The body’s fundamental source of energy is glucose. Glucose is a simple sugar (monosaccharide) used by cells for energy. In healthy individuals, a hormone called insulin helps transport glucose from the bloodstream into the cells. There, it undergoes a metabolic pathway called glycolysis to be used as fuel. Glucose comes from the food we eat and drink. Larger complex carbohydrates and polysaccharides in our food are broken down into di- and monosachharides. Normal blood glucose levels are between 70 and 130 mg/dL. After eating, these levels spike, but through the actions of insulin are brought down to normal levels after about two hours.
The bodies of patients with diabetes mellitus do not use insulin effectively or do not produce enough insulin to act on the circulating levels of blood glucose. Because of this, type 1 diabetics require regular injections of exogenous insulin to maintain normal glucose levels, as well as maintaining a strict diet and exercise regimen. Type 2 diabetics must eat appropriately sized meals and exercise regularly to help lower their glucose levels.
Blood Sugar Abnormalities
For all patients with diabetes, abnormal levels of blood sugar happen occasionally. For some, elevated levels of blood glucose above 180 mg/dL (hyperglycemia) occur, and others will experience low levels of blood glucose below 70 mg/dL (hypoglycemia). During hypoglycemic episodes, often a snack or some juice can help return the patient to normal, but most people do not know what to do when blood sugar is too high.
The danger of prolonged hyperglycemia is the development of a condition called ketoacidosis. When glucose levels are high, they are not getting into the cells to be used as energy and the body begins using fat for energy. When this occurs, the body creates a waste product called ketones. Ketones are not a problem in small amounts and are flushed out in the urine. In large amounts, as occurs with hyperglycemia, they build up in the blood stream. If left untreated, they can cause several possibly fatal complications.
If you or a loved one is experiencing hyperglycemia, it is important not to panic. The signs of hyperglycemia include frequent urination (polyuria), excessive thirst (polydipsia) and excessive hunger (polyphagia). Should a diabetic patient present with these symptoms, test blood glucose levels and retest periodically until the levels return to normal. Also, test the urine with test strips to determine if ketones are present in the urine. Type 1 diabetics should have an insulin injection administered; this may be all that was required. If ketones are not present in the urine, both type 1 and type 2 diabetics should go for a short walk as the physical activity will help use some of the circulating glucose.
Should these short-term treatments not be effective or if ketones are present in the urine, seek medical attention. At the hospital, the patient will receive fluids and electrolytes, possibly intravenously, as well as intravenous insulin therapy.
It is important for diabetics to manage blood glucose levels effectively. For type 1 diabetics, this involves strictly monitoring blood glucose levels, adhering to a heart-healthy diet, participating in consistent physical activity and seeing your physician regularly. Type 2 diabetics often have a different challenge. The disease’s association with obesity requires positive lifestyle changes. This includes eating a healthy diet, exercising, drinking in moderation and cessation of smoking. While quitting smoking has nothing to do with weight, it has everything to do with the cardiovascular risks associated with obesity and type 2 diabetes. Plus, its just plain a good idea.
Mayo Clinic: Hyperglycemia in Diabetes: Treatments and Drugs
American Heart Association: Hyperglycemia and Hypoglycemia
American Diabetes Association: Hyperglycemia (High Blood Glucose)
National Diabetes Information Clearinghouse: Hypoglycemia
National Diabetes Information Clearinghouse: Your Guide to Diabetes: Type 1 and Type 2
PubMed Health: Diabetic Ketoacidosis