What is gestational diabetes. How does it affect pregnancy. Who is at risk for developing gestational diabetes. What are the symptoms and complications of gestational diabetes. How is gestational diabetes diagnosed and treated. Can gestational diabetes be prevented. What happens after pregnancy with gestational diabetes.

Understanding Gestational Diabetes: A Temporary but Serious Pregnancy Complication

Gestational diabetes is a form of diabetes that occurs exclusively during pregnancy. Unlike type 1 diabetes, it’s not caused by an absolute lack of insulin. Instead, it results from the body’s inability to use insulin effectively, a condition known as insulin resistance. This leads to elevated blood sugar levels, which can have significant implications for both the mother and the developing fetus.

Typically, gestational diabetes develops around the 24th to 28th week of pregnancy. While the exact cause remains unknown, researchers have identified several factors that contribute to its development.

The Role of Placental Hormones

The placenta, a vital organ that supports fetal development, produces several hormones essential for maintaining a healthy pregnancy. These include:

• Estrogen
• Progesterone
• Cortisol
• Human placental lactogen

While crucial for fetal growth, these hormones can interfere with the mother’s insulin function, leading to insulin resistance. As the placenta grows and produces more hormones, the risk of insulin resistance increases.

Physiological Changes During Pregnancy

Several pregnancy-related factors can contribute to elevated blood sugar levels:

• Increased fat storage
• Higher calorie intake
• Reduced physical activity

These changes, combined with the effects of placental hormones, can overwhelm the pancreas’s ability to produce enough insulin to maintain normal blood sugar levels.

Identifying Risk Factors for Gestational Diabetes

While any pregnant woman can develop gestational diabetes, certain factors increase the risk. Understanding these risk factors can help healthcare providers identify women who may need closer monitoring during pregnancy.

Common Risk Factors

• Age over 25
• Overweight or obesity
• Family history of diabetes
• Previous gestational diabetes
• Polycystic ovary syndrome (PCOS)
• Certain ethnic backgrounds (e.g., Hispanic, African American, Native American, Asian American, Pacific Islander)

Are some women more likely to develop gestational diabetes than others? Yes, women with multiple risk factors have a higher chance of developing the condition. However, it’s important to note that even women with no known risk factors can develop gestational diabetes, which is why universal screening is recommended.

Recognizing the Symptoms of Gestational Diabetes

One of the challenges in diagnosing gestational diabetes is that it often doesn’t cause noticeable symptoms. This is why routine screening during pregnancy is crucial.

Potential Symptoms

While many women remain asymptomatic, some may experience:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision

Is it possible to have gestational diabetes without any symptoms? Absolutely. Many women with gestational diabetes experience no symptoms at all, which is why routine screening is so important for early detection and management.

Diagnosing Gestational Diabetes: The Importance of Timely Screening

Given the often asymptomatic nature of gestational diabetes, routine screening is essential for all pregnant women. The standard diagnostic process involves a two-step approach.

Glucose Challenge Test

This initial screening test is typically performed between 24 and 28 weeks of pregnancy:

1. The woman drinks a glucose solution containing 50 grams of glucose.
2. Blood glucose is measured one hour later.
3. If the result is above a certain threshold (usually 140 mg/dL), further testing is required.

Oral Glucose Tolerance Test (OGTT)

If the glucose challenge test indicates potential gestational diabetes, an OGTT is performed:

1. The woman fasts overnight.
2. A fasting blood glucose measurement is taken.
3. She drinks a solution containing 100 grams of glucose.
4. Blood glucose is measured at one, two, and three hours after drinking the solution.

What blood glucose levels indicate gestational diabetes? Diagnosis is made if two or more of the following values are met or exceeded:

• Fasting: 95 mg/dL
• 1 hour: 180 mg/dL
• 2 hours: 155 mg/dL
• 3 hours: 140 mg/dL

Managing Gestational Diabetes: A Multifaceted Approach

Once diagnosed, managing gestational diabetes is crucial for the health of both mother and baby. The primary goal is to keep blood glucose levels within a target range throughout the pregnancy.

