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Treatments and drugs
By Mayo Clinic staff
Home treatment
Talk to your doctor about managing your blood sugar and understand how different treatments can help keep your glucose levels within your goal range. Your doctor may suggest the following treatments:
- Get physical. Regular exercise is often an effective way to control your blood sugar. However, don't exercise if ketones are present in your urine. This can drive your blood sugar even higher.
- Take your medication as directed. If you have frequent episodes of hyperglycemia, your doctor may adjust the dosage or timing of your medication.
- Follow your diabetes eating plan. It helps to eat less and avoid sugary beverages. If you're having trouble sticking to your meal plan, ask your doctor or dietitian for help.
- Check your blood sugar. Monitor your blood glucose as directed by your doctor. Check more frequently if you're ill or you're concerned about severe hyperglycemia or low blood sugar (hypoglycemia).
- Adjust your insulin doses to control hyperglycemia. Adjustments to your insulin program or a supplement of short-acting insulin can help control hyperglycemia. A supplement is an extra dose of insulin used to help temporarily correct a high blood sugar level. Ask your doctor how often you need an insulin supplement if you have high blood sugar.
Emergency treatment for severe hyperglycemia
If you have signs and symptoms of diabetic ketoacidosis and diabetic hyperosmolar syndrome, you may be treated in the emergency room or admitted to the hospital. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes:
- Fluid replacement. You'll receive fluids — either orally or through a vein (intravenously) — until you're rehydrated. The fluids replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood.
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes through your veins to help keep your heart, muscles and nerve cells functioning normally.
- Insulin therapy. Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you'll receive insulin therapy — usually through a vein.
As your body chemistry returns to normal, your doctor considers what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional treatment. If your doctor suspects a bacterial infection, he or she may prescribe antibiotics. If a heart attack seems possible, your doctor may recommend further evaluation of your heart.
- Hyperglycemia (high blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html. Accessed Dec. 9, 2009.
- Nathan DM, et al. Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193.
- Shane F, et al. Metabolic and endocrine emergencies. In: Stone CK, et al. Current Diagnosis and Treatment: Emergency Medicine. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=3112282. Accessed Dec. 22, 2009.
- Collazo-Clavell ML (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 2, 2010.
- A1C. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/. Accessed Dec. 22, 2009.
- Kitabchi AE, et al. Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 22, 2009.
- Your guide to diabetes: Type 1 and type 2. Diabetes overview. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/DM/pubs/type1and2/YourGuide2Diabetes.pdf. Accessed Dec. 23, 2009.
- Checking your blood glucose. American Diabetes Association. http://www.diabetes.org/type-2-diabetes/blood-glucose-checks.jsp. Accessed March 5, 2010.
- American Diabetes Association. Standards of medical care in diabetes — 2010. Diabetes Care. 2010;33:S11
- Diagnosis and Management of Type 2 Diabetes Mellitus in Adults. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/diabetes_mellitus__type_2/management_of_type_2_diabetes_mellitus__9.html. Accessed March 3, 2010.
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