Blood glucose 300: How to Avoid Blood Sugar Highs and Lows
How to Avoid Blood Sugar Highs and Lows
Blood Sugar Highs and Lows
Glucose, or blood sugar, comes from two places — the food you eat and your liver. “Blood sugar is basically used to supply energy to the body,” explains Deborah Jane Wexler, MD, an endocrinologist in practice at Massachusetts General Hospital in Boston. For instance, one of your most valued organs — your brain — runs entirely on glucose, she notes.
Insulin moves glucose into cells to be used for energy. When you have type 2 diabetes, your body doesn’t produce enough insulin or can’t effectively use the insulin it does produce. Without insulin, glucose builds up in the blood, leading to high blood sugar levels. You may also experience a rise in blood sugar if you eat a meal high in carbs, if you don’t take enough insulin or other diabetes medication, or if you experience physical or emotional stress.
Low blood sugar can occur when you take too much insulin or other diabetes medication, skip a meal or eat fewer carbohydrates than usual, or increase your physical activity.
Monitoring your blood sugar — by making sure it doesn’t spike too high or dip too low — is an important part of managing your type 2 diabetes.
And you can start by learning the signs of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) and what steps to take to bring those levels back to normal:
Hypoglycemia: If blood sugar is too low — usually below 70 milligrams per deciliter (mg/dl) — you may have symptoms such as confusion, sweating, nervousness, nausea, and dizziness. You could even pass out, according to the ADA.
What to do: Follow the 15–15 rule. Have 15 grams of fast-acting carbohydrate — such as three to four glucose tablets, 4 ounces of fruit juice or regular soda, or a tablespoon of sugar — to raise your blood sugar, wait 15 minutes, and then check your blood sugar. If you’re still not in your target range, have 15 more grams of carbs. Repeat these steps until your blood sugar is back up to normal.
Hyperglycemia: Signs of high blood sugar include excessive thirst and urination, blurry vision, and fatigue. High blood sugar can be a problem for two reasons. Over the long term, high blood sugar quietly damages the small vessels of the eyes, kidneys, and nerves, leading to serious complications like blindness, kidney damage, and nerve damage. In the short term, it can cause weight loss and excessive urination. It also may pose a threat of coma or death. If you have blood sugar over 240 mg/dL, you may be at risk for ketoacidosis (when your body produces high levels of blood acids called ketones), which requires emergency care, according to the ADA.
What to do: If your blood sugar levels are too high, exercise can help bring them down. One note: If your blood sugar is above 240 mg/dl and you have ketones, you should not exercise. Exercising when you have ketones may make your blood sugar go even higher, according to the ADA. Talk to your doctor about the safest way to lower your blood sugar if this is the case.
Testing your blood sugar throughout the day is the best way to keep track of your levels and discover the impact food, exercise, and other activities have on your blood sugar. You should also see your doctor at least twice a year for an A1C test, which gives an overall picture of your blood sugar control for the previous two to three months.
“We strive to keep A1C under 7 percent for most people with diabetes,” says Dr. Wexler. Blood sugar that isn’t well controlled can make it hard to hit that goal.
Strategies to Control Blood Sugar
There are steps you can take to control blood sugar every day.
Educate yourself The more you know about type 2 diabetes, the more confident you’ll feel about diabetes management. That feeling of “self-efficacy” is linked with better blood sugar control, taking medication as prescribed, and making lifestyle changes such as improving your diet and exercising, researchers reported in the Summer 2014 issue of Ethnicity & Disease.
Test your blood sugar on schedule When researchers followed adults with type 2 diabetes over the course of a year, they found that those who used a structured blood sugar testing approach throughout the day had better blood sugar control than those who did not, according to an October 2013 study published in Diabetes Care. Common times to test your blood sugar include when you first wake up, before and after meals and exercise, and at bedtime. Talk to your doctor about when and how often you should test.
Exercise Physical activity increases insulin sensitivity, which can help control blood sugar. Get at least 30 minutes of moderate exercise at least five days during the week. How to tell if your intensity level is moderate? You should be able to talk but not be out of breath or able to sing out loud, according to the ADA.
And for best results, do both aerobic exercise and strength training throughout the week, researchers reported in the September 2014 issue of Diabetologia. The ADA recommends strength training at least twice a week, in addition to your 150 minutes of aerobic exercise.
Because exercise can lower blood sugar, you should keep a source of fast-acting carbohydrate on hand in case you need to treat hypoglycemia. Test your blood sugar before and after exercise to make sure it’s in a safe range.
Count your carbs Carbohydrates have the biggest impact on your blood sugar, so monitoring the amount of carbs in your meal plan can help keep blood sugar levels steady. The ADA recommends aiming for 45 to 60 grams of carbohydrate at each meal. Working with a certified diabetes educator or registered dietitian can help you set your personal goals for meals and snacks and master carb counting, notes Wexler.
Take medications as prescribed Skipping doses of your diabetes medication or taking too much can cause swings in your blood sugar levels. Always take your medication as prescribed. If you’re having trouble sticking to your medication plan, talk to your doctor about changes that can make it easier for you. He or she may recommend keeping a medication log or setting an alarm or other reminder to take your medication at the same time each day.
Improve sleep quality. “There’s evidence that people with sleep apnea and sleep deprivation have impaired glucose tolerance,” Wexler says. Health and sleep data from a study involving 6,616 European adults revealed that people with diabetes who also have obstructive sleep apnea have worse blood sugar control. The findings were published in the May 20014 issue of Chest.
Most adults should aim for seven to eight hours of shut-eye per night. Ask your doctor about undergoing a sleep study if you wake up several times during the night or have frequent trouble getting out of bed in the morning.
Getting your blood sugar under control may seem like work, but you’ll soon get used to your new habits and enjoy a healthier future.
If Your Blood Glucose is Too High or Too Low
Blood glucose that gets too high or too low can be dangerous. To stay safe and healthy, check your blood glucose regularly and watch for certain symptoms, like being very hungry, tired or sleepy. If your blood glucose is outside the normal range, take the steps described below to start feeling better.
High Blood Glucose: Hyperglycemia
Hyperglycemia means that you have too much blood glucose. It happens when your blood glucose level is around 200 mg/dL or higher. Hyperglycemia can happen if you miss taking your diabetes medications, eat too much or do not get enough exercise. Sometimes, the medications you take for other problems cause high blood glucose.
Symptoms of hyperglycemia include:
- Being very thirsty
- Being very tired
- Having blurry vision
- Having to urinate often
If you have these symptoms, check your blood glucose right away. If it’s too high, follow these steps:
- Check your blood glucose every four hours. If your level does not go down after two checks or your symptoms get worse, call a member of your diabetes team.
- Drink water or other sugar-free liquids, such as diet soda or Crystal Light.
- You may need to take an extra dose of insulin. Your diabetes educator talks with you more about this.
High Blood Glucose: Diabetic Ketoacidosis (DKA)
If your insulin level is too low, your blood glucose could become so high that it is unsafe. You might develop a serious problem called diabetic ketoacidosis (or DKA). This usually happens in people with Type 1 diabetes and those with glucose levels over 500.
If you have DKA, chemicals called ketones start to make a lot of acid in your body. The acid and high blood glucose can make you very sick. You might also become dehydrated (lose body fluid). You can prevent DKA by carefully giving yourself the correct insulin dose every day.
