So what do you consider a higher dose and what do you consider to be incredibly high?
mands
My definition of 'incredibly high' is relates to a given patient's presentation. People don't typically get symptomatic until levels get in the neighborhood of 300.
Hypoglycemia is much more serious than hyperglycemia as the brain NEEDS glucose, it doesn't take much deviation from normal ranges to cause brain damage/death.
Too much blood sugar on the other hand is relatively benign until levels get extremely high, acute issues are generally limited to the increased sugar content creating a high osmolarity which draws water and causes dehydration. Fatal hyperglycemia is typically refractory to the dehydration causing hypokalemia(decreased serum potassium) which creates a fatal arrhythmia.
A person's BGL needs to get quite high to cause dehydration to that extent. The blood sugar itself isn't even the main issue, ketones(the byproduct of fat metabolism) are also a diuretic which worsens the problem. High levels of ketones also create acidosis and the drop of blood PH removes even more potassium from the cells. The situation essentially snowballs into a complete clusterfuck.
In reply to your initial question, the state of dehydration/hypokalemia is just as important as the glucose reading itself in determining how dangerous a reading is, which in the field can only be guesstimated via skin tugor and the T wave amplitude on an EKG. In general though, I typically don't get
too worried until levels reach 500+.
Incredibly small deviations above/below normal glucose levels that are prolonged over years can cause a host of extremely serious issues. We can both agree on that and I believe is what you were trying to get at, I just don't see fatal hyperglycemia resulting from HGH being a plausible scenario.