From the Guidelines
Hyperglycemia, or high blood sugar, presents with symptoms including increased thirst, frequent urination, fatigue, blurred vision, headaches, and slow-healing wounds, and its treatment depends on severity and cause, with the most recent guidelines recommending initiation of pharmacologic therapy at diagnosis of type 2 diabetes, and metformin as the initial pharmacologic treatment choice if kidney function is normal 1.
Symptoms of Hyperglycemia
- Increased thirst
- Frequent urination
- Fatigue
- Blurred vision
- Headaches
- Slow-healing wounds
- Fruity-smelling breath
- Nausea
- Vomiting
- Confusion
Treatment Options
- Lifestyle modifications: regular exercise, balanced diet low in simple carbohydrates, maintaining a healthy weight
- Medication management:
- Type 1 diabetics: insulin therapy, such as rapid-acting insulins like Humalog or Novolog, and long-acting insulins like Lantus or Levemir
- Type 2 diabetics: oral medications like metformin, SGLT-2 inhibitors, GLP-1 receptor agonists, or insulin if other treatments are insufficient
- Blood glucose monitoring: target levels between 80-130 mg/dL before meals and less than 180 mg/dL after meals
Recent Guidelines
According to the most recent guidelines, youth with marked hyperglycemia (blood glucose ≥250 mg/dL, A1C ≥8.5%) without acidosis at diagnosis who are symptomatic should be treated initially with long-acting insulin while metformin is initiated and titrated 1. Additionally, in individuals with ketosis/ketoacidosis, treatment with subcutaneous or intravenous insulin should be initiated to rapidly correct the hyperglycemia and the metabolic derangement 1.
Management in Hospital Settings
In hospital settings, continuous insulin infusion remains the therapy of choice during hyperglycemic crises and critical illness, while for non-critically ill patients, insulin also remains the agent of choice for patients with severe hyperglycemia 1.
Importance of Monitoring and Adjustments
Hyperglycemia requires attention because chronically elevated blood sugar damages blood vessels and nerves throughout the body, leading to complications affecting the heart, kidneys, eyes, and other organs. During illness or stress, more frequent monitoring and medication adjustments may be necessary as these conditions can worsen hyperglycemia 1.
From the FDA Drug Label
Know your symptoms of high blood sugar which may include: increased thirst a hard time breathing frequent urination fruity smell on the breath drowsiness high amounts of sugar and ketones in your urine loss of appetite nausea, vomiting (throwing up) or stomach pain The first symptoms of hyperglycemia usually occur gradually over a period of hours or days. They include nausea, vomiting, drowsiness, flushed dry skin, dry mouth, increased urination, thirst and loss of appetite as well as acetone breath
The symptoms of hyperglycemia may include:
- Increased thirst
- A hard time breathing
- Frequent urination
- Fruity smell on the breath
- Drowsiness
- High amounts of sugar and ketones in the urine
- Loss of appetite
- Nausea, vomiting, or stomach pain
- Flushed dry skin
- Dry mouth
- Acetone breath
Treatment options for hyperglycemia are not explicitly stated in the provided drug labels, but it is mentioned that if high blood sugar (hyperglycemia) is not treated, it can lead to serious problems, like loss of consciousness, coma, or even death. It is recommended to follow the healthcare provider's instructions for treating high blood sugar 2.
From the Research
Hyperglycemia Symptoms
- Hyperglycemia, or high blood sugar, can lead to serious complications such as diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) 3, 4, 5, 6, 7
- Symptoms of hyperglycemia can include increased thirst and urination, blurred vision, and fatigue 4, 5
- If left untreated, hyperglycemia can lead to more severe symptoms such as confusion, seizures, and even death 3, 7
Treatment Options
- Treatment for hyperglycemia typically involves correcting fluid and electrolyte abnormalities and administering insulin 3, 4, 7
- Aggressive rehydration, insulin therapy, and electrolyte replacement are crucial in managing DKA and HHS 4, 5, 7
- Identifying and treating underlying precipitating events is also important in preventing recurrence 5, 6
- Patient education and regular follow-up are essential in preventing these potentially fatal complications 3, 7