Hyperglycemia is the medical term for high blood sugar levels, or high blood glucose levels. Keeping blood sugar in a target range, or normal range, is important for overall health, as well as for preventing long-term health complications. People with diabetes or prediabetes experience hyperglycemia. It is important to recognize the symptoms of high blood sugar (such as increased thirst and urination), as well as test your blood sugar, and know what to do if your blood sugar is high.
This article will focus on high blood sugar, or hyperglycemia.
High blood sugar, or hyperglycemia, is a common condition that can affect anyone regardless of age, sex, race, or ethnicity, although some populations are at higher risk, including people who are African American, Hispanic or Latino, American Indian, or Alaska Native, as well as some people who are Pacific Islanders or Asian American.
Early symptoms of high blood sugar include increased thirst and urination. Other signs that may occur include weight loss, hunger, itchy skin, dark skin around the neck and armpits, slow wound healing, tiredness, irritability, yeast infections, and vision changes. If you have any of these symptoms, consult your healthcare provider.
Serious symptoms of high blood sugar such as nausea and vomiting, confusion, fruity breath, or loss of consciousness require emergency medical attention.
High blood sugar is caused by various factors, such as certain foods, stress, or, more commonly for those with Type 1 diabetes, not taking enough insulin. You may be at risk for developing high blood sugar if you are overweight, have prediabetes, are 45 years or older, have a family member with Type 2 diabetes, have ever had gestational diabetes (diabetes during pregnancy), or if you get little physical activity.
Although you can test your blood sugar at home, it is best to see a healthcare professional for a medical diagnosis—and treatment if required.
Symptoms of high blood sugar generally require treatment. Depending on the severity of high blood sugar, treatment may include diet, exercise, oral or injectable medication, and in some cases, insulin.
Read more about high blood sugar treatments here.
Untreated high blood sugar, especially over time, may result in long-term health complications such as problems with the heart, nerves, kidneys, eyes, and feet.
Diabetes medications can be expensive, but there are ways to save on your medications. Save on prescriptions for high blood sugar with a free SingleCare prescription discount card.
Early signs of high blood sugar may include:
Feeling very thirsty
Having to urinate frequently
Hunger
Weight loss
Itchy skin
Darkened skin around the neck and armpits
Tiredness
Slow wound healing
Yeast infections
Blurred vision
Mood changes such as irritability.
Testing blood sugar will also alert individuals to a high blood sugar level. For adults who do not have diabetes, a normal fasting blood sugar is 70-99 mg/dl. A fasting blood sugar is measured after you have not had anything to eat or drink (except water) for at least 8 to 12 hours. A fasting blood sugar of 100 to 125 mg/dl is considered to be in the prediabetes range, and a fasting blood sugar of 126 mg/dl or more is considered to be in the diabetes range.
Diabetic ketoacidosis, or DKA, is a life-threatening condition that can lead to coma or death if untreated. DKA is more common in people with Type 1 diabetes than those with Type 2 diabetes.
DKA occurs when the body isn’t moving sugar into the cells, so it starts to burn fat for energy. This makes chemicals called ketones, which make the blood acidic. This can occur when your blood sugar is not controlled or when you are getting sick. When ketone levels are too high, they can poison the body. DKA is a medical emergency and requires treatment in the hospital.
Early symptoms of DKA include excessive thirst and/or urination, high blood sugar, and the presence of ketones in the blood or urine. Then, other symptoms appear, such as tiredness, flushed skin, nausea, vomiting, stomach pain, difficulty breathing, fruity breath, and confusion.
Insulin is a hormone made by the pancreas that regulates blood sugar. Insulin helps move blood sugar to the cells, where it can be used for energy. People with insulin resistance do not respond well to insulin, so the pancreas makes more insulin. If the pancreas continues to make enough insulin, blood sugar levels will stay in the normal range.
About one in every three adults in the US has prediabetes. Prediabetes means that you have high blood sugar levels but not high enough to be diagnosed with diabetes. While people with a normal blood sugar have a fasting blood sugar of 70-99 mg/dl, people with prediabetes generally have a fasting blood sugar of 100-125 mg/dl. Without intervention (such as diet, exercise, and possibly medication), over time, many people with prediabetes develop Type 2 diabetes.