If you have any of the following symptoms of DKA, get to your local emergency department right away. You need to be treated with insulin and fluids that are given to you through an IV (a thin tube placed in your arm):
- Blurry vision
- Decreased appetite
- Dry mouth, eyes or skin
- Fast breathing
- Feeling confused or irritable
- Feeling very weak or tired
- Fruity-smelling breath
- Stomach pain, nausea or vomiting
Low Blood Glucose: Hypoglycemia
Hypoglycemia can occur when blood glucose drops below normal levels or drops too quickly. Your blood glucose level is too low if it is under 70 mg/dL.
Hypoglycemia can be caused by:
- A combination of these factors
- Being more active than usual
- Drinking alcohol
- Eating at the wrong time for the medications you take
- Skipping or not finishing meals or snacks
- Taking too much diabetes medication
You can have hypoglycemia without any symptoms. That makes it important to check your blood glucose levels regularly. When hypoglycemia does cause symptoms, they can include:
- Being sweaty
- Fast heartbeat
- Feeling irritable
- Feeling shaky
- Feeling tired
If you have these symptoms, check your blood glucose right away. If it is too low (under 70 mg/dL), take something with sugar right away. This quickly raises your blood glucose level. Some good options include:
- Five to six hard candies
- One-half cup (4 oz) of fruit juice or regular soda
- Three glucose tablets
You should also check your blood glucose again after 15 minutes. If it’s still low, again take something with sugar. Check your blood glucose level again after another 15 minutes. If it is still low, call a member of your diabetes team. If your next meal is more than an hour away, eat a small snack.
Should You Skip a Meal if Your Blood Glucose Is High? | Healthy Eating
By Aglaee Jacob Updated December 12, 2018
High blood glucose levels can damage the small arteries and nerves in your eyes, kidneys, heart, brain and feet over time. If you have diabetes, high blood sugar is defined as higher than 130 mg/dL when fasting and above 180 mg/dL two hours after eating, unless your doctor has specified a different target for you. Managing your blood glucose levels closely is the key to healthy living with diabetes.
If your blood glucose levels are high, don’t skip a meal; rather, try to understand the causes behind your high reading and do some damage control by eating healthy and exercising.
If your blood glucose levels are higher than they should be, start by determining what caused the rise. Did you eat more carbohydrates than usual? Carbohydrates found in grains, potatoes and sugar increase your blood sugar levels the most, and eating too much can result in high glucose levels. Are you more stressed than usual or are you feeling sick? Stress and illness also increase your blood sugar levels. Did you skip your usual walk or did your forget to take your medications? Both exercise and prescribed medications decrease your blood sugar levels. Keeping a journal of what you eat, how you feel, how much you exercise and the medications and supplements you take can help you figure out the cause of your high blood sugar.
Skipping meals can actually increase your blood glucose levels. If your body doesn’t get a regular supply of energy from food, your liver may panic and start releasing glucose into your bloodstream. This glucose can come from stored liver glycogen or can be newly synthesized from protein. Skipping a meal can cause you to have high blood glucose levels, so don’t skip a meal in an attempt to lower high blood sugar.
Instead of skipping a meal, eat a balanced meal containing protein. Protein can stimulate your pancreas to produce insulin, the hormone needed to lower your blood glucose levels. If your blood sugar levels are high, have a healthy meal at your regular meal time. Avoid high-carbohydrate foods, such as pasta, rice, breads, desserts and pastries, that could further elevate your blood glucose. Instead, have a healthy meal based on non-starchy vegetables, such as broccoli, mushrooms and onions; a serving of protein from fish, chicken or meat; and healthy fats from avocado, nuts or olive oil. Continue monitoring your blood sugar levels at regular intervals to measure the impact of your meal.
Exercise is the best strategy to help you manage your high blood glucose levels. Whenever you move by walking, cycling or gardening, the muscles of your body use up some of the extra glucose circulating in your blood. Exercise also makes your cells more sensitive to insulin, which can contribute to bringing your blood sugar levels back in the healthy range. Walking at a moderate pace is the best exercise for most people. Stay properly hydrated and keep an eye on your blood sugar levels.
Hyperglycemia | Treat High Blood Sugar Early
How to Treat High Blood Glucose
According to the Concise Oxford English Dictionary, hyperglycemia is “an excess of glucose in the bloodstream”. Depending on who you are and whether you have diabetes or not, hyperglycemia (or high blood sugar) will have a different answer. For example, without diabetes, hyperglycemia is >100 mg/dL before meals and >140 ,g/dL after meals. For diabetes, these blood sugar goals are individualized, but typically it is considered high blood sugar if your pre-meal blood sugar stays above 130 mg/dLand after meal stays above 180 mg/dL. It is natural for blood sugar levels to rise, but if they remain high consistently, then action must be taken. Being able to recognize the signs and symptoms of hyperglycemia early is helpful. Remember, that signs and symptoms may not always be present and you may not have symptoms due to high blood sugars ever.
If your blood sugar rises and STAYS up too high, it can be dangerous—and it can possibly lead to an emergency room visit, especially if you are having trouble breathing, which may be a sign of diabetic ketoacidosis. That particular topic is covered in another article. When in doubt, contact your healthcare provider to find out what to do.
Also, if your blood sugar continually remains elevated over a very long period of time (decades), the likelihood of developing long-term diabetes complications such as nerve damage, kidney failure, and heart disease rises dramatically. So it is important to keep track of when your blood sugar reaches consistently elevated levels. Just because your blood sugars have risen a little higher than your current goals, that also does not mean that you will develop long-term complications. The American Diabetes Association publishes The Standards of Medical Care every year to highlight the key recommendations for diabetes care. There are particular recommendations to reduce the risk of long-term complications. Those include:
- Annual dilated eye exam by an ophthalmologist or an optometrist
- Dental exam every 6 months
- Blood tests annually to make sure cholesterol, overall blood sugar control and kidney function are within range
- Annual foot examination
Early Signs and Symptoms of Hyperglycemia
How people generally discover that they have diabetes is due to certain symptoms that are typically associated with prolonged high blood sugar. Those include:
- Increased thirst
- Increased urination
- Increased hunger
- Blurred vision
- Infections or injuries that will not heal as quickly as in the past
By following these recommendations, it will help reduce the risk of long-term complications. But, it all starts with trying to keep the blood sugars within your goal ranges.
It is also important to realize that sometimes, there will not be symptoms at all.
Early Signs and Symptoms of Hyperglycemia
How people generally discover that they have diabetes is due to certain symptoms that are typically associated with prolonged high blood sugar. Those include:
- Increased thirst
- Increased urination
- Increased hunger
- Blurred vision
- Infections or injuries that will not heal as quickly as in the past
It is also important to realize that sometimes, there will not be symptoms at all.
Blood glucose monitoring is the best tool we have to identify when hyperglycemia is occurring and if there is a pattern of it consistently happening at any particular time. For those not taking diabetes medications, you could test occasionally after meals. This can help you figure out how the meals you eat are affecting your blood sugar – if the level is above the goal that is right for you (generally <180 mg/dL at 1 hour and <140 mg/dL at 2 hours) then meal adjustments can be made. For those taking insulin, the after meal blood sugar can help them identify the correct per-meal insulin dose that is right for them. Talk to your healthcare team to create a goal of how often and when to test blood sugars.
