What Is Hyperglycemia?

Hyperglycemia is high blood glucose (sugar) levels. It is common in people with diabetes. Insulin is a hormone made in the pancreas that helps keep blood glucose levels from getting too high. It may be prescribed to prevent or treat hyperglycemia.

Acute (short-term) symptoms of hyperglycemia may include increased thirst, urination, hunger, tingling in the hands and feet, and blurry vision that usually goes away after blood glucose levels return to normal.

This article reviews what hyperglycemia is; its symptoms, treatment, and complications; the self-management of blood glucose levels; what to eat with hyperglycemia; and when to seek medical treatment.

Hyperglycemia Symptoms 

Symptoms of hyperglycemia can include:

• Increased thirst
• Frequent urination
• Increased hunger
• Blurry vision
• Tingling in the hands and feet
• Unintentional weight loss
• Fatigue
• Sores or cuts that do not heal or heal very slowly
• Headache

Do Hyperglycemia Symptoms Mean Diabetes?

A variety of factors can contribute to hyperglycemia. Sometimes high blood sugar can occur without diabetes. In these cases, high blood sugar might be due to a chronic medical condition, a hormonal disorder, certain medications, or a result of a major illness.

Slightly elevated blood sugar levels may also indicate prediabetes, which can lead to the development of diabetes. If you have high blood sugar levels often or are experiencing symptoms of high blood sugar, it’s important to check in with a healthcare provider, as well as to monitor your blood glucose at home.

Frequent high blood glucose levels can increase the risk of developing diabetes and related complications later on. 

Hyperglycemia Causes

There are several causes of hyperglycemia, which include:

• Insulin resistance (when your cells don’t respond properly to insulin)
• Reduced or lack of insulin production by the pancreas
• Eating lots of highly processed foods with carbohydrates and saturated fats
• Certain medications, such as corticosteroids, thiazide diuretics (water pills), some psychiatric medications, and certain human immunodeficiency virus (HIV) treatments
• Genetic mutations
• Hormonal diseases, such as Cushing’s syndrome or hyperthyroidism (overactive thyroid)
• Damage or removal of the pancreas
• Stress

In addition to diabetes, there are many other risk factors for hyperglycemia. A risk factor is not necessarily a cause but may contribute to the development of hyperglycemia. Risk factors for hyperglycemia are similar to those for type 2 diabetes. They include:

• Being overweight or having obesity
• Being 35 years old or older
• Having family members with diabetes
• Not being physically active on a regular basis
• Having prediabetes
  
• Having had gestational diabetes (diabetes that develops during pregnancy) or giving birth to a baby weighing 9 pounds or more

Type 2 diabetes is diagnosed more often in the United States in people who are Black, Native American, Asian American, Latinx, or Pacific Islander.

Hyperglycemic Attack: What to Do 

A hyperglycemic attack, sometimes called a diabetic attack, is when blood sugar levels spike. This can lead to a medical emergency if action is not taken to bring blood sugar levels back down.

Untreated hyperglycemia may lead to diabetic ketoacidosis (DKA), especially in people with type 1 diabetes (insulin-dependent diabetes, in which the pancreas makes little to no insulin), or hyperglycemic hyperosmolar syndrome (HHS)—which usually occurs in people with type 2 diabetes who do not have their blood glucose levels under control.

Insulin is one of the main treatments to lower blood glucose in hyperglycemic attacks. Doses are individualized and determined by a healthcare provider. If you do not take insulin, there are other medications that can help with lowering blood glucose levels. Contact a healthcare provider to see if an insulin or medication adjustment is needed.

In addition to medication, drinking plenty of water and moving your body (such as going for a walk) can help to bring blood glucose levels back down. However, if a person has ketones in their urine, they should not exercise as it can raise blood sugar further. Continue checking your blood glucose levels regularly to ensure they return to normal.

When Should You See a Healthcare Provider for Hyperglycemia?

Because prolonged hyperglycemia is a serious medical condition and can be very dangerous, it’s important to know when to see a healthcare provider for treatment. 

Seek medical treatment immediately if you are experiencing signs or symptoms of ketoacidosis, such as:

• Ketones in the urine
• Shortness of breath or rapid heartbeat
• Fruity-smelling breath
• Nausea and vomiting
• Stomach pain
• Very dry mouth or skin
• Headache
• Fatigue
• Muscle stiffness or aches

Seek emergency care if you are experiencing symptoms of hyperglycemic hyperosmolar syndrome, including:

• Dehydration
• Confusion
• Decreased alertness
• Passing out or decreased consciousness
  

Testing for Elevated Glucose Levels 

If you are at risk for hyperglycemia, it’s important to have your blood sugar levels checked regularly. Anyone who has symptoms of hyperglycemia should be tested to help prevent complications from occurring. 

