High blood sugar (hyperglycaemia) is common in people with diabetes, and can be the first sign of undiagnosed diabetes. Mild highs usually respond to simple steps. Very high levels can lead to dangerous emergencies called DKA and HHS.
Imagine a 14-year-old who’s been thirsty all the time, getting up to pee every night, losing weight and feeling exhausted. One morning they’re vomiting, breathing deeply and their breath smells fruity. These are signs of diabetic ketoacidosis, and they need emergency care now.
Signs of high blood sugar
- Feeling very thirsty and peeing a lot
- Tiredness and weakness
- Blurred vision and headaches
- Weight loss and recurring infections such as thrush
Common causes in people with diabetes
Missed or insufficient medication, illness or infection, eating more carbohydrate than usual, stress, less activity, and some medicines such as steroids.
What to do
- Follow your personal plan from your diabetes team, including any correction doses
- Drink plenty of sugar-free fluids
- Check blood sugar more often, and check ketones if you have type 1 diabetes
- Follow “sick day rules” when unwell, and don’t stop insulin
But when is it an emergency?
Get emergency help for vomiting, tummy pain, deep or fast breathing, fruity-smelling breath, confusion, drowsiness, or high ketones (signs of DKA). Older people with type 2 diabetes can develop HHS, with extreme thirst, confusion and dehydration over days. If you don’t have diabetes but have signs of high blood sugar, see a doctor promptly.
Your next step: If you live with diabetes, ask your diabetes nurse for written sick day rules and keep them on your fridge and phone.
Sources: NHS (High blood sugar), American Diabetes Association, International Diabetes Federation, World Health Organization (Diabetes). This guide is for general information and does not replace advice from your own nurse, doctor or diabetes team.
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