Hyperglycemia

Hyperglycemia is a condition in which the body has a higher than normal level of glucose in the blood. Normal blood sugar levels are around 70-100 milligrams per deciliter. However, if the value is higher than 100 milligrams per deciliter, it means that you are at risk of diabetes.

Generally, the test uses a sugar level measurement criterion before eating in the morning. The person being tested must fast for at least 8 hours the night before the test. For diabetic patients with high blood sugar levels that are not treated, it can cause complications, resulting in nerves, blood vessels, or organs being damaged, leading to serious health problems.

Symptoms of hyperglycemia

High blood sugar often has no symptoms at first, but you will notice something wrong when your blood sugar level is over 200 milligrams per deciliter. It may take several days to several weeks for symptoms to gradually appear. Some people who have had type 2 diabetes for a long time may not have any symptoms, even though their blood sugar level is high. However, the symptoms of high blood sugar that are common are as follows:

Early symptoms can be observed from

• Frequent urination , especially at night
• Blurred vision
• Very thirsty
• Headache
• Easily tired

People who have high blood sugar levels and are not treated properly can develop acidosis due to a build-up of ketones, waste products in the blood and urine, which can lead to other symptoms such as:

• Breath smells fruity
• Shortness of breath
• Dry mouth
• Nausea, vomiting
• stomach ache
• tired
• Weight loss
• Feeling confused
• The wound heals slower than normal.
• Vaginal or skin infection
• In severe cases, fainting and loss of consciousness may occur.
• Nerve damage can cause cold, painful or insensitive feet, leg hair loss, or erectile dysfunction.
• Have stomach and intestinal problems, such as chronic constipation or diarrhea.
• Have problems with your eyes, blood vessels, or kidneys

In this case, those who have chronic vomiting or diarrhea, even if they can eat or drink normally, have a fever for more than 24 hours, cannot control their blood sugar level, or have a blood sugar level higher than 240 milligrams per deciliter even though they are taking diabetes medication continuously, should see a doctor immediately for a detailed examination of their symptoms.

Causes of high blood sugar

People with high blood sugar levels are mainly caused by diabetes. This is because people with diabetes have high blood sugar levels easily because the body does not have enough insulin or is resistant to insulin, which causes abnormal control of blood sugar levels. This is different from normal people, where insulin is produced and secreted by the pancreas after meals. It acts as a carrier of blood sugar into cells throughout the body to be burned for energy, resulting in blood sugar levels dropping to normal levels.

In addition, there are other factors that may easily trigger this condition in diabetic patients, such as not receiving enough insulin or taking diabetes medication, not controlling their diet, having a sluggish lifestyle, not exercising much, being injured or undergoing surgery, taking steroids, etc.

People who do not have diabetes can also experience this condition. It may be caused by certain diseases or lifestyle behaviors, such as:

• Pancreatitis
• Pancreatic cancer
• Hyperthyroidism
• Cushing’s Syndrome is caused by the body having higher than normal levels of the hormone cortisol in the blood.
• Certain tumors that cause abnormal hormone secretion
• Severe or rapid physical changes, such as a heart attack,stroke, injury, or serious illness, can cause temporary high blood sugar levels.
• Taking certain medications, such as prednisone, beta blockers, estrogen, glucagon, and oral contraceptives.
• Eating too many carbohydrates
• Stress
• Little physical movement, no exercise

Diagnosis of hyperglycemia

Doctors will diagnose this condition primarily by examining blood glucose levels, taking into account other patient information such as abnormal symptoms, medical history, lifestyle, physical examination, etc. There are several methods of performing a preliminary blood test and the steps are not complicated, such as:

• Random Blood Sugar is a blood test that takes blood at any time. Normal blood sugar levels should be around 70-125 milligrams per deciliter. However, other methods are required to confirm the results because they are more inaccurate than other tests.
• Fasting Blood Glucose
  is a blood sugar level test after fasting for at least 8 hours. It is usually tested in the morning. Normal blood sugar levels should be less than 100 milligrams per deciliter. If it is between 100-125 milligrams per deciliter, it may be at risk for diabetes. And if it is higher than or equal to 126 milligrams per deciliter, it is considered diabetes.
• Glycohemoglobin A1c
  is a blood glucose test that measures blood sugar levels over the past 2-3 months prior to the test. Normal values ​​are lower than 5.7%. If they are between 5.7-6.4%, there is a risk of diabetes. If the average blood sugar level is 6.5% or higher, it means that the patient has diabetes.
• Oral glucose tolerance test (ORT)
  is a test that measures blood sugar levels after drinking a liquid containing glucose dissolved in it for a specified amount and time. It is commonly used to screen for gestational diabetes.

For diabetic patients, there may be slightly different classification criteria indicating this condition, as follows:

• People who are under 59 years old and do not have any underlying diseases or physical abnormalities should have a blood sugar level between 80-120 milligrams per deciliter.
• People aged 60 years and over who have underlying diseases or physical abnormalities such as heart disease, kidney disease or liver disease are likely to or have experienced low blood sugar (Hypoglycemia). Their blood sugar level should be between 100-140 milligrams per deciliter.

The diagnosis of high blood sugar from the blood test above is a general criterion that is commonly used. The blood sugar level value used as a criterion should consider the factors of each individual as well. Because some groups of people may have blood sugar levels that are different from normal people, such as pregnant women, diabetic patients with complications, and the elderly.

Treatment of hyperglycemia

High blood sugar can be treated or controlled to normal levels. The treatment method varies from person to person, depending on the cause and the severity of the patient’s health risks. Most people with mild high blood sugar or at risk for diabetes are advised by their doctor to control their diet, adjust their daily habits, or receive additional treatment.

