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[hyper- + glycemia]
Abnormally high blood sugar levels. Hyperglycemia can cause numerous unwanted effects. It can impair wound healing; decrease the body’s ability to fight infections; worsen the neurological deficits found in stroke; increase the risk of death in critically ill patients; and damage the kidneys, peripheral nerves, retinae, blood vessels, and heart.
Hyperglycemia may result from damage to the insulin-secreting cells of the pancreas; infusions of dextrose; insulin resistance; obesity; overeating; a sedentary lifestyle; the stress of heart attack or other critical illnesses; or treatment with some drugs such as steroids or protease inhibitors.
In patients with diabetes mellitus, controlling blood glucose levels reduces many complications of the disease. In pregnancy, management of elevated blood sugars reduces the likelihood of overnutrition of the fetus (macrosomia). In the acutely ill patient, maintaining plasma glucose levels below 150 mg/dL reduces the length of hospital stay, helps prevent infection, improves wound healing, and reduces health care costs. Elevated blood sugars in the hospitalized patient can be managed with adjustments in nutrition, IV hydration, and IV insulin. When insulin is infused by IV, blood glucose levels should be monitored hourly and insulin doses titrated to achieve levels as close to normal as possible without producing hypoglycemia.
Among outpatients, high blood sugar levels can be reduced with caloric restriction (dieting), regular exercise, oral hypoglycemic agents, insulin, and/or withholding offending drugs. Self-blood glucose monitoring and the keeping of a blood sugar log helps patients and their health care providers to recognize and manage hyperglycemic trends. Patients with diabetes mellitus need to understand the role maintaining glycemic control plays in preventing complications of their disease. Consultation with a diabetic nurse educator can provide the necessary information (and impetus) for good management of diet, medication regimens, and exercise.