Diabetes, hypoglycaemia and hyperglycaemia

Insulin is a vital hormone for our survival. Its role is to transport glucose in the blood to cells throughout the body. In people living with diabetes, insulin production is impaired or non-existent, resulting in abnormal changes in glycemia (blood glucose levels) [1,2].

We talk about hyperglycaemia when the amount of glucose in the blood is too high [1,2,3] and hypoglycaemia when it is too low [1,2,4,5]. In cases of diabetes, the major challenge is managing blood glucose levels and minimising the condition's impact of the condition on the person’s overall health [4,5].

Diabetes and hyperglycaemia: when the blood glucose level is too high

People with diabetes are subject to increased blood glucose levels [1,2]. Known as hyperglycaemia, these frequent spikes in blood glucose can present as one or more of the most common symptoms [1,2]:

• excessive thirst;
• frequent need to urinate;
• noticeable loss of energy accompanied by muscle weakness;
• long-term fatigue;
• nausea [1,2,3]. 

Severe hyperglycaemia can lead to acute complications such as ketoacidosis and hyperosmolar coma, which are life-threatening for people with diabetes[2,3]. To reduce the risk of hypoglycaemic and hyperglycaemic periods, people living with diabetes must manage their blood glucose levels at all times [3]. Appropriate diabetes management allows them to make the necessary adjustments depending on their type of diabetes and specific health issues: regular blood glucose measurement, appropriate diet, daily insulin injections, and/or oral diabetes medication [2,3].

Diabetes and hypoglycaemia: when the blood glucose level is too low

Inversely to hyperglycaemia, hypoglycaemia occurs when the blood glucose level is too low. It is a dangerous situation that can affect people injecting insulin or taking certain oral diabetes medications [1,2,4,5]. People with type 1 diabetes are more frequently prone to hypoglycaemic episodes as treatment in this form of the condition is usually based on insulin therapy [5].

There are two categories of symptoms specific to hypoglycaemia:

• adrenergic symptoms (tremors, palpitations, nervousness, anxiety, etc.), which generally appear first and should act as warning signs [2,4,5];
• neuroglycopenic symptoms (convulsion, fatigue, confusion, etc.), which result from the lack of glucose in the brain and central nervous system [1,2,4,5].

If hypoglycaemia is not treated, it can potentially lead to coma and death. It is vital to know how to recognise signs of hypoglycaemia in a person with diabetes [1,4,5]. The blood glucose level must be measured regularly [1,2,4,5], and if too low, you must act without delay [2,5]. Drinking or eating something sweet, for example, fruit juice will quickly start to raise the blood glucose level again [1,2,4,5]. Discuss the best hypoglycaemic treatment option for you with your diabetes care team.