diabetes

Hyperglycemic crisis

Premise

The understanding of this article requires the knowledge of some preliminary notions illustrated in the previous article dedicated to hypo-glycemic crises.

What is a hyperglycemic crisis?

A hyperglycemic crisis is the phase between the moment in which the blood sugar rises significantly above the values ​​considered normal (hyperglycemia) and that in which the blood sugar drops, returning to the normal range, due to an adequate therapeutic intervention.

It is during a hyperglycemic crisis that a person shows the classic symptoms of hyperglycemia .

Causes

A hyperglycemic crisis may depend on:

  • Diabetes mellitus not yet diagnosed;
  • Insufficient administration of hypoglycemic agents or insulin, in a context of diabetes mellitus;
  • Excessive food intake, especially foods rich in sugars and carbohydrates (sugar, white bread, sweets, pasta, sugary fruit such as eggs, persimmons, figs and bananas, etc.);
  • State of sepsis due to some serious infections;
  • Use of certain drugs, including corticosteroids, beta-blockers, epinephrine, thiazide diuretics, protease inhibitors and octreotide;
  • Strong stress;
  • Stroke, myocardial infarction, dysfunction of adrenal, thyroid and / or pituitary, pancreatic diseases and some forms of brain cancer.

Risk factors of hyperglycemic crisis

The main causes of hyperglycemic crisis are:

  • Diabetes mellitus or its inadequate treatment;
  • Taking the drugs indicated above among the potential causes;
  • The highly stressful conditions;
  • Infections followed by a state of sepsis.

Symptoms and signs

The typical symptoms and signs of a hyperglycemic crisis are:

  • Dry mouth and intense thirst ( polydipsia );
  • Need to urinate often ( polyuria ), especially at night ( nocturia );
  • Abdominal pain with vomiting;
  • Progressive alteration of consciousness, with the appearance of restlessness, agitation and confusion.
  • Pulse weak and rapid;
  • Red, dry and warm skin;
  • Breath from the characteristic smell of acetone;
  • Blurred vision;
  • Feeling tired.

Complications

The consequences of a serious hypoglycemic crisis are: hyperglycemic coma (or diabetic coma ), extreme dehydration due to hyperosmotic urine from hyperglycemia, thrombosis and death of the individual concerned, for one of the above medical conditions.

Therapy

The hyperglycemic crisis requires immediate treatment, aimed at rapidly lowering the blood sugar and bringing it back to a normal value.

In the case in which the cause is diabetes mellitus (which, as in the case of hypoglycemic crises, is the cause of greatest interest), this treatment consists of the administration of hypoglycemic drugs or insulin in the right doses, by injection or by infusion of a solution physiological.

Prevention

Remaining with diabetes mellitus, patients must: to prevent episodes of hyperglycemic crisis:

  • Take the prescribed medications regularly;
  • Carefully follow the diet prescribed by your doctor;
  • Check body weight to keep it normal.
  • Do regular physical activity
    • PLEASE NOTE: before starting any type of physical exercise, a medical consultation is necessary to understand if the association of sports with hypoglycemic drugs can decrease the blood glucose level to the point of causing a hypoglycemic crisis.