For patients with type 1 diabetes and those at high risk, treatment is mainly by giving insulin. For patients with type 2 diabetes, treatment begins with changing eating habits and injections. Sometimes insulin may be given in conjunction. However, if the patient has high blood sugar from disease or abnormalities of the body, treatment must be at the root cause in order to adjust blood sugar levels back to normal. Some patients may also receive insulin during treatment.

However, the doctor will consider the patient first to adjust the treatment plan to suit the situation. Initially, it is often recommended to adjust other behaviors along with the treatment. The treatment methods for mild hyperglycemia are often as follows:

Adjust eating habits and drink more water.
Doctors or nutritionists will help take care of you and give you advice on eating the right foods, taking into account the health risks of each patient, such as reducing carbohydrate foods or drinking enough water each day because water helps remove sugar from the body through urine and prevents dehydration, or reducing carbohydrate foods because this group of nutrients can increase blood sugar levels.

Many people do not know that the body breaks down carbohydrates into glucose or blood sugar. Eating a large amount of carbohydrates will cause the amount of sugar in the blood to rise accordingly. This is especially true for sugary drinks such as soft drinks or fruit juices, which are absorbed faster than other forms of carbohydrates. Patients should consult their doctor about consuming the right amount of carbohydrates to help them keep their blood sugar levels stable.

Exercise regularly.
Exercising or moving your body frequently helps increase energy use, causing sugar to be used. However, people with certain chronic diseases should be careful in choosing the type of exercise. They may ask for advice from a doctor initially. However, diabetic patients with ketones detected in their urine should not exercise. This condition is more common in patients with type 1 diabetes than type 2 diabetes.

Changing the type of medication.
Some medications affect blood sugar levels. People with diabetes or other conditions who have this condition may need to adjust the type and dosage of their medications to reduce side effects and health risks.

Keep blood sugar levels in the normal range.
Measuring blood sugar levels is important to help control symptoms from getting worse. Patients should record and check their blood sugar levels regularly to help their doctors monitor treatment effectively and to remind themselves to control their blood sugar levels.

In addition, patients can control their blood sugar levels by using sweeteners instead of granulated sugar, which will help them eat a variety of foods that are healthier, especially sweeteners in the group that do not provide energy, provide low energy, or have a low glycemic index. However, if patients have other health problems, they should always study the limitations and ask their doctor for advice on using sweeteners first.

Examples of sweeteners in the non-calorie, low-calorie, or low-glycemic index groups include:

• Aspartame
  is 200 times sweeter than sugar, but provides the same amount of energy. Consumers should use it in small amounts, not exceeding 40-50 milligrams per kilogram of body weight per day. However, if used in large amounts, it will produce a bitter taste. In addition, aspartame is not heat-resistant, so it cannot be used in cooking or certain types of beverages. However, patients with phenylketonuria should not use this substance because it can be harmful to the body.
• Isomaltulose
  is less sweet than sugar, does not have a bitter or astringent taste, is resistant to cooking at high heat, has a taste similar to sugar, and does not change the taste of food. It provides energy equivalent to granulated sugar but has a low glycemic index (Low GI). Some studies indicate that isomaltulose may reduce the risk of sudden high blood sugar levels by causing blood sugar levels to rise slowly and may help reduce blood triglyceride levels. Therefore, isomaltulose is another option for diabetics or those who are controlling their blood sugar levels.
• Sucralose
  has a taste similar to sugar, but is 600 times sweeter than sugar. It has no bitter or astringent taste. It can be used in cooking and beverages, but should not be consumed in amounts exceeding 15 milligrams/kg of body weight/day.
• Stevia
  or stevia has a main sweetener called steviol glycosides, which is 200-400 times sweeter than sugar and has a slightly bitter taste. It can be used to flavor food that requires high heat, but it should not be consumed in quantities greater than 4 milligrams/1 kilogram of body weight/day.

However, each sweetener has different limitations. Patients should consult their doctor about the benefits, limitations, and appropriate dosage before consuming for safety. They should also maintain good health and check their blood sugar levels regularly.

Complications of hyperglycemia

People who allow their blood sugar levels to remain high and do not receive proper treatment may be at risk of complications affecting various organs in the body, such as:

• Kidney function deteriorates, leading to kidney failure.
• Cardiovascular disease, which may increase the risk of heart attack, stroke, or peripheral artery disease.
• Nerves are damaged and malfunction, causing burning, pins and needles sensations and altered sensations.
• Eye diseases or abnormalities of the eyes called diabetic retinopathy,  such as retinal damage, glaucoma, cataracts, etc.
• Skin infection
• Foot problems due to damaged nerves and poor blood circulation, such as foot infections or loss of sensation. In some cases, it can be so severe that the leg must be amputated.
• Bone and joint problems
• Dental and gum disease

For serious complications that are common in diabetic patients, they include:

• Diabetic Ketoacidosis is caused by the body not having enough insulin, causing cells to lack energy and have to break down fat for energy. During this process, toxic ketones are created in the blood and some can be detected in the urine. If the body is left in this state for too long, it risks coma and death.
• Hyperglycemic Hyperosmolar Syndrome is a condition in which the body produces insulin normally, but it cannot work efficiently and cannot use sugar or fat for energy. This results in blood sugar levels rising to more than 600 milligrams per deciliter. Some of the sugar is excreted in the urine, causing increased urination and potentially leading to severe dehydration, leading to death or coma.

Prevention of hyperglycemia

Blood sugar levels can fluctuate at any time. Good prevention is to pay attention to your diet, exercise regularly, maintain good health, maintain basic hygiene, and check your blood sugar levels regularly. People with underlying diseases or diabetes should take their medication and see their doctor regularly. If you notice any abnormalities in your blood sugar levels, you should consult your doctor for advice on controlling or preventing your symptoms from getting worse.

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