Home Type 2 Hyperglycemia (hyperglycemia): Signs of an episode

Hyperglycemia (hyperglycemia): Signs of an episode

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hyperglycemia This is a condition in which the blood sugar level (blood sugar level) is high. It is common in people with diabetes, but it can also occur in people who have not been diagnosed with diabetes. It may develop slowly without any obvious symptoms.

This article describes the symptoms of high blood sugar and how to test and manage high blood sugar levels. We also outline complications of hyperglycemia and prevention of hyperglycemic episodes.

Illustration by Michela Buttignol from Verywell Health

Symptoms of a hyperglycemic episode

Depending on the cause of high blood sugar, physical symptoms may not appear for months or years. This is because hyperglycemia can develop and progress slowly over time.

In other cases, for example in type 1 diabetes, symptoms may develop much earlier, within a few weeks.

Symptoms of high blood sugar include:

  • increased thirst
  • Frequent urination
  • Increased feeling of hunger
  • blurred vision
  • tingling sensation in hands and feet
  • unintentional weight loss
  • Malaise
  • Wounds and cuts that do not heal or heal very slowly
  • headache

What is hypoglycemia?

Hyperglycemia is when blood sugar levels are too high, while hypoglycemia is the opposite, when blood sugar levels are too low. For most people with diabetes, this is a blood sugar level below 70 milligrams per deciliter (mg/dL).

You are more likely to experience hypoglycemia if you have diabetes or are taking medicines that lower blood sugar. Other risk factors for hypoglycemia include being over 65 or having other health conditions, such as kidney disease, heart disease, or cognitive impairment.

Why do some people have hyperglycemia?

In addition to diabetes, there are many other risk factors for high blood sugar. Risk factors are not necessarily causes, but can contribute to the development of hyperglycemia.

Risk factors for hyperglycemia are similar to those for type 2 diabetes. They include:

  • being overweight or obese
  • Be over 35 years old
  • Someone in your family has diabetes
  • Not doing physical activity regularly
  • Prediabetes (when blood sugar levels are high but not high enough to be considered diabetic)
  • have gestational diabetes (diabetes that develops during pregnancy) or have given birth to a baby weighing 9 pounds or more

Type 2 diabetes is more frequently diagnosed in the United States among Blacks, Native Americans, Asian Americans, Latinos, and Pacific Islanders.

There are several causes of high blood sugar. These include:

  • Insulin resistance (when cells do not respond properly to insulin)
  • Reduced or absent insulin production by the pancreas
  • Eat lots of highly processed foods containing refined carbohydrates and saturated fats
  • Certain drugs, such as corticosteroids, thiazide diuretics (drops), some psychiatric drugs, and certain human immunodeficiency virus (HIV) drugs
  • Genetic mutation
  • Hormonal disorders such as Cushing’s syndrome and hyperthyroidism (hyperthyroidism)
  • Damage or removal of the pancreas
  • stress

How to know if you have high blood sugar

If you have symptoms of high blood sugar, you should have your blood sugar levels tested.

Diabetics often have a home blood sugar monitor, also called a blood glucose meter or glucometer. This is a small device that inserts disposable test strips. Using a lancing device, prick your clean fingertip and drop a small amount of blood onto the test strip. Most blood glucose meters display results within seconds.

Alternatively, you can have your health care provider test your blood sugar levels. You can determine if you have high blood sugar or diabetes. To diagnose diabetes, your blood sugar levels must be:

  • 126 mg/dL or more when fasting (fasting for at least 8 hours)
  • 200 mg/dL or more, regardless of when you last ate

Hyperglycemia is generally considered too high when it exceeds an individual’s blood sugar target by 160 mg/dL or more, regardless of whether they have diabetes or not. If you have questions about your personal blood sugar goals, ask your health care provider.

If your blood sugar level is 240 mg/dL or higher and you use insulin, test your urine with a urine ketone test kit. If ketones are present, follow the “sick day” rules (these rules are a set of actions that people with diabetes have established with their health care provider) or ask their health care provider if they are not sure what to do.

Treatment and management of hyperglycemia

Several different approaches are used to treat and manage hyperglycemia. Basic treatment includes lifestyle modifications such as:

  • change your diet: This includes increasing amounts of vegetables and fruits, lean proteins, whole grains, and healthy fats while decreasing refined grains, saturated and trans fats, sodium, and added sugars.
  • stay hydrated: Water is the body’s best source of hydration. Avoid drinks with added sugar, such as regular sodas, juices, regular sports and energy drinks, and flavored coffee and tea drinks.
  • increased physical activity: Regular exercise improves insulin sensitivity and helps lower blood sugar levels. However, if you have ketone bodies in your urine, you should not exercise as it may increase your blood sugar levels.
  • get enough sleep: Aim for 7 to 9 hours of quality sleep every night.
  • managing stress: This can be done through meditation, yoga, and relaxation techniques.

