Glucose is a simple sugar that fuels the body and brain. A glucose level above normal can be an indication of diabetes. According to The Diabetes Information Library, desired glucose levels before meals, for non-diabetic patients, are less than 115 mg/dL. For diabetic patients, 80 to 120 mg/ dL is deisrable. You usually test glucose levels by a blood sample. Blood glucose machines, called glucometers, require only a drop of blood on a test strip to obtain a glucose reading.
Significance
Cells take in glucose from the bloodstream and break it down for energy. The body stores excess glucose in the liver and muscles as long chains of glucose, called glycogen. You body releases glycogen when it needs glucose; this stimulates your appetite. Blood glucose levels increase after eating and decrease in the fasting state. According to "Critical Care On Call," fasting blood sugars should range from 70 to 105 mg/dL. Glucose levels two hours after meals should be less than 120 mg/dL. Diabetic patients monitor their glucose levels multiple times during the day and adjust insulin or diet based on the glucose levels. Diabetic patients should also have a blood test called A1c on a regular basis. The A1c level shows the average level of blood sugar over a period of two to three months to see if glucose levels stayed within a target range.
Insulin
Insulin is a hormone produced by the pancreas that must be present in the body for glucose to enter from the bloodstream into the cells. When the body does not produce insulin or is not using it efficiently, blood glucose levels will rise after meals or when fasting. According to the book "Current Diagnosis and Treatment Emergency Medicine," a glucose level greater than 200 mg/dL is considered high blood sugar and requires medical treatment..
High Blood Glucose
High blood glucose, also called hyperglycemia, is most often seen with patients who have type 1 or type 2 diabetes. The buildup of glucose presents problems in fluid, electrolyte and acid-base balance and can cause a condition known as diabetic ketoacidosis, or DKA. DKA happens because the body breaks down fats when glucose is not available. Patients with hyperglycemia are extremely thirsty and urinate more often than usual; they also might have blurred vision, drowsiness and weight loss. Treatment for hyperglycemia in type 1 patients requires insulin by injections or a pump; those with type 2 diabetes might require oral diabetic agents, insulin, diet modifications or a combination of all three.
Hyperosmolar Hyperglycemic State
Elevated blood glucose levels also can result in a hyperosmolar hyperglycemic state, or HHS. HHS is a life-threatening emergency in which blood sugars are greater than 600 mg/dL. When glucose levels get this high, the kidneys are not able to concentrate urine, causing excessive urination and leading to severe dehydration. The excessive urination depletes fluid volumes quickly, and patients are not able to keep up with the lost fluids through oral rehydration. Treatment for HHS involves rigorous rehydration with intravenous fluids, administration of insulin and treating any other underlying conditions.
Complications
Maintaining normal blood sugars is an essential part of maintaining normal body functioning. High glucose levels associated with diabetes can lead to long-term complications such as eye disease, kidney disease and poor circulation. In addition, hyperglycemia is associated with heart disease and high blood pressure. Sudden onsets of high blood sugar that are not recognized and treated can lead to life-threatening emergencies and death.
References
- "Sheehy's Emergency Nursing Principles and Practice"; Mosby Elsevier: 2010
- "Current Diagnosis and Treatment Emergency Medicine"; C. Keith Stone; Roger Humphries: 2008
- Diabetes Information Library: Blood Sugar Levels - Guidelines for Diabetes
- "Critical Care On Call"; LeFor, Alan T., et al; 2002
