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Hyperglycemia

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...

Hypoglycemia and Glucagon

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...

Hypoglycemia

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...

Type I Diabetes III: Clinical Manifestations

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...

Oral Hypoglycemic Agents: Glinides

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...

Oral Hypoglycemic Agents: Biguanides and Glitazones

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...

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Updated: Jun 23, 2026

Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice

Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice

Published on: January 26, 2024

Glucocorticoid-induced hyperglycemia.

John N Clore¹, Linda Thurby-Hay

¹Division of Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, Virginia 23298, USA. jclore@mcvh-vcu.edu

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|May 21, 2009

Summary

Glucocorticoid-induced hyperglycemia is common and increases diabetes risk. Early recognition and proactive management strategies are crucial for effective treatment in various clinical settings.

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Last Updated: Jun 23, 2026

Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice

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Published on: January 26, 2024

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

Endocrinology
Pharmacology

Background:

Glucocorticoid therapy is widely used but can induce hyperglycemia.
Hyperglycemia is common in patients with and without diabetes receiving glucocorticoids.

Purpose of the Study:

To review literature on glucocorticoid-induced hyperglycemia.
To provide a treatment strategy for this condition.

Main Methods:

Electronic (MEDLINE) and library review of literature.
Literature search from 1950 to March 2009.

Main Results:

Glucocorticoid-induced hyperglycemia is frequent, with an odds ratio of 1.5-2.5 for new-onset diabetes.
Dose, duration, age, and BMI are key risk factors.
Underestimation of risk and focus on fasting glucose contribute to undertreatment.

Conclusions:

Glucocorticoid-induced hyperglycemia is treatable with proper recognition.
A proactive management schema for inpatient and outpatient settings is proposed.