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General: The pancreas is an elongated organ located behind the stomach. The pancreas secretes hormones, called insulin and glucagon, which regulate the amount of sugar (glucose) in the blood. Hyperglycemia: Hyperglycemia is a hormonal disorder that occurs when there is too much sugar in the blood. Blood sugar increases when there is not enough insulin in the blood, or if the body cannot properly use insulin. If left untreated, hyperglycemia may cause serious health problems, including ketoacidosis, which occurs when toxic waste products (ketones) build up in the blood. Ketoacidosis is a life-threatening condition that requires immediate medical treatment. Hyperglycemia is caused by diabetes. Diabetes occurs when patients are not able to produce insulin or are unable to use insulin properly to process sugar. All patients with diabetes develop hyperglycemia from time to time. Diabetics may develop hyperglycemia if they eat too much, do not exercise enough, or forget to take their medications. It may also occur if patients are exposed to physical stress (such as cold temperatures or infections) or emotional stress. Symptoms of hyperglycemia typically include frequent urination, and increased thirst. Symptoms of ketoacidosis include shortness of breath, breath that smells fruity, nausea, vomiting, and dry mouth. Patients who experience these symptoms should seek immediate medical treatment. Diabetics can determine whether or not they have hyperglycemia by checking their blood sugar levels. If patients have more than 240 milligrams of sugar per deciliter of blood, they should seek medical treatment because they are at risk of developing ketoacidosis. Patients who have hyperglycemia can take steps to lower their blood sugar levels. Exercise may help decrease blood sugar levels. However, exercise should be avoided if ketoacidosis is suspected. Exercise during ketoacidosis may actually increase blood sugar levels. Patients should take their diabetic medications if the condition occurred because a dose of medication was missed. Patients who have symptoms of ketoacidosis should seek immediate medical treatment. Patients typically receive intravenous insulin therapy. Patients also require fluid and electrolyte replacement. After treatment, patients will meet with their healthcare providers to determine what triggered the episode and how to prevent it from occurring in the future. Hypoglycemia: Hypoglycemia (low blood sugar) is a hormonal disorder that occurs when there is too much insulin in the blood. Hypoglycemia occurs most often in diabetics. If diabetics take too much insulin or other medications used to treat their condition, hypoglycemia may develop. Many other conditions may lead to low blood sugar levels in patients who do not have diabetes. For instance, some types of cancer, critical illnesses (such as kidney, heart, or liver failure), and some medications may lead to hypoglycemia. Patients who drink excessive amounts of alcohol without food may develop hypoglycemia. Patients with anorexia nervosa or patients who do not eat enough food may develop hypoglycemia. Tumors of the pancreas may stimulate the pancreas to release too much insulin, which may then lead to hypoglycemia. Common symptoms include confusion, abnormal behavior, impaired vision (such as blurred or double vision), irregular heartbeat, tremors, anxiety, sweating, and hunger. In rare cases, patients may develop seizures or lose consciousness. Healthcare providers use a method called Whipple's triad to diagnose hypoglycemia. First, healthcare providers will evaluate the patient's signs and symptoms during a physical examination. In some cases, a healthcare provider may have the patient fast for 24 hours before the exam. Next, the healthcare provider will take a sample of the patient's blood to determine how much sugar is present. The last step needed to confirm a diagnosis is evaluating the patient's symptoms after blood sugar levels are raised. Patients with hypoglycemia will experience no symptoms once their blood sugar levels are increased. Treatment of hypoglycemia involves short-term steps to increase the patient's blood sugar level. It also involves long-term steps to identify and treat the underlying cause of hypoglycemia. Patients with hypoglycemia will first receive treatment to reduce symptoms. Patients may receive glucose tablets or eat foods high in sugar (such as candy) to increase blood sugar levels. In severe cases, patients may require intravenous glucose or an injection of the glucagon hormone. Once initial symptoms are treated, healthcare providers will work with the patient to determine the underlying cause of symptoms. Treating the underlying cause reduces the chances of hypoglycemia occurring in the future. If a tumor in the pancreas is causing symptoms, patients may need to have it surgically removed. If a medication is causing the condition, an alternative drug or dose may be recommended.
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