Hyperglycaemia - Complications of hyperglycaemia

If left untreated, hyperglycaemia can lead to serious complications that can be life-threatening.

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a complication that can affect people with type 1 diabetes. It occurs when a lack of insulin means that cells cannot take glucose from the blood to use as energy. Instead, the cells start to break down fats to use as energy.

This causes chemicals called ketones to build-up in the blood, which increases the blood acidity.

The signs and symptoms of ketoacidosis include:

an elevated blood glucose level
a high number of ketones in your urine (ketone testing strips are available on prescription)
nausea or vomiting
stomach pain
a fruity smell on your breath, which may smell like pear drops or nail varnish
rapid breathing (hyperventilation)
dehydration (symptoms of which include a headache, dry skin, and a weak, rapid heartbeat)
drowsiness or confusion
loss of consciousness

If you experience these signs or symptoms, seek urgent medical attention. If left untreated, ketoacidosis can lead to coma and death.

Diabetic ketoacidosis needs to be treated urgently in hospital, where you will usually be given replacement fluids and insulin into a vein to treat dehydration and lower your blood glucose level.

Hyperosmolar hyperglycaemic state

A hyperosmolar hyperglycaemic state (HHS) is similar to DKA, but tends to affect people with type 2 diabetes.

HHS occurs when insulin is present, but it is ineffective at removing glucose from the blood. This causes your body to become dehydrated as it tries to get rid of the excess sugar.

As well as an elevated blood sugar level, warning signs of HHS can include:

frequent urination
dry mouth
extreme thirst
feeling sick
warm, dry skin
confusion
weakness down one side of the body
drowsiness and a gradual loss of consciousness

Unlike DKA, HHS does not usually lead to a build-up of ketones in your urine.

If you experience symptoms of HHS, seek urgent medical attention. Like DKA, HHS can lead to coma and even death if not treated.

HHS is usually treated in hospital, using replacement fluids and insulin given directly into a vein to treat dehydration and lower your blood glucose level.

Long-term complications

In the long-term, hyperglycaemia can increase the likelihood of complications developing as a result of diabetes.

This is because high levels of glucose in the blood can damage blood vessels, nerves and organs. If your blood glucose level is not well controlled, you may be more at risk of developing:

damage to your kidneys
damage to your eyes
damage to the nerves of your feet
heart disease (when the heart’s blood supply is blocked)
erection problems (in men)