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Hyperglycemia (high blood glucose) means there is too much sugar in the blood because the body lacks enough insulin. Associated with diabetes, hyperglycemia can cause vomiting, excessive hunger and thirst, rapid heartbeat, vision problems and other symptoms. Untreated hyperglycemia can lead to serious health problems.
Hyperglycemia, or high blood glucose, occurs when there is too much sugar in the blood. This happens when your body has too little insulin (the hormone that transports glucose into the blood), or if your body can't use insulin properly. The condition is most often linked with diabetes. Hyperglycemia is blood glucose greater than 125 mg/dL (milligrams per deciliter) while fasting (not eating for at least eight hours; a person with a fasting blood glucose greater than 125 mg/dL has diabetes).
If you have hyperglycemia and it’s untreated for long periods of time, you can damage your nerves, blood vessels, tissues and organs. Damage to blood vessels can increase your risk of heart attack and stroke, and nerve damage may also lead to eye damage, kidney damage and non-healing wounds. What are risk factors for hyperglycemia?Major risk factors for hyperglycemia are:
Other possible causes
What are the symptoms of hyperglycemia?It’s especially important to know the early signs of hyperglycemia if you have type 1 diabetes. If hyperglycemia is left untreated in people with type 1 diabetes, it can develop into ketoacidosis, where ketones, which are toxic acids, build up in the blood. This condition is an emergency situation that can lead to coma or death. Early symptoms of hyperglycemia include:
Additional symptoms include:
Symptoms of ketoacidosis are:
People with both type 1 and type 2 diabetes can manage hyperglycemia by eating healthy, being active, and managing stress. In addition, insulin is a critical part of managing hyperglycemia for people with type 1 diabetes, while people with type 2 diabetes may need oral medications and eventually insulin to help them manage hyperglycemia. If you don’t have diabetes and have any of the signs and symptoms of hyperglycemia, call your healthcare provider. Together you can work to manage your hyperglycemia.
Last reviewed by a Cleveland Clinic medical professional on 02/11/2020. References
Hypoglycemia happens when there is not enough glucose, or sugar, in the blood. The National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that symptoms usually appear when blood sugar levels are below 70 milligrams per deciliter (mg/dl). However, this number can vary between individuals. People can check with their doctor to find out their personal level of low blood sugar. People with low blood sugar may want to use a blood glucose meter — a small, portable machine that monitors blood sugar levels. Some monitors sound an alarm if levels drop below a certain level. People can purchase blood glucose monitors online or discuss with their healthcare team. Learn about home blood glucose monitors and how to use them here. People with mild hypoglycemia may experience the following common symptoms:
Severe hypoglycemia may involve:
ComplicationsIf a person does not take action, they may have:
Severe hypoglycemia can be life threatening, and in rare cases, may lead to death without treatment. Someone who regularly experiences hypoglycemia may be unaware that it is happening or getting worse. They may not notice the warning signs, which may lead to severe and possibly fatal complications. People may experience hypoglycemia for reasons including:
Blood sugar regulationThe digestive system breaks down carbohydrates from food. One of the molecules this creates is glucose, the body’s main energy source. Glucose enters the bloodstream after we eat. Insulin, a hormone the pancreas produces, then allows cells in the body to absorb glucose. This means that even if plenty of glucose is available in the bloodstream, cells will starve of energy without insulin. After eating, the pancreas automatically releases the right amount of insulin to allow cells to absorb enough glucose from the bloodstream. As glucose enters the cells, blood sugar levels fall. Any extra glucose goes into the liver and muscles in the form of glycogen, or stored glucose. The body can use this glucose later when it needs more energy. Insulin is responsible for bringing high blood sugar levels back to normal. If glucose levels fall because an individual has not eaten for a while, the pancreas secretes glucagon, another hormone, which triggers the breakdown of stored glycogen into glucose. The body then releases the glycogen into the bloodstream, bringing glucose levels back up. If people take insulin and inject too much, it can cause cells to absorb excess glucose from the bloodstream, leading to low blood sugar. Hypoglycemia and diabetesBoth type 1 and type 2 diabetes involve a problem with insulin. The American Diabetes Association (ADA) classes low blood sugar as less than 70 mg/dl. In both types of diabetes, the cells do not get enough energy from glucose. People with type 1 diabetes and some with type 2 diabetes need to take insulin or other medications to reduce their blood sugar levels. If the insulin dose is too high, blood sugar levels can fall too far, leading to hypoglycemia. Hypoglycemia can also occur if the person exercises more than usual or does not eat enough. A