Hyperglycemia vs. Hypoglycemia

Esme12, ASN, BSN, RN · Nov 22, 2013

We are happy to help.....but we need to know what you think first. Which do you think would be "scarier and why? Then we can help you.

203bravo, MSN, APRN · Nov 22, 2013

what do you mean by scarier? more clinically acute?

Ruba · Nov 22, 2013

We are happy to help.....but we need to know what you think first. Which do you think would be "scarier and why? Then we can help you.

I think hypoglycemia... I read that the brain uses 25% of the body's glucose and if the patient was not able to get enough, they would slip into a coma. I've seen A lot of patients with high blood sugar levels but I've never seen a patient who is hypoglycemic (weird, right?)

meanmaryjean, DNP, RN · Nov 22, 2013

Ruba- you are correct.

krisiepoo · Nov 22, 2013

I think hypoglycemia... I read that the brain uses 25% of the body's glucose and if the patient was not able to get enough, they would slip into a coma. I've seen A lot of patients with high blood sugar levels but I've never seen a patient who is hypoglycemic (weird, right?)

however, when I worked in case management I had several people who stroked out d/t hyperglycemia. One had a brain stem stroke, that's pretty darned scary, too. I think 'scary' depends on the situation, the person, and the characteristics of how they manifest their hypo- or hyper- states

Ruba · Nov 22, 2013

however, when I worked in case management I had several people who stroked out d/t hyperglycemia. One had a brain stem stroke, that's pretty darned scary, too. I think 'scary' depends on the situation, the person, and the characteristics of how they manifest their hypo- or hyper- states

hmmm I guess you're right. Do you remember how high their sugar levels were?

nurseprnRN, BSN, RN · Nov 22, 2013

I think hypoglycemia... I read that the brain uses 25% of the body's glucose and if the patient was not able to get enough, they would slip into a coma. I've seen A lot of patients with high blood sugar levels but I've never seen a patient who is hypoglycemic (weird, right?)

Exactly. Good reasoning. :flwrhrts:

While hyperglycemia can have bad consequences, it is far more likely that hypoglycemia will kill somebody in a hurry. This is why the paramedics have protocols to institute when they find somebody down and unresponsive for unknown reasons-- the protocols often include naloxone, to reverse any onboard opioids there might be (no harm if there aren't), and a good whopping hit of glucose. If the person is down because his glucose is 600, a dose bumping it to 700 won't make a lot of difference, but if he's at 35, it will bump him to a normal range and save his life.

Esme12, ASN, BSN, RN · Nov 22, 2013

Patients who are diabetic can tolerate a high glucose longer.....while the low glucose is life threatening immediately and they cannot tolerate it for any length of time.

If I have a patient with a glucose of 400 and a patient with a glucose of 35 I will treat the 35 FIRST then I will treat the glucose of 400.

See you critically thought it out and found your answer!!!

Good for you!

Ruba · Nov 23, 2013

Thank you all!

tsm007 · Nov 23, 2013

Hmm, I have 2 diabetic kids so I tend to jump in on diabetes questions. I find a lot of people mix these up and I can explain it over and over again, but it doesn't seem to stick. Both can be scary, I've seen both, but hyperglycemia takes a while to get there and then takes a while to cause problems as well. So if someone's in DKA it usually takes them a while to get there (my personal experience has been 24-48 hours of being sick) and they've had lots of warning signs along the way. Low blood sugars on the other hand if not treated IMMEDIATELY can get really bad and really scary. That is how I understand the big differences between the two - it's not so much which one is scarier, but which one needs to be treated immediately. (I'm still a nursing student as well by the way, but this is one area I feel pretty comfortable with.)

Esme12, ASN, BSN, RN · Nov 23, 2013

DKA in children is very different from an adult...children are much more "fragile" and don't tolerate changes of any kind really. The issue is which to treat first which remains the hypoglycemia for it has deleterious effects much quicker.