What Is Diabetes? – NIDDK

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Glucose is your body’s main source of energy. Your body can make glucose, but glucose also comes from the food you eat.

Insulin is a hormone made by the pancreas that helps glucose get into your cells to be used for energy. If you have diabetes, your body doesn’t make enough—or any—insulin, or doesn’t use insulin properly. Glucose then stays in your blood and doesn’t reach your cells.

Diabetes raises the risk for damage to the eyes, kidneys, nerves, and heart. Diabetes is also linked to some types of cancer. Taking steps to prevent or manage diabetes may lower your risk of developing diabetes health problems.

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high.

What are the different types of diabetes?

The most common types of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

If you have type 1 diabetes, your body makes little or no insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.

Type 2 diabetes

If you have type 2 diabetes, the cells in your body don’t use insulin properly. The pancreas may be making insulin but is not making enough insulin to keep your blood glucose level in the normal range. Type 2 diabetes is the most common type of diabetes. You are more likely to develop type 2 diabetes if you have risk factors, such as overweight or obesity, and a family history of the disease. You can develop type 2 diabetes at any age, even during childhood.

You can help delay or prevent type 2 diabetes by knowing the risk factors and taking steps toward a healthier lifestyle, such as losing weight or preventing weight gain.

Gestational diabetes

Gestational diabetes is a type of diabetes that develops during pregnancy. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a higher chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is type 2 diabetes.

Prediabetes

People with prediabetes have blood glucose levels that are higher than normal but not high enough to be diagnosed with type 2 diabetes. If you have prediabetes, you have a higher risk of developing type 2 diabetes in the future. You also have a higher risk for heart disease than people with normal glucose levels.

Other types of diabetes

A less common type of diabetes, called monogenic diabetes, is caused by a change in a single gene. Diabetes can also come from having surgery to remove the pancreas, or from damage to the pancreas due to conditions such as cystic fibrosis or pancreatitis.

How common are diabetes and prediabetes?

More than 133 million Americans have diabetes or prediabetes. ¹

As of 2019, 37.3 million people—or 11.3% of the U.S. population—had diabetes.¹ More than 1 in 4 people over the age of 65 had diabetes. Nearly 1 in 4 adults with diabetes didn’t know they had the disease.²

About 90% to 95% of diabetes cases are type 2 diabetes.³

In 2019, 96 million adults—38% of U.S. adults—had prediabetes.⁴

What other health problems can people with diabetes develop?

Over time, high blood glucose can damage your heart, kidneys, feet, and eyes. If you have diabetes, you can take steps to lower your chances of developing diabetes health problems by taking steps to improve your health and learning how to manage the disease. Managing your blood glucose, blood pressure, and cholesterol levels can help prevent future health problems.

Managing your blood glucose levels can help prevent future health problems, such as damage to your eyes.

References

Hypoglycemia (Low Blood Glucose) | ADA

Throughout the day, depending on multiple factors, blood glucose (also called blood sugar) levels will vary—up or down. This is normal. If it varies within a certain range, you probably won’t be able to tell. But if it goes below the healthy range and is not treated, it can get dangerous.

Low blood glucose is when your blood glucose levels have fallen low enough that you need to take action to bring them back to your target range. This is usually when your blood glucose is less than 70 mg/dL. However, talk to your diabetes care team about your own blood glucose targets, and what level is too low for you.

Low blood glucose may also be referred to as an insulin reaction, or insulin shock.

Signs and symptoms of low blood glucose (happen quickly)

Each person’s reaction to low blood glucose is different. Learn your own signs and symptoms of when your blood glucose is low. Taking time to write these symptoms down may help you learn your own symptoms of when your blood glucose is low. From milder, more common indicators to most severe, signs and symptoms of low blood glucose include:

• Feeling shaky
• Being nervous or anxious
• Sweating, chills and clamminess
• Irritability or impatience
• Confusion
• Fast heartbeat
• Feeling lightheaded or dizzy
• Hunger
• Nausea
• Color draining from the skin (pallor)
• Feeling sleepy
• Feeling weak or having no energy
• Blurred/impaired vision
• Tingling or numbness in the lips, tongue, or cheeks
• Headaches
• Coordination problems, clumsiness
• Nightmares or crying out during sleep
• Seizures

The only sure way to know whether you are experiencing low blood glucose is to check your blood glucose levels, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia.

