Hyperglycemia and Diabetic Ketoacidosisenparentshttps://kidshealth.org/EN/images/headers/P-hyperglycemia-enHD-AR1.jpgWhen blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible.hyperglycemia, when blood sugar levels are too high, high blood sugar levels, diabetic ketoacidosis, dka, ketoacidosis, controlling diabetes, monitoring diabetes control, blood glucose meter, hba1c test, insulin pump, treating high blood sugar levels, signs and symptoms of dka, treating dka, diabetes emergencies, type 1 diabetes, type 2 diabetes, diabetes and kids04/01/200506/29/201706/29/2017Mauri Carakushansky, MD and Jennifer L. Seekford, ARNP10/01/2016604daaa3-061f-4de7-adef-81dfb8478b52https://kidshealth.org/ws/RadyChildrens/en/parents/hyperglycemia.html/<p>When blood glucose levels (also called blood sugar levels) are too high, it's called <strong>hyperglycemia</strong>.</p> <p>Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy.</p> <p>Hyperglycemia is the hallmark of diabetes &mdash; it happens when the body either can't make insulin (<a href="https://kidshealth.org/ws/RadyChildrens/en/parents/type1.html/">type 1 diabetes</a>) or can't respond to insulin properly (<a href="https://kidshealth.org/ws/RadyChildrens/en/parents/type2.html/">type 2 diabetes</a>). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia.</p> <p>If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes.</p> <p>These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly.</p> <p>Blood sugar levels are considered high when they're above someone's target range. The <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-team.html/">diabetes health care team</a> will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age.</p> <h3>Causes of High Blood Sugar Levels</h3> <p>A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of:</p> <ol> <li>diabetes medicines (such as insulin)</li> <li>food</li> <li>activity level</li> </ol> <p>All of these need to be balanced to keep blood sugar levels under control. If any one is off, blood sugar levels can be, too.</p> <p>In general, problems controlling blood sugar levels are due to one or more of the following:</p> <ul> <li>not getting enough <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/insulin.html/">insulin</a> or other diabetes medicine</li> <li>not following the <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/meal-plans-diabetes.html/">meal plan</a> (like eating too much on a special occasion without adjusting medicines)</li> <li>not getting enough exercise</li> <li>illness or stress</li> <li>use of certain medicines that can raise blood sugar, like steroids used to treat inflammation</li> </ul> <h3>Signs &amp; Symptoms of Hyperglycemia</h3> <p>The symptoms of hyperglycemia are similar to those that happen when someone is diagnosed with diabetes, such as:</p> <ul class="kh_longline_list"> <li><strong>Frequent urination:</strong> The kidneys respond to high levels of glucose in the bloodstream by flushing out the extra glucose in urine (pee). A child with diabetes who has hyperglycemia may need to pee more often and in larger volumes.</li> <li><strong>Extreme thirst:</strong> Kids with&nbsp;hyperglycemia who lose&nbsp;a lot of&nbsp;fluid from urinating often become very thirsty and may drink a lot in an attempt to prevent dehydration.</li> <li><strong>Weight loss despite increased appetite:</strong> Without enough insulin to help the body use glucose, the body breaks down muscle and stored fat in an attempt to provide fuel to hungry cells.</li> <li><strong>Fatigue:</strong> Because the body can't use glucose for energy properly, kids with hyperglycemia may be unusually tired.</li> </ul> <h3>Checking for High Blood Sugar Levels</h3> <p>As part of the diabetes management plan, you'll need to check your child's blood sugar levels multiple times a day with a <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/glucose-meter.html/">blood glucose meter</a>. This helps you identify when your child has high blood sugar levels, which don't always cause symptoms. Someone&nbsp;who isn't testing regularly might have blood sugar levels high enough to damage the body without even realizing it.</p> <p>The <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/hba1c.html/">HbA1c test</a>&nbsp;can show if someone has been having significant hyperglycemia over time, even though the person may not have had obvious symptoms.</p> <p>If you find that your child is having a lot of high blood sugar levels, the diabetes health care team may suggest changing the diabetes medicines or meal plan to bring the levels back into a healthy range.