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The Cleveland Clinic

Hyperglycemia and Diabetes

Doctor to Patient

Autopilot Lost – Diabetic Ketoacidosis

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Diabetes Emergencies Need to Be Resolved QuicklyWe live in a very narrow range of normal. In the range of normal, the body performs well, but once we slip outside the norm, the body spirals slowly out of control. We take most of the internal controls of our body for granted since they are on autopilot, but many people need to fly manually.

The body's cells need two energy requirements to function. The blood stream delivers both oxygen and glucose to the front door of the cell. The the oxygen is invited in, but the glucose needs a key to open the door. The insulin molecule is that key. When we eat, the body senses the levels of glucose in the blood stream and secretes just the right amount of insulin from the pancreas so that cells and the body can function.

People with diabetes don't have the luxury of that auto-sensing. They need to balance the amount of glucose intake with the amount of insulin that needs to be injected. Not enough insulin and the glucose levels in the blood stream start to rise; too much insulin, and they plummet.

The consequences of hypoglycemia, hypoglycemia, and diabetic ketoacidosis are easy to understand.


Doctor to Patient

What is Hyperglycemia?

Hyperglycemia, or high blood glucose (sugar), is a serious health problem for those with diabetes. Hyperglycemia develops when there is too much sugar in the blood. In people with diabetes, there are two specific types of hyperglycemia that occur:

  • Fasting hyperglycemia is defined as a blood sugar greater than 90-130 mg/dL (milligrams per deciliter) after fasting for at least 8 hours.

  • Postprandial or after-meal hyperglycemia is defined as a blood sugar usually greater than 180 mg/dL. In people without diabetes postprandial or post-meal sugars rarely go over 140 mg/dL but occasionally, after a large meal, a 1-2 hour post-meal glucose level can reach 180 mg/dL. Consistently elevated high post-meal glucose levels can be an indicator that a person is at high risk for developing type 2 diabetes

When a person with diabetes has hyperglycemia frequently or for long periods of time as indicated by a high HbA1c blood test, damage to nerves, blood vessels and other body organs can occur. Hyperglycemia can also lead to more serious conditions, including ketoacidosis -- mostly in people with type 1 diabetes -- and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) in people with type 2 diabetes or in people at risk for type 2 diabetes.

It's important to treat the symptoms of hyperglycemia promptly to prevent complications from diabetes.

Doctor to Patient

Autopilot Lost – Diabetic Ketoacidosis

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Diabetes Emergencies Need to Be Resolved QuicklyWe live in a very narrow range of normal. In the range of normal, the body performs well, but once we slip outside the norm, the body spirals slowly out of control. We take most of the internal controls of our body for granted since they are on autopilot, but many people need to fly manually.

The body's cells need two energy requirements to function. The blood stream delivers both oxygen and glucose to the front door of the cell. The the oxygen is invited in, but the glucose needs a key to open the door. The insulin molecule is that key. When we eat, the body senses the levels of glucose in the blood stream and secretes just the right amount of insulin from the pancreas so that cells and the body can function.

People with diabetes don't have the luxury of that auto-sensing. They need to balance the amount of glucose intake with the amount of insulin that needs to be injected. Not enough insulin and the glucose levels in the blood stream start to rise; too much insulin, and they plummet.

The consequences of hypoglycemia, hypoglycemia, and diabetic ketoacidosis are easy to understand.


Doctor to Patient

What Causes Hyperglycemia in Diabetes?

Hyperglycemia in diabetes may be caused by:

  • Skipping or forgetting your insulin or oral glucose-lowering medicine

  • Eating too many grams of carbohydrates for the amount of insulin administered or just eating too many grams of carbohydrates in general

  • Eating too much food and having too may calories

  • Infection

  • Illness

  • Increased stress

  • Decreased activity or exercising less than usual

  • Strenuous physical activity


Next: What Are the Symptoms of Hyperglycemia in Diabetes? »

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  • insulin - Establishes the medication insulin, a drug used for the treatment of type 1 and type 2 diabetes mellitus.
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It is necessary for patients and health care practitioners to work together to understand the specific symptoms a patient is experiencing in order to make the correct diagnosis and treatment.

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