Ketoacidosis: When Hyperglycemia Becomes Severe For People With Type 1 Diabetes
If you have type 1 diabetes, it is important to recognize and treat hyperglycemia because if left untreated it can lead to a dangerous condition called .
This happens because without glucose, the body’s cells must use ketones as a source of energy. Ketoacidosis develops when ketones build up in the blood. It can become serious and lead to diabetic coma or even death.
According to the American Diabetes Association, ketoacidosis affects people with type 1 diabetes, but it rarely affects people with type 2 diabetes.
Many symptoms of ketoacidosis are similar to hyperglycemia. The hallmarks of ketoacidosis are:
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High level of ketones in the urine
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Shortness of breath
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Fruit-smelling breath
Additionally, stomach pain, nausea, vomiting, and confusion may accompany ketoacidosis. Immediate medical attention is highly recommended if you have any of these symptoms.
Some people with diabetes are instructed by their doctor to regularly test ketone levels. Ketone testing is performed two ways: using urine or using blood.
For a urine test, you dip a special type of test strip into your urine. For testing blood ketones, a special meter and test strips are used. The test is performed exactly like a blood glucose test.
If ketone testing is part of your self-monitoring of diabetes, your health care professional will provide you with other information including prevention.
Eat The Right Carbohydrates
There are
Sugars and starches raise blood sugar levels, but fiber does not cause a blood sugar spike, as the body is unable to absorb and break down this type of carb. As such, people may consider including carbs that are richer in fiber in their diet.
People may also refer to sugars and starches as simple and complex carbs. Simple carbs primarily consist of one type of sugar. The body breaks these carbohydrates down very quickly, which causes blood sugar to rise rapidly. Complex carbohydrates consist of three or more sugars that are linked together. They result in a more gradual release of sugar into the body, meaning that blood sugar levels do not rise rapidly after a person eats them.
Some people may use the glycemic index to help them monitor how much sugar and carbohydrate they eat, which will, in turn, help them manage their blood sugar levels. The GI measures and ranks various foods by how much they cause blood sugar levels to rise.
Evidence notes a link between obesity and type 2 diabetes. Research also highlights the relationship between obesity and insulin resistance. Insulin is the hormone that is responsible for allowing glucose in the blood to enter cells. Losing 510% of body weight can help those with excess weight improve their blood sugar levels.
High Blood Sugar: Causes Complications And How To Lower Blood Sugar
Your body breaks down glucose for energy using the insulin produced by the pancreas. This is required for our bodies to function. Illness can have an impact on the way our pancreas functions. Read this to learn how high blood sugar can affect your health.
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Your body requires energy to function, and this energy comes from food. Specifically, your body breaks down glucose for energy using the insulin produced by the pancreas.
Type 1 and type 2 diabetes cause impairment to this breakdown of sugar in the body, causing blood glucose levels to become irregular. When glucose is not broken down into energy, it can build up in the bloodstream and then becomes a health problem.
Your pancreas produces insulin, which breaks down glucose. With type 1 diabetes, the cells that produce insulin are mistakenly attacked by your immune system. As a result of this autoimmune condition, blood sugar levels can become dangerously high without intervention.
Type 2 diabetes occurs when your body no longer responds to insulin as well as it should and then also causes glucose to accumulate in the blood.
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Risks Of Very High Blood Sugar
Hyperglycemia can be dangerous, especially for people with type 1 diabetes. It can lead to a deadly condition known as diabetic ketoacidosis .
The risk for DKA starts at 240 mg/dL, but is more likely in much higher blood sugar levels.
Signs of DKA include nausea or vomiting, fruity-smelling breath, extreme thirst, and frequent urination. You can test for ketones at home using a urine test. If you have high ketones, call your doctor or go to the emergency room.
In people with type 2 diabetes, high blood sugar can cause hyperglycemic hyperosmolar syndrome . HHS is potentially fatal and can occur after several days or weeks of sustained high blood sugar.
In people with diabetes, high blood sugar is caused by things like:
- Eating too many carbohydrates
- Not getting enough physical activity
- Stress from an illness or infection
- Taking a corticosteroid, like prednisone
- Skipping or not taking enough glucose-lowering medication
Hypoglycemia Tests And Diagnosis
To diagnose nondiabetic hypoglycemia, your doctor will do a physical exam and ask questions about any medicines you take. Theyâll want to know all about your health and any history of diseases or stomach surgery.
