Hyperglycemia – Causes, Symptoms, Diagnosis, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Hyperglycemia means high levels of sugar in the blood. This occurs in patients suffering from Diabetes Mellitus.

This condition is caused when the body is not producing sufficient insulin, a hormone which is needed to convert excess sugar levels in the blood stream to glycogen and hence helps absorb glucose into the cells. This also happens when there is insulin resistance, a condition wherein insulin is produced but is not utilized by the body cells.
Read – Diabetes: Ayurvedic Treatment, Remedies, Prevention Tips

Types of Hyperglycemia

1. Fasting Hyperglycemia – Here the blood sugar is higher than 130 mg/dL, when the person has not taken any food or drink for at least 8 hours.
2. Post-prandial / After-meal hyperglycemia – Here the blood sugar level is higher than 180 mg/dL, 2 hours after having food. When you don’t have diabetes mellitus, you don’t see your sugar levels shooting above 140 mg/dL unless you have had a large meal.

Uncontrolled blood sugar levels are threat
Frequent episodes of high blood sugar levels can damage nerves, blood vessels and vital organs.

In type 1 diabetes mellitus, there is a buildup of acids in the blood and this condition is called as ketoacidosis.

In type 2 diabetes mellitus extremely high levels of blood sugar can lead to a condition in which your body doesn’t process sugar. This is a potentially dangerous condition and is called as Hyperosmolar nonketotic syndrome.

This is initially characterized by increased urination. Later the urination frequency and volume may come down. One may have dark urine and severe dehydration.
Read – Pre Diabetes: Symptoms, Ayurvedic Treatment, Home Remedies

Common causes of high blood sugar

• Missing to take anti-diabetic medicines
• Eat too much carbohydrates
• Frequent infections
• Long standing illnesses
• Stress
• Sedentary life
• Indulgence in excessive strenuous physical activities when the blood sugar levels are very high and insulin levels are low
  Read – Effect of Stress, Anxiety on Stomach And Intestines: Remedies

Signs and Symptoms

• Excessive thirst
• Blurring vision / giddiness
• Headache
• Difficulty in concentrating
• Fatigue
• Frequent urination
• Blood sugar levels more than 180 mg/dL
  Read – Amla Home Remedy For Frequent Urination – Prepare It Within A Minute

Other symptoms of progressive or uncontrolled hyperglycemia

• Skin infections
• Vaginal infections
• Delayed healing of wounds and sores
• Deterioration of vision
• Damage to nerves leading to painful, cold or insensitive feet
• Loss of hairs on lower extremities
• Erectile dysfunction
• Damage to eyes, kidneys and blood vessels
• Chronic constipation, diarrhea or other gut and stomach related problems

Of these, frequent urination, increased thirst, blurred vision, fatigue and headache are often the earlier symptoms of hyperglycemia.
Read – Vertigo Causes, How To prevent, Ayurvedic Treatment

Treatment principles

Diabetic patients should observe these symptom carefully and consult the doctor.

The below mentioned changes should be adopted into one’s life after taking the opinion of the consulting physician.
Drinking more water – More water removes excess sugar levels from the blood through urine, combats thirst and dehydration caused in diabetes.

Exercise often – Work and walk more. This lowers your blood sugar levels. Exercise can also worsen your blood sugar levels if there is less insulin in your body in comparison to high sugar levels. Take the help of your doctor in choosing right exercises for you. Exercise is not recommended when urine contains ketones.
Read – Exercise And Diabetes Treatment – Recent Guidelines And Ayurvedic Perspective

Make changes in your eating habits – Take help of dietitian.

Preventive measures

• Take food at proper time and in desired quantity.
• Check your blood sugar levels regularly. Make sure that your blood sugar level remains within desired range. Keep noting the readings and the timings at which they are above and below the desired range.
• Consult your doctor at least once in 2 – 3 months.
  Read – Right Time To Exercise, Benefits Of Workout As Per Ayurveda

Other measures to control blood sugar levels
Seek doctors advice before trying any home remedies. He may guide you in a proper way about what you are doing or desire to do.

