High Blood Sugar and Diabetes

High Blood Sugar and Diabetes

Blood sugar control is at the center of any diabetes treatment plan. High blood sugar, or hyperglycemia, is a major concern, and can affect people with both type 1 and type 2 diabetes . There are two main kinds:

Frequent or ongoing high blood sugar can cause damage to your nerves, blood vessels, and organs. It can also lead to other serious conditions. People with type 1 diabetes are prone to a build-up of acids in the blood called ketoacidosis.

If you have type 2 diabetes or if you’re at risk for it, extremely high blood sugar can lead to a potentially deadly condition in which your body can’t process sugar. It’s called hyperglycemic hyperosmolar nonketotic syndrome (HHNS). You’ll pee more often at first, and then less often later on, but your urine may become dark and you could get severely dehydrated.

It’s important to treat symptoms of high blood sugar right away to help prevent complications.

Your blood sugar may rise if you:

Early signs include:

Ongoing high blood sugar may cause:

If you have diabetes and notice any of the early signs of high blood sugar, test your blood sugar and call the doctor. He may ask you for the results of several readings. He could recommend the following changes:

Drink more water. H20 helps remove excess sugar from your blood through urine, and it helps you avoid dehydration.

Exercise more. Working out can help lower your blood sugar. But under certain conditions, it can make blood sugar go even higher. Ask your doctor what kind of exercise is right for you.

Caution: If you have type 1 diabetes and your blood sugar is high, you need to check your urine for ketones. When you have ketones, do NOT exercise. If you have type 2 diabetes and your blood sugar is high, you must also be sure that you have no ketones in your urine and that you are well-hydrated. Then your doctor might give you the OK to exercise with caution as long as you feel up to it.

Change your eating habits. You may need to meet with a dietitian to change the amount and types of foods you eat.

Switch medications. Your doctor may change the amount, timing, or type of diabetes medications you take. Don’t make changes without talking to him first.

If you have type 1 diabetes and your blood sugar is more than 250 mg/dL, your doctor may want you to test your urine or blood for ketones.

Call your doctor if your blood sugar is running higher than your treatment goals.

If you work to keep your blood sugar under control — follow your meal plan, exercise program, and medicine schedule — you shouldn’t have to worry about hyperglycemia. You can also:

Sources: 

American Diabetes Association: “Hyperglycemia.” 

Pearson, E.  Lancet, 2003. 

Forouhi, N. Diabetologia, 2006.

American Diabetes Association: “Standards of Medical Care in Diabetes — 2014.”

American Diabetes Association: “Exercise and Type 1 Diabetes.”

Mayo Clinic: “Diabetes and Exercise: When to Monitor Your Blood Sugar.”

American Diabetes Association: “DKA (Ketoacidosis) & Ketones.”

American Diabetes Association: “Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS).”

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What Is Ketosis?

What Is Ketosis?

Ketosis” is a word you’ll probably see when you’re looking for information on diabetes or weight loss. Is it a good thing or a bad thing? That depends.

Ketosis is a normal metabolic process, something your body does to keep working. When it doesn’t have enough carbohydrates from food for your cells to burn for energy, it burns fat instead. As part of this process, it makes ketones.

If you’re healthy and eating a balanced diet, your body controls how much fat it burns, and you don’t normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin.

Ketosis can become dangerous when ketones build up. High levels lead to dehydration and change the chemical balance of your blood.

Ketosis is a popular weight loss strategy. Low-carb eating plans include the first part of the Atkins diet and the Paleo diet, which stress proteins for fueling your body. In addition to helping you burn fat, ketosis can make you feel less hungry. It also helps you maintain muscle.

For healthy people who don’t have diabetes and aren’t pregnant, ketosis usually kicks in after 3 or 4 days of eating less than 50 grams of carbohydrates per day. That’s about 3 slices of bread, a cup of low-fat fruit yogurt, or two small bananas. You can start ketosis by fasting, too.

Doctors may put children who have epilepsy on a ketogenic diet, a special high-fat, very low-carb and protein plan, because it might help prevent seizures. Adults with epilepsy sometimes eat modified Atkins diets.

Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer’s, Parkinson’s, and Lou Gehrig’s disease.

You can find out how much ketosis is going on in your body by testing for ketones in your blood or urine. You don’t need to go to the doctor. You can buy test strips to check your pee at home. Some blood sugar meters can measure ketones in your blood.

If you don’t know how and when to test your ketones, talk to your doctor or diabetes instructor. High levels of ketones are dangerous.

Ketoacidosis is what happens when ketosis goes too far. Ketones build up in your blood, and it becomes acidic. Ketoacidosis can cause a coma or death.

People with diabetes can get ketoacidosis, or diabetic ketoacidosis (DKA), when they don’t take enough insulin. They can also get DKA when they’re sick or injured, or they don’t get enough fluids and become dehydrated.

Some people without diabetes can get ketoacidosis, too. It’s caused by alcoholism, starvation, or an overactive thyroid. A healthy low-carb diet shouldn’t cause a problem.

If you have these symptoms, call your doctor:

When you have diabetes, throwing up can be especially dangerous. Although DKA usually starts off slowly, throwing up can speed up the process so that it happens in just a few hours. Call your doctor if you’ve been throwing up for 2 hours.

SOURCES:

Paoli, A. European Journal of Clinical Nutrition, June 2013.

Dashti, H. Experimental & Clinical Cardiology, Fall 2004.

Manninen, A. Journal of the International Society of Sports Nutrition, December 2004.

Epilepsy Foundation: “Ketogenic Diet.”

Turner, Z. Practical Gastroenterology, June 2006.

Johns Hopkins Medicine: “The Ketogenic Diet Center,” “Ketone Testing: What You Need to Know.”

The American Diabetes Association: “DKA (Ketoacidosis) & Ketones,” “Checking for Ketones.”

Wood, E. Thyroid, August 2004.

Scott & White Healthcare. “Metabolic Acidosis.”

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What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too.

It usually happens because your body doesn’t have enough insulin. Your cells can’t use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system.

People with type 1 diabetes are at risk for ketoacidosis, since their bodies don’t make any insulin. Your ketones can also go up when you miss a meal, you’re sick or stressed, or you have an insulin reaction.

DKA can happen to people with type 2 diabetes, but it’s rare. If you have type 2, especially when you’re older, you’re more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration.

Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes.

Call your doctor or go to the emergency room right away if that doesn’t work, if you have any of the symptoms below and your ketones aren’t normal, or if you have more than one symptom.

You may have to go to the hospital. You’ll probably get insulin through an IV to bring your ketones down and fluids to get you hydrated and bring your blood chemistry back into balance. If you don’t treat ketoacidosis, you could pass out, go into a coma, and possibly die.

Your doctor may change your insulin dose, or the kind you use, to prevent it from happening again. You should drink more water and sugar-free, non-alcoholic beverages.

Good blood sugar control will help you avoid ketoacidosis.

Make sure your insulin hasn’t expired. Don’t use it if it has clumps. Insulin should either be clear or evenly cloudy with small flecks.

If you’re on an insulin pump, look closely for insulin leaks, and check your tube connections for air bubbles.

Talk to your doctor if your blood sugar levels are often out of your target range.

SOURCES:

American Diabetes Association: “DKA (Ketoacidosis) & Ketones,” “Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS).”

Mayo Clinic: “Diabetic Ketoacidosis.”

See how one patient learned to manage her weight and diet.

Are your ‘good’ habits doing harm?

How they help diabetes.

Are you at risk?

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WebMD does not provide medical advice, diagnosis or treatment.

See additional information.

What You Should Know About Diabetic Ketoacidosis

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