Theyâll check your blood glucose level, especially when you are having symptoms. Theyâll also check to see if you feel better when your sugar goes back to a normal level.
If your doctor suspects hypoglycemia, you may have to fast until you start to have symptoms. Theyâll test your blood glucose level at different times throughout the fast.
To check for reactive hypoglycemia, you may have to take a test called a mixed-meal tolerance test . For this, you take a special drink that raises your blood glucose. The doctor will check your blood glucose levels over the next few hours.
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Postprandial Or Reactive Hyperglycemia
This type of hyperglycemia occurs after eating .
During this type of hyperglycemia, your liver doesn’t stop sugar production, as it normally would directly after a meal, and stores glucose as glycogen.
If your blood glucose level 1-2 hours after eating is above 180mg/dL, that signals postprandial or reactive hyperglycemia.
However, it’s not just people with diabetes who can develop hyperglycemia. Certain medications and illnesses can cause it, including beta blockers, steroids, and bulimia. This article will focus on hyperglycemia caused by diabetes.
The Dangers Of Low Blood Glucose
At some time, most people with diabetes experience the sweating and shakiness that occurs when blood glucose levels fall below 70 mg/dl a condition known as hypoglycemia. The average person with type 1 diabetes may experience symptoms of low blood glucose up to two times a week. However, not all are aware that these symptoms can rapidly progress to seizures, coma and even death if hypoglycemia is severe. Though hypoglycemia can be common and occur repeatedly in some people with diabetes, symptoms of low blood glucose should always be taken seriously. People with diabetes and their families, friends or coworkers should be prepared to act quickly and responsibly at the earliest signs of low blood glucose.
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How Often Should I Check My Blood Sugar
The number of times that you check your blood sugar will depend on the type of diabetes that you have and the type of medicine you take to treat your diabetes. For example, people who take insulin may need to check more often than people who do not take insulin. Talk with your health care team about how often to check your blood sugar.
The common times for checking your blood sugar are when you first wake up , before a meal, 2 hours after a meal, and at bedtime. Talk with your health care team about what times are best for you to check your blood sugar.
If A Person Is Unconscious
If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what theyre doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isnt available
- theres nobody available whos trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone whos unconscious as they could choke.
If youre able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.
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What Is High Blood Sugar
Most of the food you eat is broken down into glucose. Your body needs glucose because its the primary fuel that makes your muscles, organs, and brain work properly. But glucose cant be used as fuel until it enters your cells.
Insulin, a hormone produced by your pancreas, unlocks cells so glucose can enter them. Without insulin, that glucose keeps floating around in your bloodstream with nowhere to go. It can become increasingly more concentrated over time.
When glucose builds up in your bloodstream, your blood glucose levels rise. Over time, this can cause damage to organs, nerves, and blood vessels.
Blood sugar spikes occur in people with diabetes because their bodies are unable to use insulin effectively.
Keep reading to learn about the symptoms, causes, and treatment of blood sugar spikes.
What Is Diabetic Ketoacidosis
If you think you may have low blood sugar, check it even if you dont have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
- Fast, deep breathing.
- Nausea and vomiting.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.
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Can Hyperglycemia Be Treated
Your doctor may recommend a low-impact exercise program as your first line of defense. If youre already following a fitness plan, they may recommend that you increase your overall level of activity.
Your doctor may also suggest that you reduce glucose-rich food intake. Its important to maintain a balanced diet and stick to healthy food portions. If you arent sure where to begin, your doctor can refer you to a dietician or nutritionist who can help you establish a diet plan.
If these changes dont help lower your high blood sugar, your doctor may prescribe medication. If you have diabetes, your doctor may prescribe oral medications or change the amount or type of insulin youve already been prescribed.
Correcting High Blood Sugar Levels With Insulin
If you take insulin, one way to reduce blood sugar is to inject insulin.
However, be careful as insulin can take 4 hours or longer to be fully absorbed, so you need to make sure you take into account how much insulin you may already have in your body that is yet to be absorbed by the blood. Insulin that is yet to be absorbed by the blood is called active insulin.
If you decide to correct with insulin, watch you dont over correct as this can lead to hypoglycemia and can be dangerous, particularly so before bed.