person does not need to increase their dose to have too much insulin in their body. It may be that the insulin they took was more than their body needed at that moment. According to the NIDDK, insulin and two other diabetes medications — sulfonylureas and meglitinides — can result in hypoglycemia. Learn about insulin resistance here. Hypoglycemia in children: Pediatric ketotic hypoglycemiaSome children experience pediatric ketotic hypoglycemia, a condition involving low blood sugar levels and high levels of ketones. If people do not have enough glucose to use as energy, the body begins to break down fat in the body instead. The body produces chemicals called ketones as a by-product of breaking down fat. According to a 2019 study, pediatric ketotic hypoglycemia usually occurs due to poor intake of food, a gastrointestinal illness and vomiting, or a period of prolonged fasting. Severe metabolic and hormonal conditions may also cause pediatric ketotic hypoglycemia. Pediatric ketotic hypoglycemia may affect children from 6 months old and often resolves after the age of 6 years. SymptomsSymptoms of hypoglycemia in infants and children may include:
If a child shows any of the above signs or symptoms, a doctor should examine them as soon as possible. Insulin autoimmune syndromeAnother possible cause of hypoglycemia is insulin autoimmune syndrome, a rare disease that happens when the body’s immune system attacks insulin, mistaking it for an unwanted substance. Symptoms tend to appear suddenly, according to the Genetic and Rare Diseases Information Center (GARD). Symptoms often go away after a few months, but they can return if blood sugar levels drop. Symptoms and treatment are similar to those for hypoglycemia due to other causes. Treatment can usually control the symptoms. Anybody with symptoms of hypoglycemia and does not know the underlying cause will need to consult with a doctor. A doctor may:
Whipple’s triadA collection of three criteria, known as Whipple’s criteria, can suggest that symptoms stem from a pancreatic tumor. The three criteria of Whipple’s triad are as follows:
During a doctor’s appointment, a person may not have symptoms. The doctor may ask them to fast for a time, usually overnight. This allows hypoglycemia to occur so that the doctor can make a diagnosis. Some people may have to spend time in the hospital and fast for longer. If symptoms appear after eating, they will need another glucose test after food. Learn more here about pancreatic cancer. A person who notices the signs of hypoglycemia should consume 15–20 grams (g) of carbohydrates or glucose, such as:
They should then check blood sugar levels after 15 minutes, and eat another snack and repeat until their blood sugar levels are within a normal range. After this, people can eat slower-release carbohydrates, such as cereal, bread, rice, or fruit. People will also need to seek treatment for any underlying cause. For diabetesA person with diabetes can follow the 15:15 rule. They will need to check their blood sugar, treat the hypoglycemia with 15g of carbohydrate, and then wait 15 minutes and recheck their levels. If their blood sugar levels are still low, the person should repeat the process. They should eat some glucose, wait about 15 minutes, then recheck their blood sugar. People with diabetes may need to follow regular eating times to help keep blood sugar levels stable. Severe symptomsIf symptoms are severe, and the individual cannot treat themselves, somebody else will need to give them glucagon through an injection or via the nose. People will usually regain consciousness within 5–15 minutes but may then experience nausea or vomiting. Losing consciousnessIf the person loses consciousness, someone will need to place them in the recovery position and administer a glucagon injection. If this is not possible, people will need to call 911 immediately. It is important not to place food or drink into the mouth of an unconscious person, as it could block the airways. Do not drive with low blood sugarPeople will need to avoid driving while they have low blood sugar levels as it could be dangerous. People will need to wait until their levels return to within a normal range before driving. If people start to experience symptoms of hypoglycemia while driving, they will need to safely stop the car and check their blood sugar levels. People may find it helpful to store quick-acting carbohydrates, such as orange juice or glucose tablets, in their car if their levels drop while driving. If people have hypoglycemia or diabetes, they can discuss an eating plan with a healthcare provider. Tips may include the following:
Learn about counting carbs with diabetes here. Preventing hypoglycemia will depend on the underlying cause. Managing the underlying condition can help to avoid hypoglycemia. There are steps people can consider that may help. These include:
Hypoglycemia can lead to symptoms such as dizziness, weakness, and, in severe cases, a loss of consciousness. People with some medical conditions, including diabetes, may have a higher risk of hypoglycemia. It is important for people to know how to recognize the symptoms and be ready to take action if they occur. Consuming carbohydrates or glucose when blood sugar levels drop can help return them to a normal range. Last medically reviewed on December 6, 2021
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