The Doctors column: Is your blood sugar high or low?
VAIL CO, Colorado
They’re both characterized by the amount of sugar you have in your blood, they’re both linked to diabetes – and that’s about all hyperglycemia and hypoglycemia have in common.
A little background: When you eat, your body breaks down sugar and starch into glucose, an energy source for the cells in your muscles and tissue. Glucose gets absorbed into the blood, but it can’t enter most cells without the help of insulin. People with diabetes have high blood glucose levels, either because their bodies don’t make enough insulin, they’re resistant to insulin, or both. When blood sugar levels get too high, that’s hyperglycemia. If during the treatment of diabetes, glucose drops too low – that’s hypoglycemia. Here’s a look at how else the conditions differ:
Hyperglycemia (high blood sugar)
The cause: Lots of factors contribute, including not using insulin or taking diabetes medications improperly, not eating right or not exercising. Even being sick or super-stressed can trigger it (the same hormones that help combat illness and stress also cause blood sugar to rise).
Detect it: Frequent urination, increased thirst, blurred vision, fatigue and headaches are some of the symptoms that may start when blood sugar hits 200 mg/dl (normal fasting glucose levels are 70-130 mg/dl). Left untreated, hyperglycemia can cause toxic acids (called ketones) to build up in your blood and urine and cause signs and symptoms including fruity-smelling breath, weakness, confusion and even coma.
Treat it: Eating less and avoiding sugary beverages might help. So does exercising, but it comes with a caveat: Check your blood sugar before you lace up your sneakers, especially if you’re feeling any symptoms. If it’s at 240 mg/dl or above, use an over-the-counter urine ketones test kit. If the test is positive, don’t exercise. Working out when ketones are present can drive your blood sugar even higher. Talk to your doctor to help lower your glucose levels safely – he may adjust the dosage and timing of your medication or insulin.
Prevent it: Monitor your blood glucose, stick to your diabetes management plan, and look for symptoms. Long-term, hyperglycemia can damage your kidneys, nerves and heart, or lead to life-threatening conditions.
Hypoglycemia (low blood sugar)
The cause: Most of the time, it’s a side effect of diabetes drugs. For example, if you happen to take too much insulin for the amount of glucose in your blood, it can cause sugar levels to drop too low. Eat less than usual or exercise more than usual after taking your diabetes medicine, and the result may be the same. Hypoglycemia in people without diabetes is much less common. Some causes include excessive alcohol drinking without eating or severe liver illnesses.
Detect it: You’ll feel confused and shaky, turn sweaty and pale, be hungry, get a headache or experience a tingling sensation around your mouth. Of course, these symptoms aren’t unique to hypoglycemia. Check your blood sugar if you feel any of these signs to know for sure – below 70 mg/dl is low.
Treat it: Consume some sugar in the form of a glucose tablet, hard candy or fruit juice – and do it fast. Your brain needs glucose to function properly. Ignore symptoms too long and you may lose consciousness. If that happens, you’ll need an immediate injection of glucagon (which raises blood sugar) or emergency treatment in a hospital.
Prevent it: If you have diabetes, stick to the tried and true: Monitor your blood sugar, follow your diabetes management plan and watch for symptoms. If you don’t have diabetes, but you do have recurring episodes of hypoglycemia, work with your doctor to find and treat the underlying cause.
The Doctors is an Emmy-winning daytime TV show with pediatrician Jim Sears, OB-GYN Lisa Masterson, ER physician Travis Stork, and plastic surgeon Andrew Ordon. Check http://www.thedoctorstv.com for local listings.