Lifestyle Modifications

The first line of treatment often involves lifestyle changes:

• Balanced diet: Focus on complex carbohydrates, lean proteins, and healthy fats
• Regular physical activity: Moderate exercise can help improve insulin sensitivity
• Blood glucose monitoring: Regular self-monitoring helps track progress and guide treatment

Medical Interventions

If lifestyle changes alone aren’t sufficient, medical interventions may be necessary:

• Insulin injections: The most common medical treatment for gestational diabetes
• Oral medications: In some cases, oral diabetes medications may be prescribed

How often should blood glucose be monitored in gestational diabetes? Most healthcare providers recommend checking blood glucose levels four times a day: fasting (before breakfast) and one hour after each meal.

Potential Complications of Gestational Diabetes

While proper management can significantly reduce risks, untreated or poorly controlled gestational diabetes can lead to complications for both mother and baby.

Maternal Complications

• Increased risk of cesarean delivery
• Higher likelihood of developing type 2 diabetes later in life
• Increased risk of gestational diabetes in future pregnancies
• Preeclampsia (high blood pressure during pregnancy)

Fetal and Neonatal Complications

• Macrosomia (excessive birth weight)
• Shoulder dystocia during delivery
• Neonatal hypoglycemia
• Jaundice
• Increased risk of obesity and type 2 diabetes later in life

Can gestational diabetes harm the baby? If left untreated or poorly managed, gestational diabetes can indeed lead to complications for the baby. However, with proper care and management, most women with gestational diabetes deliver healthy babies.

Prevention Strategies: Reducing the Risk of Gestational Diabetes

While it’s not always possible to prevent gestational diabetes, there are steps women can take to reduce their risk, especially if planning a pregnancy.

Pre-Pregnancy Lifestyle Modifications

• Maintain a healthy weight: Losing excess weight before pregnancy can significantly reduce the risk
• Adopt a balanced diet: Focus on whole grains, lean proteins, fruits, and vegetables
• Regular exercise: Aim for at least 30 minutes of moderate activity most days of the week
• Quit smoking: Smoking increases the risk of various pregnancy complications, including gestational diabetes

During Pregnancy

• Follow a pregnancy-specific diet plan
• Engage in safe prenatal exercises
• Attend all prenatal check-ups for early detection and management

Is it possible to completely prevent gestational diabetes? While these strategies can significantly reduce the risk, it’s not always possible to prevent gestational diabetes entirely, especially for women with multiple risk factors.

Life After Gestational Diabetes: Long-Term Implications and Management

For most women, gestational diabetes resolves after delivery. However, it’s important to understand the long-term implications and follow-up care required.

Postpartum Glucose Testing

Women who had gestational diabetes should undergo glucose testing 6-12 weeks after delivery to ensure blood sugar levels have returned to normal.

Long-Term Health Considerations

• Increased risk of type 2 diabetes: Women with a history of gestational diabetes have a 50% chance of developing type 2 diabetes within 5-10 years
• Cardiovascular risk: Higher likelihood of developing heart disease later in life
• Future pregnancies: Increased risk of gestational diabetes in subsequent pregnancies

Ongoing Management

• Regular health check-ups and diabetes screenings
• Maintaining a healthy lifestyle through diet and exercise
• Breastfeeding, which may help reduce the risk of developing type 2 diabetes

How often should women with a history of gestational diabetes be screened for type 2 diabetes? The American Diabetes Association recommends screening every 1-3 years, depending on other risk factors.

Gestational diabetes, while a temporary condition of pregnancy, has significant implications for maternal and fetal health. Understanding its causes, risk factors, and management strategies is crucial for ensuring the best possible outcomes. With proper care and follow-up, most women with gestational diabetes can have healthy pregnancies and reduce their long-term health risks. As research in this field continues, we may gain even more insights into prevention and management strategies, further improving outcomes for mothers and their babies.

Blood sugar 159 mg/dl after-eating – good or bad?

We help you interpret your blood sugar values. You have tested your blood sugar after eating and the result was 159 mg/dl. The corresponding A1C is 7.2%. Let’s have a look at the blood sugar gauge:

Your result is:

High blood sugar (Hyperglycemia)

To improve your blood sugar after eating you need to
lower your blood glucose level by 19mg/dl.

Your blood sugar level (up to 2 hours) after eating should always be below 140mg/dl but not fall below 80mg/dl.

It is normal for blood sugar levels to rise immediately after a meal. The increased glucose is a product of the carbohydrates in the food that was just consumed. The higher blood glucose triggers the pancreas to produce more insulin.