What Can Cause Hyperglycemia?
It is unrealistic to expect blood sugar levels to remain within recommended levels all the time. Various situations can cause hyperglycemia:
- Eating more than you planned to eat (especially carbohydrates, since too many at one time can increase the blood sugars)
- Not exercising enough or not being active at all
- Having a cold or the flu, which causes stress on the body
- Mental stress – having a fight with a friend/spouse/child, preparing for a test or a big project
- Not getting enough sleep
- Taking corticosteroids for an illness or treatment
- The medications that you are taking are not working well enough
- For those on insulin, not taking enough or skipping a dose
There are MANY factors that can affect blood sugars, so sometimes the actual cause may not be evident.
If your blood glucose is consistently high (based on your individualized target levels), then adjustments need to be made. Work with your healthcare team to problem solve a plan that is right for you.
Diabetes self-management education (DSME) is the ongoing process of facilitating the knowledge, skill, and ability necessary for diabetes self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. Diabetes education and ongoing resources provide the foundation to help people with diabetes navigate their everyday lives by providing the tools they need to be successful in managing their diabetes. The overall objectives of DSME are to support informed decision making, self-care behaviors, problem solving, and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life. Working with a diabetes educator who provides answers to diabetes questions, discusses blood sugar goals and problem solving tips to maintain better overall blood sugar improvements have been shown to improve health outcomes. Since hyperglycemia is a common problem with diabetes, it is important to note that goal setting is individualized. What may work for one person, may not work for another. So, sitting down with a diabetes educator and receiving ONGOING diabetes education can help you understand WHY your blood sugars may rise, give you tips on how to help maintain blood sugars within your goal ranges and help create a plan of what to do if the blood sugars start to rise in the future. We know that receiving advice may work for a little while, but lives change, our needs change and that means a new plan must be created to help what is happening NOW.
Some tried and true ways to help reduce blood sugars:
1. Exercise: Exercise can help your body use the extra glucose since our muscles use sugar for energy, whether you have type 1 diabetes or type 2 diabetes.
But please note, if your blood glucose level is above 250 mg/dL and you have type 1 diabetes, you’ll need to check for ketones before exercising (you can use a ketone strip to test your urine). If you have ketones or if your blood sugar is >300, you should not exercise since exercising with ketones or with very high blood sugars will cause your levels to rise even higher.
2. Drink water: Since consistently high blood sugars lead to increased urination, this will remove more fluid from the body and lead to mild dehydration. We need to help replace the fluids lost.
3. Adjust what and when you eat: Meeting with a Registered Dietitian Nutritionist (RDN) a few times to better individualize your meal planning needs will help identify how to better spread out meals and understand which foods (and their quantities) may have the biggest impact on blood sugar levels.
4. Adjust your medications or insulin: As with your meal plan, your medications (including insulin) may need an adjustment if your blood glucose readings are not in the range set for you. Speak with your healthcare team to have a plan of how to adjust medications for prolonged hyperglycemia.
How to Prevent Prolonged Hyperglycemia
Diabetes is a long-term condition which requires frequent adjustments to maintain blood glucose levels within a healthy range. Working with a diabetes educator on an ongoing basis can help hone in on trends that affect blood sugar levels. Remember, those on Medicare receive up to two hours of diabetes self-management education and two hours of nutrition education every year through a recognized diabetes education program. Take advantage of it!
To find a program near you, you can use the American Diabetes Association Program Finder or American Association of Diabetes Educators’ Program Finder.
Updated on: August 22, 2019
How to Avoid Diabetic Ketoacidosis
How to Lower Your Blood Sugar Fast and What to Do If It’s an Emergency
- To lower your blood sugar quickly, you should take more insulin.
- Exercise and hydration can also help lower blood sugar, but aren’t always the safest or most effective options.
- If your blood sugar levels are too high, and you don’t have insulin or it’s an emergency, you should seek medical attention immediately.
- This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
- This story is part of Insider’s guide to Diabetes.
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If you have
, your body isn’t able to regulate blood sugar properly, either because the pancreas doesn’t produce insulin (type 1 diabetes) or the body has become resistant to it (type 2 diabetes).
As a result, people with diabetes have to carefully manage their blood sugar levels through diet, exercise, and medications to make sure it stays in a healthy range.
But sometimes, blood sugar can become too high. In many of these cases, people with diabetes will be able to quickly lower blood sugar on their own, by taking more insulin. However, other times, they may need to visit the ER for immediate medical attention.
Here’s how to tell if your blood sugar is too high and what you’ll need to do in order to lower it quickly.
What is hyperglycemia?
People with diabetes are considered to have high blood sugar, or hyperglycemia, if blood glucose levels are higher than:
- 124 milligrams per deciliter when you haven’t eaten
- 180 milligrams per deciliter one to two hours after eating
While there are other conditions that can cause hyperglycemia, it is most commonly linked to both type 1 and
type 2 diabetes
. That’s why it is important for people with diabetes to check their blood sugar using blood glucose meters — with the goal of keeping levels from getting too low or too high.
In addition, there are other signs and symptoms of high blood sugar you might notice.
High blood sugar symptoms
The most common symptoms of hyperglycemia are:
- Increased thirst and/or hunger
- Blurred vision
- Frequent urination (peeing)
“If someone … has hyperglycemia, it would mean they would be very thirsty, tired, they might be urinating more frequently and basically not feeling well,” says Sam Zager, M.D. a family medicine physician in Maine.
How to lower blood sugar quickly
Hyperglycemia is not automatically an emergent situation. Anyone with diabetes knows high blood sugar readings will happen, and it’s okay, as long as it doesn’t last too long or get too high.
If it does occur, here are a few ways to quickly lower blood sugar on your own:
Take more insulin
Insulin can be used to treat acute cases of high blood sugar for people with diabetes.
type 1 diabetes
(who always use insulin) and some people with type 2 diabetes (who sometimes use insulin) can give themselves an extra dose of insulin to quickly lower their blood sugar to safer levels. How much to take depends on the situation and what your doctor recommends.
When you have high blood sugar, you may experience frequent urination as your body tries to get rid of the extra glucose. Losing this fluid can cause dehydration and make hyperglycemia symptoms even worse.
It’s important to drink water when you have hyperglycemia in order to stay hydrated and help your body regulate and lower blood sugar. But drinking lots of water won’t necessarily lower blood sugar on its own. For more information, read about how much water you’re supposed to drink a day.
Exercise isn’t always the safest or most effective way to quickly lower blood sugar. It is important to note that exercise only works if there is insulin present, whether naturally or through injection, so that glucose can get into the cells to be metabolized.
If there is no insulin, your body will start burning fat for energy, and this could lead to a dangerous condition called diabetic ketoacidosis. People with type 1 diabetes should not exercise if they have hyperglycemia.
However, exercise can lower blood sugar for most people with diabetes — it just shouldn’t be used in emergency situations. In a 2013 study in the journal Diabetes Care, more than 5,000 people with diabetes recorded their blood glucose levels before and after exercising for as little as 10 minutes. Overall, more than 75% of people saw their level decrease an average of about 17%.
Overall, Zager says that exercise is important for managing diabetes, but warns that it isn’t a great short-term fix. For more information on how to control blood sugars in the long-term, learn about the 6 best ways to lower blood sugar naturally.
