Hyperglycemia

Hyperglycemia & Hypoglycemia Instruction

Instructions of Hyperglycemia

Factors that contribute to hyperglycemia:

1. Not using enough insulin or oral diabetes medication.
2. Not injecting insulin properly or using expired insulin.
3. Not following your diabetes eating plan.
4. Being inactive.
5. Having an illness or infection.
6. Using certain medications, such as steroids.
7. Being injured or having surgery.
8. Experiencing emotional stress.

Early signs and symptoms of hyperglycemia:

Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for:

• Frequent urination
• Increased thirst
• Blurred vision
• Fatigue
• Headache

Later signs and symptoms of hyperglycemia (needs urgent treatment at hospital):

• Nausea and vomiting
• Shortness of breath
• Dry mouth
• Weakness
• Abdominal pain
• Confusion
• Coma

Hyperglycemia is an elevated blood sugar above target or blood sugar above 250 mg/dL on two separate occasions.
It’s important to treat hyperglycemia, because if left untreated, it can become severe and lead to serious complications requiring emergency care, such as a diabetic coma.
In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves, and heart.

Come to Emergency Room in Case if

1. You’re sick and can’t keep any food or fluids down.
2. Persistent diarrhea and vomiting within few hours.
3. Your blood glucose levels are persistently above 250 mg/dL.

Tips to lower blood sugars

1. Get physical. Regular exercise is often effective to control blood sugar (e.g. walking 30 min, 5 days a week).
2. Follow your diabetes eating plan. Eat less, avoid sugary beverages.
3. Avoid high carbohydrate foods: bread, potato, juices, dates, honey, rice, pasta, sweets.
4. Increase intake of white meat (fish, tuna, chicken), vegetables, and dairy products.
5. Drink plenty of water and sugar-free drinks.
6. Check your blood sugar every 4 hours and write in your logbook.
7. If you forgot to take pills, take them once you remember.
8. If on insulin: take next recommended dose with less carbs in next meal. If glucose still high after 4 hours, take a correction dose of fast-acting insulin (according to doctor’s instructions).
9. Always keep a list of medications and bring it to follow-up visits or emergency.

Follow up with the outpatient clinic (…) within (…) or in case if

1. Blood glucose > 250 mg/dL despite taking medication.
2. Trouble keeping glucose within range, while able to eat and drink, with no nausea/vomiting/diarrhea.

Instructions of Hypoglycemia

Hypoglycemia is a condition characterized by blood glucose < 70 mg/dL, your body’s main energy source.

Causes:

1. Too much insulin or diabetes pills.
2. Skipped or late meals.
3. Too much or unplanned exercise.

Signs and symptoms:

• May have no warning signs.
• Dizziness, hunger.
• Confusion, nervousness.
• Weakness or tiredness.
• Sweating, shaking.
• Fast heartbeat.
• Numbness around mouth/lips.
• Moody, grumpy, poor thinking.
• Blurred vision.
• Not able to speak.
• Decreased consciousness or coma.

Management of hypoglycemia

1. Check blood sugar immediately if symptoms occur (<70 mg/dL).
2. Rule of 15:
   • Eat/drink 15g fast-acting carbs (½ cup juice, 1 tbsp sugar, 1 tbsp honey, 3–4 glucose tablets).
   • Check sugar after 15 min. If still <70 mg/dL, repeat 15g carbs.
   • Once ≥100 mg/dL, eat snack/meal with slow-acting carbs.
3. Always carry fast-acting carbs. Avoid high-fat carb foods.
4. Ask provider if you should carry a glucagon kit (injection for severe hypoglycemia/unconsciousness).
5. Teach family/friends what to do:
   • Give fast-acting carbs if possible.
   • Give glucagon if unconscious or seizing.
   • Call Emergency.
   • Never force food/drink if unconscious.

Prevention of hypoglycemia

1. Eat regular meals/snacks, don’t skip.
2. Always carry sugar, dates, or glucose tablets.
3. Check blood sugar as directed (before/after meals).
4. Record readings and share with your doctor.
5. Check sugar before exercise. If <100 mg/dL, have snack (e.g. crackers, ½ banana, milk, juice).
6. If exercise >1 hr, check every 30 min, and after exercise.
7. Take medication as directed, no extra doses.
8. Inform others about your diabetes and low sugar treatment.
9. Teach others how to use glucagon kit (especially in type 1 diabetes).
10. Always carry a card/bracelet showing you have diabetes.
11. Consult doctor/dietitian before weight loss diet.
12. Keep all appointments and follow-ups.
13. Always keep a list of medications for follow-up or emergencies.

Come to emergency room in case if

1. Seizure or loss of consciousness.
2. Blood sugar <50 mg/dL and not responding to treatment.

Follow up with outpatient clinic (…) within (…) or in case if

1. Recurrent low blood sugar episodes.
2. Need for medication/insulin adjustment.
3. Concerns about your condition.