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N2K Newsletter


Hyperglycaemia and Ketoacidosis – Lack of Insulin

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Hyperglycaemia is when you have a high blood sugar. This tends to feel less dramatic (unless it’s untreated, in which case it can end up with hospitalisation). Many diabetics find unexpected or unexplained high blood sugars very distressing, especially if they’re trying hard to achieve good control. 
Remember though – not all blood test results over 8.0 mmols/L need to be addressed. If your result is 9.0 or 10 mmols/L you should wait and see if it drops before treating it with extra insulin. 
The likely symptoms of hyperglycaemia will be: feeling thirsty, feeling tired, generally not feeling well and having to go to the toilet a lot to urinate. Depending on the medication, this can be addressed by taking a small shot of insulin. If unaddressed, this might result in what is often called a sugar coma (or diabetic coma), which is a result of ketoacidosis (see below). If left untreated, you can lose consciousness and will need hospitalisation to regain control and consciousness. 
Ketoacidosis
Ketoacidosis is a process that begins in the body when the blood sugars are very high. It involves the breaking down of body fat in order to release energy for the body to use. This is the body going into an emergency back-up situation – it’s not designed to sustain this for long and essentially it becomes toxic to the body. 
The by-product of this breakdown are ketones, which can build up and start to affect brain function. It’s ironic that the diabetic is suffering from the impact high sugars have and yet the body cannot access these sugars as it needs insulin in order to do so. The patient will become dehydrated and can literally just waste away unless there is medical intervention (this is what people with diabetes used to die of before insulin was discovered by Banting and Bets in 1919).
There are guidelines which say that if a diabetic does a blood test and it’s higher than 12.0 mmols/L, they should also test for ketones. Some test machines are available that test for ketones – one even tests blood and ketones (with separate strips).
The fact is, if you have relatively well-controlled diabetes you should not need to worry about ketones. However, if you do start getting ketone readings you may want to talk it over with your diabetes team. The only way to treat the ketoacidosis is to get back to good diabetes control with sugars under 10 mmols/L but over 4.0 mmols/L.
Please be aware that if you are ill your body is likely to have slightly raised blood sugars as a result. However, don’t stop taking your medication. You may need to cut it back, especially if you are off your food, but do not stop taking it!
For more information about lack of insulin, hyperglycaemia and ketoacidosis, take a look at Diabetes – The Essential Guide. Buy a printed copy and get the eBook totally free!

Hyperglycaemia

Hyperglycaemia is when you have a high blood sugar. This tends to feel less dramatic (unless it’s untreated, in which case it can end up with hospitalisation). Many diabetics find unexpected or unexplained high blood sugars very distressing, especially if they’re trying hard to achieve good control.

hyperglycaemia-and-ketoacidosis.jpg

Remember though – not all blood test results over 8.0 mmols/L need to be addressed. If your result is 9.0 or 10 mmols/L you should wait and see if it drops before treating it with extra insulin. 

The likely symptoms of hyperglycaemia will be: feeling thirsty, feeling tired, generally not feeling well and having to go to the toilet a lot to urinate. Depending on the medication, this can be addressed by taking a small shot of insulin. If unaddressed, this might result in what is often called a sugar coma (or diabetic coma), which is a result of ketoacidosis (see below). If left untreated, you can lose consciousness and will need hospitalisation to regain control and consciousness. 

Ketoacidosis

Ketoacidosis is a process that begins in the body when the blood sugars are very high. It involves the breaking down of body fat in order to release energy for the body to use. This is the body going into an emergency back-up situation – it’s not designed to sustain this for long and essentially it becomes toxic to the body. 

The by-product of this breakdown are ketones, which can build up and start to affect brain function. It’s ironic that the diabetic is suffering from the impact high sugars have and yet the body cannot access these sugars as it needs insulin in order to do so. The patient will become dehydrated and can literally just waste away unless there is medical intervention (this is what people with diabetes used to die of before insulin was discovered by Banting and Bets in 1919).

There are guidelines which say that if a diabetic does a blood test and it’s higher than 12.0 mmols/L, they should also test for ketones. Some test machines are available that test for ketones – one even tests blood and ketones (with separate strips).

The fact is, if you have relatively well-controlled diabetes you should not need to worry about ketones. However, if you do start getting ketone readings you may want to talk it over with your diabetes team. The only way to treat the ketoacidosis is to get back to good diabetes control with sugars under 10 mmols/L but over 4.0 mmols/L.

Please be aware that if you are ill your body is likely to have slightly raised blood sugars as a result. However, don’t stop taking your medication. You may need to cut it back, especially if you are off your food, but do not stop taking it!

Extract taken from Diabetes - The Essential Guide. For more information on hypoglycaemia and ketoacidosis, take a look at the book - available now in eBook, printed book and large print formats. Buy the printed version and get the eBook free!