When to seek medical attention in an emergency
For people with type 1 diabetes, untreated high blood sugar can lead to a life-threatening condition called diabetic ketoacidosis, or DKA.
When there is no insulin and glucose can’t get into cells, your body starts breaking down fat into a fuel called ketones. If ketones build up in your blood, it becomes dangerously acidic. DKA can cause very serious health complications — such as fluid building up in the brain, kidney failure, and cardiac arrest.
If your blood sugar is above 240 mg/dL, you should check your urine for ketones, a sign you may be at risk for DKA. You can do this with an at home test, but you also should contact your doctor. If there are ketones in your urine, you should go to the emergency room. Other symptoms of DKA include:
- Increased respiratory rate, or trouble breathing
- Breath that smells fruity
- Nausea and vomiting
- A very dry mouth
In rare occasions, DKA can occur in people with type 2 diabetes, but the more common complication for people with type 2 is called hyperglycemic hyperosmolar state, or HHS. HHS occurs when blood glucose levels are high for an extended period of time. The extra sugar is passed into the urine, causing the person to urinate frequently and become severely dehydrated, just like with DKA.
For people with type 2 diabetes, blood sugar above 600 mg/dL indicates HHS. Other symptoms include:
- Blurred vision
These symptoms generally come on slowly, but you should contact your doctor immediately. In the ER, doctors will likely use insulin to lower your blood sugar, as well as give you fluid and electrolytes, to keep your heart, kidneys, muscles, and nerve cells functioning properly.
For people with diabetes, a single instance of high blood sugar is generally not an emergency, as long as it is addressed. Usually, taking an extra dose of insulin will quickly lower your blood sugar back to normal levels. However, if you are on insulin and run out, or have symptoms of DKA or HHS, you should get medical attention right away.
Q&A: How to Lower your Blood Sugar when it’s Over 200 mg/dl
Q: How do I lower my blood sugar when it goes over 200 mg/dl? I have Type 2 diabetes.
A: An excellent question, but a complicated one to answer. Your doctor or nurse educator should be contacted any time your blood sugar runs consistently higher than 250 mg/dl for more than two days. When a person with Type 2 diabetes encounters a high blood sugar, the strategy used in bringing it down will vary from individual to individual. This is because of the differences in treatment concerning diet, exercise, and medication. It will also depend upon the guidelines for glucose control that you and your doctor have mutually agreed upon.
When high blood sugars do occur, there are a number of strategies that can be employed to adjust the glucose level back down to a normal range. These might include:
1) Eating less food at the next meal, eliminating a snack and/or eating foods with a lower glycemic index.
A general rule of thumb to follow is decreasing 15 grams of carbohydrate (the amount found in one starch exchange, one fruit exchange, or one cup skim milk exchange) will lower blood glucose by 30 mg/dl. If you test your blood sugar at 182 mg/dl before a meal or snack, then eliminate one starch and one cup milk at the next meal to bring the glucose value as close to 120 mg/dl as a baseline. Although people with diabetes will respond differently to this adjustment, it provides a basic guideline to start with.
For persons with Type 2 diabetes who are overweight, the loss of only 5% to 10% of total weight loss can dramatically improve blood glucose values (so just cutting calories moderately can achieve better blood glucose control).
Lastly, choosing foods with a lower glycemic index, i.e., foods that do not raise blood sugar as quickly or dramatically, can help to bring blood glucose back into a normal range. To test the glycemic effect of a food on your system, you will need to do more frequent monitoring. For example, you may want to compare the effect of brown rice versus baked potato by eating equivalent carbohydrate amounts of these foods at dinner and comparing your blood glucose response two hours later. Some examples of foods with a low glycemic index are dried beans and lentils. The exact effect will vary from person to person.
2) Increasing activity or incorporating more exercise.
Persons with Type 2 diabetes generally respond quite favorably to increased exercise with a lowered blood glucose value. Simple exercise, such as walking 20 minutes or more per day, can effectively improve glucose tolerance and induce weight loss. Proper exercise can actually be effective enough to lower or completely eliminate the need for medication altogether.
3) Increasing, changing medications, and/or administering them more frequently.
Although this is certainly an option, it makes more sense to address this problem of elevated blood glucose by exercise and cutting back on food. These are measures that are less costly and have fewer side-effects, but if they aren’t effective, a medication change may be indicated. If you are on the minimal dose of oral agents, your doctor might raise the dose or split it into morning and evening doses.
This could also be true of those using insulin. Taking more shots per day does not mean your diabetes is worse. It may even bring more flexibility into your lifestyle. In fact, a rule of thumb for those on insulin (check with your doctor first before making these adjustments) is to take one unit of regular insulin to lower blood glucose 30 mg/dl. If the blood sugar is 191 mg/dl before a meal, an extra three units of insulin will bring the glucose down about 100 mg/dl. It is important to note that this rule may change for people who exercise regularly (it will take less insulin to achieve the desired effect) or for those who become ill (they are more insulin resistant and may need more insulin to achieve the desired effect). The effectiveness of insulin is dramatically decreased also by high blood sugar levels.
4) Relaxation techniques and behavioral management.
Relaxation exercises, including deep breathing and audio tapes that guide you through deep muscle relaxation, can reduce stress and help you deal more effectively with it. There are tapes available specifically designed to create images of healthiness in diabetic individuals and encourage visualization of improved glucose control. Behavioral management techniques also improve an overall sense of control of one’s life and self-efficacy, so that diabetes becomes a state of “wellness in the midst of illness.” When relaxed and in control, blood glucose values can improve.
5) Treating identified illness and/or infections.
Illness and infection causes a rise in adrenergic hormones which increase the production of glucose in the body. This extra surge of glucose is part of the healing process, but can upset glucose control. Thus, continuing to take medications despite poor appetite is vital. You may temporarily require more medication during periods of extended illness. Ask your doctor for instructions on dealing with illness.
6) Monitoring on a more frequent basis and/or monitoring other parameters.
When blood glucose values exceed the target ranges established by you and your doctor, monitoring should be done every two hours until the blood glucose returns to normal. This gives you an opportunity to treat and adjust blood glucose as soon as possible, rather than waiting until your next doctor visit or next meal (which might be four or five hours later). It also tells you whether or not what you are doing is helping to bring the blood glucose down. Other parameters would include ketone checks (done by urine dip stick or via a fingerstick to measure betahydroxybutyrate, an acid) if your blood sugar is over 250 mg/dl. Testing ketones hourly until they disappear is recommended.
7) Increasing consumption of sugar-free fluids.
Often, the poor hydration of some individuals will account for the concentration of sugar in the blood. All people (with diabetes or not) should drink two to three quarts of sugar-free fluids per day. When glucose is elevated, drinking helps to dilute it. Also, drinking fluids is filling, decreasing the possibility of overeating.
People with heart disease who take diuretics and those with renal (kidney) complications may need to be on restricted fluids. Check with your doctor and/or dietitian if you fall into these special categories.
To combat high blood sugars, the most important strategy is prevention. Prevention of high blood sugars is usually possible with frequent and consistent monitoring. If you have awareness of your usual glucose response patterns to foods and exercise, it will be easier to plan out your day and prevent fluctuations in your blood sugar.
Help full links:
High Morning Blood Sugars | ADA
The occasional morning high will have little impact on your A1C, a measure of your average blood sugar (blood glucose) levels over time that indicates how well managed your diabetes is. But if those highs become consistent, they could push your A1C up into dangerous territory.
