High blood glucose usually refers to elevated levels of glucose in the blood. The normal value of fasting blood glucose is below 6.1mmol/L, and the normal value of 2-hour postprandial blood glucose is below 7.8mmol/L. If it is higher than this range, it is called hyperglycemia. It is categorized into physiological elevation and pathological elevation. Physiological hyperglycemia can be seen in 1~2 hours after meal, or when the adrenal secretion increases in emotional stress. Pathological hyperglycemia can be seen in endocrine dysfunction caused by diabetes mellitus; cranial trauma, intracranial hemorrhage, meningitis caused by increased intracranial pressure; dehydration, acute and chronic pancreatitis and liver dysfunction.

Department of Medicine

Endocrinology

Common Diseases

Diabetes mellitus, acute pancreatitis, chronic pancreatitis, hyperthyroidism, pheochromocytoma, insulinoma and so on.

Examination

Serum glucose measurement, oral glucose tolerance test, glycated hemoglobin measurement, endocrine hormone measurement.

Causes

Common Causes

1. Physiological or temporary elevation of blood glucose 1 to 2 hours after meals, after glucose injections, increased adrenal secretion from emotional stress, or after adrenaline injections.

2. Pathological hyperglycemia (1) Pancreatic islet dysfunction: insufficient insulin secretion, relative or absolute insufficiency. (2) Increased secretion of hormones that elevate blood glucose: such as anterior pituitary hyperfunction, hyperadrenocorticism, hyperthyroidism, pheochromocytoma, insulin A cell tumor. (3) Dehydration: such as vomiting, diarrhea, high fever, etc. can make blood glucose increase mildly. (4) Others: anesthesia, asphyxia, infection, epilepsy, eclampsia, etc.

Examination

Physical examination

General examination: observe changes in temperature, respiration, pulse, blood pressure, and find out whether there is eye protrusion, goiter, liver and spleen.

Laboratory examination

1. Blood routine is important for the diagnosis of infectious diseases and hematological disorders.2. Serum (plasma) glucose determination and glucose tolerance test are important for the diagnosis and monitoring of diabetes mellitus.

3. Glycated hemoglobin can effectively reflect the control of blood glucose in diabetic patients in the past 1 to 2 months, and is used as a monitoring indicator for diabetes control.

4. Serum insulin and C-peptide levels reflect the reserve function of pancreatic islet B-cells. serum insulin is normal or increased in the early stage of type 2 diabetes mellitus or obesity, and as the disease progresses, pancreatic islet function gradually diminishes, and the ability of insulin secretion decreases.

5. Endocrine hormone measurement includes adrenocorticotropic hormone, thyroid hormone, pituitary hormone, diabetic hormone, etc., which can measure the content of related hormones in the body.

Imaging tests

1. CT, magnetic **** vibration imaging can detect systemic occupying lesions, and preliminary characterization and localization.

2. Ultrasound can find out about the heart, breast and abdominal organs.

Diagnosis and treatment

Differential diagnosis

1. Diabetes mellitus

(1) Type 1 diabetes mellitus: the age of onset of the disease is young, and the onset of the disease is usually acute, with very pronounced symptoms of thirst, polydipsia, polyuria, polyphagia, fatigue, emaciation, and rapid weight loss, high blood glucose levels, ketosis as the first symptom in many patients, low serum insulin and C-peptide levels. ICA, IAA or GAD antibodies may be positive, insulin is absolutely lacking, and insulin treatment is necessary. (2) Type 2 diabetes mellitus: with