[Health Column] Acute Complications Caused by High Blood Sugar: Life-Threatening Hyperglycemic Shock

Director Choi Woo-hyuk

 

 

Hello, this is Director Choi Woo-hyuk.

 

High blood sugar refers to an abnormally high level of glucose in the blood, and if not properly managed, it can develop into an acute complication that threatens life.

 

When it comes to hyperglycemic complications, the commonly used term is "hyperglycemic shock," but this is not a medical term. In reality, the types of acute hyperglycemic complications are classified as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS).

 

In this article, I will explain the symptoms, causes, diagnostic criteria, treatment methods, and prevention strategies for hyperglycemia, including hyperglycemic shock and other acute hyperglycemic complications.

 

 

What is high blood sugar?

 

 

High blood sugar is a condition where the glucose level in the blood becomes abnormally high, primarily occurring in diabetic patients. In healthy individuals, insulin regulates blood sugar, but in diabetics or people with impaired insulin function, high blood sugar is more likely to occur.

 

If these high blood sugar levels are not managed, they can lead to hyperglycemic complications. Hyperglycemic complications mostly occur in people who have been diagnosed with diabetes or have not yet been diagnosed, but whose blood sugar levels already fall within the diagnostic criteria for diabetes. In normal individuals, it is difficult for blood sugar to become so high as to cause hyperglycemic complications.

 

 

Symptoms and progression stages of hyperglycemia

In the early stages of hyperglycemia, symptoms may be mild, but as blood sugar levels rise, symptoms such as dry mouth, frequent urination, fatigue, and blurred vision appear. If blood sugar levels increase rapidly, hyperglycemic acute complications may occur.

 

Acute hyperglycemic complications are classified into diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS). When acute hyperglycemic complications occur, they cause electrolyte imbalances, leading to symptoms such as dizziness, abdominal pain, nausea, vomiting, and even altered consciousness or loss of consciousness.

 

The term "hyperglycemic shock" is commonly used to describe symptoms such as coma and unconsciousness, but it is not a medical term, and the definition of shock is different from coma and unconsciousness, making it an incorrect concept. The correct term to describe conditions caused by a sudden increase in blood sugar levels in the body is "hyperglycemic acute complication."

 

 

Causes of high blood sugar

The causes of high blood sugar generally include eating more than usual, frequently consuming snacks high in carbohydrates, decreased physical activity, and stress, and these factors affect both healthy individuals and diabetics.

 

In this case, it can also occur if diabetic patients do not properly take their oral hypoglycemic agents or insulin injections.

 

In rare cases, when stress situations such as infection or trauma occur in individuals with pre-existing conditions, stress hormones like cortisol in the body may increase, leading to elevated blood sugar levels.

 

 

Criteria for judging high blood sugar levels

 

First, the definition of hyperglycemia includes all cases where blood sugar levels are higher than normal blood sugar levels.

 

 

Fasting blood sugar between 70 and 99 mg/dL, and blood sugar less than or equal to 139 mg/dL two hours after a meal are considered normal ranges. A fasting blood sugar of 126 mg/dL or higher, or blood sugar of 200 mg/dL or higher two hours after a meal, meet the diagnostic criteria for diabetes.

 

 

Symptoms of acute hyperglycemic complications

When blood sugar levels exceed a certain threshold, the risk of life-threatening hyperglycemic acute complications increases. Hyperglycemic acute complications vary in diagnostic criteria and pathophysiology depending on the type. A table summarizing the differences between the two types of hyperglycemic acute complications, DKA and HHS, is provided for your reference.

 

Differences between DKA and HHS

 

Characteristics	Diabetic ketoacidosis (DKA)	Hyperosmolar Hyperglycemic Syndrome (HHS)
Main patient groups	Type 1 diabetes patient	Type 2 diabetes mellitus patient
Cause of onset	Increased fat breakdown and ketone accumulation due to insulin deficiency	Insulin action remains partially present, but severe hyperglycemia and dehydration lead to increased osmotic pressure.
Blood sugar level standards	Exceeds 200 mg/dL	Exceeds 600 mg/dL
Rate of onset	Rapid progress (several hours to several days)	Gradual progress (several days to several weeks)
Main symptoms	Abdominal pain, vomiting, severe thirst, rapid and deep breathing, decreased consciousness, etc.	Severe thirst, increased urination, confusion, decreased consciousness, etc.
Prevention methods	Insulin maintenance	Fluid intake, insulin or medication administration

 

For diabetic patients, especially those at high risk of complications, it is important to regularly monitor blood glucose levels from the outset. Hyperglycemic acute complications are serious emergency situations that can occur in diabetic patients, requiring prompt and appropriate response.

 

 

High blood sugar treatment

 

Treatment for high blood sugar varies depending on severity. In mild cases, increasing fluid intake, adjusting carbohydrate consumption, and engaging in light exercise can help lower blood sugar levels.

 

 

In patients with diabetes, insulin or other prescribed medications are generally adjusted under the guidance of a physician. Immediate medical intervention, including intravenous fluid therapy, insulin therapy, and electrolyte supplementation, is necessary to treat serious complications such as hyperosmolar hyperglycemic state (HHS) or diabetic ketoacidosis (DKA).

 

 

Prevention of high blood sugar

 

To prevent high blood sugar, it is essential to regulate lifestyle habits and regularly check blood sugar levels. Maintaining a low-carbohydrate diet, increasing muscle mass through exercise to improve insulin resistance, and managing stress are helpful measures.

 

 

Diabetic patients should regularly monitor their blood sugar levels and adjust oral hypoglycemic agents or insulin as needed to prevent prolonged hyperglycemia.

 

 

High blood sugar is a condition that can lead to serious complications, including diabetic ketoacidosis, if left untreated. Pay attention to early symptoms of high blood sugar, initiate early treatment, and maintain normal blood sugar levels through regular blood sugar monitoring and lifestyle improvements to preserve a healthy life.

 

 

Director Choi Woo-hyuk

Graduated from Korea University College of Life Sciences
Graduated from Kyung Hee University College of Medicine
Kyung Hee University Hospital Resident
Full member of the Korean Society of Dermatology and Aesthetic Medicine

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