Blood Sugar Levels Over 20 mmol/L: How Serious Is It?

Blood sugar levels exceeding 20 mmol/L are considered significantly elevated, whether measured as fasting blood glucose or two hours after a meal. This level of blood sugar is abnormal and indicates a serious health concern. If left unaddressed, it can lead to a range of complications, both acute and chronic, making prompt medical attention essential.

Normal Blood Sugar Ranges

Typically, the normal fasting blood sugar range is between 3.9 and 6.1 mmol/L. Two hours after eating, blood glucose levels should fall between 3.9 and 7.8 mmol/L. When levels rise above 20 mmol/L, especially on a regular basis, the risk of developing both immediate and long-term complications increases dramatically.

Potential Acute Complications

Diabetic Ketoacidosis (DKA)

One of the most urgent concerns with extremely high blood sugar is diabetic ketoacidosis. This condition is more common in younger individuals and can occur when blood glucose levels exceed 11 mmol/L. Symptoms include deep and rapid breathing, a fruity odor on the breath (similar to rotten apples), confusion, and in severe cases, coma. Immediate hospitalization is required to stabilize the condition through insulin therapy, fluid replacement, and electrolyte correction.

Hyperosmolar Hyperglycemic State (HHS)

This condition typically affects older adults and usually occurs when blood sugar levels rise above 33.3 mmol/L. However, even levels above 20 mmol/L can begin to increase the risk, although less commonly. Symptoms include excessive thirst, frequent urination, and severe dehydration. Without timely treatment, HHS can lead to seizures, loss of consciousness, and even death. Hospital care is crucial to lower blood sugar levels and restore fluid and electrolyte balance.

Long-Term Chronic Complications

Consistently high blood sugar levels above 20 mmol/L can lead to a number of chronic complications associated with diabetes. These include:

Diabetic Nephropathy: Damage to the kidneys that can progress to kidney failure.
Retinopathy: Eye damage that can lead to vision loss or blindness.
Neuropathy: Nerve damage causing numbness, tingling, or pain, especially in the extremities.
Cardiovascular Disease: Increased risk of heart attack, stroke, and peripheral artery disease.
Diabetic Foot: Poor circulation and nerve damage can lead to ulcers and infections, sometimes requiring amputation.

Managing these complications begins with strict blood sugar control. In the early stages, maintaining healthy glucose and blood pressure levels can significantly improve outcomes. Lifestyle modifications, including a balanced diet, regular exercise, and avoiding smoking and excessive alcohol consumption, are also vital in reducing risk.

What Should You Do?

If you or someone you know experiences blood sugar levels consistently above 20 mmol/L, it is crucial to seek medical care immediately. Early diagnosis and treatment can prevent life-threatening complications and improve long-term health outcomes. Follow-up care, including regular blood sugar monitoring and adherence to prescribed medications, is essential. Additionally, routine check-ups with healthcare professionals such as endocrinologists, dietitians, and specialists in diabetes care can help manage and reduce the risk of complications.

Remember, high blood sugar is a warning sign. Taking action early can make a life-changing difference in maintaining your health and quality of life.