Hyperglycemia - wikipedia Hyperglycemia Not to be confused with the opposite disorder, hypoglycemia. Hyperglycemia White hexagons in the image represent glucose molecules, which are increased in the lower image. Classification and external resources Specialty Endocrinology ICD - 10 R73. 9 ICD - 9 - CM 790.29 DiseasesDB 6234 MedlinePlus 007228 MeSH D006943 ( edit on Wikidata ) Hyperglycemia, or high blood sugar ( also spelled hyperglycaemia or hyperglycæmia ) is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol / l ( 200 mg / dl ), but symptoms may not start to become noticeable until even higher values such as 15 -- 20 mmol / l ( ~ 250 -- 300 mg / dl ). A subject with a consistent range between ~ 5.6 and ~ 7 mmol / l ( 100 -- 126 mg / dl ) ( American Diabetes Association guidelines ) is considered slightly hyperglycemic, while above 7 mmol / l ( 126 mg / dl ) is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person 's renal threshold of glucose and overall glucose tolerance. On average however, chronic levels above 10 - 12 mmol / L ( 180 - 216 mg / dL ) can produce noticeable organ damage over time. Contents 1 Etymology 2 Definition 3 Signs and symptoms 3.1 Complications 4 Causes 4.1 Diabetes mellitus 4.2 Drugs 4.3 Critical illness 4.4 Stress 5 Treatment 6 See also 7 References 8 External links Etymology The origin of the term is Greek : prefix ὑπέρ - hyper - `` over - '', γλυκός glycos `` sweet wine, must '', αἷμα haima `` blood '', - ία, - εια - ia suffix for abstract nouns of feminine gender. Definition It is critical for patients who monitor glucose levels at home to be aware of which units of measurement their testing kit uses. Glucose levels are measured in either : Millimoles per liter ( mmol / l ) is the SI standard unit used in most countries around the world. Milligrams per deciliter ( mg / dl ) is used in some countries such as the United States, Japan, France, Egypt and Colombia. Scientific journals are moving towards using mmol / l ; some journals now use mmol / l as the primary unit but quote mg / dl in parentheses. Glucose levels vary before and after meals, and at various times of day ; the definition of `` normal '' varies among medical professionals. In general, the normal range for most people ( fasting adults ) is about 4 to 6 mmol / l or 80 to 110 mg / dl. ( where 4 mmol / l or 80 mg / dl is `` optimal ''. ) A subject with a consistent range above 7 mmol / l or 126 mg / dl is generally held to have hyperglycemia, whereas a consistent range below 4 mmol / l or 70 mg / dl is considered hypoglycemic. In fasting adults, blood plasma glucose should not exceed 7 mmol / l or 126 mg / dL. Sustained higher levels of blood sugar cause damage to the blood vessels and to the organs they supply, leading to the complications of diabetes. Chronic hyperglycemia can be measured via the HbA1c test. The definition of acute hyperglycemia varies by study, with mmol / l levels from 8 to 15 ( mg / dl levels from 144 to 270 ). Signs and symptoms Temporary hyperglycemia is often benign and asymptomatic. Blood glucose levels can rise well above normal for significant periods without producing any permanent effects or symptoms. However, chronic hyperglycemia at above normal levels can produce a very wide variety of serious complications over a period of years, including kidney damage, neurological damage, cardiovascular damage, damage to the retina or damage to feet and legs. Diabetic neuropathy may be a result of long - term hyperglycemia. In diabetes mellitus ( by far the most common cause of chronic hyperglycemia ), treatment aims at maintaining blood glucose at a level as close to normal as possible, in order to avoid these serious long - term complications. This is done by a combination of proper diet, regular exercise, and insulin or other medication such as metformin, etc. Acute hyperglycemia involving glucose levels that are extremely high is a medical emergency and can rapidly produce serious complications ( such as fluid loss through osmotic diuresis ). It is most often seen in persons who have uncontrolled insulin - dependent diabetes. The following symptoms may be associated with acute or chronic hyperglycemia, with the first three composing the classic hyperglycemic triad : Polyphagia - frequent hunger, especially pronounced hunger Polydipsia - frequent thirst, especially excessive thirst Polyuria - increased volume of urination ( not an increased frequency for urination ) Blurred vision Fatigue Restlessness Weight loss Poor wound healing ( cuts, scrapes, etc. ) Dry mouth Dry or itchy skin Tingling in feet or heels Erectile dysfunction Recurrent infections, external ear infections ( swimmer 's