Blood glucose is commonly considered too high if it is higher than 130 mg/dl before a meal or higher than 180 mg/dl two hours after the first bite of a meal. However, most of the signs and symptoms of high blood glucose don’t appear until the blood glucose level is higher than 250 mg/dl. Some of the symptoms have a rapid onset, while others require a long period of high blood glucose to set in.It’s important to note that individuals differ in their sensitivity to the effects of high blood glucose: Some people feel symptoms more quickly or more strongly than others. But each sign or symptom has a biological underpinning, or a specific cause behind the effect.Hyperglycemia can be acute or chronic. Acute hyperglycemialasts only briefly and is often the result of a high-carbohydrate meal, a missed dose of medicine, stress, or illness. Chronic hyperglycemia, on the other hand, is a state of long-term elevated blood glucose. It is often the result of undiagnosed diabetes or of an inadequate diabetes treatment regimen. Chronic hyperglycemia is arguably the more dangerous of the two, as long-term elevated blood glucose has a toxic effect on the body’s tissues. In fact, some of the signs of high blood glucose are actually the aftermath of cellular damage caused by high blood glucose.
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The classic symptoms of high blood glucose are polyuria, polydipsia, and polyphagia. In plain English, that means excessive urination, excessive thirst, and excessive hunger. Any doctor who hears this trio of complaints will reach for a blood glucose meter. But often, the person experiencing these symptoms doesn’t notice them right away. This is partly because they often creep up on a person in a gradual fashion, and partly because the signs and symptoms of high blood glucose aren’t well known among people who don’t have diabetes – or don’t know they have diabetes.
Here’s what’s behind these classic three symptoms:
Excessive urination. Polyuria is the result of a runaway biological and chemical chain reaction that feeds on itself. It starts in the blood, where high glucose concentrations osmotically pull intracellular fluid into the bloodstream. This is the body’s attempt to equalize the concentration of glucose in the blood with the concentration in the cells. By diluting the blood with intracellular fluid, the body brings the glucose concentration of the blood closer to normal. Initially, this increases the fluid volume of the blood while dehydrating the cells.
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Meanwhile, in the kidneys, a related dysfunction is brewing. Normally, the kidneys serve as filters, removing waste products and returning cleansed fluid back to the body. The return of the cleansed fluid – or reabsorption of fluid – takes place in the renal tubules, the internal structure of the million or so filtering nephrons in each kidney. However, when the glucose concentration of the fluid entering the nephrons exceeds 250 mg/dl, the reabsorption capacity of the renal tubules is blocked, triggering what is known as osmotic diuresis –a discharge of large amounts of urine. Until the glucose levels are normalized, the renal tubules can’t regain the ability to absorb fluids.