What to do when you have hyperglycaemia (high blood glucose)

High blood glucose levels can be dangerous. Learn more about why this is and what to do about it

July, 2017

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What is hyperglycaemia?

Hyperglycaemia is when you have too much glucose (a form of sugar) in your bloodstream. It’s the opposite of hypoglycaemia (also known as a hypoglycaemic event, or “hypo”) which is when blood glucose is too low. Diabetes UK define hyperglycaemia in general as being blood glucose which is:

  • Over 7.0 mmol/l when fasting
  • Over 8.5 mmol/l 2 hours after meal

Having high blood glucose is the defining characteristic of Type 2 diabetes. Your blood glucose levels can be monitored in two ways:

  • Blood glucose monitors you either use at home, if you have been offered one, or at the doctor’s
  • The HbA1c test done by healthcare professionals at least once a year

Most of the advice and medications you will get from your doctor or diabetes specialist nurse will be about getting your average blood glucose level (HbA1c) down.

Why do I need to lower my blood glucose?

Having high blood glucose levels for a short time can make you feel unwell. If your blood glucose levels remain high for longer periods (say, over months and years), this can start to cause serious, permanent damage to different parts of the body, including eyes, nerves, kidneys, feet and blood vessels. That’s why it’s important to work to get your blood glucose levels down if they are consistently too high.

What causes hyperglycaemia?

Having Type 2 diabetes means you either don’t produce enough of your own insulin, or the insulin you do produce isn’t used effectively. Your body needs insulin to use the glucose in your bloodstream: the cells need the glucose for fuel, but without insulin, they can’t use it.

Your blood glucose level can rise in certain situations. For example:

  • If you miss a dose of your diabetes medication
  • If you eat more carbohydrates (particularly sugary foods) than your body can manage
  • If you’re going through a mentally stressful time (e.g. pressure at work, money worries)
  • If you’re under physical stresses (e.g. injuries, surgery, illnesses)
  • If you get an infection
  • If you are taking certain medications for another illness, like corticosteroids

How Type 2 diabetes causes high blood glucose

What does hyperglycaemia feel like?

The symptoms of hyperglycaemia are very like the symptoms you may have noticed when you were first diagnosed with Type 2 diabetes. This is because the causes are the same: not enough insulin, or insulin that’s not being used properly. Having said that, you might not get any symptoms at all. If you do, things to look out for include:

high-glucose

What can I do about hyperglycaemia?

Lowering your blood glucose involves three main strategies:

  • Making your diet healthier, particularly cutting out sugary food
  • Taking regular, gentle exercise
  • If prescribed, taking blood glucose-lowering medications

It’s also a good idea to stay hydrated with plenty of water (and other liquids without sugar), and to find time to relax and de-stress as being stressed can raise your blood glucose levels.

Help lower your blood glucose level with our handy guide

If you’ve been diagnosed with Type 2 diabetes and your blood glucose levels are staying too high despite making lifestyle changes AND taking any medications you’ve been prescribed, it might be a good idea to talk to your GP or diabetes specialist nurse. It might be time to try another medication, or to make other lifestyle changes.

When hyperglycaemia gets serious: HHS

If you have extremely high blood glucose levels (severe hyperglycaemia) you may develop “hyperosmolar hyperglycaemic state” or HHS. There is no exact definition of the blood glucose level that leads to HHS, but it is often seen at levels over 40 mmol/l.

HHS can develop over a matter of weeks if you get an illness and become dehydrated. Missing doses of medications you’ve been prescribed to help lower your blood glucose can also contribute.

HHS is a potentially life-threatening medical condition, and needs to be treated. If you experience symptoms like the ones below, call either your GP practice or your diabetes specialist nurse. Out of hours you can call the 111 service for advice. If you feel extremely unwell, especially if you start to become drowsy or fall unconscious, someone will need to dial 999 and tell the emergency services that you have Type 2 diabetes and very high blood glucose.

Symptoms of HHS to look out for include:

  • Urinating a lot
  • Feeling thirsty
  • Feeling sick
  • Having dry skin
  • Feeling disoriented
  • Feeling sleepy
  • Gradual loss of consciousness

What to do about HHS

Diabetes UK suggests the following actions:

  • Always take your diabetes medication, even if you feel unwell and can’t eat
  • If you monitor your blood glucose, you may need to test more frequently
  • Contact your healthcare team if your blood glucose levels remain high (>15 mmol/l) despite taking medications and making suitable lifestyle changes
  • Drink plenty of unsweetened fluids

If you can’t eat, replace meals with snacks and drinks containing carbohydrate.

When hyperglycaemia gets serious: ketoacidosis

Diabetic ketoacidosis mainly affects people with Type 1 diabetes, but some people with Type 2 diabetes can still develop it (especially if they’re being treated with insulin), so it’s good to be aware of the possible symptoms.

When there’s a severe lack of insulin in your body, your cells can’t use the glucose from your blood stream. They need this glucose for fuel, but without insulin they can’t use it. Your body then needs to find other sources of energy – it does this by breaking down your fat stores. A by-product of this process is an acid called ketone. The ketones build up in your blood and can make you feel extremely ill.

Diabetic ketoacidosis is treated as a medical emergency, because it needs to be sorted out immediately or it can be highly dangerous – and in some cases, fatal. If you or someone you know with diabetes experiences any of the signs of ketoacidosis, get medical help straight away.

Symptoms of ketoacidosis to look out for include:

  • Urinating a lot
  • Feeling thirsty
  • Feeling tired and lethargic
  • Blurred vision
  • Having abdominal pain
  • Feeling sick or being sick
  • Breathing changes (deep sighing breaths)
  • Fruity-smelling breath (like pear drops)
  • Collapsing or falling unconscious

What to do about ketoacidosis

If you (or someone else) develops diabetic ketoacidosis, act quickly – get medical help straight away.

In the long term, you can help yourself to avoid diabetic ketoacidosis by working to get and keep your blood glucose levels down.

  • Always take your diabetes medication, even if you feel unwell and can’t eat
  • If you monitor your blood glucose, you may need to test more frequently
  • Contact your healthcare team if your blood glucose levels remain high (>15 mmol/l)
  • Drink plenty of unsweetened fluids

If you can’t eat, replace meals with snacks and drinks containing carbohydrate.

How to say it: pronunciation guide

Some of the terms used in managing diabetes can be quite alien, and most people won’t have heard of them in daily life unless they are diagnosed with diabetes themselves. It can help to know what your doctor or diabetes specialist nurse means by these terms, and also how to use them yourself when you’re talking to a healthcare professional, so everyone can make themselves understood.

Terms on this page include:

WordHow it’s saidWhat it means
hyperglycaemiahigh-per-gly-see-me-ahHigh blood glucose
hypoglycaemiahigh-poe-gly-see-me-ahLow blood glucose
hyperosmolarhigh-per-oz-moe-lerAn abnormal concentration of certain body fluids
ketoacidosiskey-toe-assi-doe-sisHigh levels of ketones (an acid) in your blood