The dawn phenomenon
In the early hours of the morning, hormones, including cortisol and growth hormone, signal the liver to boost the production of glucose, which provides energy that helps you wake up. This triggers beta cells in the pancreas to release insulin in order to keep blood glucose levels in check. But if you have diabetes, you may not make enough insulin or may be too insulin resistant to counter the increase in blood sugar. As a result, your levels may be elevated when you wake up. The dawn phenomenon does not discriminate between types of diabetes. Approximately half of those with either type 1 or type 2 experience it.
If your insulin level falls too low overnight, your blood sugar rises. The reasons for the drop in insulin vary from person to person, but it most commonly occurs when your insulin pump settings provide too little basal (background) insulin overnight or if your long-acting insulin dose is too low. Insulin duration—how long the drug works in your body—also comes into play. If you inject your long-acting insulin early, it may not last into the morning.
The Somogyi effect
Named after Michael Somogyi, PhD, a chemist who was the first to describe it in the 1930s, the Somogyi effect is the body’s response to low blood sugar (hypoglycemia) during the night. Say you miss dinner or take too much insulin after your evening meal. Your blood sugar may fall too low overnight. Your body makes more glucose in order to compensate, and you wake up with high blood sugar.
So, what can you do?
Gather the clues
If a pattern of frequent morning highs emerges during your routine glucose monitoring, check your blood sugar levels at bedtime, in the middle of the night and first thing when you wake up to develop a better understanding of your glucose patterns. If you use a continuous glucose monitor (CGM), you can sleep through the night and it’ll gather the data you need. If you don’t use one, see if your doctor can provide a temporary loaner.
Identify the culprit
Your readings will tell you and your doctor when your highs and lows occur and that, in turn, will help narrow the cause of the problem.
If the data shows you’re high at bedtime, the culprits are likely food and medication.
If you have high blood sugars before you go to sleep, the elevated level can persist until morning. A large dinner or a snack at bedtime can cause elevated blood sugar levels that last all night, as can too low a dose of insulin with your evening meal. Adjusting your medication or what and when you eat may help.
If the data shows you’re in range at bedtime, the culprit is likely too little medication.
You may go to bed with blood sugar levels within your target range, but that doesn’t mean they’ll stay that way overnight. For example, if you are taking a long-acting insulin in the morning and it wears off before the next dose the following day, you would see morning high blood sugar. Changing the timing of your long-acting insulin injection, or switching to a twice-daily basal insulin or an ultra-long-acting insulin, might fix the problem.
If the data shows you’re high in the wee hours, the culprit is likely dawn phenomenon.
If you’re experiencing the dawn phenomenon, which raises your blood sugar between approximately 3 and 8 a. m., your doctor may recommend that you avoid increasing your long-acting insulin. While a higher dose of insulin will bring your morning highs down to normal, it could cause too great a drop in your blood sugar after you first go to sleep, but before your blood sugar starts to rise in the early hours of the morning. Sometimes the only way to adequately address the dawn phenomenon is with an insulin pump, which you can program to automatically deliver more insulin in the early morning hours.
If you don’t use insulin, it may take a good bit of trial and error before you and your health care provider figure out the best medication and lifestyle strategy to help reduce morning highs.
Work it out
Exercise can also help you manage your morning highs. If you have waning insulin, an after-dinner walk or other workout can help keep your blood sugar down overnight. But use caution when exercising before bedtime. The blood sugar-lowering effects of exercise can last for hours, so if you work out before bed, you risk going low overnight.
Morning exercise may be best if your blood sugar data has shown a trend of nighttime lows after late afternoon or evening exercise. Working up a sweat in the a.m. is a good idea for anyone experiencing the dawn phenomenon, too—it can help burn up that extra blood glucose.
Try, try again
There’s no single recipe to control morning highs. What works for one person may not work for you. It may take time to find the best strategy to keep your blood sugar at the right level in the morning while avoiding hypoglycemia overnight. In rare cases, the ideal balance can’t be found. For those people, their doctors might change their morning blood sugar goal so that it’s a little bit higher, as long it stays within goal the rest of the day. But most people will be able to figure out what’s happening and what to readjust.
Diabetes mellitus / Diseases / Clinic EXPERT
For patients who suspect that they may develop diabetes mellitus, the doctors of the EXPERT Clinic have created a list of studies for the basic examination.
Once a diagnosis of diabetes mellitus has been established, achieving and maintaining normal blood sugar is paramount. This is the main goal in the treatment of the disease.
This is achieved with the help of:
- diet therapy
- drug treatment
Treatment of any type of diabetes mellitus is impossible without diet therapy.This is the first thing that needs to be adjusted according to the characteristics of the disease. Diets for different types of diabetes differ slightly from each other. Wider diet for type 1 diabetes and significant dietary restrictions for type 2 diabetes, especially in combination with obesity. With gestational diabetes, dietary recommendations will also be “special”.
In our clinic, detailed conversations are held, dietary recommendations are given, which allows the patient to feel more comfortable when choosing and preparing certain products.
In type 1 diabetes mellitus, the use of insulin is mandatory.
In type 2 diabetes, dietary therapy alone may sometimes be sufficient if glucose is maintained at normal levels.
Most often, diet therapy for type 2 diabetes is supplemented with medication tablets to achieve normoglycemia. Only an endocrinologist can select and correct the treatment.
In our clinic, we carry out medical correction of treatment in accordance with international recommendations for the treatment of diabetes mellitus.The process of selecting therapy can take some time.
While type 2 diabetes mellitus is non-insulin dependent, the use of insulin in its treatment may also be quite likely. The need for insulin administration may arise in case of a long-term uncompensated disease, other acute diseases and conditions. Insulin therapy for type 2 diabetes mellitus will be permanent or temporary, it will only show the course of the disease. At the same time, dependence on the administration of insulin is not formed.
Treatment of gestational diabetes mellitus begins with the obligatory specific dietary therapy. In the absence of normalization of blood glucose levels, insulin therapy is prescribed. Patients are referred to a specialized maternity hospital for follow-up and subsequent delivery.
Do not postpone and make an appointment with an endocrinologist!
Today, diabetes is an incurable disease. Therefore, close cooperation between doctor and patient is of particular importance.Only in this case it is possible to predict stable compensation for the disease and prevent the development of complications of diabetes mellitus.
Even in the absence of an established diagnosis of diabetes mellitus, it is recommended to control blood sugar once a year – this is the simplest and most accessible method of early diagnosis of the disease. There is no specific prevention of diabetes mellitus, therefore it is recommended to maintain a healthy lifestyle: rational physical activity and proper nutrition.
In the event that this diagnosis is confirmed, constant contact between the patient and the doctor is necessary. Only under this condition is it possible to prevent the destructive effects of diabetes on the body.
Frequently asked questions
I was diagnosed with type 2 diabetes mellitus, but I do not notice anything bad in my health. Is diabetes really so dangerous?
Diabetes mellitus type 2 most often begins like this – “not noticeable” and is detected only when the patient donates blood for analysis for a completely different reason.Such “silence” of the disease is very insidious. Until the moment when the patient learned about the diagnosis, there may already be chronic complications of the disease in the form of damage to the eyes, kidneys, and legs. These complications are very dangerous and difficult to treat. Plus, with diabetes mellitus, atherosclerosis begins to progress very quickly, which is fraught with stroke, heart attack, ischemia of the lower extremities. Therefore, diabetes mellitus is a dangerous disease.
