Medicines for High blood sugar

What it is

High blood sugar (hyperglycaemia) is when the level of glucose (sugar) in the blood is higher than it should be. It occurs most commonly in people with diabetes, when there is not enough insulin (the hormone that controls blood sugar) or the body cannot use it effectively, so glucose builds up in the blood. In people with diabetes, high blood sugar can be triggered by factors such as eating more carbohydrate than the medication covers, missing or not taking enough diabetes medication or insulin, being unwell or having an infection, stress, or being less active than usual. High blood sugar can also be found in people not previously known to have diabetes, and can be a sign of newly developing diabetes. The symptoms of high blood sugar can include: feeling very thirsty; passing more urine than usual, particularly at night; tiredness; blurred vision; feeling hungry; unintentional weight loss; recurrent infections (such as thrush); and headaches. Mild or occasional high blood sugar may cause few symptoms, and short-term high readings can often be corrected by following the advice for managing diabetes. However, persistently high blood sugar over time can damage the body (contributing to the long-term complications of diabetes affecting the eyes, kidneys, nerves, and blood vessels), which is why good blood sugar control is important. In addition, very high blood sugar can lead to serious, life-threatening emergencies — particularly diabetic ketoacidosis (DKA, more common in type 1 diabetes) and another severe state (more common in type 2 diabetes) — which need urgent hospital treatment. So it is important to recognise high blood sugar, manage it as advised, and know the warning signs of the emergencies. The key messages are that high blood sugar occurs mainly in diabetes, that recognising and managing it (and good overall diabetes control) matter, and that very high blood sugar with certain warning signs is a medical emergency.

How it is treated

High blood sugar is managed by correcting the immediate cause and, in the longer term, achieving good blood sugar control, while recognising and responding to the warning signs of emergencies. For a person with diabetes who has high blood sugar, management follows their diabetes care plan and advice, and may involve: checking blood sugar (and, in type 1 diabetes, ketones, if advised); following the guidance for their treatment — for example taking diabetes medication or insulin as prescribed (and any correction doses as advised in their plan), staying hydrated (drinking water), and adjusting as directed; identifying and addressing the cause (such as an illness, missed medication, or dietary factors); and following "sick day rules" when unwell, as illness commonly raises blood sugar and needs particular care (people with diabetes are given specific advice for managing their diabetes during illness). Longer-term, good blood sugar control — through the balance of diet, activity, medication or insulin, monitoring, and regular diabetes reviews — reduces the risk of the long-term complications of diabetes, and the diabetes team helps tailor and adjust treatment. For someone not known to have diabetes who has high blood sugar or symptoms of it (such as excessive thirst, passing lots of urine, tiredness, or weight loss), assessment for diabetes is important, so it can be diagnosed and managed. Crucially, it is important to recognise and seek urgent help for the warning signs of a diabetic emergency: symptoms of diabetic ketoacidosis (DKA) — such as feeling very unwell, being sick, tummy pain, deep or rapid breathing, breath smelling fruity, drowsiness or confusion, and very high blood sugar with ketones — are a medical emergency needing immediate treatment, as is a severe high-blood-sugar state with dehydration and reduced consciousness; these need urgent hospital care. So, alongside day-to-day management, knowing these warning signs and acting on them is vital. The reassuring messages are that high blood sugar can usually be managed by following diabetes care and correcting the cause, that good overall control reduces long-term risks, and that recognising the emergency warning signs (and seeking urgent help) is essential — and, for those not known to have diabetes, that symptoms of high blood sugar should be checked, as diabetes is very manageable once diagnosed.