Hyperglycemia: Causes

Pathogenesis (development of disease)

The cause of hyperglycemia is either impaired insulin secretion and/or impaired insulin action (insulin resistance). Hyperglycemia is the result of a disturbance in the coordination or regulation between glucose delivery by the liver, ie, from the glycogen reservoir or by gluconeogenesis, and glucose uptake by the consuming organs. Regulation is by insulin and glucagon: insulin is responsible for promoting the uptake of glucose from the blood. It also ensures the conversion of glucose into glycogen, which is an important storage form for glucose. In this form, glucose can be stored in the liver and muscles without increasing glucose serum levels. The glucose serum level is usually within narrow limits between 70 and 110 mg/dl (3.9-6.1 mmol/l). Thus, insulin ensures that the glucose serum level remains constant. Another type of cells are the A cells. They synthesize glucagon. Among other things, this hormone stimulates specific enzymes that convert glycogen back into glucose. This increases the glucose serum level. The insulin of the B cells and the glucagon of the A cells thus have an antagonistic effect. In addition to impaired insulin secretion, impaired insulin action may be due to insulin resistance: Insulin resistance is a reduced response of cells to the hormone insulin. In particular, the muscles, liver and adipose tissue react less sensitively to the hormone insulin (= relative insulin resistance). This reduced sensitivity of the body’s cells to insulin impairs the effect of both endogenous and exogenous, i.e. injected, insulin. The most common cause of hyperglycemia is diabetes mellitus.

Etiology (Causes)

Biographic causes

  • Genetic burden
    • Cystic fibrosis (ZF) – genetic disease with autosomal recessive inheritance.

Behavioral causes

  • Nutrition
    • Intake of very large amounts of carbohydrates with a high glycemic index (mono- and disaccharides; monosaccharides and disaccharides) can lead to hyperglycemia (postprandial hyperglycemia).
    • Micronutrient deficiency (vital substances) – see prevention with micronutrients.

Disease-related causes

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Acromegaly – endocrinologic disorder caused by overproduction of growth hormone (somatotropic hormone (STH), somatotropin); with marked enlargement of body end limbs or protruding parts of the body (acras) such as hands, feet, lower jaw, chin, and eyebrow ridges.
  • Diabetes mellitus (diabetes)
  • Hyperadrenalism – increased hormonal activity of the adrenal gland.
  • Hyperpituitarism – increased hormonal activity of the pituitary gland.
  • Graves’ disease – autoimmune disease of the thyroid gland leading to hyperthyroidism (hyperthyroidism).
  • Transient infant hyperglycemia – transient increase in blood glucose in infants.

Cardiovascular system (I00-I99)

  • Acute myocardial infarction (heart attack).

Infectious and parasitic diseases (A00-B99).

  • Sepsis (blood poisoning)

Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87).

Neoplasms – tumor diseases (C00-D48).

  • Brain tumors, unspecified
  • Paraneoplastic – occurring in the setting of cancer.
  • Pheochromocytoma – usually benign (benign) tumor (about 90% of cases), which originates mainly from the adrenal gland and can lead to hypertension crises (hypertensive crisis).

Psyche – nervous system (F00-F99; G00-G99).

Injuries, poisonings, and other sequelae of external causes (S00-T98).

  • CO poisoning
  • Traumatic brain injury (TBI)

Other causes

Medication