Blood Sugar after eating

This release of insulin usually takes place within about 10 minutes of eating. The insulin removes the glucose from the blood and stores it for the body to use as energy. In a healthy individual, blood glucose levels should return to a normal level within about two hours after finishing the meal. In diabetics, the blood sugar level often remain elevated for a longer period because of the body’s inability to produce or utilize insulin properly.An elevated two-hour postprandial (after a meal) blood sugar may indicate diabetes or prediabetes. As a general rule, a normal two- hour postprandial blood sugar is as follows:

• Age 50 and under: Less than 140 mg/dl
• Age 50 – 60: Less than 150 mg/dl
• Over age 60: Less than 160 mg/dl

A doctor may recommend different postprandial blood sugar levels based on an individual’s particular circumstances and health history.

Several factors may cause a person’s postprandial blood sugar to remain elevated.

• Smoking after the meal: Studies show that smoking raises blood sugar levels in people with diabetes.
• Extreme stress: Stress produces the body’s fight-or-flight response triggering the release of stress hormones such as cortisol. These hormones cause the body to release the glucose it has previously stored for energy.
• Eating or drinking after the meal and before testing the blood sugar: Continuing to eat will keep blood sugars closer to their immediate post-meal levels.

Studies show that 15 to 20 minutes of moderate exercise, such as walking, shortly after a meal may improve glucose metabolism and reduce postprandial glucose levels.

Gestational Diabetes | Cedars-Sinai

Not what you’re looking for?

What is gestational diabetes?

Gestational diabetes is a type of diabetes that happens during
pregnancy. Unlike type 1 diabetes, gestational diabetes is not caused by having too
little insulin. Instead a hormone made by your placenta keeps your body from using
the insulin as it should. This is called insulin resistance. Blood sugar (glucose)
then builds up in your blood instead of being absorbed by the cells in your
body.

The symptoms of gestational diabetes often go away after delivery.
But sometimes they don’t. Or you may have a greater risk of developing type 2
diabetes later.

What causes gestational diabetes?

Healthcare providers don’t know what causes gestational diabetes.
But they do know what happens.

The placenta gives your growing baby nutrients and water. The
placenta also makes several hormones to keep the pregnancy healthy. These hormones
include:

• Estrogen
• Progesterone
• Cortisol
• Human placental lactogen

These hormones can affect how your body uses insulin
(contra-insulin effect). This often begins about 20 to 24 weeks into your pregnancy
and could lead to gestational diabetes.

During pregnancy, more fat is stored in your body, you take in
more calories, and you may get less exercise. All of these things can make your
blood sugar (glucose) levels higher than normal and possibly lead to gestational
diabetes.

As the placenta grows, it makes more of the hormones. The risk for
insulin resistance becomes greater. Normally your pancreas is able to make more
insulin to overcome insulin resistance. But if it can’t make enough to overcome the
effects of the placenta’s hormones, you can develop gestational diabetes.

Who is at risk for gestational diabetes?

Any woman can develop gestational diabetes during pregnancy. But
you may be more likely to get it if you:

• Are overweight or obese
• Have a family history of diabetes
• Are older than 25
• Are African American, American Indian, Asian American,
  Hispanic or Latino, or Pacific Islander
• Have pre-diabetes (impaired glucose tolerance)
• Have high blood pressure

What are the symptoms of gestational diabetes?

Gestational diabetes doesn’t cause any symptoms. That’s why it’s
important to get tested for it if you are at high risk.

If your blood sugar levels are very high, you may have these
symptoms:

• You urinate more than normal
• You are hungrier or thirstier than normal.
• You have blurred vision
• You have nausea and vomiting
• You lose weight even though you are hungrier

How is gestational diabetes diagnosed?

You should be tested for gestational diabetes in your 24th to 28th
week of pregnancy.

The American Diabetes Association also advises that you be tested
for type 2 diabetes if you have risk factors for this condition. This testing should
be done at your first prenatal visit.

Screening is done by these tests:

• One-hour glucose
  tolerance test.
  You drink a special beverage high in sugar. One hour
  later, the healthcare provider measures your blood sugar (glucose) levels. If
  your levels are higher than a certain level, this is considered an abnormal
  result.
• Three-hour
  glucose tolerance test.
  If the 1-hour test is abnormal, you will have a
  second glucose tolerance test done to confirm the diagnosis. You will drink
  another special beverage, but with more sugar. Your healthcare provider will
  measure your blood sugar levels 1 hour, 2 hours, and 3 hours later. You have
  gestational diabetes if at least two of the glucose measurements are higher than
  normal.

