First, let’s define a few words:
Carbohydrates: sugar, in all its forms, present in the diet (starch, fiber, added/natural sugar).
Glucose: sugar molecule
Glycemia: blood sugar level, can be measured with a glucometer.
Hyperglycemia: high blood sugar level.
Hyperglycemia occurs when the amount of insulin in the blood is insufficient or ineffective. When glucose circulating in the blood cannot enter the cells because of a lack of insulin, it accumulates in the blood and raises a person’s glycemia (blood glucose levels).
High blood sugar values for the majority of people with diabetes are:
- above 7 mmol/L, fasting or before a meal
- above 10 mmol/L, two hours after the begining of a meal
For pregnant women living with diabetes, hyperglycemia values are:
- fasting: above 5.3 mmol/L
- 1 hour after a meal: above 7.8 mmol/L
- 2 hours after a meal: above 6.7 mmol/L
Symptoms
Some people may not notice their hyperglycemia. However, above a certain threshold, high blood sugar can lead to the following symptoms:
- drowsiness
- increased urination
- intense thirst
- excessive hunger
- involuntary weight loss
- irritability
- dizziness
Causes
The primary causes of hyperglycemia are:
- a diet abnormally high in carbohydrates
- reduced physical activity
- insufficient insulin and/or antidiabetic medication (dosage error or a skipped dose)
- physical stress (illness, surgery, infection, etc.) or psychological stress (mourning a death, new job, moving, etc.)
- taking certain drugs (e.g.: cortisone)
Hyperglycemia can also be caused by two lesser known phenomena: the dawn phenomenon and the Somogyi effect.
Preventing hyperglycemia
Be aware of all the factors that can influence your blood sugar levels (there are 42 of them!). In most cases, hyperglycemia can be avoided by taking the following precautions:
- Measure your blood glucose (sugar) levels regularly
- Be aware of the impact of food on blood sugar levels
- Follow dietary advice adapted to your reality, developed with a dietitian-nutritionist
- Take insulin or anti-diabetic medication as prescribed (avoid forgetting)
- Adjust insulin as prescribed
- Adopt an active lifestyle (physical activity, active transportation, etc.)
Treatment
In the presence of symptoms of hyperglycemia, the person living with diabetes should take the following measures:
- Identify the cause of hyperglycemia and take appropriate action, if possible:
- test blood glucose more frequently
- if safe, engage in low-intensity physical activity to help lower blood glucose levels (e.g. walking)
- adjust insulin as prescribed;
- drink water regularly to prevent dehydration
- Identify the cause of hyperglycemia to better prevent it in the future;
- if you live with type 1 diabetes: if your blood glucose level is higher than 14 mmol/L, check for ketones in your urine or blood
Emergency situations
The following symptoms may indicate a hyperglycemic emergency. Seek medical attention immediately if one or more of these situations occur:
- you cannot retain liquids due to vomiting or diarrhea
- your state of consciousness changes: confusion, agitation, lack of reaction to stimulation, hallucinations or unusual behaviour
- you exhibit signs of dehydration: dry mouth, sunken eyes, dry skin, etc.
- your body temperature has stayed above 38.5 °C for more than 48 hours.
- if you live with type 2 diabetes: your blood glucose level is higher than 25 mmol/L with excessive drowsiness
- if you live with type 1 diabetes:
- your blood glucose level is higher than 20 mmol/L with nausea, vomiting and/or abdominal pain
- your blood glucose reading is higher than 14 mmol/L with ketones:
- above 4 mmol/L in urine
- above 1.5 mmol/L in blood