Thiazides are used to treat type 2 diabetes but it also causes severe hyperglycemia. Stress
A high proportion of patients with an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a diagnosis of diabetes. (Or perhaps stroke or myocardial infarction was caused by hyperglycemia and undiagnosed diabetes.) Human and animal studies suggest that this is not benign, and that stress-induced hyperglycemia is associated with a high risk of mortality after both stroke and myocardial infarction. Somatostatinomas and aldosteronoma-induced hypokalemia can cause hyperglycemia but usually disappears after the removal of the tumour.Stress causes hyperglycaemia via several mechanisms, including through metabolic and hormonal changes, and via increased proinflammatory cytokines that interrupt carbohydrate metabolism, leading to excessive glucose production and reduced uptake in tissues, can cause hyperglycemia.Hormones such as the growth hormone, glucagon, cortisol and catecholamines, can cause hyperglycemia when they are present in the body in excess amounts. Diagnosis
Monitoring
It is critical for patients who monitor glucose levels at home to be aware of which units of measurement their glucose meter uses. Glucose levels are measured in either:
Millimoles per liter (mmol/L) is the SI standard unit used in most countries around the world. Milligrams per deciliter (mg/dL) is used in some countries such as the United States, Japan, France, Egypt and Colombia.Scientific journals are moving towards using mmol/L; some journals now use mmol/L as the primary unit but quote mg/dL in parentheses.Glucose levels vary before and after meals, and at various times of day; the definition of "normal" varies among medical professionals.
Hemotympanum, or hematotympanum, refers to the presence of blood in the tympanic cavity of the middle ear. Hemotympanum is often the result of basilar skull fracture.Hemotympanum refers to the presence of blood in the middle ear, which is the area behind the eardrum. In most cases, the blood is trapped behind the eardrum, so no discharge is visible. Treating hemotympanum depends on the underlying cause. Presentation
The most common symptoms of hemotympanum are:

pain
sense of fullness in the ear
hearing loss

Causes
Skull fracture
A basal skull fracture is a fracture in one of the bones at the base of the skull. This is almost always caused by impact trauma such as a hard fall or a car crash. If the temporal bone is affected, one of the following may co-occur:

Auricular cerebrospinal fluid discharge
Dizziness
Bruises around the eyes or behind the ears
Facial weakness
Difficulty seeing, smelling, or hearing

Nasal packing
Following nasal surgery or frequent nosebleeds, gauze or cotton may be inserted into the nose to stop the bleeding. This process is called therapeutic nasal packing. Nasal packing sometimes causes blood to back up into the middle ear, causing hemotympanum. Removing the packing may allow the blood to drain from the ear. Antibiotics can prevent an ear infection. Bleeding disorders
Bleeding disorders, such as hemophilia or idiopathic thrombocytopenia purpura, can also cause hemotympanum. These disorders prevent proper blood clotting. In that circumstance, a mild head injury or a strong sneeze can cause hemotympanum. Anticoagulant medications
Anticoagulants, often called blood thinners, are medications that keep blood from clotting too easily.