Hyperglycemia

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Contents 1 More Specific Terms 2 Etiology 3 Pathology 4 Clinical-manifestations 5 Laboratory 6 Management 7 More General Terms 8 Additional Terms 9 References

More Specific Terms

• hyperglycemic-hyperosmolar syndrome; hyperglycemic-hyperosmolar nonketotic coma (HHNC)

Etiology

• diabetes mellitus
• pre- diabetes

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

• see glycemic control & diabetes mellitus

More General Terms

• sign/symptom

Additional Terms

• diabetes mellitus
• glucose in serum/plasma
• hypoglycemia

References

1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 830
2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
3. Prescriber's Letter 9(1):4 2002
4. Prescriber's Letter 13(4): 2006 Inpatient Management of Hyperglycemia Detail-Document#: [1] (subscription needed) [2]
5. Henry's Clinical Diagnosis & Management by Laboratory Methods, 21st edition, McPherson RA & Pincus MR (es), W.B. Saunders Co., Philadelphia, PA. 2007, page 160

hyperglycemia