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Hyperglycemia-what is it:Gale Encyclopedia of childhood and adolescence:"Also known as diabetic ketoacidosis, hyperglycemia develops over a period of a few days as the blood sugar levels of a diabetic child gradually rise. The first signs are frequent urination and increased thirst. The child may then show any of the following symptoms, including flushed face, dry skin, dry mouth, headache, nausea, vomiting and abdominal pain, drowsiness and lethargy, blurry vision, fruity-smelling breath, rapid heartbeat, and deep and labored breathing. Without treatment, the child can lapse into a diabetic coma and die. Treatment for hyperglycemia includes an injection of insulin, usually in combination with administration of intravenous fluids and salts." http://www.findarticles.com/cf_dls/g2602/0003/2602000309/p1/article.jhtml Hyperglycemia-a comprehensive overview:Genesis Health:"People with diabetes need to monitor their blood sugar levels every day to protect themselves from hyperglycemia. This allows them to make immediate changes in their treatment plan when needed. Diabetes is a lifelong disease. It requires monitoring all of the time. It is very necessary for you to work with your healthcare provider in keeping this disease under control, for the long-term effects of uncontrolled diabetes are permanent" http://www.genesishealth.com/Healthlib/DIAB4395.htm How To Avoid Hyperglycemia:dietsite.com:"Follow your meal plan. Eat meals and snacks when they are scheduled. Don't skip breakfast and then try to make up for it by eating more food at lunch—remember, your body uses insulin better when you eat smaller meals more often. Follow your physical activity routine and take all necessary precautions when exercising. Test your blood glucose before and after exercising, or as directed by your doctor. If you have type I diabetes, ask your doctor about exercising when your blood glucose level is above 240 mg/dl Take your medication as prescribed, in the proper amounts at the proper times Test your blood glucose regularly. Follow the testing routine prescribed by your doctor. Record all self-monitoring test results and look for a pattern of high blood glucose levels Follow a sick-day plan if you become ill Continue your education to further develop your diabetes management skills" http://www.dietsite.com/diets/diabetes/sickdaymanagement/hyperglycemia.htm Hyperglycemia-signs and symptoms:Endocrine Web:"The basic defect in all patients with diabetes is the decreased ability of insulin to induce cells of the body to remove glucose (sugar) molecules from the blood. Whether this decreased insulin activity is due to a decreased amount of insulin produced (e.g. Type I Diabetes), or from the insensitivity of the cells to a normal amount of insulin, the results are the same...blood glucose levels which are too high. This is termed "hyperglycemia" which means "high glucose in the blood"." http://www.endocrineweb.com/diabetes/hyperglycemia.html Hyperglycemia (high blood sugar) treatment, prevention:vh.org:"If your blood sugars are above your target range, test four times a day before meals and at bedtime. You may need to test your urine for ketones also. Following your diet plan is very important. If you have not been following your diet, try to get back on it. Check your blood sugars to find out if being back on your diet plan brings your blood sugars down. If your blood sugars stay high even when you follow your diet plan, call your doctor or nurse. If symptoms of high blood sugar occur or your blood sugars stay high for two or three days, call your doctor or nurse. High blood sugars may be a sign that you have an infection or illness that needs to be treated. High blood sugars may be a sign that you need a change in the way your diabetes is treated." http://www.vh.org/Patients/IHB/IntMed/EndoMetab/DiabHyperglycemia.html Preventing high blood sugar (hyperglycemia) emergencies:hcp.org:"Unlike low blood sugar, high blood sugar usually develops slowly over a period of hours to days. Blood sugar levels just above the safe range may make a person feel tired and thirsty. If your blood sugar level stays higher than normal, your body will adjust to that level. Over time, high blood sugar damages the eyes, heart, kidneys, blood vessels, and nerves. If your blood sugar continues to rise, your kidneys will increase the amount of urine produced and you can become dehydrated. If you become severely dehydrated, you can go into a coma and possibly die." http://www.hcp.org/kbase/as/aa20968/actionset.htm Hyperglycemia after myocardial infarction:ACP Journal Club:"Is stress hyperglycemia associated with an increased risk for in-hospital death and congestive heart failure (CHF) after myocardial infarction (MI) in patients with and without diabetes mellitus?Stress hyperglycemia after myocardial infarction is associated with an increased risk for in-hospital death in patients with and without diabetes; an increased risk for congestive heart failure or cardiogenic shock is also seen in patients without diabetes" http://www.acpjc.org/Content/133/3/ISSUE/ACPJC-2000-133-3-116.htm Is hyperglycaemia an independent predictor of poor outcome after acute stroke?:BMJ:"A total of 811 patients with computed tomography confirmed acute stroke and plasma glucose data were studied. In 624 (77%) cases the plasma glucose concentration was measured on admission, and in 187 (23%) cases it was measured early next morning. The mean times to measurement of glucose concentration were 3.6 hours after admission to the unit and 14.4 hours after stroke onset. Sixty one (8%) patients were diabetic, seven (1%) being insulin dependent. Table 1) compares the characteristics of the diabetic and non-diabetic patients. As expected, the median plasma glucose concentration and proportion of patients with hyperglycaemia were higher in the diabetic group. Our main analysis was restricted to the 750 non-diabetic patients. Fifteen patients were lost to follow up for placement (owing to failure of hospital discharge record linkage) but not for survival. The mean follow up time was 1.65 years." http://bmj.com/cgi/content/full/314/7090/1303 Hyperglycemia and Ketoacidosis-includes charts and additional links:Diabetes 123:"Hyperglycemia means high blood sugar. For people with Type 1 diabetes, hyperglycemia may lead to diabetic ketoacidosis, a very serious situation that requires emergency medical treatment. If you're used to using urine test strips to check for ketones, the following chart can help you interpret the results of the Precision Xtra's blood ketone test results" http://www.diabetes123.com/d_0n_030.htm HYPERGLYCEMIA AFTER RENAL TRANSPLANTATION:National Institue of Transplantation:"Hyperglycemia is a significant problem that could increase morbidity and mortality post-kidney transplant, by increasing risk of atherosclerosis and progression to overt DM. lmmunosuppressive agents not only cause glucose intolerance, but also increase serum lipids and cause hypertensaion as shown by a number of investigators." http://www.a-s-t.org/abstracts98/abs593.htm Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes:University of TN Health Science Center:"Admission hyperglycemia has been associated with increased hospital mortality in critically ill patients; however, it is not known whether hyperglycemia in patients admitted to general hospital wards is associated with poor outcome. The aim of this study was to determine the prevalence of in-hospital hyperglycemia and determine the survival and functional outcome of patients with hyperglycemia with and without a history of diabetes. We reviewed the medical records of 2030 consecutive adult patients admitted to Georgia Baptist Medical Center, a community teaching hospital in downtown Atlanta, GA, from July 1, 1998, to October 20, 1998." University of Tennessee Health Science Center 951 Court Avenue Room 335M Memphis, Tennessee 38163 gumpierrez@utmem.edu http://intl-jcem.endojournals.org/cgi/content/abstract/87/3/978 Search Nursing Diabetics http://www.nursingdiabetics.com/A-Z_list/ ******************************************************
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