Is it possible to completely recover from diabetes?
Today, unfortunately, there is no such possibility. We establish the diagnosis of diabetes mellitus once in a lifetime and save it forever. You can ideally compensate for diabetes mellitus and then your blood sugar will not differ from people without diabetes mellitus, therefore, you will not risk the development of complications of the disease. Usually doctors write in the diagnosis like this: “Diabetes mellitus (type 1 or 2) is compensated.
Should I follow a diabetes diet if my blood sugar returned to normal during treatment?
Diet therapy for diabetes mellitus should never be canceled.Diet is the first ingredient in the treatment of this complex disease. Even if it seems to you that “one piece of cake” will not hurt, and even if you do not see high blood sugar on the meter after errors in nutrition, this is not a reason to cancel the diet. Failure to comply with dietary measures leads to gradually increasing sugar levels, which are then quite difficult to return to normal.
Is it possible to play sports with diabetes mellitus?
Not possible, but absolutely necessary! Rational physical activity is useful not only for general well-being and maintaining muscle tone, but also playing sports reduces blood sugar, improves blood flow in the muscles, which means more oxygen enters the cells of the body and ischemia, so often associated with diabetes mellitus, does not occur.
What blood glucose indicators should you strive for in the treatment of diabetes mellitus?
Blood sugar in this disease is very desirable to have in the range of normal values, which are determined for all people. These are fasting blood sugar figures of 3.3-5.5 mmol / l (in capillary blood) and 4.8-6.1 mmol / l (in venous plasma) and up to 7.8 mmol / l 2 hours after eating. Reducing blood sugar and keeping it in a physiological norm will reduce the risk of developing chronic complications of the disease to a minimum.There are situations when an endocrinologist advises not to lower blood sugar to normal. This occurs when the risk of lowering blood glucose below normal is more dangerous than a moderate increase in blood sugar. Various neurological and psychiatric diseases, coronary heart disease, old age usually require less strict control over diabetes. Of course, this should not mean that you can have a sugar of 12-20 mmol / l. Everything should be reasonable.
If diabetes mellitus is a lifelong disease and proceeds “imperceptibly” without changing the general well-being, should it be treated and controlled so strictly?
Of course, diabetes mellitus needs to be treated and this is very important.For the time being (this period can be quite long) there are no specific complications of the disease, even with persistent hyperglycemia, and then they can appear “all at once” and this will quickly affect the quality and life expectancy of a patient with diabetes.
What complications should be feared in diabetes mellitus?
Diabetes mellitus has acute and chronic complications. As the name implies, acute complications develop rapidly, “acutely”. The most common acute conditions in diabetes mellitus are hypoglycemia (a sharp drop in blood sugar below normal) and diabetic ketoacidosis (a significant increase in blood sugar, against the background of which acetone appears in the blood and urine).Both of these complications can lead to significant damage to body systems and death in a short time. Chronic complications are a slow lesion of blood vessels and other tissues of the body against the background of chronic hyperglycemia. Eye Damage – Diabetic retinopathy can lead to complete blindness. Kidney damage leads the patient to a hemodialysis bed. Damage to the nervous tissue leads to disruption of higher nervous activity and the development of “neuropathic ulcers”. These slow-onset complications do not lead to immediate death, but disable patients.
There are now a lot of pills for the treatment of diabetes mellitus. How do you know which drugs are best?
Only a doctor can understand which treatment will be the best for each specific patient after examining the patient and a follow-up examination. Eight classes of drugs exist to treat the disease, and more and more drugs are emerging. Pharmacotherapy of diabetes mellitus is perhaps the most “spoiled” branch of medicine. All drugs have their own indications and contraindications, and this is quite individual.The choice of the drug is the doctor’s task.
If insulin is prescribed for diabetes mellitus, is it “forever”? How to live “on injections”?
There are different types of diabetes mellitus, so there are different treatments. Insulin therapy is mandatory and vital for patients with type 1 diabetes. Without insulin, these patients die quickly. In type 2 diabetes, a temporary or permanent need for insulin treatment may also arise. With a sharp increase in blood sugar, with prolonged decompensation of diabetes mellitus, when the body’s reserve capacities are practically exhausted, insulin administration is required.After normalization of blood sugar, insulin (only in type 2 diabetes mellitus!) Can be canceled and returned to pill therapy. It should be remembered that with type 2 diabetes, continuous insulin administration may be required. And this is not because there is a dependence on insulin (this is what patients who received insulin in the hospital often say), but because there is an insulin demand, because its own pancreas is no longer able to produce enough insulin.
My relatives have diabetes.What can I do to avoid getting sick?
Diabetes mellitus belongs to diseases with a genetic predisposition and it can often be seen that in one family they suffer from this disease more often. The risk of getting sick, of course, exists, but it is in our power to try to reduce this risk. If, unfortunately, we cannot change the genetic predisposition, then we can completely exclude the provoking factors for the development of the disease. Rational nutrition and physical activity, a decrease in alcohol consumption, a decrease in body weight (in case of excess) – these are the measures for the prevention of diabetes mellitus.This set of measures – everyone knows and it is called a “healthy lifestyle”, but in terms of the prevention of diabetes – there is nothing better.
Laboratory diagnostics of diabetes mellitus in St. Petersburg
Diabetes – an endocrine disease, a complex of pathological conditions based on the pathology of insulin synthesis and function, as well as a violation of glucose metabolism. As a result, the patient develops persistent hyperglycemia – a high concentration of glucose in the blood.Pathology refers to chronic diseases. Gradually, in addition to carbohydrate pathology, it affects other types of metabolic processes – fatty, protein, mineral. The clinical picture of diabetes is diverse, because it affects different organs and systems. The consequences of diabetes affect the condition of the skin, peripheral nerves, brain, kidneys, heart and blood vessels. Each of the disorders entails corresponding consequences and, as a result, diabetes is a combination of several pathologies.
Laboratory diagnosis of diabetes is important for making a diagnosis, monitoring treatment, and determining the extent and stage of the process. Various features of hyperglycemia are indicators for a particular treatment strategy.
How to recognize a disease?
Diabetes symptoms develop depending on the stage of the process. The disease can gradually develop or debut in the form of an acute condition – coma.To streamline the symptoms of diabetes, they are divided into two categories: major and minor.
Let’s take a look at the main signs of diabetes:
Frequent urination, increased fluid secretion. This is due to the fact that high glucose levels increase osmotic pressure, which affects the functioning of the renal glomeruli and tubules. Glucosuria develops – a lot of glucose becomes in the urine, although normally it is not there at all. Patients report an increase in the urge to urinate at night.
In diabetes, there is intense thirst that is not related to physical activity or weather conditions. If, in the usual mode of life, the patient notes a strong thirst and a frequent desire to drink water, it is worth thinking about taking a blood glucose test. This clinical sign is associated with increased fluid loss.
The person constantly wants to eat. This hunger, like thirst, is not associated with environmental conditions or increased stress.The reason is that more nutrients are consumed and their metabolism in tissues is disrupted. Glucose is found in the blood but does not enter the cells. This affects the receptors, the body perceives the situation as a lack of glucose and increases appetite to replenish the supply.