A low blood glucose level triggers the release of epinephrine (adrenaline), the “fight-or-flight” hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling, and anxiety.

If the blood sugar glucose continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood glucose stays low for too long, starving the brain of glucose, it may lead to seizures, coma, and very rarely death.

Treatment—The “15-15 Rule”

The 15-15 rule—have 15 grams of carbohydrate to raise your blood glucose and check it after 15 minutes. If it’s still below 70 mg/dL, have another serving.

Repeat these steps until your blood glucose is at least 70 mg/dL. Once your blood glucose is back to normal, eat a meal or snack to make sure it doesn’t lower again.

This may be:

• Glucose tablets (see instructions)
• Gel tube (see instructions)
• 4 ounces (1/2 cup) of juice or regular soda (not diet)
• 1 tablespoon of sugar, honey, or corn syrup
• Hard candies, jellybeans, or gumdrops—see food label for how many to consume

Make a note about any episodes of low blood glucose and talk with your health care team about why it happened. They can suggest ways to avoid low blood glucose in the future.

Many people tend to want to eat as much as they can until they feel better. This can cause blood glucose levels to shoot way up. Using the step-wise approach of the “15-15 Rule” can help you avoid this, preventing high blood glucose levels.

Note:

• Young children usually need less than 15 grams of carbs to fix a low blood glucose level: Infants may need 6 grams, toddlers may need 8 grams, and small children may need 10 grams. This needs to be individualized for the patient, so discuss the amount needed with your diabetes team.
   
• When treating a low, the choice of carbohydrate source is important. Complex carbohydrates, or foods that contain fats along with carbs (like chocolate) can slow the absorption of glucose and should not be used to treat an emergency low.

Severe hypoglycemia

When low blood glucose isn’t treated and you need someone to help you recover, it is considered a severe event.

Treating severe hypoglycemia

Glucagon is a hormone produced in the pancreas that stimulates your liver to release stored glucose into your bloodstream when your blood glucose levels are too low. Glucagon is used to treat someone with diabetes when their blood glucose is too low to treat using the 15-15 rule.

Glucagon is available by prescription and is either injected or administered or puffed into the nostril. For those who are familiar with injectable glucagon, there are now two injectable glucagon products on the market—one that comes in a kit and one that is pre-mixed and ready to use. Speak with your doctor about whether you should buy a glucagon product, and how and when to use it.

The people you are in frequent contact with (for example, friends, family members, and coworkers) should be instructed on how to give you glucagon to treat severe hypoglycemia. If you have needed glucagon, let your doctor know so you can discuss ways to prevent severe hypoglycemia in the future.

Steps for treating a person with symptoms keeping them from being able to treat themselves.

1. If the glucagon is injectable, inject it into the buttock, arm, or thigh, following the instructions in the kit. If your glucagon is inhalable, follow the instructions on the package to administer it into the nostril.
2. When the person regains consciousness (usually in 5–15 minutes), they may experience nausea and vomiting.

Don’t hesitate to call 911. If someone is unconscious and glucagon is not available or someone does not know how to use it, call 911 immediately.

Do NOT:

• Inject insulin (it will lower the person’s blood glucose even more)
• Provide food or fluids (they can choke)

Causes of low blood glucose

Low blood glucose is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications. The average person with type 1 diabetes may experience up to two episodes of mild low blood glucose each week, and that’s only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher.

Insulin

Too much insulin is a definite cause of low blood glucose. One reason newer insulins are preferred over NPH and regular insulin is that they’re less likely to cause blood glucose lows, particularly overnight. Insulin pumps may also reduce the risk for low blood glucose. Accidentally injecting the wrong insulin type, too much insulin, or injecting directly into the muscle (instead of just under the skin), can cause low blood glucose.

Food

What you eat can cause low blood glucose, including:

• Not enough carbohydrates.
• Eating foods with less carbohydrate than usual without reducing the amount of insulin taken.
• Timing of insulin based on whether your carbs are from liquids versus solids can affect blood glucose levels. Liquids are absorbed much faster than solids, so timing the insulin dose to the absorption of glucose from foods can be tricky.
• The composition of the meal—how much fat, protein, and fiber are present—can also affect the absorption of carbohydrates.

