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When you eat, your body converts carbohydrates into glucose—a “vital fuel for the body,” says Chhaya Makhija, M.D., endocrinologist at Unified Endocrine and Diabetes Care. That glucose is released into your bloodstream. And insulin helps it move into your cells, where it gets used as energy. But when that final step doesn’t happen, glucose can build up in your bloodstream—causing you to have high blood sugar and experience hyperglycemia symptoms, which may be indicators of diabetes.
“High blood sugar—also called hyperglycemia—means there’s too much glucose in your bloodstream,” says Lisa Shah, M.D., a physician who specializes in metabolic health. This typically happens because your body doesn’t produce insulin (type 1 diabetes), doesn’t produce enough insulin (type 2 diabetes), or isn’t able to use insulin effectively (prediabetes and type 2 diabetes), she explains. But you can experience hyperglycemia even if you don’t have diabetes.
Meet the experts: Chhaya Makhija, M.D., CEO, founder, and endocrinologist at Unified Endocrine and Diabetes Care; Lisa Shah, M.D., physician, executive vice president, and chief medical officer at Twin Health; Akhil Shenoy, M.D., endocrinologist, internal medicine physician, and medical adviser at Aeroflow Diabetes.
When left untreated, high blood sugar can make you feel tired, weak, and dehydrated—and lead to potentially life-threatening complications, like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)—more on these below. But you may not experience any symptoms at first, says Akhil Shenoy, M.D., endocrinologist and internal medicine physician. “Hyperglycemia doesn’t always feel obvious right away,” Dr. Shah explains. “The symptoms can be gradual and vague.”
Because of this, experts recommend routine screening—especially if you have risk factors for diabetes. Even if you don’t, you should keep an eye out for the following high blood sugar symptoms and get to a doctor if you experience several of them at once.
High blood sugar symptoms
Frequent urination
Constantly running to the toilet? Hyperglycemia may be to blame. “When [your] blood sugar is high, your body works hard to bring it back into balance,” Dr. Shah says. Your kidneys go into overdrive trying to flush out that extra sugar. “Since the kidneys cannot simply push out solid sugar cubes, [they] draw water to go along with the sugar, leading to excessive urination,” Dr. Shenoy explains.
Increased thirst
Your body is a system. So as your kidneys work to get rid of that extra glucose—and as you start peeing more—you’ll also get thirstier. “The brain senses high glucose and signals you to drink more water,” Dr. Makhija explains. You might catch yourself reaching for your water bottle more often. You might also experience dehydration symptoms, like weakness and dry mouth.
Fatigue
Hyperglycemia can make you feel weak, exhausted, and unlike your usual self. “You might feel tired, fatigued, or sluggish,” Dr. Shah says. “You might feel foggy or have a hard time concentrating on something.” In general, you’ll just feel “off,” she explains. And as time goes on, you might notice more obvious high blood sugar symptoms, like increased thirst and urination.
Persistent hunger
When you have high blood sugar, glucose gets “stuck” in your bloodstream, Dr. Shenoy explains. “Meanwhile, the cells of the body—such as the brain, the heart, and the muscle cells—are not receiving the sugar that is needed for normal function,” he says. Your body may try to compensate by going into “starvation mode,” making you feel hungrier than usual.
Weight loss
High blood sugar can cause rapid, unexplained weight loss—for a couple of different reasons. When your body can’t rely on glucose for energy, it starts burning fat and muscle instead, per the Cleveland Clinic. “This is an unhealthy type of weight loss,” Dr. Shenoy explains. Urinating more and dehydration can also contribute to weight loss, Dr. Makhija adds.
Blurry vision
Prolonged high glucose may damage blood vessels and nerves throughout the body—including your eyes. The macula (a part of the eye) can swell due to leaky blood vessels (known as macular edema), resulting in blurry vision. While diabetic retinopathy tends to happen after very long periods of high blood sugars, causing leaking blood vessels or new abnormal ones to grow, this tends to lead to blindness. Again, that’s the worst-case scenario, and it often takes a while to occur.
Hyperglycemia may make your vision blurry, simply because it makes you dehydrated. “Dehydration affects the eyes, particularly the retinas, which have a rich blood supply,” Dr. Makhija says. When you’re low on fluids, your eyes may get blurry. This is usually a temporary condition. “[But] if sugars remain high for many years, the eye can be permanently damaged,” Dr. Shenoy explains.
