Hyperglykæmi

Hyperglykæmi, or hyperglycemia in English, is a condition defined by higher than normal concentrations of glucose in the blood. It is most commonly associated with diabetes but can occur in people without diabetes during illness, stress, or after certain medications. Clinically, fasting plasma glucose above 7.0 mmol/L (126 mg/dL) or a random glucose above 11.1 mmol/L (200 mg/dL) can indicate hyperglycemia, and an HbA1c of 6.5% or higher suggests chronic hyperglycemia over several months.

Causes and pathophysiology vary. In diabetes, insufficient insulin action or increased insulin resistance leads to reduced glucose uptake by tissues and increased hepatic glucose production. Other causes include acute illness or infection, severe stress, pancreatogenic diabetes, hormonal disorders, and medications such as corticosteroids or some antipsychotics. Non-diabetic hyperglycemia may occur transiently after meals or during acute illness.

Symptoms and presentation range from asymptomatic elevated glucose to classic signs such as increased thirst (polydipsia), frequent urination (polyuria), fatigue, and blurred vision. Severe or prolonged hyperglycemia can cause dehydration, electrolyte disturbances, and, in the context of diabetes, complications such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS).

Diagnosis relies on glucose measurements and HbA1c testing, alongside assessment for symptoms and comorbid conditions. Management aims to normalize blood glucose, treat underlying causes, and prevent complications. This may involve dietary changes, physical activity, and pharmacologic therapies (for example, metformin, insulin, or other agents) tailored to the individual. In emergencies, rapid intravenous fluids, electrolyte correction, and appropriate insulin therapy are essential.

Prevention focuses on achieving sustained glycemic control, adherence to medications, regular monitoring, and prompt management of intercurrent illness. Long-term hyperglycemia raises risks for cardiovascular disease, nephropathy, retinopathy, and neuropathy.