Physical activity

Exercise has many benefits. The tricky thing for people with type 1 diabetes is that it can lower blood glucose in both the short and long-term. Nearly half of children in a type 1 diabetes study who exercised an hour during the day experienced a low blood glucose reaction overnight. The intensity, duration, and timing of exercise can all affect the risk for going low.  

Medical IDs

Many people with diabetes, particularly those who use insulin, should have a medical ID with them at all times.

In the event of a severe hypoglycemic episode, a car accident or other emergency, the medical ID can provide critical information about the person’s health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc. Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can’t speak for themselves.

Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record for use in an emergency.

Hypoglycemia unawareness

Very often, hypoglycemia symptoms occur when blood glucose levels fall below 70 mg/dL. As unpleasant as they may be, the symptoms of low blood glucose are useful. These symptoms tell you that you your blood glucose is low and you need to take action to bring it back into a safe range. But, many people have blood glucose readings below this level and feel no symptoms. This is called hypoglycemia unawareness.

People with hypoglycemia unawareness can’t tell when their blood glucose gets low so they don’t know they need to treat it. Hypoglycemia unawareness puts the person at increased risk for severe low blood glucose reactions (when they need someone to help them recover). People with hypoglycemia unawareness are also less likely to be awakened from sleep when hypoglycemia occurs at night. People with hypoglycemia unawareness need to take extra care to check blood glucose frequently. This is especially important prior to and during critical tasks such as driving. A continuous glucose monitor (CGM) can sound an alarm when blood glucose levels are low or start to fall. This can be a big help for people with hypoglycemia unawareness.

Hypoglycemia unawareness occurs more frequently in those who:

• Frequently have low blood glucose episodes (which can cause you to stop sensing the early warning signs of hypoglycemia).
• Have had diabetes for a long time.
• Tightly manage their diabetes (which increases your chances of having low blood glucose reactions).

If you think you have hypoglycemia unawareness, speak with your health care provider. Your health care provider may adjust/raise your blood glucose targets to avoid further hypoglycemia and risk of future episodes.

Regaining hypoglycemia awareness

It’s possible to get your early warning symptoms back by avoiding any, even mild, hypoglycemia for several weeks. This helps your body re-learn how to react to low blood glucose levels. This may mean increasing your target blood glucose level (a new target that needs to be worked out with your diabetes care team). It may even result in a higher A1C level, but regaining the ability to feel symptoms of lows is worth the temporary rise in blood glucose levels.

Other causes of symptoms

Other people may start to have symptoms of hypoglycemia when their blood glucose levels are higher than 70 mg/dL. This can happen when your blood glucose levels are very high and start to go down quickly. If this is happening, discuss treatment with your diabetes care team.

How can I prevent low blood glucose?

Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it early—before it gets worse.

Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia. Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low.

If you can, check often!  

• Check before and after meals.
• Check before and after exercise (or during, if it’s a long or intense session).
• Check before bed.
• After intense exercise, also check in the middle of the night.
• Check more if things around you change such as, a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.

Why am I having lows?

If you are experiencing low blood glucose and you’re not sure why, bring a record of blood glucose, insulin, exercise, and food data to a health care provider. Together, you can review all your data to figure out the cause of the lows. 

The more information you can give your health care provider, the better they can work with you to understand what’s causing the lows. Your provider may be able to help prevent low blood glucose by adjusting the timing of insulin dosing, exercise, and meals or snacks. Changing insulin doses or the types of food you eat may also do the trick.

If you’re new to type 2 diabetes, join our free Living With Type 2 Diabetes program to get help and support during your first year.

How sugar is indicated in a blood test

Now the world is developing a real pandemic of diabetes. And the sooner the correct diagnosis is established, the more likely it is to live a full life.

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Laboratory

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• The most common blood sugar test?
• Criteria for diabetes by glucose level
• Glucose tolerance test
• Glycated hemoglobin for the diagnosis of diabetes mellitus
• Urinalysis for glucose
• Fructosamine test

We remind you that on our portal you can find Dr. Fedorov’s answers to questions about how
correctly decipher indicators in general analyzes
urine and blood, biochemical
blood test, analysis
blood for lipid profile, analysis
urinary sediment. And also you can find out what some changes in the electrocardiogram mean.

