Comparing Diabetic Hypoglycemia and Hyperglycemia

Diabetics must manage their blood glucose levels through medication, diet, exercise, and daily monitoring. Failure to do so can result in wildly fluctuating blood sugars that can lead to either diabetic hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Both of these conditions are dangerous for the diabetic and can lead to other medical complications.

The following list compares the many symptoms and complications these two conditions can cause.

1. The on set of hypoglycemia is rapid while the onset of hyperglycemia is gradual and can take days.
2. Hypoglycemia will cause the person to be weepy, irritable, nervous and liable and Hyperglycemia causes a person to be lethargic
3. Concentration, coordination, speaking and the ability to focus are all affected with hypoglycemia, Hyperglycemia causes confusion
4. Nightmares, shaking, hunger, headache and dizziness are seen with hypoglycemia. Thirst, abdominal pain, nausea/vomiting and thirst are associated with Hyperglycemia.
5. Hypoglycemia will cause pallor and sweating. Hyperglycemia causes flushing and signs of dehydration
6. With hypoglycemia the mucous membranes will be normal, hyperglycemia the mucous membranes are often dry and crusty.
7. The breath rate remains normal during hypoglycemia and becomes deep and rapid (kussmaul breathing) during hyperglycemia
8. Heart rate with hypoglycemia will become fast (tachycardia). During times of hyperglycemia the heart rate will become slow and weak.
9. Breath odor will be normal with hypoglycemia and smell fruity with hyperglycemia.
10. Hypoglycemia will cause tremors that can later lead to hyperreflexia, dilated pupils and seizure. Paresthesia (a sensation of tingling, prickling, or numbness of the skin) can result from hyperglycemia.
11. If untreated hypoglycemia can lead to shock and coma. Hyperglycemia will progress to acidosis and coma.
12. Hypoglycemia is a blood sugar below 60 mg/dl. Hyperglycemic is a blood sugar of 250 mg/dl or more
13. During hypoglycemia the blood will be negative for ketones and have a high/large amount during hyperglycemia.
14. Osmolarity will remain normal during hypoglycemia. Hyperglycemia will result in a high osmolarity.
15. Blood pH will remain normal during hypoglycemia and be low (7.25 or less) with hyperglycemia.
16. Hematocrit remains normal with hypoglycemia and is increased with hyperglycemia.
17. HCO3 remains normal with hypoglycemia. Hyperglycemia will cause HCO3to become less than 20 mEq/L
18. Urine output will remain normal with hypoglycemia. Polyuria (increased urination) will occur during the early stages of hyperglycemia. Oliguria (low urine output) occurs late with hyperglycemia.
19. Urine is negative for glucose with hypoglycemia and contains a large amount with hyperglycemia.
20. Ketones will be trace or negative in urine during hypoglycemia and high with hyperglycemia.
21. Hyperglycemia will cause blurred vision and hypoglycemia will cause diplopia (double vision).

Looking at the length of this comparative list it is easy to see why monitoring and managing blood glucose levels is so important for anyone with diabetes.

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