</p> <p>In other cases, an equipment issue, like an <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/insulin-pump.html/">insulin pump</a> problem or expired insulin, may be the cause. Make sure you contact the diabetes team if your child's blood sugar levels are often above the target range.</p> <h3>Treating High Blood Sugar Levels</h3> <p>Treating high blood sugar levels means correcting their cause. The diabetes health care team will give you specific advice on how to keep your child's blood sugar levels in a healthy range. But here are some suggestions for managing some causes of hyperglycemia:</p> <div class="kh_art_tabs_2"> <table> <tbody> <tr><th scope="col"><strong>&nbsp;Cause</strong></th><th scope="col"><strong>What to Do</strong></th></tr> <tr> <td><br /> Not getting enough insulin or other diabetes medication</td> <td> <ul> <li>Make sure your child takes the right type of insulin and the correct dose at the right time.</li> <li>Check that the insulin is not expired.</li> <li>Make sure that all equipment (pumps, meters, etc.) works properly.</li> <li>Diabetes medicines may need to be changed or adjusted &mdash; check with the diabetes health care team.</li> </ul> </td> </tr> <tr> <td><br /> Not following the meal plan (like eating too much food on special occasions without adjusting medicines)</td> <td> <ul> <li>Work with a registered dietitian to change your child's meal plan as needed.</li> <li>Adjust insulin/pills whenever your child eats more or less than what's on the meal plan (the care team can help you with this).</li> </ul> </td> </tr> <tr> <td><br /> Not getting enough exercise</td> <td> <ul> <li>Help your child make time for exercise.</li> <li>Adjust your child's medicines based on the care team's instructions.</li> </ul> </td> </tr> <tr> <td><br /> Illness or stress</td> <td> <ul> <li>Contact the diabetes health care team.</li> <li>Your child should continue to take insulin (the dose may need to change).</li> <li>Check blood sugar levels often as per the diabetes management plan.</li> </ul> </td> </tr> <tr> <td><br /> Use of medicines that increase blood sugar</td> <td> <ul> <li>Contact the diabetes health care team.</li> <li>Insulin or pills may need to change while your child takes the medicine that's causing high blood sugar levels.</li> </ul> </td> </tr> </tbody> </table> </div> <p>A single high blood sugar reading usually isn't cause for alarm &mdash; it happens to everyone with diabetes from time to time. However, consistently high blood sugar levels need to be addressed.</p> <h3>Diabetic Ketoacidosis (DKA)</h3> <p>Insulin lets glucose get into the body's&nbsp;cells. Without enough insulin, the body&nbsp;can't use glucose for energy and starts to use fat for fuel. This can happen, for example, when someone skips doses of insulin or when the need for insulin suddenly increases (for example, due to stress or illness) and the doses are not adjusted.</p> <p>When the body uses fat for energy, chemicals called ketones are released into the blood, causing <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/az-ketoacidosis.html/">diabetic ketoacidosis (DKA)</a>. Some of the ketones, like extra glucose, exit the body through urine.</p> <p>But high levels of ketones in the blood can be a problem because they cause the blood to become acidic. Too much acid in the blood throws off the body's chemical balance.</p> <p>Diabetic ketoacidosis is a very serious &mdash; but completely preventable &mdash; condition that can lead to coma or death if it's not treated quickly. It happens more often in people with type 1 diabetes, but can sometimes happen in people with type 2 diabetes.</p> <h3>Signs &amp; Symptoms of Diabetic Ketoacidosis</h3> <p>Symptoms of diabetic ketoacidosis usually don't start all at once &mdash; they usually come on slowly over several hours. Signs and symptoms include:</p> <ul> <li>fatigue (extreme tiredness)</li> <li>excessive thirst/urination</li> <li>dry mouth and <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/dehydration.html/">dehydration</a></li> </ul> <p>These symptoms are caused by the sustained hyperglycemia (usually lasting several hours) that typically happens before someone develops diabetic ketoacidosis.</p> <p>If the person isn't treated, these symptoms can happen:</p> <ul> <li>abdominal pain</li> <li>nausea and/or vomiting</li> <li>fruity (acetone) breath odor</li> <li>rapid, deep breathing</li> <li>confusion</li> <li>unconsciousness ("diabetic coma")</li> </ul> <h3>Checking for Diabetic Ketoacidosis</h3> <p>How do you know if your child has diabetic ketoacidosis? The signs and symptoms can mimic or be triggered by other illnesses, like the flu. So, it's very important to check your child's blood sugar levels and urine ketones during illness &mdash; especially if there are&nbsp;high blood sugar readings &mdash; or if your child has symptoms of diabetic ketoacidosis.