Check your carbohydrates (carbs) – Reduced carbs reduces blood sugar levels.

Choosing the right carbohydrates – Simple carbohydrates made up of one kind of sugar is found in foods like white bread, pasta and candy. They are quickly broken down into sugar. This causes rapid raise in blood sugar. Complex carbohydrates on the other hand are made up of three or more sugars and are broken after long time into sugars. Therefore the sugars are released gradually. Example – whole grain oats and sweet potatoes.

Increase fiber in your diet – Since the fiber slows down the digestion of carb and absorption of sugar, it promotes more gradual rise in blood sugar levels. It includes inclusion of good quantity of vegetables, fruits, whole grains and legumes.
Read – Importance Of Diet (Pathya) For Specific Diseases

Implementing portion control –
This can be achieved by measuring the portion of consumable foods, using smaller plates, avoiding eating restaurants, road side foods, snacks etc, reading the food labels, maintaining food journals and eating slowly. It is useful to manage weight and blood sugar levels.

Eating foods having low glycemic index – The glycemic index was developed to access the response of blood sugar to the foods that contain carbs. Eating low glycemic index reduces long-term blood sugar levels in diabetics. Below mentioned are some of the foods with low glycemic index –

• Beans, Lentils, Legumes
• Barley, Non starch vegetables, Most fruits
• Oats, Sweet potatoes, Corn, Yams, Meat, Seafood
  Read – Ayurveda Mahodadhi: Legumes Green Gram, Chickpea, Peas

Lose weight – Maintaining healthy weight lowers the risk of developing diabetes. Even a 7% weight reduction can decrease your risk of developing diabetes by up to 58% (reference). Keep a check on your waistline. When your waist measures 35 inches or more if you are a woman and 40 inches or more if you are a man, you have increased risk of developing diabetes. (reference)

Control your stress levels – During stress cortisol and glucagon are increased which consequentially cause blood sugar levels to shoot up. Exercise, meditation and relaxation methods like yoga reduce stress, blood sugar levels. (ref)

Maintain quality sleep – Maintaining good quality of sleep is necessary for good health and to maintain sugar and insulin levels. Poor sleeping habits affect blood sugar levels, insulin sensitivity, increase appetite and cause weight gain. (research)

Sunlight – Diabetes and insulin resistance are linked to low vitamin D levels. Vitamin D plays a vital role in the production of insulin. If the vitamin D levels are low, the person is prone to develop type 2 diabetes mellitus. Exposure for at least 30 minutes to the sun reduces the risk of vitamin D deficiency. Vitamin D rich foods like orange juice, cheese, cereals, yogurt, soy milk etc should be included in the diet.

Foods rich in magnesium and chromium – Deficiency of chromium is said to predispose one to carb intolerance. Magnesium deficiency has been linked to higher risk of developing diabetes. One study showed 47% lower risk of becoming diabetic in people who take good quantity of magnesium. Green beans, broccoli, high bran cereals, nuts, whole grain products, coffee, meat and egg yolks are rich in chromium. On the other hand, dark leafy greens, beans, bananas, whole grains, avocados, dark chocolate and fish are rich in magnesium.

Apple cider vinegar – It influences body’s response to sugars and also improves insulin sensitivity. It can be added to salad or used by mixing in water.
Read – Apple Benefits, Qualities, Remedies, Research

Cinnamon – Cinnamon shall be used regularly to top up the dishes or as a spice add on. It is found to increase insulin sensitivity at cellular level and also to lower the blood sugar levels. It is found to have insulin like action.

Fenugreek seeds – These are fiber sources and control sugar levels.

Aloe vera – is said to control blood sugar levels due to its anti-inflammatory properties.

Jamun – It has been a proven remedy to reduce blood sugar level.

Vitamin C – Ayurveda uses Indian Gooseberry having rich quantity of vitamin C in treatment of diabetes. Its combination with turmeric is frequently used.

Bitter gourd – It is rich in plant insulin-polypeptide-P and compounds charatin and momordicin which have the ability to reduce sugar levels.

Mango leaves – Powder of washed and sun-dried leaves should be consumed with water. Water boiled and cooled with mango leaves should be consumed on empty stomach early in the morning.

