripheral tissues, which result in hyperglycemia and parallel changes in osmolality of the extracellular space (12,13). The combination of insulin deficiency and increased counterregulatory hormones in DKA also leads to the release of free fatty acids into the circulation from adipose tissue (lipolysis) and to unrestrained hepatic fatty acid oxidation to ketone bodies (β-hydroxybutyrate [β-OHB] and acetoacetate), with resulting ketonemia and metabolic acidosis. On the other hand, HHS may be caused by plasma insulin concentrations that are inadequate to f Continue reading >>
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