Hyperglycemia and How to Treat It


What is hyperglycemia?

Hyperglycemia, or high blood sugar, occurs when glucose is trapped in the bloodstream due to lack of insulin.

Individual blood glucose ranges vary, so talk with your diabetes team about your threshold for high blood glucose levels. A reading above 160 mg/dL (8.9 mmol/L) indicates hyperglycemia according to the Joslin Diabetes Center, although symptoms may not be present until blood sugar levels reach 200 mg/dL or 11 mmol/L (Mayo Clinic).

If left untreated, hyperglycemia may lead to severe dehydration, diabetic ketoacidosis, and coma. The effects of tong-term hyperglycemia include damage to the eyes, kidneys, nervous system and heart.

Why does it occur?

Taking too little insulin, under-counting carbohydrates at mealtimes, stress, not exercising as much as planned, fluctuating hormones and illness can all contribute to hyperglycemia.

Hyperglycemia can occur when when your body is under physical stress, like when you’re fighting an infection or other illness, if you’re recovering from an injury, or recently had surgery. Emotional stress also contributes to hyperglycemia as hormones produced in response to stress cause blood glucose levels to rise.

Make a plan with your endocrinologist for sick days as your insulin needs may change (your pump may even have a “sick day” category in the basal settings). Keep a close eye on your blood sugar and check for ketones when you’re under the weather to prevent yourself from feeling the negative effects of hyperglycemia, too. Communicate with your diabetes team about how you’re feeling and ask questions about adjusting your insulin schedule.

Sometimes hyperglycemia can occur when insulin has expired or if it “goes bad,” from being exposed to extreme heat or cold. Store your insulin within appropriate temperature ranges to maintain its effectiveness.

Dr. Osama Hamdy of the Joslin Diabetes Center mentioned in Hypoglycemia and How to Treat It that overcorrecting a low can cause blood glucose levels to rebound or spike — also known as “rebounding.” If your blood sugar seems out of whack for no reason, it’s a good idea to check to see if your pump site or tubing is occluded, resulting in your body not properly absorbing insulin.

Initial signs and symptoms

  • Unquenchable thirst
  • Dry mouth
  • Fatigue
  • Frequent urination
  • Blurred vision
  • Recurring infections
  • Slow-healing cuts or sores

Advanced symptoms

  • Fruity-smelling breath
  • Weight loss
  • Abdominal pain
  • Confusion
  • Presence of ketones
  • Vomiting
  • Exhaustion
  • Coma

How should I treat it?

  • Check for ketones if your blood glucose is above 240 mg/dL (13.3 mmol/L) and avoid exercise until your blood sugar comes down and ketones are no longer present. Drink water to help flush the excess sugar out of your body.
  • Take a close look at your pump, tubing and infusion set to be sure there are no kinks or other problems that affect insulin delivery.
  • Be sure to carefully read the label on your insulin to make sure you’re keeping it within the appropriate temperature limits. Writing the date on the box when you open a new vial of insulin is a helpful way to remember how long you’ve been using it.
  • For cases of prolonged hyperglycemia, a visit to the doctor or ER may be necessary. Diabetic ketoacidosis and other complications may occur if blood sugar levels have been running high for a long time. IV fluids can help lower blood sugar and rehydrate the body.

Along with a “sick day” plan, make a plan with your doctor about when you should seek medical assistance. Ask questions about the best way to treat hyperglycemia for you, what to do if you’re unable to keep food or liquids down, and the best way for preventing instances of hyperglycemia for you.

Read Hypoglycemia and How to Treat It and Cold and Flu and What to Do.