The NDSS is administered by Diabetes Australia

Managing hyperglycaemia

There’ll be times when your blood glucose level isn’t what you expected. Let’s find out what it means when your blood glucose is too high, what to look for and what to do.

What is hyperglycaemia?

If your blood glucose level is above your target range, it’s called hyperglycaemia.

The common reasons you might develop hyperglycaemia are:

  • you’re sick from an infection
  • you’re not getting enough insulin for the carbohydrate (carbs) you’re eating or drinking
  • you’ve missed insulin doses
  • you’re very stressed
  • you’re not as active as you usually are
  • you’ve over-treated your low blood glucose levels (hypoglycaemia or hypos for short).

How to know when it's hyperglycaemia?

Knowing the signs and symptoms can help you manage hyperglycaemia. When blood glucose levels are only a little higher than your target, you may not feel any symptoms. You’ll only know from checking your blood glucose levels.

If your blood glucose level continues to rise, you may notice some or all these symptoms:

  • passing urine (peeing) more often, especially at night
  • feeling very thirsty
  • feeling tired and weak
  • having headaches
  • having blurred vision
  • losing weight.

You may remember these symptoms from the time before you were diagnosed with type 1 diabetes.

Hyperglycaemia can become serious. If left untreated, the liver starts to break down fat for fuel, causing a build up of acid in the blood called ketones.

This is called diabetic ketoacidosis or DKA. The symptoms to watch for are: 

  • fruity-smelling breath
  • nausea and vomiting
  • tummy pain
  • shortness of breath
  • dehydration such as a very dry mouth
  • confusion.

Your diabetes health professionals will ask you to check for ketones any time your blood glucose level is 15 mmol/L or higher.

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Diabetic ketoacidosis is an emergency

If the ketones in your bloodstream are more than 1.5 mmol/L (or moderate to large in your urine) you can have DKA. DKA is a medical emergency, and you need urgent medical care.

What to do if your blood glucose level is above your target

If your blood glucose level is high for a short time, you know the reason and you’re feeling well, treatment may not be necessary. Continue to check your blood glucose level. If you’re using continuous or flash glucose monitoring (CGM or Flash GM), you can set an alarm to alert you to when the glucose is above your target. This can help you track how you’re going.

Let’s find out what you can do to reduce your risk of hyperglycaemia

  • Check your blood glucose regularly.
  • You may choose to use CGM or Flash GM to check your glucose level through the day and night and set an alarm to alert you when your glucose is tracking higher.
  • Counting your carbohydrates (carbs) can help you to work out your bolus insulin dose.
  • Take your insulin and other medication as prescribed.
  • Look for patterns of when your blood glucose is above your target.
  • Manage your sleep and stress.
  • Have a sick day action plan.

Read or download our CGM, Flash GM and Blood glucose monitoring fact sheets.

Managing hyperglycaemia

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Determine the cause

It may be just a reaction to what you’ve been doing, what you’ve eaten, or how you’re feeling. If your blood glucose levels continue to stay above your target, you may need extra insulin. This is called a ‘correction’ dose.

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Ask for help

Ask your doctor or diabetes nurse practitioner about how and when to use insulin correction doses and ask them to give you a written sick day action plan.

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Let a friend or family member know that you are unwell

Tell them about your sick day action plan in case you need help. If possible, have someone stay with you or check on you frequently.

Other causes of hyperglycaemia

There are many other reasons why your blood glucose levels may be too high, but it also may be for no reason at all. Reasons why your blood glucose levels may be high include:

Using insulin that is out of date or has been accidentally frozen

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Eating too many carbs, unhealthy fats or sweet foods or drinks

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Feeling super excited

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Reacting to a vaccine.
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Puberty and other hormones.
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Faulty equipment, if you are using CGM or Flash GM recheck with a blood glucose meter to confirm hyperglycaemia.

If you are using CGM or Flash GM, always recheck with a blood glucose meter to confirm hyperglycaemia.

Hyperglycaemia and your sick day action plan

When you’re ill or sick, it can be a challenge keeping your blood glucose levels in your target range. Whether the hyperglycaemia is from an infection or just a reaction to not sleeping well, or stress.

When this happens your body releases stress hormones, which increases the amount of glucose the liver releases into the bloodstream. In most situations, having a sick day action plan can help you manage a sick day. Checking blood glucose levels and ketones, drinking fluids such as water, following your sick day action plan and getting support from your diabetes health professionals can reduce the risk of getting DKA.

Don’t wait until you are sick to ask your diabetes health professionals about a sick day action plan. Once you have your plan, it needs to cover:

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When to check blood glucose levels and ketones

What to do with your insulin dose

What to eat and drink to keep hydrated and your blood glucose level from dropping too low

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What medication to take to treat the illness

When to seek help

When to check for ketones

Always check for ketones if:

  • your blood glucose level is 15 mmol/L or above
  • you’re sick or feel unwell, even if your blood glucose level is less than 15 mmol/L.

Your diabetes health professional will help you decide the best way for you to check for:

  • you can check for blood ketones using a compatible blood glucose meter and blood ketone strips OR
  • urine ketones using urine ketone strips (subsidised through the NDSS).

Drinking water will help reduce the risk of dehydration. Continue to check your blood glucose levels and ketones every 2-4 hours. If the ketones in your bloodstream are more than 1.5 mmol/L (or moderate to high in your urine) follow your sick day action plan. Start straight away to avoid emergency problems like DKA. DKA is best treated with fluids and insulin, usually in hospital.

When to seek medical attention

In most situations you’ll be able to manage hyperglycaemia at home. Use your sick day action plan as a guide, as well as the support from your diabetes health professionals and your family. If there’s no improvement, it has become a medical emergency and you’ll need to go to hospital for treatment. DKA is serious if it isn’t treated fast. You know your own body and if you feel your symptoms are getting worse seek emergency medical care. Here are some of the warning signs to look out for.

Here are some of the warning signs to look out for

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Your glucose level isn’t improving or the ketones in your blood or urine is increasing

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You’re getting drowsy and confused, have signs of dehydration such as a headache, or have severe tummy pain or difficulty breathing

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You’ve been vomiting more than 2 hours or can’t drink any fluids

The symptoms of your illness aren’t improving such as a high temperature or headache

Try and protect yourself against getting sick

Talk to your diabetes health professionals about vaccines such as the flu injection. Washing your hands and avoiding people who are sick seems simple but is effective in keeping you well.

Hyperglycaemia quiz

Check your knowledge!

This information is intended as a guide only. It should not replace individual medical advice. If you have any concerns about your health, or further questions, you should contact your health professional.