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What To Eat To Better Regulate Your Blood Sugar
While high blood sugar is the characteristic symptom of diabetes, your blood sugar can also be high even if you dont have the condition. To avoid making high blood sugar worse, it is important to make good dietary choices and choose foods that can help you regulate your blood sugar.
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How Can I Treat Low Blood Sugar
If youve had low blood sugar without feeling or noticing symptoms , you may need to check your blood sugar more often to see if its low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.
Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry or have other symptoms, check your blood sugar. Even if you dont have symptoms but think you may have low blood sugar, check it. If your blood sugar is lower than 70 mg/dL, do one of the following immediately:
- Take four glucose tablets.
- Drink four ounces of fruit juice.
- Drink four ounces of regular soda, not diet soda.
- Eat four pieces of hard candy.
Wait for 15 minutes and then check your blood sugar again. Do one of the above treatments again until your blood sugar is 70 mg/dL or above and eat a snack if your next meal is an hour or more away. If you have problems with low blood sugar, ask your doctor if your treatment plan needs to be changed.
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When To Avoid Exercise
People with blood sugar levels above 240 mg/dL should check their urine for ketones before engaging in physical activity. If ketones are present, do not exercise. Ketones are the result of stored fat being broken down for energy. Your liver starts breaking down fat when theres not enough insulin in your bloodstream to absorb blood sugar into cells. When too many ketones are quickly produced, they can cause DKA. In this state, ketones may actually make your blood sugar level go even higher and you may need intravenous fluids to rebalance.
What Are The Symptoms Of Hyperglycemia
The signs and symptoms include the following:
- High blood glucose
- High levels of glucose in the urine
- Frequent urination
- Increased thirst
Part of managing your diabetes is checking your blood glucose often. Ask your doctor how often you should check and what your glucose sugar levels should be. Checking your blood and then treating high blood glucose early will help you avoid problems associated with hyperglycemia.
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What To Think About When Your Blood Sugar Is High
High blood sugar can harm you. If your blood sugar is high, you need to know how to bring it down. If you have diabetes, here are some questions to ask yourself when your blood sugar is high:
- Are you eating right?
- Are you eating too much?
- Have you been following your diabetes meal plan?
- Did you have a meal or a snack with a lot of carbohydrates, starches, or simple sugars?
Are you taking your diabetes medicines correctly?
- Has your doctor changed your medicines?
- If you take insulin, have you been taking the correct dose? Is the insulin expired? Or has it been stored in a hot or cold place?
- Are you afraid of having low blood sugar? Is that causing you to eat too much or take too little insulin or other diabetes medicine?
- Have you injected insulin into a scar or overused area? Have you been rotating sites? Was the injection into a lump or numb spot under the skin?
What else has changed?
To prevent high blood sugar, you will need to:
- Follow your meal plan
- Take your diabetes medicines as instructed
You and your doctor will:
- Set a target goal for your blood sugar levels for different times during the day. This helps you manage your blood sugar.
If your blood sugar is higher than your goals over 3 days and you don’t know why, check your urine for ketones. Then call your health care provider.
Reflect On The Amount Of Sugar In Your Diet
Hyperglycemia occurs when there is too much glucose in the blood.
Therefore, one way of reducing your blood glucose levels is reflecting on where sugar may be consumed in the diet. Think about any refined and processed foods that may be in your diet as these are often high in sugar. This can be achieved through a low carbohydrate diet.
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Broccoli And Broccoli Sprouts
Sulforaphane is a type of isothiocyanate that has blood-sugar-reducing properties.
This plant chemical is produced when broccoli is chopped or chewed due to a reaction between a glucosinolate compound called glucoraphanin and the enzyme myrosinase, both of which are concentrated in broccoli .
Test-tube, animal, and human studies have shown that sulforaphane-rich broccoli extract has powerful antidiabetic effects, helping enhance insulin sensitivity and reduce blood sugar and markers of oxidative stress .
Broccoli sprouts are concentrated sources of glucosinolates like glucoraphanin, and theyve been shown to help promote insulin sensitivity and reduce blood sugar levels in people with type 2 diabetes when supplemented as a powder or extract (
Keep in mind that the best way to enhance the availability of sulforaphane is to enjoy broccoli and broccoli sprouts raw or lightly steamed, or to add active sources of myrosinase like mustard seed powder to cooked broccoli (
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