Hyperglycemia

Hyperglycemia is when blood sugar is higher than 200. The poster we made for our home says greater than 30 but our book from the hospital says greater than 200. Since I can’t remember where I got the information for our poster we’ll go with greater than 200. It is caused by too little insulin, too much food, too little exercise or illness, infection and/or fever. Puberty is also a cause of hyperglycemia as is some medications. The signs of hyperglycemia are increased thirst, frequent urination, weight loss, vision problems, tired or weak, headache, irritability/crabbiness.

Hyperglycemia can lead to Diabetic Ketoacidosis. Diabetic Ketoacidosis occurs when ketones build up in the blood. They can turn into acid which then is like a poison. You can read a little more about ketones on the December 23, 2012 blog under Mom’s Diary. I go into a bit more detail in that blog because Kimmy had been sick and I spent a lot of time talking about testing ketones so I explained what they are and why we were testing in that particular blog. Anyway, Diabetic Ketoacidosis occurs when the ketones build up in the system. The symptoms of Diabetic Ketoacidosis are: Upset stomach or a stomach ache; vomiting; deep, heavy breathing; sweet or fruity breath; drowsiness or coma. Our poster also lists chest pain but that’s not in our book. Again, I can’t remember where I got the information for our poster; I think it was from the notes I took while we were in training at the hospital. When these symptoms occur you need to call the doctor and quite frankly if your child is having chest pains it’s time to call the doctor whether they are diabetic or not!

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Prior to Kimmy Sue’s hospitalization and diagnosis of Type I Diabetes, she was experiencing quite a few of these symptoms. She started out complaining of nausea but she never did vomit. She was tired all the time and she just wasn’t herself. Kimmy Sue is a cheerful young lady with an effervescent personality. When Kimmy Sue mopes on the couch for weeks on end there is something wrong with her and that’s what we were experiencing. Lethargic is the word that comes to mind. She was always thirsty and always hungry but she never ate much. By the time she was hospitalized she had lost so much weight that you could see her bones! She had to go to the bathroom all the time and she wasn’t sleeping well either.

The first step in treatment of hyperglycemia is to check blood sugar. Actually, that’s the first step in anything. Until you know a blood sugar number you don’t really know what’s going on so if your child is feeling yucky, check you blood sugar. It’s our “go to diagnostic tool.” If the number is 300 or over it’s time to check ketones. If vomiting is occurring, check ketones. If you or your child is sick, check ketones.

Ketone strips are sold at any pharmacy. I shop a lot at WalMart so I can tell you they are right in front of the pharmacy counter with all the diabetes supplies. Incidentally, that’s where you find the alcohol swabs too. A ketone strip is basically a skinny piece of paper with a tab on the end. Obviously that tab has been treated with some sort of chemical that will react to ketones. The tabbed end is held in the urine stream to be saturated. If ketones are present the strip will turn a color corresponding to the amount of ketones in the urine. Ketones are measured as negative, trace, small, moderate and large. If ketones are trace or small it is important to drink lots of liquids – sugar free liquids that is! Water is probably best but water can get boring so we add some flavor to it as long as it’s sugar free! Drink 8 oz of water until ketones are negative for two ketone tests in a row. If ketones are moderate or large keep drinking water but it is now time to call the doctor. It does NOT mean, however, that you are headed for the hospital. It just means that an extra dose of fast acting insulin might be needed. Only your doctor can determine this so call him or her!

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Our book says “A “one time high blood sugar with negative ketones is not a diabetes emergency. If child has a patter of frequent high blood sugar call the diabetes doctor or nurse educator for assistance with insulin adjustments.” This is sound advice. Remember, a child who is sick is probably going to have higher blood sugar numbers. It’s best to contact your endocrinologist when your child is sick.

We hope we’ve given you some basic information on hyperglycemia. The information that we’ve given you comes from the New Onset Diabetes Handbook that we received from St. Louis Children’s Hospital. Information on hyperglycemia is found in Chapter 4 entitled “Hyperglycemia” on page 12.

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