This time, Dr. Fedorov answers questions about blood sugar levels.

What is the most common blood sugar test?

The most frequent blood test for sugar, which each of us took at least once in a lifetime –
fasting glucose level in a biochemical blood test. Usually, the analysis is taken in the morning, after sleep, while it is not recommended
drink nothing but plain water. The glucose level can be determined in the capillary (then the analysis is taken from the finger)
or venous blood.

Depending on the method of sampling, the upper limit of the blood sugar norm also varies:

• for capillary blood it is 5.5 mmol/l,
• for venous – 6. 1 mmol / l.

The criteria for diabetes mellitus is the detection, against the background of full health, of an increase in blood sugar levels of more than
7.0 mmol/l on an empty stomach or more than 11.1 mmol/l after meals. “You have high blood sugar”
then doctors say. If the glucose level fluctuates from 6.1 to 7 mmol / l, then we are talking about a violation
glucose tolerance (or prediabetes). This is a state that is still possible to reverse, and for
more accurate diagnosis will require additional tests.

Should I take a glucose tolerance test?

One such test is the glucose tolerance test. To do this, the patient takes a blood test for glucose,
and then they offer to drink a sweet solution, the glucose content of which is 75 grams. In 2 hours
a standard venous blood sampling is performed to determine the level of glucose.

• If the indicator is in the range of 7.8 mmol / l – 11.1 mmol / l, we are talking about a violation
  glucose tolerance, even despite normal fasting sugar levels.
• If it exceeds 11.1 mmol/l, then with a high degree of probability the patient has diabetes
  diabetes.

In both cases he is referred to an endocrinologist
for lifestyle modification, nutrition or selection
hypoglycemic therapy. In recent years, the need for a glucose tolerance test has decreased,
since a new, informative indicator has appeared in the arsenal of physicians – glycated hemoglobin.

What is glycated hemoglobin and why is it considered the “gold standard”
diagnosis of diabetes?

Glycated hemoglobin (HbA1C) is another important blood sugar test. This is a universal indicator
if you omit the details, you can say that it represents information about the average concentration of sugar in the blood
for the last 3 months. The analysis is more convenient than other tests for diabetes: it can be taken during the entire
days, and not necessarily on an empty stomach, the indicator does not increase in the presence of an acute or chronic infection and after
stress, which is typical for a standard blood sugar test.

• Normal glycated hemoglobin ranges from 4% to 5.6%.
• An HbA1C level of 5.7 to 6.4% indicates a high risk of developing diabetes. In that
  case, lifestyle changes are required – weight loss, daily physical activity, restriction
  consumption of fast-digesting carbohydrates.
• A reading above 6.5% indicates high blood sugar in the last 120 days – we are talking about sugar
  diabetes.

In addition to the primary diagnosis of impaired glucose tolerance and diabetes mellitus, the indicator actively
used to evaluate the effectiveness of hypoglycemic therapy.

What does a urine test for glucose indicate?

• Normally, there is no sugar in the urine or it is excreted in the urine in a minimal amount (less than 0.8
  mmol/l), since all glucose is reabsorbed from the primary urine into the kidneys.
  tubules.
• Glucose enters the urine only when its concentration in the blood exceeds 10
  mmol/l.

Mild glucosuria may occur during pregnancy. In addition to various types of diabetes (diabetes, kidney,
steroid) glucose in the urine can appear with myocardial infarction and ischemic stroke of the brain,
polytrauma, prolonged compression syndrome and massive burns. Most of these conditions are related to resuscitation
and does not involve routine testing on an outpatient basis.

The doctor ordered a fructosamine test. What is this research?

This substance is a combination of plasma proteins with glucose, it gives the doctor information about the level
glycemia for the last 2-3 weeks.

• Blood is taken for analysis after an 8-hour fast and the normal value is 319 mmol/l.

This analysis is considered a “safety net” for glycated hemoglobin in cases where it
information content is reduced, for example, with anemia. And also in cases when you need to evaluate the fresh dynamics
blood sugar levels in recent weeks – during pregnancy in diabetic women, as well as
recent change in diabetes treatment regimen.

