Hyperglycemia refers to elevated blood glucose levels; persistently high levels are the hallmark of diabetes. They can also be indicative of other disorders such as polycystic ovary syndrome, Cushing’s syndrome, hyperthyroidism, cystic fibrosis and chronic obstructive pulmonary disease. Sleep disorders, severe trauma and medications such as beta-blockers, corticosteroids and anti-depressants, can cause hyperglycemia as well. No matter the cause, there can be significant hyperglycemia risks and complications.
Microvasculature Complications
Microvasculature complications of diabetes—those affecting the smallest blood vessels of the body—are the result of a decrease in blood supply to organ tissues. Most commonly, damage occurs in the kidneys, eyes and nervous system. A review article in "The Journal of the American College of Cardiology" reported that the development of microvasculature complications is directly related to the severity and duration of increases in blood glucose concentrations. The Diabetes Control and Complications Trial Research Group reports that maintaining glucose levels in the normal range significantly reduces the risk of injury to the eyes, kidneys and nerves in diabetic patients.
Macrovasculature Complications
The macrovasculature complications of diabetes—those affecting the larger blood vessels of the body—are caused by progressive atherosclerosis, which can lead to heart attacks and strokes. Atherosclerosis refers to hardening of the arteries and the build-up of cholesterol and fat inside them. Macrovasculature complications are primarily caused by high levels of circulating fat and cholesterol. The ADA has advocated a multi-tiered approach to reduce the risk of cardiovascular disease in patients with hyperglycemia. This approach includes normalizing blood glucose levels, reducing blood pressure, decreasing levels of circulating fats and cholesterol and increasing healthy lifestyles.
Manageable Risk Factors
Diets high in carbohydrates and saturated fat influence glucose tolerance, insulin sensitivity and lipid profiles. A 2010 article in “Nutrition” reports that the Joslin Diabetes Center recommends a diet comprised of approximately 40 percent carbohydrate, 30 percent fat and 30 percent protein for overweight individuals with hyperglycemia. Daily inactivity affects weight gain and being overweight or obese are primary risk factors for developing prediabetes and type II diabetes. A study in the journal “Diabetologia” reported that overweight persons who adopted a low-fat, low-calorie diet and increased their physical activity had significantly decreased fasting blood glucose levels.
Inherited Risk Factors
Risk factors for hyperglycemia that cannot be changed by lifestyle intervention include having a family history of diabetes, advanced age and race. A study in the November 2009 issue of “Pediatric Research” reported that having a family history of diabetes increases the likelihood of the development of fasting hyperglycemia, even in the absence of obesity.
MayoClinic.com reports that the risk of prediabetes increases after the age of 45. This condition, however, is increasingly being seen in younger persons. Additionally, persons of certain races, including African-Americans, Hispanics, American Indians, Asian-Americans and Pacific Islanders, are more likely to develop prediabetes.
Stress-related Risk Factors
Acute illnesses, surgery and severe trauma can cause the development of hyperglycemia. A review article published in the “American Association of Critical Care Nurses Clinical Issues” noted that the release of stress hormones that occurs in serious illnesses can cause hyperglycemia and insulin resistance in patients. Persons with stress-related hyperglycemia are commonly treated with insulin which resolves the hyperglycemia; however, persistent hyperglycemia in these patients may be indicative of prediabetes or type II diabetes.
References
- American Diabetes Association: Pre-Diabetes FAQs
- PubMed: Carbohydrate for Weight and Metabolic Control
- PubMed: Prevention of Type II Diabetes in Subjects with Impaired Glucose Tolerance
- PubMed: Obesity and Family History of Diabetes as Risk Factors of Impaired Fasting Glucose
- PubMed: Insulin resistance and Hyperglycemia in Critical Illness