ear ) Cardiac arrhythmia Stupor Coma Seizures Frequent hunger without other symptoms can also indicate that blood sugar levels are too low. This may occur when people who have diabetes take too much oral hypoglycemic medication or insulin for the amount of food they eat. The resulting drop in blood sugar level to below the normal range prompts a hunger response. This hunger is not usually as pronounced as in Type I diabetes, especially the juvenile onset form, but it makes the prescription of oral hypoglycemic medication difficult to manage. Polydipsia and polyuria occur when blood glucose levels rise high enough to result in excretion of excess glucose via the kidneys, which leads to the presence of glucose in the urine. This produces an osmotic diuresis. Signs and symptoms of diabetic ketoacidosis may include : Ketoacidosis Kussmaul hyperventilation : deep, rapid breathing Confusion or a decreased level of consciousness Dehydration due to glycosuria and osmotic diuresis Acute hunger and / or thirst ' Fruity ' smelling breath odor Impairment of cognitive function, along with increased sadness and anxiety Complications Hyperglycemia can be a serious problem if not treated in time. In untreated hyperglycemia, a condition called ketoacidosis ( contrast ketosis ) could occur. Ketoacidosis develops when the body does not have enough insulin. Without insulin, the body is n't able to utilize the glucose for fuel, so the body starts to break down fats for energy. Ketoacidosis is a life - threatening condition which needs immediate treatment. Symptoms include : shortness of breath, breath that smells fruity ( such as pear drops ), nausea and vomiting, and very dry mouth. Chronic hyperglycemia ( high blood sugar ) injures the heart in patients without a history of heart disease or diabetes and is strongly associated with heart attacks and death in subjects with no coronary heart disease or history of heart failure. Causes Diabetes mellitus Chronic hyperglycemia that persists even in fasting states is most commonly caused by diabetes mellitus. In fact, chronic hyperglycemia is the defining characteristic of the disease. Intermittent hyperglycemia may be present in prediabetic states. Acute episodes of hyperglycemia without an obvious cause may indicate developing diabetes or a predisposition to the disorder. In diabetes mellitus, hyperglycemia is usually caused by low insulin levels ( Diabetes mellitus type 1 ) and / or by resistance to insulin at the cellular level ( Diabetes mellitus type 2 ), depending on the type and state of the disease. Low insulin levels and / or insulin resistance prevent the body from converting glucose into glycogen ( a starch - like source of energy stored mostly in the liver ), which in turn makes it difficult or impossible to remove excess glucose from the blood. With normal glucose levels, the total amount of glucose in the blood at any given moment is only enough to provide energy to the body for 20 -- 30 minutes, and so glucose levels must be precisely maintained by the body 's internal control mechanisms. When the mechanisms fail in a way that allows glucose to rise to abnormal levels, hyperglycemia is the result. Drugs Certain medications increase the risk of hyperglycemia, including corticosteroids, octreotide, beta blockers, epinephrine, thiazide diuretics, niacin, pentamidine, protease inhibitors, L - asparaginase, and some antipsychotic agents. The acute administration of stimulants such as amphetamine typically produces hyperglycemia ; chronic use, however, produces hypoglycemia. Some of the newer psychotropic medications, such as Zyprexa ( Olanzapine ) and Cymbalta ( Duloxetine ), can also cause significant hyperglycemia. Critical illness A high proportion of patients suffering an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a diagnosis of diabetes. ( Or perhaps stroke or myocardial infarction was caused by hyperglycemia and undiagnosed diabetes. ) Human and animal studies suggest that this is not benign, and that stress - induced hyperglycemia is associated with a high risk of mortality after both stroke and myocardial infarction. Stress The following conditions can also cause hyperglycemia in the absence of diabetes. 1 ) Dysfunction of the thyroid, adrenal, and pituitary glands 2 ) Numerous diseases of the pancreas 3 ) Severe increases in blood glucose may be seen in sepsis and certain infections 4 ) Intracranial diseases ( frequently overlooked ) can also cause hyperglycemia. Encephalitis, brain tumors ( especially those located near the pituitary gland ), brain bleeds, and meningitis are prime examples. 