Hypers

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Duane Charles

Duane Charles

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I was wondering at what point does it become considered that you’re having a hyper, or is it like D itself different for everyone?
 
To answer my own question and this surprised me but a Hyper is classed as being above 7 prior to eating and 8.5 two hours later. I didn’t realise it was that low.
 
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Duane62 said:
To answer my own question and this surprised me but a Hyper is classed as being above 7 prior to eating and 8.2 two hours later. I didn’t realise it was that low.
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I personally think that is stretching it! For me a hyper is mid teens or above, but I don't think there is a definitive answer.
 
rebrascora said:
I personally think that is stretching it! For me a hyper is mid teens or above, but I don't think there is a definitive answer.
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It may also be different for each person. However the info came from the Diabetes UK website
 
Is there an 'official' definition?

I've seen a definition of 10mmol/l two hours after eating as being 'hyperglycaemia' on another website.
 
harbottle said:
Is there an 'official' definition?

I've seen a definition of 10mmol/l two hours after eating as being 'hyperglycaemia' on another website.
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Perhaps there’s someone on the forum who can answer the question. However, I do believe that everyone is different and also the way D treats them and in how they cope/live with it.
 
Duane62 said:
It may also be different for each person. However the info came from the Diabetes UK website
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Yes... Well.... Don't take everything on the Diabetes UK website as an absolute! There are quite a few things there I would disagree with. To be fair, there are few things with diabetes that have absolute answers.
 
I think a more important value is the length of time levels are high, as this is what causes the problems.

Wikipedia has its own idea, with a caveat of 'it depends':

Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/L (200 mg/dL), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/L (~250–300 mg/dL). A subject with a consistent range between ~5.6 and ~7 mmol/L (100–126 mg/dL) (American Diabetes Association guidelines) is considered slightly hyperglycemic, and above 7 mmol/L (126 mg/dL) is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average, however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time.
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I think it's important to recognise the distinction between hypo & hyper. The notion of "having a hyper" isn't really comparable to "having a hypo". Hypo is typically a defined event that requires immediate treatment. Hyper, as seen from previous replies, can have various meanings both in level & duration. So theoretically you could be "having a hyper" after eating, but that would be perfectly normal & require no action.

In general for us T2s, I think a sensible definition would be a sustained period of days of being in excess of double digits.
 
Personally I've usually considered that once my BG meter starts suggesting I better test for ketones, which is at 13.0 then anything above that will automatically be hyper - but I've never asked any doctor or specialist nurse to define it.
 
Oh - and it certainly hasn't stopped me being well above that level at times, either.
 
Duane,
As RBZ said the main worry is hypo and the risk of a clinical event.So going Hypo so below 3.9 is to be guarded against and requires attendant action in a timely manner to prevent symptomatic hypo.
There is no specific point defining hyper though some will say 10 as in above targeted range whereas more likely people will class it as above 13.
However it is the time you spend at that hyper level over long periods that is the issue as that is associated with long term complications but short excursions into that Territory are very much within the burdens of tolerance
 
I do agree about hypo’s being more important. That was one of the things I learned as a volunteer first aider with St John Ambulance. It’s just that nobody ever talked about BG levels and hypers, hence my question.
 
Duane62 said:
I was wondering at what point does it become considered that you’re having a hyper, or is it like D itself different for everyone?
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With the advantage of having read all the earlier replies, my conclusion is that:

The number displayed on any meter is not necessarily absolutely accurate, so some caution is needed with what one sees.​
The low threshold is much more critical than a high threshold, because hypo is dangerous as well as unpleasant and high can affect each of us fairly differently.​
Lastly our European units in mmol/L almost certainly originate from American units such as mg/dl and ours have some variation from the American units just because of rounding off from nos that were themselves probably originally rounded off.​

Almost 4 years ago a Consultant wrote about my frequent hypos calling them "excursions". I was pretty miffed since he didn't write about what could be done to help and just reading his report made it sound more like holidays than nasty, potentially dangerous lows.

I think a hyper above 7 might fairly be considered as an excursion but in the same breath should not be treated as at all significant at 7.1 or even 8. However, in my opinion, sustained time in double figures should be monitored and responded to (CGM has a big role in this) and once above 15 the ketone risk should also be monitored.

I note the Wiki remark that 11 is a possible threshold, which is close to the convenient round number of 200 when expressed in the American units of mg/dl. It seems quite probable that in previous decades the American Diabetes Association (ADA) had considerable influence on various criteria and then conversion from the American units to metric (for blood glucose multiply by 18) brought about certain clumsy metric figures which then get "rounded" to make them more memorable. "Four is the floor" would be such an example for a hypo alert; the American equivalent is 70mg/dl which converts into 3.9 mmol/L. Noteworthy is that if we accept that 3.5 mmol/L is close to the real hypo point, this converts into 63 for mg/dl - another very unmemorable figure. I wonder what number in mg/dl is deemed to be the real US equivalent, rather than the rounded up 70mg/dl.

As you, @Duane62 have rightly remarked previously we are all different. There are members on this forum who have a hyper awareness even for quite a low excursion into 10+ . This awareness isn't necessarily very debilitating, in the way an excursion to below 3.5 can be; but some people feel sluggish or worse and generally below par. I don't seem to have that awareness at all when above 10; but that could be because I have no panc'y so am missing all the panc'y hormones and enzymes including somatostatin and pancreatic polypeptide both of which play a part in regulating between insulin and glucose in one's blood.

Just my thoughts from both interesting threads about hypo and hyper thresholds.
 
Sorry, I have just realised that @Tdm started the thread about hypo and 3.5.
 
I must be in a permanent hyper as I haven’t been in single figures over the past week. In fact my morning reading today mentioned ketones. Something else I’ll talk to my GP about on Thursday.

The key from this thread is we are all aware of how our bodies react to our BS levels and act accordingly.
 
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