1. HYPERGLYCEMIA

2. HYPERGLYCEMIA

Hyperglycemia means high blood sugar or glucose.

Insulin is a hormone that moves glucose into cells to
give them energy.

Hyperglycemia happens when body doesn't make
enough insulin or can't use it the right way.

Blood glucose levels can vary from day to day.

3. An
occasional high level (above 10mmol/L) is not a
problem, as long as it returns to normal (below 8mmol/L)
within 12-24 hours.

Persistently high blood glucose levels (above
15mmol/L) for more than 12-24 hours can result in the
symptoms of hyperglycemia.

4. Cells
remove glucose from the blood in response to
insulin.
If
pancreas doesn't make enough insulin, glucose can't
enter the cells and remains in the blood.
Blood
glucose levels can also get too high if cells are
unable to respond to insulin properly (insulin resistance).

5. Types of hyperglycemia
Complicated hyperglycemia is life-threatening .
 Two type of hyperglycemia
1. diabetic ketoacidosis (DKA)
2. hyperosmolar hyperglycemic state (HHS)
DKA- is a problem that occurs in people with diabetes.
It occurs when the body cannot use sugar (glucose) as a fuel
source because there is no insulin or not enough insulin.
Fat is used for fuel instead.
Byproducts of fat breakdown, called ketones, build up in the
body.


6. HHS- hyperglycemic hyperosmolar syndrome is a
condition of:
1. Extremely high blood sugar (glucose) levels
2. Extreme lack of water dehydration
 Hyperosmolarity is a condition in which the blood has a
high concentration of salt (sodium), glucose, and other
substances that normally cause water to move into the
bloodstream.
 This draws the water out of the body's other
organs, including the brain. Sometimes it can cause coma.


7. CAUSES OF HYPERGLYCAEMIA






Blood glucose levels
Diabetes
Medications that cause hyperglycaemia
Gestational diabetes
Critical illness
Other factor

8. Blood glucose levels
The amount of glucose in your blood is controlled by
a hormone called insulin, which is produced by
pancreas.

Insulin takes glucose out of blood and moves it into
cells, where it is broken down to produce energy.

Glucagon is a different peptide hormone secreted by
the pancreatic cells.


9. Its secretion is stimulated by low blood glucose
levels, and its general effect is to oppose the action of
insulin.

Glycogenesis and glycogenolysis are controlled by
these hormones.

The three regulatory enzyems of glycolysis HK , PFK.
PK. Are also regulate by these hormones.

These pathways play an important role in blood glucose
regulation .


10. DIABETES
In people with diabetes the body is unable to break
glucose down into energy.

This is because there is either not enough insulin to
move the glucose, or because the insulin that is there does
not work properly.

The glucose remains in the blood, causing a high blood
glucose level.


11. In diabetes type 1 hyperglycemia is usually caused by
low insulin levels .
 In type 2 hyperglycemia caused by resistance to insulin
at the cellular level depending on the type and state of the
disease.
 Low insulin levels or insulin resistance prevent the
body from converting glucose into glycogen which can
cause excess glucose level in blood.


12. Medications that cause hyperglycaemia

Sometimes, hyperglycaemia and diabetes can occur as a
side effect of taking some medicines.
Olanzapine and risperidone are medications that are
sometimes used to treat mental health conditions, such
as schizophrenia (a condition that can cause hallucinations
and delusions).


13. Certain medications increase the risk of
hyperglycemia, including corticosteroids, octreotide, bet
blockers, epinephrine, thiazide diuretics, niacin,
pentamidine, protease inhibitors, L-asparaginase, and
some antipsychotic agents.


14. GESTATIONAL DIABETES
Gestational diabetes is when a woman develops diabetes
during pregnancy.
 This may occur if your body is unable to produce
enough extra insulin to meet the demands of pregnancy.
 This leads to an increased level of glucose in the blood.