Drumstick leaves – The anti oxidant rich leaves have nutrients which increase insulin production.

Turmeric – Turmeric has been used in Ayurveda since ages in the treatment of diabetes. It can be included in the diet or with amla juice / powder. It is also an important ingredient of many Ayurvedic formulations used in treating urinary disorders and diabetes mellitus.
Read – How Turmeric Helps in Diabetes Treatment: 7 Ways

Herbal Supplements

• Green tea
• Fenugreek
• Cinnamon
• Aloe vera
• American ginseng
• Bitter melon
• Chromium etc

Things to be avoided in Diabetes –

• Refined sugar
• Alcohol consumption – damages liver and pancreas and intervenes with insulin production. Beer should be avoided since it has lot of carbohydrates in it.
• Cow’s milk – is not conducive whereas sheep and goat milk are not harmful.
• GMO foods – promote diabetes along with causing liver and kidney diseases. Products labeled as GMO-free should be chosen.
  Read – Cow’s Milk Benefits According To Ayurveda

Does hyperglycemia always cause symptoms?
Hyperglycemia usually causes noticeable symptoms when the blood glucose levels are significantly elevated, above 180-200 mg/dL.

Elevations of symptoms of hyperglycemia are not spontaneous and often take place over several days or even weeks.

If the symptoms are controlled earlier and if the condition is maintained well, the symptoms might not get serious. On the contrary if the blood glucose levels in hyperglycemia remain high for long time, without being addressed, the symptoms may get serious enough and also produce complications.

It is interesting to note that despite elevated sugar levels in the blood, some people suffering from type 2 diabetes mellitus for a long time might not show any symptoms.
Read – Prameha: Ayurvedic Approach To Urinary Disorders

When to contact doctor?

• When one finds difficult to keep the blood glucose levels under control
• The blood sugar levels are constantly keeping above 240 mg/dL and when urine contains ketones, in spite of one being on diabetes medication
• Not feeling well and feeling tired
• When one cannot keep any food or fluids down
• Suffering from diarrhea or vomiting
• Fever for more than 24 hours

Risk factors

• Not regularly taking insulin or oral diabetes medicines
• Improperly injecting insulin
• Use of expired insulin
• Not following the eating methods in accordance to diabetes dietetic protocol
• Leading a sedentary life
• Chronic illness
• Recurrent / long standing infection
• Using certain medications like steroids
• Being injured
• Having surgery
• Emotional stress at family or work
  Read – Charaka Prameha Nidana: 4th Chapter

Complications

a. Long term complications – Below mentioned are the long term complications of untreated hyperglycemia –

• Cardiovascular diseases
• Neuropathy / nerve disorders
• Nephropathy / kidney damage
• Retinopathy / blindness / cataract
• Disorders of bones and joints
• Frequent and unresolved infections of teeth and gum
• Problems in feet caused by poor blood supply or damage of foot nerves leading to skin infections, ulcerations or amputation
  Read – Diabetic carbuncle – Ayurvedic Understanding And Treatment Modalities

b. Emergency complications – if blood sugar levels are high enough for prolonged time period it would lead to serious and life threatening complications. They are –

Diabetic ketoacidosis – happens due to deficit insulin levels in the body. Consequentially the glucose in the blood cannot enter the cells leading to raised blood sugar levels in the blood. Since the cells can’t get energy, there would be break down of fat to derive energy. This produces ketones which are toxic acids. The excessively accumulated ketones in the blood eventually spill over into the urine. This condition is called ketoacidosis. It leads to diabetic coma if left untreated and may become life-threatening.
Read – Charaka Prameha Chikitsa – 6th chapter

Hyperglycemic hyperosmolar state – This condition manifests when you produce insulin but the insulin does not work properly. Blood sugar level in the blood becomes very high. The body cannot use either glucose or fat for energy since the insulin is not working. The glucose is spilled into the urine. As a result there is excessive urination. When this condition is not treated diabetic hyperglycemic hyperosmolar state can lead to life threatening dehydration and coma. This condition should be treated as soon as possible.
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