High blood sugar, or hyperglycemia, occurs when there is an excessive amount of glucose circulating in the bloodstream. This condition is a significant concern for individuals with diabetes, as the body either does not produce enough insulin or cannot effectively use the insulin it produces to move glucose into cells for energy. When blood sugar levels rise to extreme heights, it can trigger severe health complications that pose a direct threat to life and require immediate medical intervention.
Understanding Dangerously High Blood Sugar Levels
Defining dangerously high blood sugar involves specific numerical thresholds that indicate a medical emergency. While there isn’t a single “death level,” blood glucose levels exceeding certain points significantly increase the risk of severe complications. For individuals without diagnosed diabetes, a fasting blood glucose level greater than 125 mg/dL is considered hyperglycemia, and values above 126 mg/dL on more than one occasion lead to a diabetes diagnosis. After eating, a blood glucose level above 180 mg/dL is considered high for someone with diabetes.
Critically high blood sugar levels, where severe complications are probable, often involve readings above 600 mg/dL (33.3 mmol/L). Symptoms may not become noticeable until levels reach around 250 mg/dL or higher. Chronic levels above 180-216 mg/dL (10-12 mmol/L) can lead to organ damage over time.
Acute Medical Emergencies from Extreme Hyperglycemia
Extremely high blood sugar can precipitate life-threatening medical conditions, primarily Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS). These conditions arise when the body’s metabolic processes are severely disrupted due to insufficient insulin or its ineffective use. Both DKA and HHS can lead to coma, organ failure, and, if left untreated, death.
DKA primarily affects individuals with type 1 diabetes, occurring when there’s an absolute or relative lack of insulin. Without enough insulin, glucose cannot enter cells for energy, prompting the liver to break down fat into ketones as an alternative fuel source. The rapid overproduction of these acidic ketones accumulates in the blood and urine, causing the blood to become acidic, a condition known as ketoacidosis. This acidic environment disrupts normal bodily functions, leading to significant fluid and electrolyte loss.
HHS, often seen in people with type 2 diabetes, involves severe hyperglycemia, extreme dehydration, and highly concentrated blood (hyperosmolarity). In HHS, the body produces some insulin, but it is insufficient to manage very high blood sugar levels or is not used effectively. The kidneys attempt to remove excess glucose through urine, resulting in substantial water loss and severe dehydration. The elevated concentration of glucose, salt, and other substances in the blood draws water out of other organs, including the brain, contributing to altered consciousness and neurological deficits.
Recognizing and Responding to a Hyperglycemic Crisis
Recognizing the warning signs of a worsening hyperglycemic state, such as DKA or HHS, is important for timely intervention. Initial symptoms often include excessive thirst, frequent urination, and fatigue. As the condition progresses, more severe symptoms may appear, such as nausea, vomiting, and abdominal pain. For DKA, a distinct fruity odor on the breath due to acetone, dry mouth, and shortness of breath are common.
Confusion, decreased alertness, and even loss of consciousness can signal a severe crisis. If blood glucose levels remain high, particularly above 240 mg/dL, and ketones are present in the urine, immediate medical attention is necessary. Contact emergency services or go to the nearest emergency department if these severe symptoms are present. Self-treating severe hyperglycemia without medical guidance can be dangerous, as these conditions require professional medical management, including intravenous fluids and insulin therapy.
Strategies to Prevent Critically High Blood Sugar
Preventing blood sugar levels from reaching dangerous heights involves consistent self-management and healthcare collaboration. Regular blood sugar monitoring is important, allowing individuals to track trends and make necessary adjustments to their treatment plan. Adhering to prescribed medications, whether insulin or oral diabetes drugs, is equally important for maintaining stable blood glucose levels.
A balanced diet, focusing on whole grains, lean proteins, and plenty of fruits and vegetables, helps regulate blood sugar. Practicing carbohydrate counting and portion control can prevent sudden spikes in blood glucose. Regular physical activity enhances insulin sensitivity and contributes to lowering blood glucose levels. Staying well-hydrated by drinking plenty of water helps the body flush out excess glucose and prevents dehydration. During illness or periods of stress, blood sugar levels can rise, necessitating closer monitoring and potential adjustments to medication, often guided by “sick day rules” provided by a healthcare provider.