</p> <p>Because high levels of ketones in the blood cause ketones to appear in the urine, ketones can be checked at home by testing a sample of your child's urine. If the urine test for ketones is negative, it generally means that symptoms are not due to diabetic ketoacidosis. If the urine test is positive, contact your child's diabetes health care team.&nbsp;</p> <p><span style="font-size: 1em;">Tests done by a lab or hospital can confirm whether a child has&nbsp;</span>diabetic ketoacidosis<span style="font-size: 1em;">, if necessary. Some newer blood glucose meters also offer the option of testing blood for ketones. Ask the diabetes health care team if such a meter is a good idea&nbsp;for your child.</span></p> <h3>Treating Diabetic Ketoacidosis</h3> <p>Diabetic ketoacidosis requires immediate medical treatment with intravenous (IV)&nbsp;insulin and fluids and close monitoring in a hospital. Contact the diabetes health care team immediately or seek emergency care if you think your child is having symptoms of diabetic ketoacidosis.</p> <p>All adult family members and your child's caregivers and school staff should know about the risk of diabetic ketoacidosis in a child with diabetes, and they should know when to call 911.</p> <p>In addition, all kids and teens with diabetes should wear some sort of medical identification (like a bracelet or necklace) and/or carry medical identification (ID) information at all times. Besides identifying your child as having diabetes, these IDs can provide emergency contact information.</p> <h3>Avoiding Hyperglycemia &amp; Preventing Diabetic Ketoacidosis</h3> <p>The best way to prevent diabetic ketoacidosis is to treat high blood sugar levels appropriately, which means following the diabetes management plan prescribed by the diabetes health care team.</p> <p>Make sure your child:</p> <ul> <li>takes insulin and diabetes medicines as prescribed</li> <li>follows the meal plan and/or makes appropriate adjustments to diabetes medicines when changes to the meal plan are made</li> <li>monitors his or her blood sugar levels regularly and ketone levels when indicated</li> <li>follows the instructions and advice of the diabetes health care team and diabetes management plan, which should include instructions for <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-sick-days.html/">sick days</a></li> </ul> <p>By regularly monitoring blood sugar levels, you'll know when your child's blood sugar is high. If that happens, contact the diabetes health care team for more information and to learn how to help bring your child's diabetes back under control.</p>
Blood Glucose RecordIf your child has diabetes, you can use this printable sheet to record his or her blood glucose levels.https://kidshealth.org/ws/RadyChildrens/en/parents/glucose-record.html/0245e739-6b0e-44e9-aaad-0002ca04eabc
Blood Test: Basic Metabolic Panel (BMP)A basic metabolic panel (BMP), commonly ordered as part of routine medical exam, is a set of blood tests that gives information about sugar (glucose) and calcium levels, kidney function, and electrolyte and fluid balance.https://kidshealth.org/ws/RadyChildrens/en/parents/blood-test-bmp.html/d899bdac-ae4f-4205-90b1-756fd8a20d93
Blood Test: GlucoseThe blood glucose test, which measures the amount of sugar in the blood, may be done as part of a routine physical or to help diagnose diabetes.https://kidshealth.org/ws/RadyChildrens/en/parents/test-glucose.html/ca91bc44-6e9e-49c3-a43f-c13ea3e042ef
Definition: KetoacidosisKetoacidosis is a severe life-threatening condition requiring immediate treatment.https://kidshealth.org/ws/RadyChildrens/en/teens/ketoacidosis.html/5172d9e8-b254-402a-8c77-8d447ba81c5b
Definition: KetonesWhen fats are broken down for energy, chemicals called ketones appear in the blood and urine.https://kidshealth.org/ws/RadyChildrens/en/teens/ketones.html/01cc7291-4630-459e-9797-3e2c83dadcb9
Diabetes CenterDiabetes means a problem with insulin, an important hormone in the body. Find out how children with diabetes can stay healthy and do the normal stuff kids like to do.https://kidshealth.org/ws/RadyChildrens/en/kids/center/diabetes-center.html/0767277a-98f9-4541-b2f6-f3c68f43a94c
Diabetes Control: Why It's ImportantKeeping blood sugar levels under control can help keep you healthy and prevent health problems from happening down the road. Find out more.https://kidshealth.org/ws/RadyChildrens/en/kids/diabetes-control.html/5ec43be3-261e-4e07-b64b-831ea38c9fbf
