hyperglycemia
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Etiology
- diabetes mellitus
- pre-diabetes
- pharmaceuticals[6]
Epidemiology
- hospital admission for hypoglycemia now exceed those for hyperglycemia among older adults[7]
Pathology
- impaired insulin secretion
- diminished tissue responsiveness to insulin
- immunological distubances:
- abnormalities in granulocyte adherence, chemotaxis, phagocytosis & microbicidal function
- inhibition of attachment of complement C3 to microbial surfaces
- inactivation of bisphosphoglycerate mutase via glycation of Lys-159, may disrupt regulation of hemoglobin oxygen affinity (predicted increase in hemoglobin O2 affinity)
Clinical manifestations
- urinary frequency, polyuria
- increased thirst
- also see diabetes mellitus
Laboratory
- serum glucose increase
- urine glucose: glycosuria (+/-)
- assume diabetes mellitus
- hemoglobin A1c to assess long-term glycemic control
- urine microalbumin: early stages of diabetic nephropathy
- lipid panel
Management
More general terms
More specific terms
- hyperglycemic-hyperosmolar syndrome; hyperglycemic-hyperosmolar nonketotic coma (HHNC)
- postprandial hyperglycemia
Additional terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 830
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 17. 18 American College of Physicians, Philadelphia 1998, 2015, 2018.
- ↑ Prescriber's Letter 9(1):4 2002
- ↑ Prescriber's Letter 13(4): 2006 Inpatient Management of Hyperglycemia Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220412&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Henry's Clinical Diagnosis & Management by Laboratory Methods, 21st edition, McPherson RA & Pincus MR (es), W.B. Saunders Co., Philadelphia, PA. 2007, page 160
- ↑ 6.0 6.1 Prescriber's Letter 21(5): 2014 Drugs That Significantly Increase Blood Glucose Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=300508&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 7.0 7.1 Lipska KJ, Ross JS, Wang Y et al. National trends in US hospital admissions for hyperglycemia and hypoglycemia among Medicare beneficiaries, 1999 to 2011. JAMA Intern Med. 2014;174(7):1116-1124 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24838229
- ↑ Inzucchi SE. Clinical practice. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006 Nov 2;355(18):1903-11. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17079764