15. CRITICAL ILLNESS
A high proportion of patients suffering an acute stress
such as stroke or myocardial infarction may develop
hyperglycemia.
 stress' hormones such as epinephrine.
 several of the steroids, infections, trauma.
 Dysfunction of the thyroid, adrenal, and pituitary
glands

Numerous diseases of the pancreas


16. OTHER REASONS
1.
2.
3.
4.
5.
6.
7.
a change of medication
a wrong (or missed dose) of insulin
changing your diet, or eating too much
not exercising regularly
an illness, such as a cold
Being inactive
Family history of diabetes

17. BLOOD SUGAR REGULATION
It
is important that the concentration of glucose in the
blood is maintained at a constant level.
 Insulin and glucagon, are hormone produced by the
pancreas that regulates glucose levels in the blood.

18. Role of insulin in Blood Glucose Control
Glucose level
Effect on pancreas
Effect on liver
Effect on glucose
level
too high
insulin secreted into
the blood
liver converts glucose
into glycogen
goes down
too low
insulin not secreted
into the blood
liver does not convert
glucose into glycogen
goes up

19. REGULATION OF HIGH BLOOD GLUCOSE LEVEL

20. REGULATION OF LOW GLUCOSE LEVEL

21. Symptoms of Hyperglycemia
Increased thirst
 Headaches
 Difficulty concentrating
Blurred vision
 Frequent urination
Fatigue (weak, tired feeling)
Weight loss

22. What are the risks of hyperglycemia

Without treatment, high blood sugar levels can lead to severe
dehydration.

May get a blood clot in your leg or arm. The clot may travel to your
heart or brain and cause life-threatening problems, such as a heart attack
or stroke.
Hyperglycemia

may cause pancreatitis.
Hyperglycemia can also lead to diabetes.

23. Hyperglycemia can damage nerves, veins, arteries, and
organs over time.
 Damage to arteries may increase risk for a heart attack
or stroke.
Hyperglycemia can be a serious problem if not treated in
time. In untreated hyperglycemia, a condition
called ketoacidosis (contrast ketosis) could occur.


24. Without insulin, the body isn't able to utilize the
glucose for fuel, so the body starts to break down fats for
energy.
 Ketoacidosis is a life-threatening condition which needs
immediate treatment.


25. References
^"
Hyperglycemia".
^ What are mg/dl and mmol/l? How to convert?
^ Total Health Life (2005). "High Blood Sugar". Total Health Institute. Retrieved May 4, 2011.
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Evidence for reduced availability of nitric oxide during hyperglycemia". Circulation 95 (7): 1783–
90.doi:10.1161/01.CIR.95.7.1783. PMID 9107164.
^ Pais I, Hallschmid M, Jauch-Chara K, et al. (2007). "Mood and cognitive functions during acute euglycaemia and mild
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^ Sommerfield AJ, Deary IJ, Frier BM (2004). "Acute hyperglycemia alters mood state and impairs cognitive performance in people
with type 2 diabetes". Diabetes Care 27(10): 2335–40. doi:10.2337/diacare.27.10.2335. PMID 15451897.

26. ^ Cetin M, Yetgin S, Kara A, et al. (1994). "Hyperglycemia, ketoacidosis and other complications of Lasparaginase in children with acute lymphoblastic leukemia". J Med25 (3–4): 219–29. PMID 7996065.
^ Luna B, Feinglos MN (2001). "Drug-induced hyperglycemia". JAMA 286 (16): 1945–
8. doi:10.1001/jama.286.16.1945. PMID 11667913.
^ Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC (2001). "Stress hyperglycemia and prognosis of
stroke in nondiabetic and diabetic patients: a systematic overview". Stroke 32 (10): 2426–
32. doi:10.1161/hs1001.096194.PMID 11588337.
^ "Chronic hyperglycemia may lead to cardiac damage". Journal of the American College of Cardiology.
Retrieved 3 February 2012.
^ Ron Walls MD; John J. Ratey MD; Robert I. Simon MD (2009). Rosen's Emergency Medicine: Expert
Consult Premium Edition - Enhanced Online Features and Print (Rosen's Emergency Medicine: Concepts &
Clinical Practice (2v.)). St. Louis: Mosby.ISBN 0-323-05472-2.