Diabetes: When to Call the DoctorCaring for a child with diabetes includes knowing when to get medical help. Learn more about when to call the doctor.https://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-doctor.html/5fc3393c-7b34-4629-9843-65c2c2a21b79
Handling Diabetes When You're SickBeing sick is no fun for anyone. For people with diabetes, being sick can also affect blood sugar levels.https://kidshealth.org/ws/RadyChildrens/en/teens/diabetes-sick.html/69541ace-0bab-456f-a426-a3d04ed05b99
HypoglycemiaWhen blood glucose levels drop too low, it's called hypoglycemia. Very low blood sugar levels can cause severe symptoms that require immediate treatment.https://kidshealth.org/ws/RadyChildrens/en/parents/hypoglycemia.html/a5a7783c-d631-4896-baa4-6f28cc0d82bd
Keeping Track of Your Blood SugarTo keep your diabetes under control, stay healthy, and prevent future problems, you need to keep blood sugar levels in a healthy range. To do that, check and track those levels regularly.https://kidshealth.org/ws/RadyChildrens/en/teens/track-blood-sugar.html/723dff80-03a4-4bdf-a5e9-d21412553ea8
Managing Your Child's Diabetes on Sick DaysParents of kids with diabetes need to take a few extra steps to keep blood sugar levels under control on sick days.https://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-sick-days.html/7859fa32-6bc5-4783-9f8e-0490a4f74809
Meal Plans and DiabetesKids with diabetes don't have to follow a special diabetes diet, but they may need to pay more attention to when they eat and how much is on their plates.https://kidshealth.org/ws/RadyChildrens/en/parents/meal-plans-diabetes.html/5e58b666-d65f-49a0-8e74-204173c9f797
Medicines for DiabetesTaking medicines is a major part of staying healthy if you have diabetes because they help you keep your blood sugar levels under control.https://kidshealth.org/ws/RadyChildrens/en/teens/medicines-diabetes.html/bbb46625-eff9-4291-97bd-a4a9b50a4866
Monitoring Blood SugarTo keep blood sugar levels under control, you have to check them regularly. Learn about checking and recording your child's blood sugar levels.https://kidshealth.org/ws/RadyChildrens/en/parents/track-blood-sugar.html/3fe33959-0544-4019-97bd-85605bd27355
Type 1 Diabetes: What Is It?Diabetes is a disease that affects how the body uses glucose, a sugar that is the body's main source of fuel. In type 1 diabetes, glucose can't get into the body's cells where it's needed.https://kidshealth.org/ws/RadyChildrens/en/teens/type1.html/af259e3d-ac7d-4b73-958c-795acbc7e5c3
Type 2 Diabetes: How Is It Treated?People with type 2 diabetes need to follow a plan to manage their diabetes and stay healthy and active.https://kidshealth.org/ws/RadyChildrens/en/teens/treating-type2.html/b6458cdd-5ad3-4b39-80ba-79625d8b958c
Type 2 Diabetes: What Is It?Diabetes is a disease that affects how the body uses glucose, a sugar that is the body's main source of fuel. Find out more about a kind of diabetes called type 2 diabetes in this article for kids.https://kidshealth.org/ws/RadyChildrens/en/kids/type2.html/2133f492-3435-442e-9b0b-e12beab5aaea
What Is Hypoglycemia?Lots of people wonder if they have hypoglycemia, but the condition is not common in teens. Get the facts on hypoglycemia.https://kidshealth.org/ws/RadyChildrens/en/teens/hypoglycemia.html/68e1b77a-ed33-44fb-b4d2-acd4b5bd7f7f
When Blood Sugar Is Too HighToo much glucose in the blood can be unhealthy. Learn more about what to do when blood sugar is too high in this article for kids.https://kidshealth.org/ws/RadyChildrens/en/kids/high-blood-sugar.html/b1f31b86-0514-439b-9289-50be0310de8b
When Blood Sugar Is Too LowHypoglycemia is the medical word for low blood sugar level. It needs to be treated right away. Learn more about what to do when blood sugar is too low in this article for kids.https://kidshealth.org/ws/RadyChildrens/en/kids/low-blood-sugar.html/58cf6333-fb32-4731-a3a5-8d93292e7b04
Word! KetoacidosisKetoacidosis, a condition that can happen to people with diabetes, occurs when the body uses fat instead of glucose for fuel.https://kidshealth.org/ws/RadyChildrens/en/kids/word-ketoacidosis.html/c937036f-4eda-411b-9f86-df9820989b5a
Word! KetonesWhen fat is broken down, chemicals called ketones are produced.https://kidshealth.org/ws/RadyChildrens/en/kids/word-ketones.html/ded147c0-7c81-417b-a100-40857e36d929
kh:age-allAgesOrAgeAgnostickh:clinicalDesignation-endocrinologykh:genre-articlekh:primaryClinicalDesignation-endocrinologyDiabetes Basicshttps://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-center/diabetes-basics/e7c6c2d5-789f-475d-bead-54cfac997f23Living With Diabeteshttps://kidshealth.org/ws/RadyChildrens/en/parents/diabetes-center/living-diabetes/5a968d25-3c67-4e70-bae8-74e297508436