Hyperglycemia

Hyperglycemia is a medical condition characterized by an excess of glucose in the blood plasma. It is primarily seen in diabetes mellitus and is defined as a blood glucose level of greater than 7.0 mmol/L (126 mg/dL) when fasting or greater than 11.1 mmol/L (200 mg/dL) two hours after a meal.

Hyperglycemia

Physiology and Pathophysiology

• Under normal circumstances, Blood glucose regulation is tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers blood glucose levels when they rise beyond a set point, and other hormones, such as glucagon, epinephrine, and cortisol, increase blood glucose levels when they fall too low.
• In diabetes mellitus, the body either fails to produce enough insulin (Type 1 diabetes) or fails to respond properly to insulin (Type 2 diabetes), leading to hyperglycemia.

Symptoms

Classic symptoms of hyperglycemia include polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), and unexplained weight loss. Other symptoms may include fatigue, blurred vision, slow healing of cuts or wounds, and frequent infections.

Diagnosis

The diagnosis of hyperglycemia is made by measuring blood glucose levels. This can be done using fasting blood glucose, oral glucose tolerance test, or a random blood glucose test along with symptoms.

Treatment

Treatment of hyperglycemia is primarily through the use of insulin and other medications to lower blood glucose levels. In addition, lifestyle changes such as diet modification and exercise can also be effective in managing this condition.

Complications

Long-term, untreated hyperglycemia can lead to serious complications, including retinopathy, nephropathy, neuropathy, and cardiovascular disease.

References

• American Diabetes Association. (2019). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care, 42(Supplement 1), S13-S28.
• Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a *patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.

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