High Blood Sugar (Hyperglycemia)
High blood sugar, or hyperglycemia, happens when there is too much sugar in the blood; generally a blood sugar level of 180 mg/dL or higher after meals. High blood sugar may affect people whether or not their diabetes is well controlled. In people whose diabetes is not well controlled, episodes of high blood sugar may happen because they are not treating their diabetes, or may not even know that they have diabetes. It can also sometimes happen to insulin pump users if their insulin pump tubing gets blocked. If left untreated, high blood sugar can cause serious health problems.
A person with type 1 diabetes may experience high blood sugar if they:
- Skip a dose of insulin
- Eat more than usual
- Are less active than usual
- Feel stressed
- Are sick
People with blood sugar that is too high may:
- Feel very thirsty or hungry
- Need to pass urine more often
- Feel like their mouth and skin are dry
- Have blurry eyesight
- Feel tired or weak
- Notice that sores and wounds are healing slower than usual
- Have unexplained weight loss
What to do about high blood sugar
If you see or feel the symptoms of high blood sugar, check it. To help lower blood sugar that is higher than usual:
- Follow the meal plan created by the diabetes care team
- Follow the activity plan created by the diabetes care team
- Take/administer insulin and other medicines at the right time, as prescribed by your/their health care provider
High blood sugar and DKA
High blood sugar can lead to diabetic ketoacidosis, or DKA. DKA happens when there is a buildup of ketones in the blood. Ketones are made when the body uses fat for energy instead of sugar. This can happen when the cells don’t get the sugar they need to use for energy.
Symptoms of DKA can include:
- Blood sugar above 240 mg/dL and not falling
- Intense thirst or dry mouth
- Need to urinate often
- Lack of appetite, or stomach pain
- Vomiting or nausea
- Blurry vision
- Fever or warm, dry, or flushed skin
- Difficulty breathing
- Feeling weak
- Fruity odor on the breath
Testing for Ketones
A person with type 1 diabetes should test for ketones when:
- His or her blood sugar is above 240 mg/dL and not falling
- They are ill, especially if they have a high fever, are vomiting, or have diarrhea
- Feeling symptoms of DKA, such as being very tired, having fruity breath, difficulty breathing, or a hard time concentrating
Just like there are test strips for blood sugar, there are also test strips that are used to measure the amount of ketones in the urine of a person with type 1 diabetes. These strips are available without a prescription in most local pharmacies. There are also some blood sugar meters that check for ketones in the blood.
The diabetes care team will often specify what level of ketones is dangerous for the person with diabetes. If the diabetes care team has not set a level, call if the urine test shows moderate or large amounts of ketones. Often, health care providers can provide advice about what to do in this situation over the phone.
DKA has a way of creeping up on people with diabetes when they are sick. That’s why testing blood sugar and ketones every 4 hours during an illness is important. Even if the sick person’s blood sugar isn’t high, if there’s nausea or vomiting, check the urine for ketones.
If ketones do not go down, or if the person with diabetes is vomiting and cannot stop, it is time to seek emergency help!
High levels of ketones and high blood sugar levels can mean diabetes is out of control. Check with your doctor about how to handle this situation. You or the person you care for should NOT be active when urine tests show ketones and blood sugar is high.