People with insulin resistance or prediabetes may not have any symptoms. There may be darkened skin in the armpits or around the neck—this is called acanthosis nigricans. There may also be skin tags in these areas.
People with diabetes have a fasting blood sugar of 126 mg/dl or more. About 11% of the US population has diabetes, with many more going undiagnosed.
Type 1 diabetes is an autoimmune condition where the immune system attacks cells in the pancreas, preventing the pancreas from making enough insulin to bring down blood sugar. People with Type 1 diabetes will always require insulin to replace the insulin that the pancreas is not making.
Type 2 diabetes generally will require treatment such as lifestyle changes (including diet and exercise), oral medication such as Glucophage (metformin) or injectable medication such as Trulicity, and in some cases, insulin.
Diabetes is considered a progressive disease. Having high blood sugar for a long time can lead to long-term complications. There is less chance of complications with tightly controlled blood sugar. This means that you keep your blood sugar in the target, or normal, range, for as much time as possible.
If you are testing your blood sugar at home and your fasting blood sugar is 100 mg/dl or higher, contact your healthcare provider. If you notice symptoms mentioned above, such as increased thirst and urination, hunger, and weight loss, even if you are not checking your blood sugar at home, contact your healthcare provider right away. It is important to get a timely diagnosis so that you can start getting your blood sugar into a normal range right away. People with Type 1 diabetes, often children or young adults, are usually admitted to the hospital for several days when diagnosed.
You can start with your primary care provider, or go directly to an endocrinologist. Your healthcare provider may order some tests, including fasting blood sugar and hemoglobin A1C. The hemoglobin A1C is a measure of blood sugar control over a period of about three months.
A normal hemoglobin A1C for people without diabetes is less than 5.7%.
An A1C of 5.7 to 6.4% is in the prediabetes range.
An A1C of 6.5% or higher is in the diabetes range.
It is important to keep blood sugar in the normal range as much as possible. If high blood sugar is untreated over a long period of time, it can lead to long-term health complications, including:
Eye problems, including vision loss, sensitivity to light, and blindness
Infections and sores on the feet and skin. In some cases, an amputation may be required.
High blood pressure, high cholesterol, heart attack, heart disease, stroke, and circulation problems
Nerve damage, causing pain, burning, numbness, tingling, and loss of feeling. Nerve damage can also make it difficult for men to achieve and maintain an erection.
Digestive problems, including constipation or diarrhea
Kidney problems, which may require dialysis or a kidney transplant
A weakened immune system, making infections (and complications from infections) more likely
Depression
Increased risk of dementia and osteoporosis
Women may have irregular periods and problems getting pregnant
For people with prediabetes, diet and exercise will be recommended. If this is not enough, a prescription medication may be required.
People with Type 1 diabetes always require insulin. For people with Type 2 diabetes, healthcare providers will recommend dietary changes and exercise. Oral or injectable prescription is generally required, and in some cases, insulin may be needed to help control blood sugar levels.
Examples of medications used along with diet and exercise to control blood sugar in adults with Type 2 diabetes include:
Biguanides: this drug class includes Glucophage (metformin), which is available in immediate-release and extended-release formulations
Sulfonylureas such as Amaryl (glimepiride), Glucotrol (glipizide), and Micronase (glyburide)
Alpha glucosidase inhibitors such as Glyset (miglitol) and Precose (acarbose)
Thiazolidinediones, also known as glitazones, such as Actos (pioglitazone)
DPP-4 inhibitors, also known as gliptins, such as Januvia (sitagliptin), Nesina (alogliptin), and Tradjenta (linagliptin)
SGLT2 inhibitors such as Farxiga (dapagliflozin), Invokana (canagliflozin), and Jardiance (empagliflozin)
Meglitinides such as Prandin (repaglinide) or Starlix (nateglinide)
GLP-1 receptor agonists such as the injections Trulicity (dulaglutide), Victoza (liraglutide), and Ozempic (semaglutide)—and the oral drug Rybelsus (semaglutide)
There are also many combination medications that combine ingredients from two or three drug classes. A few examples are ActoPlus Met (pioglitazone and metformin), Glyxambi (linagliptin and empagliflozin), Janumet (sitagliptin and metformin), and Trijardy XR (linagliptin, empagliflozin, and metformin).
