How to Manage Type 2 Diabetes With Hyperglycemia

Type 2 diabetes increases your risk for episodes of hyperglycemia. It helps to know the symptoms so you can manage blood glucose and get medical help when needed.

This article will define hyperglycemia, and review its symptoms and complications. Tips on treatment and prevention are also discussed.

Woman checking blood sugar levels

evrim ertik / Getty Images

What Is Hyperglycemia?

Hyperglycemia is elevated (hyper) blood sugar (glycemia). Cells throughout your body need sugar for energy. But when levels of glucose in the blood are high, it can cause health problems like heart disease and damage to the nerves, eyes, and kidneys.

Blood sugar can be measured with several different lab tests. The chart below describes various blood sugar levels (milligrams per deciliter) and the associated diagnosis.

Fasting blood glucose
Random blood glucose (mg/dL) A1C (%)
Normal Below 100 Below 5.7
Prediabetes 100 to 125 5.7 to 6.4
Diabetes 126 or above 200 or above 6.5 or above

Type 2 Diabetes With Hyperglycemia

Type 2 diabetes is a condition in which the blood sugar is elevated because the body either does not make enough insulin or does not use insulin effectively. Insulin is a hormone made by the pancreas and secreted into the blood. There, it signals cells throughout the body to take up blood sugar to be used for energy.

What Is Insulin Resistance?

Insulin resistance is a condition in which the body makes insulin, but the cells don't respond normally to it. Higher and higher levels of insulin are required for glucose to enter the cells, and over time blood sugar builds up in the blood. Some risk factors for insulin resistance are obesity, a sedentary lifestyle, and a family history of diabetes.

In the United States, almost 1 in 10 people have diabetes, with the majority having type 2 diabetes. Diabetes can take years to develop. Since it may not cause any symptoms in the early stages, many people are unaware of having the condition.


Mildly elevated blood sugar levels may not cause any symptoms. However with higher levels, symptoms can include the following:

  • Increased thirst
  • Increased urination
  • Fatigue
  • Blurred vision

If blood sugar becomes very elevated, two dangerous conditions can develop: hyperglycemia hyperosmolar syndrome (HHS) or diabetic ketoacidosis (DKA). Signs of these potentially life-threatening conditions include the following:

  • Sweet-smelling breath
  • Nausea
  • Vomiting
  • Abdominal pain
  • Rapid breathing or shortness of breath
  • Confusion or coma

Risk Factors

There are many factors that can influence the development of diabetes and hyperglycemia, including:

  • Family history of type 2 diabetes
  • Sedentary lifestyle
  • Metabolic syndrome (abnormal cholesterol, abdominal fat, elevated blood pressure)
  • History of diabetes in pregnancy (known as gestational diabetes)


Elevated blood sugar can damage organs throughout the body and increases the risk of the following:


Treating high blood sugar in type 2 diabetes requires a combination of lifestyle, diet, and medication. Lowering blood sugar can decrease the risk of complications. Some people are even able to put diabetes into remission and come off blood sugar–lowering medication with these steps.


A healthy lifestyle can help lower blood sugar and control type 2 diabetes. This can include the following;


Diet is a major contributor to blood sugar control, and fortunately, it's something we have a great deal of control over to help get blood sugar under control.

For people with diabetes, eating meals with low glycemic load (low ability to raise blood sugar) can help prevent hyperglycemia. People with diabetes should consider the following when planning meals:

  • Reduce total carbohydrate intake.
  • Avoid simple carbohydrates like pastries and white bread.
  • Choose whole grains such as brown rice instead of white rice, whole wheat instead of white bread or pasta.
  • Avoid sweet drinks like sodas and juices.
  • Increase fiber intake.
  • Decrease portion size.


If you have type 2 diabetes, your healthcare provider will recommend blood sugar–lowering medication to help get hyperglycemia under control. There are many different types of oral medications to lower blood sugar. Your healthcare provider will work with you to find a medication that you tolerate and is effective for you. It's essential to adhere to the medication plan laid out by your healthcare provider and avoid missing doses.

If oral medications and dietary and lifestyle changes are not enough to bring blood sugar down, your healthcare provider may recommend injectable medications or insulin. If you are prescribed insulin, checking your blood sugar at home will be important.

In addition to the blood sugar–lowering medication, your healthcare provider may recommend other drugs to lower blood pressure, cholesterol, and lower cardiovascular disease risk.