Frequent infections
Chronic high blood sugar “impairs the immune response,” making it harder for your body to fight off infections, Dr. Makhija explains. And being dehydrated all the time certainly doesn’t help, she adds. Because of this, you may find yourself getting sick more often—and staying sick longer than you normally would.
Slow-healing wounds
Since hyperglycemia impacts your immune response, it can also make it harder for your body to heal cuts and bruises. Chronic high blood sugar can also cause poor circulation and nerve damage, which can “reduce awareness of injury and delay healing,” compounding the problem, Dr. Makhija adds.
Fruity breath
Fruity breath isn’t merely a sign of high blood sugar—it’s a symptom of diabetic ketoacidosis (DKA), a dangerous hyperglycemia complication. When your body starts burning protein and fat for energy, it releases ketones, Dr. Makhija explains. One of these ketones, acetone, can make your breath smell fruity or metallic—and it’s a warning sign you need to see a doctor ASAP. Untreated DKA can lead to death, so head to the emergency room, stat.
Confusion
High blood sugar can cause fatigue and brain fog. But if those symptoms become more severe—and you feel confused, disoriented, or delirious—you may need immediate medical care. These “changes in mental status” may be symptoms of DKA or hyperosmolar hyperglycemic state (HHS), potentially life-threatening hyperglycemia complications, per Yale Medicine.
Upset stomach
Nausea, vomiting, and stomach cramps are warning signs of DKA. When your body can’t rely on glucose for energy, it starts to burn fat and protein—and releases ketones in the process. As those ketones build up in your gastrointestinal tract, they can upset your stomach. “If you experience nausea, vomiting, abdominal pain, or mental fog, check your ketones and seek urgent care,” Dr. Makhija says. Ketone Sticks are over-the-counter test strips that detect ketones in the urine.
High blood sugar complications
Though high blood sugar starts subtly, it can cause serious complications if left untreated. “You may not feel symptoms in the early stages, but long-term high blood sugar can quietly cause irreversible damage,” Dr. Makhija says.
When glucose builds up in your bloodstream, it can damage your blood vessels—and subsequently your organs and nerves, Dr. Shenoy explains. Chronic high blood sugar can also lead to diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), two serious complications that can cause coma, organ damage, and death in severe cases.
Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis (DKA) is a serious complication of high blood sugar that’s especially common in people with type 1 diabetes, explains Dr. Makhija. When your body can’t rely on glucose for energy, it starts breaking down fat and protein instead. “A byproduct of this process is ketones, which are acidic compounds that build up in the blood and make it dangerously acidic,” Dr. Shah says.
Per the Cleveland Clinic and Yale Medicine, DKA symptoms may include:
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Increased thirst or dehydration
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Nausea, vomiting, and stomach cramps
When left untreated, DKA may cause a range of dangerous complications, including organ damage, coma, and even death, per the Cleveland Clinic. “DKA is a life-threatening emergency and requires urgent treatment,” Dr. Makhija says.
Hyperosmolar hyperglycemic state (HHS)
Hyperosmolar hyperglycemic state (HHS) is another dangerous hyperglycemia complication, but it’s more common among people with type 2 diabetes, Dr. Makhija explains. When your blood sugar stays high for too long, it can cause extreme dehydration and confusion—without the excess ketones you see in DKA, Dr. Shenoy says.
“HHS is similar [to DKA] in that blood sugar is extremely high, but your body produces enough insulin to prevent ketones from building up,” Dr. Shah says. “Instead, the problem is that the excess sugar makes your blood very concentrated. Your body then tries to dilute it by pulling water from elsewhere into the bloodstream, which exacerbates dehydration and throws off electrolyte balance.”
Per the Cleveland Clinic and Yale Medicine, HHS symptoms include:
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Increased thirst or dehydration
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Weakness, especially on one side of the body
The bottom line
A routine blood test (or even a finger prick) can give your doctor insight into your levels. The good news, when caught early, there are many medications available (from Ozempic to full-on insulin) to help manage blood sugars. If you have the symptoms on this list or are simply concerned that your blood sugar is high, ask your healthcare provider about next steps. If you believe you are experiencing DKA or HHS, seek immediate treatment. In severe cases, these conditions may cause seizures, organ damage, coma, and death. “If symptoms escalate or you’re unsure, call 911 or go to the emergency room,” Dr. Makhija says. “DKA and HHS are not manageable at home.”
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