{"id":13576,"date":"2014-09-15T00:00:00","date_gmt":"2014-09-15T04:00:00","guid":{"rendered":"https:\/\/www.diabete.qc.ca\/hyperglycemic-emergencies\/"},"modified":"2023-07-26T11:59:23","modified_gmt":"2023-07-26T15:59:23","slug":"hyperglycemic-emergencies","status":"publish","type":"page","link":"https:\/\/www.diabete.qc.ca\/en\/diabetes\/information-on-diabetes\/diabetic-emergencies\/hyperglycemic-emergencies\/","title":{"rendered":"Hyperglycemic emergencies"},"content":{"rendered":"\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:100%\">\n<div class=\"wp-block-media-text alignwide has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 35%\"><div class=\"wp-block-media-text__content\">\n<p>There are two types of hyperglycemic emergencies: <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Diabetic ketoacidosis (DKA)<\/strong>, mainly in people with <strong>type 1 diabetes<\/strong>.<\/li>\n\n\n\n<li><strong>Hyperosmolar hyperglycemic state (HHS)<\/strong>, mainly in people with <strong>type 2 diabetes<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>DKA can also occur in people with undiagnosed type 1 diabetes<\/strong>.<\/p>\n\n\n\n<p>These situations require emergency medical intervention, since they can lead to serious conditions such as coma, even death, if left untreated.<\/p>\n\n\n\n<p class=\"has-text-align-left\">These complications can arise in specific situations, during&nbsp;<a href=\"\/en\/diabetes\/the-life-with-diabetes\/sick-days\/\">sick days<\/a>, for example.<\/p>\n<\/div><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301-1024x683.jpg\" alt=\"\" class=\"wp-image-14928 size-full\" srcset=\"https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301-1024x683.jpg 1024w, https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301-300x200.jpg 300w, https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301-768x512.jpg 768w, https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301-1536x1024.jpg 1536w, https:\/\/www.diabete.qc.ca\/wp-content\/uploads\/2023\/02\/Urgences-hyperglycemiques-1390147301.jpg 1920w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n  <section  class=\"block-accordions-group theme-block theme-block--innerblock aligndefault\" >\n        \n    <div class=\"acf-innerblocks-container\">\n    \n<section class=\"accordion\">\n  <div class=\"accordion__table\">\n    <div class=\"accordion__accordion\">\n          \n      <button class=\"accordion__header-row accordion-toggle\" id=\"accordion69ea3f61b0231id\" aria-controls=\"sect69ea3f61b0231\" aria-expanded=\"false\"\n        aria-label=\"Open or close accordion &quot;Diabetic ketoacidosis (DKA)&quot;.\">\n                  <span class=\"accordion__header__title\">Diabetic ketoacidosis (DKA)<\/span>\n                <span class=\"accordion__header__icon\" role=\"presentation\">\n          <i class=\"icon icon-arrow-down\"><\/i>\n        <\/span>\n      <\/button>\n    \n        \n      <div class=\"accordion__sub-rows wysiwyg\" id=\"sect69ea3f61b0231\" role=\"region\" aria-labelledby=\"accordion69ea3f61b0231id\">\n        <div class=\"acf-innerblocks-container\">\n\n<p> DKA is characterized by :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>High blood sugar, often greater than 20 mmol\/L<\/strong><\/li>\n\n\n\n<li><strong>The presence of <a href=\"https:\/\/www.diabete.qc.ca\/en\/diabetes\/diabetes-management\/hyperglycemia\/ketones\/\" data-type=\"page\" data-id=\"24291\">ketones<\/a> in the blood or urine<\/strong><\/li>\n<\/ul>\n\n\n\n<p>DKA is usually caused by <strong>low insulin levels<\/strong>, which means blood glucose can&#8217;t get into the cells as it should. Therefore, the body use its fat reserves for the energy it normally gets from glucose. <\/p>\n\n\n\n<p>Ketones are produced from the breakdown of fats. Their accumulation in the blood is toxic for the body.  <\/p>\n\n\n\n<p><strong>DKA can arise due to :<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A forgotten or skipped insulin dose<\/li>\n\n\n\n<li>An improper adjustment to the insulin dose <\/li>\n\n\n\n<li>An insulin pump that stops working<\/li>\n\n\n\n<li>An infection (e.g., pneumonia, urinary tract infection (UTI))<\/li>\n\n\n\n<li>A serious medical problem (e.g., heart attack, stroke, pancreatitis)<\/li>\n\n\n\n<li>A serious physical injury<\/li>\n<\/ul>\n\n\n\n<p>The following <strong>symptoms <\/strong>are associated with DKA:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Deep and rapid breathing<\/li>\n\n\n\n<li>Fruity breath (ketonic odor)<\/li>\n\n\n\n<li>Nausea, vomiting<\/li>\n\n\n\n<li>Abdominal pain<\/li>\n\n\n\n<li>Decreased consciousness, confusion, agitation, unusual behavior<\/li>\n<\/ul>\n\n\n\n<p class=\"has-primary-color has-text-color\">IF YOU ARE EXPERIENCING THESE SYMPTOMS, CONTACT YOUR DOCTOR IMMEDIATELY OR GO TO THE EMERGENCY ROOM.<\/p>\n\n<\/div>      <\/div>\n\n    <\/div>\n  <\/div>\n<\/section>\n\n\n    \n<section class=\"accordion\">\n  <div class=\"accordion__table\">\n    <div class=\"accordion__accordion\">\n          \n      <button class=\"accordion__header-row accordion-toggle\" id=\"accordion69ea3f61b09caid\" aria-controls=\"sect69ea3f61b09ca\" aria-expanded=\"false\"\n        aria-label=\"Open or close accordion &quot;Hyperosmolar hyperglycemic state&quot;.\">\n                  <span class=\"accordion__header__title\">Hyperosmolar hyperglycemic state<\/span>\n                <span class=\"accordion__header__icon\" role=\"presentation\">\n          <i class=\"icon icon-arrow-down\"><\/i>\n        <\/span>\n      <\/button>\n    \n        \n      <div class=\"accordion__sub-rows wysiwyg\" id=\"sect69ea3f61b09ca\" role=\"region\" aria-labelledby=\"accordion69ea3f61b09caid\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>This state is characterized by :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Hyperglycemia often greater than 30 mmol\/L <\/strong><\/li>\n\n\n\n<li><strong>Severe dehydration<\/strong><\/li>\n<\/ul>\n\n\n\n<p>During a hyperglycemic episode, the accumulation of glucose in the blood increases the frequency and volume of urination. This can cause excessive water loss and significant dehydration. This can be followed by a drop in blood pressure leading to decreased consciousness and eventually to coma if the HHS is left untreated.<\/p>\n\n\n\n<p>Contrary to DKA, there is normally no significant presence of ketones in the blood or urine because insulin is not totally absent.<\/p>\n\n\n\n<p>The symptoms are typical of hyperglycemia, including :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Frequent and abundant urination<\/li>\n\n\n\n<li>Intense thirst<\/li>\n\n\n\n<li>Exhaustion<\/li>\n\n\n\n<li>Signs of dehydration (e.g., dry mouth, sunken eyes, dry skin, etc.)<\/li>\n<\/ul>\n\n\n\n<p><strong>Who is at risk?<\/strong><\/p>\n\n\n\n<p>The risk is minimal with an appropriate diabetes management. It is higher for some people :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>People with kidney problems<\/li>\n\n\n\n<li>Elderly people<\/li>\n<\/ul>\n\n<\/div>      <\/div>\n\n    <\/div>\n  <\/div>\n<\/section>\n\n\n    \n<section class=\"accordion\">\n  <div class=\"accordion__table\">\n    <div class=\"accordion__accordion\">\n          \n      <button class=\"accordion__header-row accordion-toggle\" id=\"accordion69ea3f61b116cid\" aria-controls=\"sect69ea3f61b116c\" aria-expanded=\"false\"\n        aria-label=\"Open or close accordion &quot;When to call 911?&quot;.\">\n                  <span class=\"accordion__header__title\">When to call 911?<\/span>\n                <span class=\"accordion__header__icon\" role=\"presentation\">\n          <i class=\"icon icon-arrow-down\"><\/i>\n        <\/span>\n      <\/button>\n    \n        \n      <div class=\"accordion__sub-rows wysiwyg\" id=\"sect69ea3f61b116c\" role=\"region\" aria-labelledby=\"accordion69ea3f61b116cid\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Call a doctor without delay or get the person to the emergency room if:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>They cannot retain liquids because of vomiting or diarrhea<\/li>\n\n\n\n<li>Their <strong>level of consciousness<\/strong> changes; e.g., confusion, agitation, absence of reaction to stimuli, hallucinations or unusual behaviour<\/li>\n\n\n\n<li>There are signs of <strong>dehydration<\/strong>: dry mouth, sunken eyes, dry skin, etc.