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Special Features

Are you Hypo- or Hyper-glycemic?

By: Darleth Romana-Bantiles, MD article_11

Tessa broke into a run and before reaching a kilometer of her usual morning jog, the surroundings started to become blurry! The voices and other sounds in the environment also got muffled and she felt her extremities becoming cold. She felt dizzy and the last thing she remembered was somebody shouting and running towards her.

I saw her a few minutes after she passed out, as community security officers brought her to the emergency room for first aid. I immediately had her blood sugar level tested and my suspicion was confirmed – she had very low blood sugar level or hypoglycemia. Probing the patient after she regained consciousness revealed that she forgot to take anything for breakfast and even the night prior to running. She had no food intake for a total of 12 hours!

Blood sugar or glucose levels may vary in people from time to time. Extremes in glucose values may cause symptoms that compromise one’s well-being. The mentioned example is an extremely low level of blood sugar, or hypoglycemia, brought about by a lack of food intake combined with energy-requiring physical activity. On the other hand, hyperglycemia is the extremely high blood sugar level that may also happen with variations in blood sugar levels.

The utilization of glucose in the body is facilitated by the hormone insulin. Extremes of blood sugar levels happen when the production or utilization of insulin in the body is not optimal, and this is especially true in people with diabetes. Hypoglycemia may be caused by increased physical or mental activity or increased demand for glucose in the body. Intake of alcoholic beverages may also cause the depletion of sugar stores in the liver, making a person prone to a ‘hypoglycemic attack’. As for hyperglycemia, it can be precipitated by infections or stressors that lead to inefficient cell uptake of glucose by the body. Inactivity and excessive consumption of carbohydrates are the common culprits that induce extremely high blood sugar levels.

Is it high or low?

While hypoglycemia and hyperglycemia both cause blurry vision, rapid pulse, shallow breathing, and confusion that can lead to coma, their onset of symptoms and other notable signs differ.  Below is a table to help a person tell the two apart:

 

Hypoglycemia

Hyperglycemia

Onset

rapid

slow (over a period of time)

Extremities

cool, pale, moist

warm, dry

Other symptoms

hunger, dizziness

thirst, rapid urination (positive with ketone bodies), sweet breath

Complications

eye, kidney, heart or other organ damage

loss of consciousness and death

Symptoms may help differentiate the two blood glucose extremes, but checking via a glucometer will make the diagnosis more or less definite. Hypoglycemia will have a reading of less than 70 mg/dL, while hyperglycemia will register more than 200 mg/dL even at a fasting state.

Ascertaining the blood glucose level will also make the treatment certain. Hypoglycemia, in its early phase, can be addressed with 15 to 20 grams of a simple carbohydrate such as candy, apple juice or glucose tablets. In the case of hyperglycemia, treatment may use the help of insulin injections and other fluids. Medical management is required, especially when changes in sensorium are already being manifested by the patient.

Keeping it steady

Even if it will entail more effort, especially for people with diabetes, the good news is that blood sugar may be maintained at stable levels. Everyday habits significantly affect blood sugar levels, so dramatic changes in the diet or lifestyle is a no-no. Sometimes, the experience of either hypo- or hyper- glycemia is a wake-up call that one may be neglecting personal health.

Here are some tips to keep the body’s sugar uptake optimized:

  • Watch what you eat. Avoid experiencing the sugar rush by consuming more complex sugars that are unprocessed. Simple sugars in refined bread or snacks tend to be broken down faster and the blood glucose levels shoot up and crash faster after eating them.
  • Add more fiber to your diet. Satiety is facilitated by this fare, as well as weight control that helps prevent diabetes or inefficient blood sugar utilization. Include more vegetables and even fruits in daily meals. Consumption of more root crops like kamote and taro will also do a lot of good in blood sugar level control and weight management.
  • Take good care of yourself. Exercise or appropriate regular physical activities may condition the body and help sugar metabolism. There may be appropriate workouts for different age groups and different lifestyles. In the case of a person with diabetes, blood sugar monitoring at regular periods may also prevent life-threatening spikes or dips. If regular intake of medication is required, compliance spells a world of difference. Periodic check-ups or consultations with a medical specialist to discuss management plans may also be necessary. If the fluctuations occur often, a special identification or tag may be needed to be always with a person to alert other people. It would not hurt to notify or warn others about the occurrence of blood sugar level extremes.

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Keywords: sugar metabolism, exercise, fibers, medical management, fasting, glucometer, comatose, carbohydrates, insulin, glucose, hyperglycemic, hypoglycemic, blood sugar, diabetes   
  
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