Some individuals with Type 2 diabetes, and all individuals with Type 1 diabetes, will require insulin. Insulin is most commonly administered by a pen injection or through an insulin pump. There are various types of insulin, including fast-acting and long-acting insulin. Long-acting insulin may be used once or twice daily, and is referred to as basal insulin. This insulin helps keep blood sugar steady in the absence of food. Fast-acting insulin can be used before meals or to bring down high blood sugar.
There are many options available to treat high blood sugar. Your healthcare provider will discuss options and determine which is the best treatment for you.
When you have high blood sugar, focusing on keeping your blood sugar level in the target range will help reduce long-term health complications. Here are some tips for living with high blood sugar:
Check your blood sugar as directed—or ask your doctor about a continuous glucose monitor (CGM)—and report numbers to your doctor.
Maintain healthy blood pressure and cholesterol.
Keep all doctor appointments and lab work appointments.
Exercise (ask your healthcare professional before starting a new exercise program).
Maintain a healthy diet. You can consult a registered dietician for advice on an eating plan that helps control blood sugar.
Take your medications and/or insulin as directed and do not skip doses. In addition to medications for diabetes, your healthcare professional may also prescribe medications for other health conditions or to prevent certain complications. Your doctor will review your treatment plan with you.
Avoid smoking. If you do smoke, ask your healthcare provider about quitting.
Check your feet daily, and get regular foot exams as recommended by your healthcare provider. Ask your provider what kind of socks and shoes you should wear.
Get regular dental exams, at least every 6 months, and see your eye doctor at least once a year or as recommended by your health care team.
High blood sugar may be caused by prediabetes or diabetes. Having high blood sugar can be overwhelming. A strong healthcare team is essential in helping you manage your blood sugar. In addition to your primary care provider and endocrinologist, you may want to add a registered dietician who specializes in prediabetes and diabetes to your healthcare team. These healthcare professionals can help you formulate an eating plan to help you manage your blood sugar. A Certified Diabetes Care and Education Specialist, or CDCES, is a healthcare professional with extensive education in diabetes management, who can teach and support you. You can ask your doctor to recommend a CDCES or find one here.
Staying in regular contact with your healthcare team, and making adjustments to your lifestyle and medication regimens when needed, is the best way to help keep your blood sugar in the normal range and avoid long-term complications of high blood sugar.
With the direction of your healthcare team, hard work, patience, and effort, high blood sugar can be manageable. However, if high blood sugar symptoms continue, worsen, or are accompanied by new symptoms, it could be a sign of complications. Only your healthcare provider can rule out other serious health conditions. Consult your doctor to determine the best way to manage symptoms of high blood sugar.
You may feel very thirsty and need to urinate a lot. Other symptoms may include hunger, weight loss, blurry vision, dark skin around the neck and armpits, slow wound healing, and irritability.
This will depend on the type of diabetes you have. People with Type 1 diabetes, or those with Type 2 diabetes who use insulin, will use their fast-acting insulin to bring blood sugar down. Drinking extra water and exercising are other ways to help bring down blood sugar. You can ask your physician for specific medical advice on how to lower your blood sugar.
In men or women, high blood sugar can be caused by various factors, including prediabetes or diabetes. People with Type 1 diabetes may have high blood sugar when they do not administer enough insulin. Blood sugar can also increase when you eat more than planned or exercise less than planned, or due to certain stresses on the body such as illness, or other stress like family arguments.
Manage blood sugar, Centers for Disease Control and Prevention (CDC)
The big picture: checking your blood glucose, American Diabetes Association
Diabetes treatments and medications, SingleCare
Hyperglycemia (high blood glucose), American Diabetes Association
Insulin basics, American Diabetes Association
Oral medication, American Diabetes Association
Clinical trials, American Diabetes Association
Clinical trials for diabetes, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
High blood sugar - self care, U.S. National Library of Medicine - Medline Plus.
What is diabetes?, Centers for Disease Control and Prevention (CDC)
What is diabetes?, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
After receiving her doctorate from the University of Pittsburgh School of Pharmacy, Karen Berger, Pharm.D., has worked in both chain and independent community pharmacies. She currently works at an independent pharmacy in New Jersey. Dr. Berger enjoys helping patients understand medical conditions and medications—both in person as a pharmacist, and online as a medical writer and reviewer.
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