<\/li>\n\n\n\n<li>The body temperature is above 38.5\u00b0C for more than 48 hours<\/li>\n<\/ul>\n\n\n\n<p><strong>For type 1 diabetes:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Blood sugar level is <strong>above 14 mmol\/L and ketones<\/strong> are present :\n<ul class=\"wp-block-list\">\n<li>in the urine: \u201cmedium\u201d to \u201chigh\u201d level<\/li>\n\n\n\n<li>in the blood: level higher than 1.5 mmol\/L<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Blood sugar level is <strong>above 20 mmol\/L with nausea, vomiting and\/or abdominal pain<\/strong><\/li>\n<\/ul>\n\n\n\n<p><strong>For type 2 diabetes:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Blood sugar level is <strong>above 25 mmol\/L with excessive drowsiness<\/strong><\/li>\n<\/ul>\n\n<\/div>      <\/div>\n\n    <\/div>\n  <\/div>\n<\/section>\n\n\n    \n<section class=\"accordion\">\n  <div class=\"accordion__table\">\n    <div class=\"accordion__accordion\">\n          \n      <button class=\"accordion__header-row accordion-toggle\" id=\"accordion69ea3f61b15c7id\" aria-controls=\"sect69ea3f61b15c7\" aria-expanded=\"false\"\n        aria-label=\"Open or close accordion &quot;Preventing hyperglycemic emergencies&quot;.\">\n                  <span class=\"accordion__header__title\">Preventing hyperglycemic emergencies<\/span>\n                <span class=\"accordion__header__icon\" role=\"presentation\">\n          <i class=\"icon icon-arrow-down\"><\/i>\n        <\/span>\n      <\/button>\n    \n        \n      <div class=\"accordion__sub-rows wysiwyg\" id=\"sect69ea3f61b15c7\" role=\"region\" aria-labelledby=\"accordion69ea3f61b15c7id\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>In addition to the basic measures to prevent hyperglycemia, the following recommendations can help you prevent a hyperglycemic emergency.<\/p>\n\n\n\n<p><strong>If you have type 1 diabetes:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Check for ketones in your urine or blood if your blood sugar levels are higher than 14mmol\/L, and during sick days.<\/li>\n\n\n\n<li>Measure your blood sugar levels more frequently and follow the protocol established by your health care team for sick days.<\/li>\n\n\n\n<li>Keep adequately hydrated if your blood sugar level is above 14 mmol\/L.<\/li>\n<\/ul>\n\n\n\n<p><strong>If you have type 2 diabetes:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Measure your blood sugar levels more frequently and follow the recommendations of your health care team for sick days.<\/li>\n\n\n\n<li>Keep adequately hydrated if your blood sugar level is above 14 mmol\/L.<\/li>\n<\/ul>\n\n<\/div>      <\/div>\n\n    <\/div>\n  <\/div>\n<\/section>\n\n<\/div> \n  <\/section>\n  \n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Helpful resources<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">External resources<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/type1better.com\/en\/home\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Type 1 BETTER Project<\/a><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Research and writing:<\/strong> Diabetes Qu\u00e9bec&#8217;s team of health professionals<\/p>\n\n\n\n<p>June 2014 (updated july 2023)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>There are two types of hyperglycemic emergencies: diabetic ketoacidosis and hyperosmolar hyperglycemic state. These situations require urgent medical intervention, as they can lead to serious consequences such as coma, and even death if left untreated.<\/p>\n","protected":false},"author":1,"featured_media":14928,"parent":24329,"menu_order":124,"comment_status":"closed","ping_status":"open","template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"7588,7531,10292,12656,9530,12718","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-13576","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13576","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/comments?post=13576"}],"version-history":[{"count":7,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13576\/revisions"}],"predecessor-version":[{"id":31104,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13576\/revisions\/31104"}],"up":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/24329"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/media\/14928"}],"wp:attachment":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/media?parent=13576"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}