Your body is remarkably good at hiding its own malfunctions. For a long time, everything feels fine. Then, things start to get weird. Maybe your vision blurs for a second while you're driving, or you realize you've been hitting the bathroom six times before noon. These aren't just quirks of getting older. Often, they are the quiet, persistent symptoms of very high blood sugar screaming for attention.
Hyperglycemia isn't always a "crash and burn" situation. It’s a slow creep.
When your glucose levels—the sugar in your blood—stay elevated, your organs basically start marinating in fuel they can’t use. It’s like trying to run a car engine by pouring gasoline over the exterior instead of inside the tank. The engine starves while the outside corrodes.
The Thirst That Never Ends
Most people think they’re just dehydrated. You drink a glass of water. Ten minutes later, your mouth feels like it’s full of cotton balls again. This is polydipsia. It happens because your kidneys are working overtime to filter out the excess glucose.
They can't keep up.
To flush that sugar out, your kidneys pull fluid from your tissues. This leaves you parched. You drink more. You pee more. It’s a vicious, exhausting cycle that keeps you awake half the night. Honestly, if you're suddenly waking up three times a night to use the restroom when you used to sleep through, that’s a massive red flag.
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Why You’re Tired But Can't Sleep
You’d think with all that sugar—literal energy—in your blood, you’d be bouncing off the walls. The opposite is true.
Because the insulin isn't moving that sugar into your cells, your muscles and brain are essentially starving. You feel heavy. Lethargic. It’s a specific kind of exhaustion that a nap won't fix. Doctors call this "polyphagia" when it's linked to hunger, but the fatigue is the part that hits most people first. You might find yourself craving sweets specifically, which is your brain's desperate attempt to get the energy it thinks it's missing.
It’s a cruel irony. Your blood is thick with energy, but your cells are dying for a snack.
The Warning Signs Nobody Mentions
Everyone talks about thirst, but what about your skin? Or your breath?
When blood sugar gets dangerously high—we’re talking levels that might lead toward Diabetic Ketoacidosis (DKA)—your breath might start smelling fruity. Some people say it smells like Juicy Fruit gum; others say it's more like chemical nail polish remover. That’s acetone. Your body is burning fat for fuel because it can’t get to the sugar, and the byproduct is literally poisoning your blood.
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Then there's the "brain fog." It’s not just being forgetful. It’s a genuine inability to focus.
Your brain is incredibly sensitive to glucose fluctuations. When levels spike, the osmotic pressure in your brain changes. It swells slightly. This leads to that "out of it" feeling. You might also notice your vision getting wonky. High sugar pulls fluid from the lenses of your eyes, changing their shape and making it impossible to focus on the TV or a book.
- Slow-healing cuts: A scratch on your shin that stays red for three weeks.
- Tingling feet: That "pins and needles" feeling that doesn't go away when you move.
- Recurrent infections: Yeast infections or skin sties that keep coming back.
- Unexplained weight loss: Even though you're eating more than ever.
The Nuance of "High" Numbers
What counts as "very high"? It depends on who you ask.
The American Diabetes Association generally considers anything over 180 mg/dL after a meal to be hyperglycemia. But "very high"—the kind that lands you in the ER—is usually north of 250 or 300 mg/dL.
However, some people walk around at 250 mg/dL for months without "feeling" it. Their bodies have adapted to the dysfunction. This is dangerous. Just because you don't feel like you're dying doesn't mean your kidneys and nerves aren't being permanently damaged by those symptoms of very high blood sugar.
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Real Talk: When Is It An Emergency?
If you start vomiting, or if you feel confused and "loopy," stop reading this and go to the hospital. Seriously.
DKA and HHS (Hyperglycemic Hyperosmolar State) are medical emergencies. They happen when the body becomes too acidic or too dehydrated to function. You can't "water" your way out of that at home. You need IV fluids and professional insulin management.
Actionable Steps to Take Right Now
If you recognize these signs in yourself, don't panic, but do move fast.
- Get a glucose meter. You don't need a prescription for a basic one at a pharmacy. Test yourself first thing in the morning and two hours after a meal.
- Track the data. One high reading might be a fluke (or a very large slice of cake). Five days of high readings is a pattern.
- Drink water, not "sugar-free" soda. Even if it has no calories, some sweeteners can mess with insulin sensitivity in certain people. Stick to plain water to help your kidneys flush.
- Call a primary care doctor. Tell them specifically: "I am experiencing polyuria (excessive peeing) and extreme thirst." Those specific words usually get you an appointment faster.
- Check your feet. Look for sores you didn't know were there. High sugar numbs the nerves, so you might have an infection you can't even feel.
Living with high blood sugar is like living in a house where the heater is stuck on 100 degrees. Eventually, things start to melt. Catching it early—before the "melting" starts—is the difference between a minor lifestyle adjustment and a lifelong medical struggle. Pay attention to the thirst. Listen to the fatigue. Your body doesn't have a check engine light; these symptoms are all you've got.