Symptoms of high blood sugar vs low blood sugar

• Overview
• Symptoms and Causes
• Management and Treatment
• Prevention

Overview

What is hyperglycemia?

Hyperglycemia, or high blood glucose, occurs when there is too much sugar in the blood. This happens when your body has too little insulin (the hormone that transports glucose into the blood), or if your body can't use insulin properly. The condition is most often linked with diabetes.

Hyperglycemia is blood glucose greater than 125 mg/dL (milligrams per deciliter) while fasting (not eating for at least eight hours; a person with a fasting blood glucose greater than 125 mg/dL has diabetes).

• A person has impaired glucose tolerance, or pre-diabetes, with a fasting blood glucose of 100 mg/dL to 125 mg/dL.
• A person has hyperglycemia if their blood glucose is greater than 180 mg/dL one to two hours after eating.

If you have hyperglycemia and it’s untreated for long periods of time, you can damage your nerves, blood vessels, tissues and organs. Damage to blood vessels can increase your risk of heart attack and stroke, and nerve damage may also lead to eye damage, kidney damage and non-healing wounds.

What are risk factors for hyperglycemia?

Major risk factors for hyperglycemia are:

• You have a family history of type 2 diabetes.
• You are African American, Native American, Hispanic or Asian American.
• You are overweight.
• You have high blood pressure or cholesterol.
• You have polycystic ovarian syndrome (PCOS).
• You have a history of gestational diabetes.

Symptoms and Causes

What causes hyperglycemia in people with diabetes?

• The dose of insulin or oral diabetes medication that you are taking is not the most helpful dose for your needs.
• Your body isn’t using your natural insulin effectively (type 2 diabetes).
• The amount of carbohydrates you are eating or drinking is not balanced with the amount of insulin your body is able to make or the amount of insulin you inject.
• You are less active than usual.
• Physical stress (from illness, a cold, the flu, an infection, etc.) is affecting you.
• Emotional stress (from family conflicts, emotional problems, school or work stresses, etc.) is affecting you.
• You are taking steroids for another condition.
• The dawn phenomenon (a surge of hormones the body produces every morning around 4 am to 5 a.m.) is affecting you.

Other possible causes

• Endocrine conditions, such as Cushing syndrome, that cause insulin resistance.
• Pancreatic diseases such as pancreatitis, pancreatic cancer and cystic fibrosis.
• Certain medications (such as diuretics and steroids).
• Gestational diabetes, which happens in 4% of pregnancies, and is due to decreased insulin sensitivity.
• Surgery or trauma.

What are the symptoms of hyperglycemia?

It’s especially important to know the early signs of hyperglycemia if you have type 1 diabetes. If hyperglycemia is left untreated in people with type 1 diabetes, it can develop into ketoacidosis, where ketones, which are toxic acids, build up in the blood. This condition is an emergency situation that can lead to coma or death.

Early symptoms of hyperglycemia include:

• High blood sugar.
• Increased thirst and/or hunger.
• Blurred vision.
• Frequent urination (peeing).
• Headache.

Additional symptoms include:

• Fatigue (feeling weak, tired).
• Weight loss.
• Vaginal and skin infections.
• Slow-healing cuts and sores.

Symptoms of ketoacidosis are:

• Vomiting.
• Dehydration.
• Unusual fruity smell on the breath.
• Deep labored breathing or hyperventilation.
• Rapid heartbeat.
• Confusion and disorientation.
• Coma.

Management and Treatment

How can I treat and manage hyperglycemia?

People with both type 1 and type 2 diabetes can manage hyperglycemia by eating healthy, being active, and managing stress. In addition, insulin is a critical part of managing hyperglycemia for people with type 1 diabetes, while people with type 2 diabetes may need oral medications and eventually insulin to help them manage hyperglycemia.

If you don’t have diabetes and have any of the signs and symptoms of hyperglycemia, call your healthcare provider. Together you can work to manage your hyperglycemia.

Prevention

How do I prevent hyperglycemia?

• Exercise to help lower blood sugar. Work with your healthcare provider to make a daily activity plan.
• Follow your meal plan if you have one. Learn how carbohydrates impact your blood sugar, and work with your diabetes care team to find the best meal plan for you.
• Maintain a healthy weight.
• Don’t smoke.
• Limit drinking alcohol. Alcohol can raise blood sugar levels, but can also cause dangerously low blood sugar levels. Work with your provider to determine how much is safe to drink.

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Last reviewed by a Cleveland Clinic medical professional on 02/12/2020.

References

• American Diabetes Association. Hyperglycemia (http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html) Accessed 2/28/2020.
• National Institutes of Health. Hyperglycemia. (https://www.ncbi.nlm.nih.gov/books/NBK430900/) Accessed 2/28/2020.
• Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes

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