What are potential complications of untreated hyperglycemia?

Untreated hyperglycemia can lead to serious complications, with diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) being two of the most critical.

Diabetic ketoacidosis is a condition that occurs primarily in individuals with type 1 diabetes, but can also occur in type 2 diabetes under certain circumstances. It is characterized by a triad of hyperglycemia, acidosis (due to the production of ketones), and an elevated anion gap. If glucose levels remain excessively high, the body begins to break down fats for energy, leading to an accumulation of ketones, which can result in life-threatening metabolic acidosis.

Hyperglycemic hyperosmolar state, on the other hand, often occurs in older adults with type 2 diabetes. It is characterized by extremely high blood glucose levels and severe dehydration, along with a lack of significant ketone production. This state can lead to increased osmolarity and symptoms such as confusion, dehydration, and even coma. HHS may develop over days to weeks, making it a unique emergency compared to the rapid onset of DKA.

Both DKA and HHS highlight the severe consequences of hyperglycemia, emphasizing the necessity for timely recognition and