If lifestyle modifications alone are not sufficient to manage high blood sugar, drug therapy may be considered. Several different classes of drugs are used to lower blood sugar levels. They may be oral drugs (pills), injections/infusions, and/or inhalants.

Whether your treatment plan includes only lifestyle modifications or medication, it is important to adhere to it. It is essential to keep blood sugar levels in the normal range to prevent complications from occurring.

If you have difficulty following your treatment plan or cannot tolerate your medication, talk to your health care provider. Regular follow-up allows you to adjust your treatment plan and increases your chances of successfully managing your high blood sugar.

Complications of mismanaged hyperglycemia

If hyperglycemia is not treated, blood sugar levels can become very high. This can lead to acute (meaning fairly rapid onset) but serious complications.

Complications include:

  • Diabetic ketoacidosis (DKA), especially in people with type 1 diabetes (insulin-dependent diabetes in which the pancreas produces little or no insulin)
  • Hyperglycemic hyperosmolar syndrome (HHS). It usually occurs in people with type 2 diabetes who have uncontrolled blood sugar levels.

DKA develops when the body does not have enough insulin to help move glucose from the blood to cells for use as energy. When this happens, the liver breaks down the fat and uses it for energy instead. This process produces acid byproducts called ketones.

These ketones can quickly accumulate to dangerously high levels in the body. Symptoms of DKA include increased thirst and urination, rapid and deep breathing, fruity-smelling breath, dry mouth, headache, fatigue, nausea, and vomiting.

HHS is a life-threatening complication of type 2 diabetes in which blood sugar levels become very high in the absence of ketone bodies. It usually occurs at the same time as dehydration, which causes the blood to become more concentrated than normal. This causes symptoms such as increased thirst and urination, weakness, nausea, dry mouth, fever, and confusion.

If you develop symptoms of DKA or HHS, seek emergency medical care.

Other complications of poorly controlled hyperglycemia tend to take much longer to develop, but are just as serious. Long-term complications that can be caused by untreated high blood sugar include:

How to prepare for and deal with hyperglycemia symptoms

If you have risk factors for hyperglycemia, it is important to note that some of those risk factors, such as age and genetic makeup, are immutable or cannot be changed. However, there are some modifiable risk factors, usually related to lifestyle, that can be modified.

The best way to get ahead of high blood sugar symptoms is to stick to your treatment plan, if you have one. Maintaining a healthy, balanced diet and getting regular physical activity are two of the most important things you can do to keep your body healthy and your blood sugar levels in the normal range. If you are taking medication, make sure you are taking it as prescribed.

Find a support person to help keep you accountable during your visits with your medical team. Your support person can celebrate your successes and act as a sounding board to bounce ideas off of when you’re struggling.

Blood sugar monitoring

Managing your blood sugar levels is often a collaborative effort between you and your health care team. Although you are responsible for the day-to-day management of your blood sugar levels, your health care provider can recommend a personalized treatment plan to keep your blood sugar levels within normal limits.

This may include regularly self-monitoring your blood sugar levels at home. The first step is to purchase or receive a prescription for a blood sugar monitor and test strips.

Your health care provider or Certified Diabetes Care and Education Specialist (CDCES) can teach you or your caregiver how to use it. Learn when and how often you should test your blood sugar levels at home, such as when you wake up before a meal, 2 hours after a meal, and at bedtime.

Depending on your diagnosis, you may be eligible for continuous glucose monitoring (CGM). This small wearable device automatically checks your blood sugar levels day and night. Blood sugar levels are transmitted wirelessly to another receiver or smart device, where you can read the results.


Hyperglycemia is high blood sugar (sugar) levels. Symptoms include increased thirst and urination, blurred vision, and tingling in the hands and feet.

Hyperglycemia occurs more often in people with diabetes, but it can also occur in people without diabetes. Causes of hyperglycemia include insulin resistance, lack of insulin production, certain medications, stress, and some medical conditions.

You can check your blood sugar levels at home using a blood sugar monitor, and your health care provider can test for high blood sugar levels. Short-term complications of untreated hyperglycemia include diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS).

Long-term complications include heart disease and stroke, diabetic neuropathy (nerve damage), kidney disease, foot problems, eye disease, and periodontal disease.

Treatment for high blood sugar may include lifestyle modifications such as eating a nutritious diet, regular exercise, getting enough sleep, and managing stress. This may include medication and self-monitoring of blood sugar levels at home.

Regular follow-ups with your health care team are important to ensure your treatment plan is working and still appropriate for you. Taking proactive steps to prevent and manage high blood sugar now will help keep your blood sugar levels in the normal range, benefiting your overall health for years to come.

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