Common tests for hyperglycemia include:

• A1C test: This test reflects your blood glucose levels over the past three months.
• Fasting plasma glucose test: This test measures your blood glucose levels after fasting for at least eight hours or overnight.
• Random plasma glucose test: This test measures your blood glucose levels without regard to when you last ate.
• Oral glucose tolerance test (OGTT): This test measures your blood glucose after you have fasted for at least eight hours. Then you will drink a liquid containing glucose and subsequently have your blood drawn to measure your blood glucose every hour for one, two, or three hours, depending on the test.

It’s recommended that people without diabetes who have normal glucose results be tested every three years. People who do not have diabetes and are pregnant should be tested for gestational diabetes between 24 and 28 weeks of each pregnancy.

If you have diabetes, follow your healthcare provider’s recommendations on how often you should have your blood glucose levels tested.

Hyperglycemia Treatment

Hyperglycemia treatment will help blood sugar levels return to a normal range. Talk with a healthcare provider to learn how to best treat your hyperglycemia. They may suggest the following:

• Take your medication as prescribed: If you are taking your medicine as instructed and are still having frequent high blood sugar levels, talk with your healthcare provider about changing the dose or the time you take the medication.
• Be physically active: Participating in regular exercise can help improve insulin sensitivity and bring blood glucose levels down. However, if you have ketones in your urine, do not exercise, as this may make your blood sugar levels go higher.
• Follow a healthy diet: Talk with a healthcare provider or registered dietitian (RD) or registered dietitian nutritionist (RDN) if you have questions about what dietary pattern is best for you.
• Check your blood glucose levels as directed: You can also check it more often than directed if you are concerned about your blood sugar levels.

In addition to conventional treatment, there are several alternative treatments, such as:

• Vitamins, minerals, herbs and other dietary supplements: Some include magnesium, chromium, cinnamon, ginseng, polyphenols, and alpha-lipoic acid. Be sure to speak with your healthcare provider before taking any dietary supplement.
• Acupuncture or acupressure
• Managing stress through meditation, yoga, or relaxation techniques

Complications From Untreated Hyperglycemia

In addition to DKA and HHS, untreated hyperglycemia can lead to other medical conditions, such as:

• Heart disease and stroke
• Diabetic neuropathy (nerve damage)
• Kidney disease
• Foot problems
• Eye disease
• Gum disease and other dental problems
• Sexual problems or bladder problems
• Dementia

How to Check for Hyperglycemia at Home

Knowing how to test your blood glucose levels at home is a big component of blood glucose self-management.

The first step is to purchase or get a prescription for a blood glucose monitor, also called a blood glucose meter or glucometer, and test strips. This device measures the amount of glucose in a small amount of blood, usually from your fingertip.

Your healthcare provider or a certified diabetes care and education specialist (CDCES) can teach you and/or a caregiver how to use it. They will instruct you on when and how often you need to test your blood glucose levels at home, such as when you first wake up and before eating, two hours after a meal, or at bedtime. 

You might qualify for a continuous glucose monitor (CGM), depending on your diagnosis. This small wearable device automatically checks your blood glucose levels throughout the day and night. Blood glucose levels are wirelessly sent to a separate receiver or smart device where you can read the results.

Daily Hyperglycemia Management 

If you are at risk for hyperglycemia or experience hyperglycemia often, you should actively manage your blood sugar levels on a daily basis. Follow the treatment plan recommended by your healthcare provider, which may include:

• Taking all medications as prescribed
• Checking your blood sugar levels regularly
• Quitting smoking if you smoke
• Engaging in regular physical activity, especially something you enjoy
• Following a healthy diet, which avoids or limits foods high in added sugars, saturated fats, and sodium
  

Summary

Hyperglycemia is high blood glucose levels. Symptoms include increased thirst and urination, blurred vision, and tingling in the hands and feet. Hyperglycemia often occurs in people with diabetes but can also occur in people without diabetes.

Causes of hyperglycemia include insulin resistance, lack of insulin production, certain medications, stress, and some medical conditions.

A healthcare provider can perform tests for hyperglycemia, such as an A1C, fasting and random plasma glucose, and oral glucose tolerance test. Seek emergency medical attention if you experience any symptoms of diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome.

Treatment for hyperglycemia may include insulin or another medication, following a healthful diet, exercising regularly, and monitoring blood glucose levels at home.