How Long Can High Blood Sugar Last Before Affecting Health?

How long can persistent high blood sugar affect the body?

Grandpa is a long-term diabetes patient.
After being diagnosed with diabetes by a Western doctor, he continued to seek treatment at an unlicensed traditional Chinese medicine clinic for a year, believing that they could cure his diabetes.
During a five-day trip with friends, he had an unrestricted diet (white rice, beer), and after urinating, the entire toilet was filled with ants.
I would like to ask the director some questions regarding diabetes:
1.
If the toilet is filled with ants after urination, how high could his blood sugar be?
2.
How many days of sustained high blood sugar can harm the body? After the five-day trip, not only was the toilet filled with ants after urination, but Grandpa also became confused and lethargic.
When I called the traditional Chinese medicine doctor, he advised Grandpa to fast and only drink vegetable and fruit juices to lower his blood sugar.
3.
Can high blood sugar lead to aphasia? After this illness, Grandpa, who used to be very talkative, has stopped speaking (he says he doesn’t know what to say).
Regarding insulin injections (my father is also a diabetes patient):
4.
If he forgets to inject insulin for four consecutive days, will his pre-meal blood sugar accumulate and rise day by day? For example, 200 on the first day, 300 on the second day, and so on?
5.
How many days of sustained high blood sugar can lead to ketoacidosis?
6.
If high blood sugar is detected, will an immediate insulin injection bring it down right away?
7.
After a meal, does blood sugar rise slowly or does it spike immediately?
8.
My father's blood sugar has never been well controlled, and his HbA1c has always been above the target range.
However, his fasting blood sugar in the morning is low.
Why is this the case? The doctor has not adjusted the dosage; he has consistently been injecting 44 units of Lantus and 6 units of Novolog.

shǎguā, 20~29 year old female. Ask Date: 2021/01/07

Dr. Wu Zongying reply Family Medicine

In patients with type 2 diabetes who have poorly controlled or elevated blood glucose levels, intracellular fluid shifts into the bloodstream, leading to hyperosmolarity, which can cause altered consciousness and dehydration.
This condition is referred to as Hyperglycemic Hyperosmolar Nonketotic Coma (HHNK), which is distinct from diabetic ketoacidosis (DKA), the latter typically occurring in type 1 diabetes.
Both conditions require urgent medical treatment.
In addition to medication, diet and exercise are crucial for diabetes management.
Poorly controlled blood glucose levels can lead to various complications in the future, such as cardiovascular disease, neuropathy, nephropathy, retinopathy, and delayed wound healing.

Reply Date: 2021/01/07

More Info

Managing diabetes effectively requires a comprehensive understanding of blood sugar levels, their implications, and the necessary lifestyle adjustments. Your grandfather's situation raises several important questions regarding high blood sugar and its effects on health.

1. High Blood Sugar and Urine Ants: The presence of ants around the toilet after urination is often a sign of high glucose levels in the urine, which can occur when blood sugar levels exceed the renal threshold (approximately 180 mg/dL). When blood sugar is persistently high, the kidneys excrete excess glucose into the urine, which can attract insects. While it’s difficult to pinpoint an exact blood sugar level based solely on this observation, it indicates that your grandfather's levels are likely significantly elevated.

2. Duration of High Blood Sugar Effects: High blood sugar can lead to acute and chronic complications. If blood sugar remains elevated for just a few days, it can cause symptoms such as increased thirst, frequent urination, fatigue, and blurred vision. Prolonged periods of high blood sugar (weeks to months) can lead to serious complications, including diabetic ketoacidosis (DKA), which is a life-threatening condition. In your grandfather's case, the five days of uncontrolled blood sugar during travel could have already begun to affect his health, especially if he experienced confusion or lethargy.

3. High Blood Sugar and Cognitive Function: Persistent high blood sugar can lead to cognitive issues, including confusion and difficulty concentrating. While it may not directly cause aphasia (loss of ability to speak), it can contribute to a general decline in cognitive function, particularly if the high levels lead to DKA or other metabolic disturbances.

4. Insulin Administration and Blood Sugar Levels: If your father forgets to administer insulin for several consecutive days, blood sugar levels can indeed accumulate and rise significantly. For example, if he starts with a blood sugar of 200 mg/dL and does not take insulin, it can rise to 300 mg/dL or higher, depending on food intake and other factors. Each day without insulin can lead to a compounding effect, especially if meals are consumed.

5. Duration for Ketoacidosis: Diabetic ketoacidosis can develop within 24 hours of significantly elevated blood sugar levels, particularly if insulin is not administered. Symptoms include nausea, vomiting, abdominal pain, and rapid breathing. If your grandfather is experiencing confusion and lethargy, it is crucial to seek immediate medical attention, as these can be signs of DKA.

6. Immediate Insulin Administration: Injecting insulin can help lower blood sugar levels, but the effect may not be instantaneous. It typically takes about 30 minutes to an hour for rapid-acting insulin to start working, and the full effect can take several hours. Therefore, while immediate administration can help, it may not provide immediate relief from symptoms.

7. Post-Meal Blood Sugar Response: Blood sugar levels generally rise after eating, but the rate of increase can vary based on the type of food consumed. Simple carbohydrates can cause a rapid spike, while complex carbohydrates and fiber can lead to a more gradual increase. Monitoring blood sugar levels after meals can provide insights into how different foods affect your grandfather's glucose levels.

8. Low Morning Blood Sugar with High HbA1c: It is possible for someone to have low fasting blood sugar levels while still having a high HbA1c. This can occur if blood sugar levels fluctuate significantly throughout the day, with high levels after meals. The HbA1c test reflects average blood sugar levels over the past two to three months, so if your father experiences spikes after meals, it can lead to a higher average despite normal fasting levels.

In conclusion, managing diabetes effectively requires regular monitoring of blood sugar levels, adherence to medication regimens, and lifestyle modifications, including diet and exercise. It is essential for your grandfather to consult with a healthcare professional to adjust his treatment plan and address any immediate health concerns. Regular follow-ups and education on diabetes management can significantly improve outcomes and quality of life.

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