The author of the article: Aleksey Yurievich Fedorov

Doctor’s consultation

You can get the advice of the necessary specialist online

Laboratory

You can undergo a comprehensive examination of all major body systems

How to properly prepare for a blood sugar (glucose) test. Preparing for sugar analysis.

What does a blood sugar test show?

The analysis shows the level of sugar (glucose) in the blood, which can indicate the presence of diabetes and other diseases.

Low sugar levels (hypoglycemia) can signal diseases of the pancreas, liver, kidneys and adrenal glands, as well as the hypothalamus.

The most common cause of high blood sugar (hyperglycemia) is diabetes mellitus. Hyperglycemia can also speak of other endocrine diseases, problems of the liver and hypothalamus, and a constant inflammatory process in the body.

There is also a glucose tolerance test (aka glucose tolerance test or GTT), which is carried out to detect prediabetes, and is also prescribed for pregnant women.

Indications for analysis

Symptoms that may be caused by low blood sugar include:

• constant lethargy, fatigue;
• increased sweating;
• anxiety;
• bouts of hunger.

Symptoms that high blood sugar can cause include:

• rapid breathing;
• dry mouth, thirst;
• dry skin;
• decreased clarity of vision;
• frequent urge to urinate;
• poor wound healing;
• itching of the skin and mucous membranes;
• weight loss.

If you notice some of the listed symptoms behind you, make an appointment with a general practitioner, he will diagnose and write out a referral for the necessary analysis.

With both deviations from the norm, an unstable mental state, mood swings can be observed.

How sugar is tested

A blood sugar test is done by taking blood either from a finger (capillary blood) or from a vein under the elbow (venous blood).

Blood sugar norms

l The norm of blood sugar in an adult is:

• 3.3–5.5 mmol/l (for capillary blood sampling)
• 3.7–6.1 mmol/l (at sampling)

If the mark exceeds 6.1 mmol/l, it is necessary to be examined.

In order for your results to be reliable, you need to properly prepare for the test for sugar.

How to take a blood sugar test

So that the test results do not turn out to be false, it is necessary to follow some rules for preparing the patient for a blood test for sugar. Otherwise, you may need to retake the analysis (and this is a waste of your time and money), or an incorrect diagnosis and treatment may be prescribed.

Can I drink water before testing for sugar?

You can drink water. But no more – it is necessary to exclude alcoholic and containing sugar and sweeteners drinks.

Preparing for a glucose test

• On an empty stomach. 8-hour or better 12-hour fasting. Drink only water. Alcohol (for 102 days it is better to exclude) and sweet drinks are strictly prohibited.
• Better sleep well
• Avoid intense mental work, stress and outbursts of emotions. The body can increase blood glucose levels during a stressful situation. Excessive emotions can suppress insulin production.
• It is best not to brush your teeth with sugary toothpaste.
• No smoking. (with diabetes it is better to exclude smoking altogether)
• Be careful with medication. If necessary, treatment of acute or chronic episodes of the disease should warn the doctor about the existing problems and reschedule the study or interpret its results in accordance with the ability of some drugs to raise or lower the studied parameters
• During the period of colds or other acute infections, the result may be false positive
• On the eve of the analysis, you should not participate in feasts, eat tightly before bedtime, drink alcohol, get involved in fatty foods, fast food, etc.
• Immediately after therapeutic procedures and serious studies (massage, ultrasound, X-ray, physiotherapy), you cannot take a sugar test.
• On the eve and before donating blood for sugar, it is better not to engage in active sports. It is better to spend the day and morning before the analysis in the usual calm mode.

What not to eat before a sugar test

What then can you eat before a sugar test?

If you need to prepare for a blood glucose test, but you are overcome by hunger, then eat something light and healthy. For example:

• boiled/baked chicken
• green vegetables
• cereals

Can I brush my teeth before donating blood for sugar

It is not recommended to brush your teeth before the examination, because. toothpastes contain sugar, which is well absorbed through the oral mucosa and can affect the accuracy of the analysis. Avoid chewing gum as well.

Preparation for pregnancy blood sugar test

Preparing for a glucose tolerance test for pregnant women does not differ from the above measures.