You can think of blood sugar as a range form normal to prediabetes to diabetes. It can take years for diabetes to develop, but in the meantime with screening, you can uncover prediabetes and initiate changes to decrease your risk of developing type 2 diabetes.

Lifestyle and dietary changes can also be implemented to prevent a diagnosis of diabetes. Additionally, when prediabetes is diagnosed and you are at a higher risk of developing type 2 diabetes, your healthcare provider may prescribe a medication called Glucophage (metformin).


Hyperglycemia, or elevated blood sugar, is a part of type 2 diabetes that can result in complications affecting various organs and increased risk of heart disease. While you may not be able to control all risk factors for type 2 diabetes, you can help prevent it through a healthy lifestyle and diet. Treatment of diabetes involves the same steps as prevention, in addition to medication to lower blood sugar to prevent complications.

Frequently Asked Questions

  • Is hyperglycemia common in type 2 diabetes?

    Hyperglycemia is a hallmark of type 2 diabetes, diagnosed when fasting blood sugar exceeds 126 mg/dL (normal is less than 100 mg/dL). Chronically high blood sugar, as in type 2 diabetes, damages tissues and organs, including nerves, eyes, kidneys, and blood vessels. Lowering blood sugar to prevent these complications is a major goal of treatment in type 2 diabetes.

  • Is hyperglycemia a sign of prediabetes?

    Hyperglycemia goes hand in hand with prediabetes, which is diagnosed when fasting blood sugar is between 100-126 mg/dL (normal is less than 100 mg/dL). This is just below the threshold for diagnosing diabetes (greater than 126 mg/dL). Having prediabetes increases your risk of developing diabetes later on. However, identifying prediabetes early can allow you to initiate strategies to prevent diabetes.

  • Is type 2 diabetes with hyperglycemia dangerous?

    Both in the short term and long term, hyperglycemia in type 2 diabetes can be dangerous. In the short term, extremely high blood sugar levels can lead to a life-threatening state called hyperglycemic hyperosmolar syndrome (HHS), which is characterized by high blood sugar levels, dehydration, abdominal pain, nausea, and confusion or coma. In the long term, chronically high blood sugar damages organs in your body from the nerves to the kidneys, eyes, and blood vessels.

16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Diabetes.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes tests & diagnosis.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. What is diabetes?

  4. National Institute of Diabetes and Digestive and Kidney Diseases. Insulin resistance and prediabetes.

  5. Centers for Disease Control and Prevention. Type 2 diabetes.

  6. American Diabetes Association. Hyperglycemia (high blood glucose).

  7. MedlinePlus. Diabetic hyperglycemic hyperosmolar syndrome.

  8. Centers for Disease Control and Prevention. Diabetes risk factors.

  9. Centers for Disease Control and Prevention. Prevent diabetes complications.

  10. Mottalib A, Sakr M, Shehabeldin M, Hamdy O. Diabetes remission after nonsurgical intensive lifestyle intervention in obese patients with type 2 diabetesJ Diabetes Res. 2015;2015:468704. doi:10.1155/2015/468704

  11. Janbozorgi N, Allipour R, Djafarian K, Shab-Bidar S, Badeli M, Safabakhsh M. Water intake and risk of type 2 diabetes: A systematic review and meta-analysis of observational studiesDiabetes Metab Syndr. 2021;15(4):102156. doi:10.1016/j.dsx.2021.05.029

  12. Zhu B, Hershberger PE, Kapella MC, Fritschi C. The relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes: An integrative reviewJ Clin Nurs. 2017;26(23-24):4053-4064. doi:10.1111/jocn.13899

  13. Zamani-Alavijeh F, Araban M, Koohestani HR, Karimy M. The effectiveness of stress management training on blood glucose control in patients with type 2 diabetesDiabetol Metab Syndr. 2018;10:39. doi:10.1186/s13098-018-0342-5

  14. MedlinePlus. Diabetic diet.

  15. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesCirculation. 2019;140(11):e596-e646. doi:10.1161/CIR.0000000000000678

  16. American Diabetes Association. 3. Prevention or delay of type 2 diabetes: Standards of Medical Care in Diabetes-2019Diabetes Care. 2019;42(Suppl 1):S29-S33. doi:10.2337/dc19-S003

By Angela Ryan Lee, MD
Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.