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Hyperglycemia in Diabetes
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Hyperglycemia in diabetes refers to blood glucose levels that consistently exceed individual targets—typically over 130 mg/dL fasting or 180 mg/dL post‑meal. Acute spikes can trigger dehydration and ketone formation, while chronic elevation quietly injures blood vessels, nerves, kidneys, and retina. Hyperglycemia is therefore both an immediate and long‑term threat demanding vigilant management.
Symptoms
Classic symptoms are polyuria, polydipsia, blurred vision, fatigue, headaches, and unexplained weight loss. In severe cases, patients develop nausea, abdominal pain, rapid breathing, and fruity breath—warning signs of diabetic ketoacidosis or hyperosmolar hyperglycemic state. Subtle chronic hyperglycemia may present only as slow wound healing or recurrent infections.
Causes
Hyperglycemia results from insufficient insulin, insulin resistance, stress hormones, high‑carb meals, medications like steroids, illness, missed doses, malfunctioning insulin pumps, or dehydration. Lack of physical activity and sleep deprivation raise glucose through hormonal pathways. Infections increase insulin demand, tipping controlled patients into hyperglycemia.
Risk Factors
Risk factors include long diabetes duration, poor medication adherence, limited glucose monitoring, steroid therapy, hormonal disorders like Cushing syndrome, acute illness, pregnancy (gestational diabetes), adolescent growth spurts, and psychosocial barriers such as depression or financial constraints limiting insulin access.
Diagnosis
Diagnosis is immediate with capillary glucose testing or continuous glucose monitor readings. Lab confirmation includes venous glucose and basic metabolic panel to assess electrolytes and ketones. HbA1c reflects prolonged hyperglycemia. Urine dipsticks for ketones and serum beta‑hydroxybutyrate guide urgent treatment decisions.
Treatments
Mild hyperglycemia is corrected with rapid‑acting insulin, hydration, and physical activity. Sick‑day protocols advise frequent monitoring and ketone checks. Severe cases require intravenous fluids, insulin infusions, and electrolyte replacement in the hospital. Education addresses underlying triggers—device issues, carb counting errors, or medication side effects.
Prevention
Preventive strategies: structured self‑monitoring or CGM, individualized insulin‑to‑carb ratios, regular endocrinology follow‑up, sick‑day plans, vaccination to reduce infection‑induced spikes, and mental‑health support to improve adherence. Technology alerts for rising trends allow intervention before dangerous thresholds.
Our Take
At Covenant we treat every glucose trend line as valuable feedback. We pair CGM data with dietitian coaching, turning hyperglycemia from a crisis into a learning opportunity that tightens future glucose control and prevents vascular damage.
Hyperglycemia is the clearest signpost showing diabetes needs attention. Covenant empowers patients with tools, skills, and support to keep glucose in range and protect long‑term health.