Since glucose metabolism is impaired, the catabolism of fats and proteins increases. This leads to a decrease in body volume and weight. Losing weight occurs with increased appetite, which further enhances it.
This is typical for type 1 diabetes. In this case, the pathology can begin acutely, the symptoms develop quickly and the patient remembers the approximate time of the onset of the disease.
Less specific, additional symptoms are common in all types of diabetes. They appear gradually, the patient cannot remember exactly how long they have bothered him. The following changes can be observed:
- Skin and mucous membranes are constantly itchy and itchy;
- unpleasant dryness of the oral mucosa appears;
- Muscle weakness is felt;
- persistent headache;
- Frequent and prolonged skin inflammations, including purulent ones, which do not heal even during treatment;
- Appearance of acetone in urine.
90,010 visual disturbances;
There may be other general symptoms such as weakness and fatigue. It becomes difficult for a person to work or study, working capacity decreases, sleep is disturbed.
Go to analyzes
Modern diagnostic program for pathology
There are the following diagnostic methods for glucose metabolism disorders:
Let’s consider in more detail these methods and their features.
The technique is indicated for pathology of the liver, pancreas, obesity, for confirming or excluding diabetes, as well as for monitoring its treatment.
Blood for analysis is collected in the morning, before meals and no earlier than 8 hours after the last meal. The patient should not be exposed to physical or emotional stress from the evening until the study.
2) Glucose Tolerance Test
The study is shown when the concentration of glucose in the blood does not go beyond the critical range. If the glucose measurement shows a result from 3.88 to 7 mmol / l, it is too early to talk about hyper- or hypoglycemia and it is necessary to clarify the patient’s condition. The test is also used for those who have risk factors for diabetes.
The study is carried out in the morning, before meals and not earlier than 8 hours after the last meal.The patient should be in a calm state, not subjected to physical exertion and stress. The test is not performed if the blood glucose level is higher than 7 mmol / L.
How is the test going? First, the blood glucose level is measured with a glucometer, after which blood is drawn. Next, the patient is asked to drink 300 ml of water with 75 g of glucose dissolved in it. After 2 hours, a second blood sample is taken. All this time, you should not eat and drink, smoke and exercise.
The test is deciphered as follows: a positive result is a blood glucose concentration of less than 7.8 mmol / l, from 7.8 to 11.0 – tolerance is considered impaired, if glycemia is above 11.0 – a diagnosis of diabetes mellitus is made.
3) Glycated hemoglobin – an indicator that allows you to distinguish short-term hyperglycemia from a long course of pathological glucose metabolism. The principle of the study is based on the detection and measurement of the amount of hemoglobin that irreversibly binds to glucose molecules. The technique allows you to assess the picture over the last 3 months, since that is how long an erythrocyte with altered hemoglobin remains in the blood. Evaluation is important for predicting complications of diabetes and making a diagnosis.Also, the analysis shows how high-quality the treatment of the disease was over the past period and whether correction is needed.
The normal concentration of glycated hemoglobin is 4 to 5.9%. If the value exceeds 8%, correction of treatment tactics is urgently required.
No special preparation is required before analysis. The results are independent of food intake, exercise and time of day.
The study is indicated for the diagnosis of diabetes, to control the dynamics of the process.
4) Urine test for diabetes includes an analysis of the level of acetone and glucose. An estimate of the daily amount of urine is used to determine the total glucosuria per day. Normally, there should be no glucose in the urine. Sometimes the analysis is divided into time intervals so that four portions of urine are obtained. This allows you to determine the daily fluctuations and find out their cause. A single urine test is the standard procedure for determining or excluding glucosuria.
Assessment of the level of acetone is similar and is performed simultaneously with the determination of glucose. Acetone is also normally absent in urine, its appearance speaks of pathology.
The technique is used to control the quality of treatment. It is also used for feeling unwell, general health disorders, during illness.
5) Determination of the level of insulin is necessary for prolonged hyperglycemia.The hormone rises in response to a high concentration of glucose – this is natural and physiological. And the doctor manages to assess the features of glucose-insulin metabolism, thanks to this technique. Venous blood is used for analysis. It is advisable to combine this test with a glucose tolerance test.
The study is carried out on an empty stomach and after an 8-hour break after eating. Intense exertion should be avoided. For a day, you should stop taking food with a high sugar content.Do not smoke for 2 hours before analysis.
6) Analysis for C-peptide is included in the diagnosis of diabetes, since it is a product of carbohydrate metabolism and shows its quality in the body. As a rule, the level of this substance corresponds to the concentration of insulin in the blood. Insulin resistance and pancreatic islet abnormalities are accompanied by a decrease in C-peptide. The normal indicator is 0.9-7.9. An increased concentration indicates the presence of type 2 diabetes mellitus, reactions to drugs that lower glucose levels may indicate the presence of insulinoma, antibodies to insulin, neuroendocrine processes and kidney problems.
Preparation for the analysis implies the rejection of intense exertion, exercise, stress. It is necessary to donate blood on an empty stomach, give up before donating not only food, but also smoking.
7) The leptin test is also part of the comprehensive diabetes health assessment program. It is a hormone that regulates appetite and body weight. It is produced by adipocytes – fat cells. The norm is 1.1 – 27.6 ng / ml for men and 0.5-13.5 ng / ml for women.
Preparation for the analysis includes refusal of food 8 hours before blood donation, a small amount of water is allowed. The patient should avoid stress and stress.
The study is indicated if a patient is suspected of a deficiency of this hormone, impaired reproductive function, if it is necessary to differentiate diabetes or obesity, as well as with frequent thrombosis. The value can increase with increased food intake, diabetes mellitus, which does not depend on insulin levels, and obesity.Reduced results can be accompanied by rapid weight loss, prolonged fasting and genetic hormone deficiency.
8) Analysis of antibodies to pancreatic cells is used to diagnose autoimmune disorders of carbohydrate metabolism. It is an indicator of destruction of gland cells, which has an autoimmune mechanism. It is used for the correction of therapy, differential diagnosis, determination of the type of diabetes in difficult cases and with an incomprehensible clinic.
Normally, there should be no antibodies to the cells of the pancreas in the body.Their presence indicates a malfunction of the immune system.
A blood test is taken on an empty stomach; physical and emotional stress must be avoided before the examination. In addition to food, it is worth quitting smoking, you can drink a small amount of water without gas.
All analyzes should be carried out under appropriate conditions, with observance of asepsis and antiseptics. The collected biological material must be properly stored and transported to the laboratory.
Appointment of certain research methods depends on the stage of the process, the doctor’s recommendations.It is advisable to combine various analyzes so that the diagnosis is complete and covers different aspects of carbohydrate metabolism. Qualitative diagnosis of diabetes allows you to start treatment on time, which corresponds to the state of the body. If blood glucose levels are stabilized and kept to a normal concentration, a number of complications can be avoided. This is the value of diagnostic procedures for disorders of glucose metabolism.
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What is glucose
Glucose is a monosaccharide that is found in most tissues and organs.As a result of its oxidation, energy is released.
A person receives about 60% of glucose from food (carbohydrates). The concentration of the monosaccharide in the blood is regulated by various hormones and depends on the rate of its formation and utilization. Glucose is normally filtered in the renal glomeruli, after which it is reabsorbed in the tubules. Due to metabolic disorders, its level in the blood changes.