5 ) Mild to high blood sugar levels are often seen in convulsions and terminal stages of many diseases. Prolonged, major surgeries can temporarily increase glucose levels. Certain forms of severe stress and physical trauma can increase levels for a brief time as well yet rarely exceeds 6.6 mmol / l ( 120 mg / dl ). Treatment Treatment of hyperglycemia requires elimination of the underlying cause, such as diabetes. Acute hyperglycemia can be treated by direct administration of insulin in most cases. Severe hyperglycemia can be treated with oral hypoglycemic therapy and lifestyle modification. See also Hypoglycemia Diabetes Prediabetes Reference ranges for blood tests References Jump up ^ What are mg / dl and mmol / l ? How to convert ? Jump up ^ Total Health Life ( 2005 ). `` High Blood Sugar ''. Total Health Institute. Retrieved May 4, 2011. Jump up ^ Giugliano D, Marfella R, Coppola L, et al. ( 1997 ). `` Vascular effects of acute hyperglycemia in humans are reversed by L - arginine. Evidence for reduced availability of nitric oxide during hyperglycemia ''. Circulation. 95 ( 7 ) : 1783 -- 90. PMID 9107164. doi : 10.1161 / 01. CIR. 95.7. 1783. Jump up ^ Pais I, Hallschmid M, Jauch - Chara K, et al. ( 2007 ). `` Mood and cognitive functions during acute euglycaemia and mild hyperglycaemia in type 2 diabetic patients ''. Exp. Clin. Endocrinol. Diabetes. 115 ( 1 ) : 42 -- 6. PMID 17286234. doi : 10.1055 / s - 2007 - 957348. Jump up ^ Sommerfield AJ, Deary IJ, Frier BM ( 2004 ). `` Acute hyperglycemia alters mood state and impairs cognitive performance in people with type 2 diabetes ''. Diabetes Care. 27 ( 10 ) : 2335 -- 40. PMID 15451897. doi : 10.2337 / diacare. 27.10. 2335. Jump up ^ `` Chronic hyperglycemia may lead to cardiac damage ''. Journal of the American College of Cardiology. Retrieved 3 February 2012. Jump up ^ Cetin M, Yetgin S, Kara A, et al. ( 1994 ). `` Hyperglycemia, ketoacidosis and other complications of L - asparaginase in children with acute lymphoblastic leukemia ''. J Med. 25 ( 3 -- 4 ) : 219 -- 29. PMID 7996065. Jump up ^ Luna B, Feinglos MN ( 2001 ). `` Drug - induced hyperglycemia ''. JAMA. 286 ( 16 ) : 1945 -- 8. PMID 11667913. doi : 10.1001 / jama. 286.16. 1945. Jump up ^ Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC ( 2001 ). `` Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients : a systematic overview ''. Stroke. 32 ( 10 ) : 2426 -- 32. PMID 11588337. doi : 10.1161 / hs1001. 096194. Jump up ^ Ron Walls ; John J. Ratey ; Robert I. Simon ( 2009 ). Rosen 's Emergency Medicine : Expert Consult Premium Edition - Enhanced Online Features and Print ( Rosen 's Emergency Medicine : Concepts & Clinical Practice ( 2v. ) ). St. Louis : Mosby. ISBN 0 - 323 - 05472 - 2. External links Hyperglycemia information - from the American Diabetes Association Hyperglycemia in infants - from MedlinePlus Hyperglycemia affects brain Hemichorea / Hemiballismus Abnormal clinical and laboratory findings for blood tests ( R70 -- R79, 790 ) Red blood cells Size Anisocytosis Macrocyte Microcyte Shape Poikilocytosis membrane abnormalities : Acanthocyte Codocyte Ovalocyte Spherocyte Dacrocyte Echinocyte Schistocyte Degmacyte Drepanocyte Stomatocyte Knizocyte Hemoglobinization Anisochromia Hypochromia Inclusion bodies Developmental Howell -- Jolly body Basophilic stippling Pappenheimer bodies Cabot rings Hemoglobin precipitation Heinz body Other Rouleaux Reticulocyte Elevated ESR Lymphocytes Smudge cell Downey cell Small molecules Blood sugar Hypoglycemia Hyperglycemia Prediabetes Impaired fasting glucose Impaired glucose tolerance Oxyhyperglycemia Nitrogenous Azotemia Hyperuricemia Hypouricemia Proteins LFT Elevated transaminases Elevated ALP Hypoproteinemia Hypoalbuminemia Other Elevated cardiac markers Elevated alpha - fetoprotein Minerals Iron overload disorder Pathogens / sepsis Bacteremia Viremia Fungemia Parasitemia Algaemia Retrieved from `` https://en.wikipedia.org/w/index.php?title=Hyperglycemia&oldid=785087588 '' Categories : Disorders of endocrine pancreas Abnormal clinical and laboratory findings for blood Disorders causing seizures Hidden categories : All articles with links needing disambiguation Articles with links needing disambiguation from June 2017 Talk Contents About Wikipedia Afrikaans Azərbaycanca Català Čeština Deutsch Español Esperanto فارسی Français Gaeilge Հայերեն हिन्दी Bahasa Indonesia Italiano עברית Kapampangan Latviešu മലയാളം Nederlands 日本 語 Norsk Polski Português Română Русский Shqip Simple English Suomi Svenska தமிழ் తెలుగు Türkçe Українська Edit links This page was last edited on 11 June 2017, at 16 : 02. 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Question: excessive amount of sugar in the blood is called
Answer: Hyperglycemia