The value of glucose in the human body
Once in the gastrointestinal tract, carbohydrates are broken down into simpler compounds.As a result of fermentation, they are converted into monosaccharides galactose, glucose and lactose. Approximately 80% of all monosaccharides are glucose. It is she who is the source of energy, without which the normal functioning of muscle cells, brain cells and red blood cells is impossible.
Glucose is especially important for the brain, as its cells are not able to synthesize it on their own. If blood sugar is maintained at a normal level (at least 3 mmol / L), the central nervous system is fully functional.
Indications for taking a blood sugar test
It is recommended to take a blood test to determine the level of glucose if the following symptoms occur:
- frequent headaches,
- increased fatigue,
- weight loss with persistent / increased appetite,
- Constant thirst that does not go away even after drinking liquids,
- dry mouth,
- copious and too frequent urination (increased frequency of nocturnal urges),
- purulent lesions of the skin,
- slow healing of wounds, ulcers, boils,
- decreased immunity, frequent colds,
- genital itching,
- Visual impairment (especially in people over the age of 50).
You should also go through the diagnostics:
- for hypertensive patients,
- for liver diseases,
- during pregnancy,
- if you need to determine glucose tolerance,
- for diseases of the pituitary gland, thyroid gland, adrenal glands.
90,010 obese people, 90,011
90,010 over the age of 45,
Patients with non-insulin-dependent and non-insulin-dependent diabetes mellitus should constantly monitor their blood glucose levels.
Preparation for taking a blood test for glucose level
Blood for glucose determination is taken from a vein or from a finger. The patient must come to the medical laboratory in the morning on an empty stomach. Diagnosis should be preceded by a 12-hour fasting period.
In the morning, you can only drink pure non-carbonated water. Even chewing gum should not be chewed. On the eve, it is important to exclude food overload, to give up the use of sweets, alcoholic beverages.
Interpretation of analysis results
Blood glucose levels are age dependent.Indicators of the norm are given in the table:
|Age||Normal blood glucose level, mmol / L|
|Premature newborns||1.1 – 3.3|
|Newborn children in the first day of life||2.2 – 3.3|
|Newborn babies from the second day||2.8 – 4.4|
|Children under one month old||1.7 – 3.3|
|Children||3.3 – 5.6|
|Adults (under 60)||3.89 – 5.83|
|Adults (60 to 70 years old)||4.4 – 6.38|
|Seniors over 70||4.61 – 6.10|
If blood glucose is elevated
High blood glucose is detected at:
- acute pancreatitis,
- diabetes mellitus (type 1, 2),
- physiological stress hyperglycemia,
- Cushing’s disease,
- carcinoid syndrome,
- chronic kidney and liver diseases,
- diseases of the pancreas,
- endocrine pathologies,
- myocardial infarction, cerebral hemorrhage.
Also, the blood sugar level may increase as a result of taking certain medications (norepinephrine, glucocorticoids, phenytoin, thiazide diuretics, adrenaline, thiazide, caffeine).
If the blood glucose level is low
Low blood glucose may indicate:
- reactive hypoglycemia,
- nutritional deficiency,
- Reye’s syndrome,
- insufficient glycogen production,
- galactosemia, fructosemia,
- eating disorders,
- increased physical activity,
- poisoning with salicylates, chloroform, arsenic, alcohol, antihistamines,
- long-term use of steroids, amphetamine, propranol.
ABC Laboratory Technology Center – Glucose (in blood)
Glucose is the main energy substrate of the body. The blood glucose level in healthy people is relatively stable and depends on muscle activity and the interval between meals. The main hormone responsible for the entry of glucose into organs and tissues is insulin. Along with it, counterinsular hormones (glucagon, cortisol, adrenaline, somatoropine, thyroxine) take part in the regulation of blood glucose levels, the effect of which on glucose is directly opposite to that of insulin.
The daily range of values may increase in pathological conditions caused by dysregulation of blood sugar levels. Hyperglycemia most often develops with a deficiency of insulin or its insufficient effectiveness and is observed in diabetes mellitus, conditions associated with severe liver damage, hyperthyroidism, and pancreatic diseases; traumatic lesions of the central nervous system, brain tumors.
Hypoglycemia is observed in case of insulin overdose, fasting, after taking medications (for example, oral antidiabetic drugs), hormonal insufficiency of the pancreas, toxic liver damage.
Research methods: Enzymatic UV test (hexokinase method)
Units of measurement in CLT ABC: mmol / L (millimol per liter)
Biomaterial used for research:
|Biomaterial||Home visit||In med. office||Independently|
|Capillary blood *||✔||✔|
* In case of hard-to-reach veins, in pediatric practice.
It is recommended to donate blood in the morning, strictly on an empty stomach (fasting for at least 8 hours). On the eve, exclude food loads, especially carbohydrates. Before the study, it is necessary to exclude increased psycho-emotional and physical stress. Inform the attending physician about the medications taken that may affect the test result.
Factors influencing the indicator:
1. Diseases of the endocrine system.
2.Diseases of the gastrointestinal tract and urinary tract.
3. Taking corticosteroids, antidepressants, diuretics, estrogens, salicylates, alcohol, anabolic steroids, tetracycline antibiotics.
1. Suspected diabetes mellitus.
2. Monitoring of previously diagnosed diabetes mellitus.
3. Diseases of the endocrine system (pathology of the thyroid gland, adrenal glands, pituitary gland).
4. Diseases of the liver, pancreas.
6. Chronic renal failure.
With this service additionally appoint:
|Sample result in PDF format||Download|
Blood sugar, blood sugar, Glucose, Glu
Biochemical analyzes – a large group of studies that allow you to determine the state of many organs based on the indicators of the metabolism of specific substances in the body.Some studies have become mandatory for medical examinations even of healthy people, while some biochemical tests are prescribed only if there is a suspicion of specific diseases associated with metabolic disorders.
WARNING! The diagnosis is not made by one analysis, the consultation of a specialist is always necessary!
The results of biochemical tests are very sensitive to food intake (especially, analysis for glucose, cholesterol, ALT, AST), therefore, it is recommended to take biochemical tests on an empty stomach.
Value of analyzes (we do not give norm indicators, because they can vary depending on the research method) .
Blood glucose (sugar).
High levels (hyperglycemia) are most common in type 1 and type 2 diabetes. In addition, an increase in blood sugar is possible with hormonal disorders (hyperthyroidism, diseases of the adrenal glands, pituitary gland), taking glucocorticosteroids, severe stress.
Low glucose levels (hypoglycemia) occur with prolonged starvation (exhaustion), intestinal and liver diseases, hormonal disorders (pituitary and adrenal glands, hypothyroidism), and insulin overdose.
Alt (alanine aminotransferase) and AST (aspartate aminotransferase).
A high level of ALT and AST indicates that cell destruction occurs in the body. The most common cause of an increase is the destruction of liver cells. It can also be a sign of destruction of cells of the heart, kidneys, skeletal muscles. Diseases in which it occurs: hepatitis (inflammation of the liver), cirrhosis of the liver, liver tumors, crash syndrome (syndrome of prolonged compression in trauma), myocardial infarction.
Low levels of ALT and AST may indicate severe liver cirrhosis, vitamin B6 deficiency, pancreatic pathology.
This substance is formed in the liver from blood breakdown products.