If you are diagnosed with gestational diabetes, you should get
tested for diabetes 4 to 12 weeks after your baby is born. You should also get this
screening at least every 3 years for the rest of your life.

What is the treatment for gestational diabetes?

You and your healthcare provider will figure out the best
treatment for you based on:

• How old you are
• Your overall health and past health
• How sick you are
• How well you can handle specific medicines, procedures, or
  therapies
• How long the condition is expected to last
• Your opinion or preference

Treatment for gestational diabetes focuses on keeping your blood
sugar levels in the normal range. Treatment may include:

• Special diet.

  You should eat 5 servings of vegetables, fruits, low-fat or nonfat dairy
  products, and lean meats. Use liquid fats for cooking instead of solid fats. You
  should eat whole grains and avoid high-calorie snacks or sweet desserts.

• Exercise.
  You should do moderate exercise unless your healthcare provider tells you not
  to.
• Daily blood
  glucose monitoring.
  Your goal is to keep your blood sugar levels lower
  than 130mg/dL to 140mg/dL 1 hour after eating.
• Insulin
  injections.
  You may need these to control your blood sugar levels. Or
  you may need other medicines taken by mouth.

What are possible complications of gestational
diabetes?

Gestational diabetes usually doesn’t cause birth defects. But it
can affect your baby in other ways if your blood sugar levels are not under
control.

Below are the 2 major health problems that can develop.

Macrosomia

Macrosomia means a baby who is much larger than normal. This
happens if the mother’s blood has too much blood sugar in it. The fetus’
pancreas senses this high level of blood sugar and makes more insulin. The fetus
then changes the extra blood sugar into fat. This extra fat means a larger
baby.

A larger than normal baby can be difficult to deliver. The
baby may have trauma or nerve damage, or need to be delivered by cesarean
section.

Hypoglycemia

Hypoglycemia is low blood sugar. This can happen to the baby
just after he or she is born if the mother’s blood sugar levels are too high.
The high levels in the mother cause the fetus to make more insulin. Once the
baby is born, he or she no longer has the high blood sugar levels from the
mother. This causes the baby’s blood sugar levels to fall very low.

Your blood sugar levels will be watched very closely during
labor. Your healthcare provider may give you insulin to keep your blood sugar in
a normal range. This will prevent your baby’s blood sugar from dropping greatly
after delivery.

Babies born to mothers with gestational diabetes may also have
low levels of calcium or magnesium in their blood.

These complications can be prevented. The key to prevention is
careful control of your blood sugar levels just as soon as the diagnosis of
diabetes is made.

Key points about gestational diabetes

• Gestational diabetes is a type of diabetes that happens
  during pregnancy.
• It may be caused by the hormones made by your placenta.
  These hormones can make insulin in your body not work as well as it should.
• Gestational diabetes happens about halfway through pregnancy
  and doesn’t cause birth defects.
• If your blood sugar is not under control, your baby can
  develop problems. One problem is larger growth than normal. The other problem is
  very low blood sugar just after birth.

Next steps

Tips to help you get the most from a visit to your healthcare
provider:

• Know the reason for your visit and what you want to
  happen.
• Before your visit, write down questions you want
  answered.
• Bring someone with you to help you ask questions and
  remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and
  any new medicines, treatments, or tests. Also write down any new instructions
  your provider gives you.
• Know why a new medicine or treatment is prescribed, and how
  it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the
  results could mean.
• Know what to expect if you do not take the medicine or have
  the test or procedure.
• If you have a follow-up appointment, write down the date,
  time, and purpose for that visit.
• Know how you can contact your provider if you have
  questions.

Medical Reviewer: Irina Burd MD PhD

Medical Reviewer: Donna Freeborn PhD CNM FNP

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Why is blood sugar so important after eating?

Postprandial blood sugar.

Few of those with diabetes know why it is so important…

Blood sugar after a meal is referred to as postprandial blood sugar. So the opposite, namely before a meal, is called preprandial. The American Diabetes Association (ADA) advises keeping your blood sugar levels before meals between 80–130 mg/dl and your levels 1–2 hours after meals under 180.

Usually, blood sugar begins to rise 10-15 minutes after a meal and reaches its peak after an hour. However, it is important to note that these are just approximate guidelines as postprandial glucose depends on several factors, such as the type of food consumed.

Influence on HbA1c

Research has shown that postprandial blood sugar levels are significant for HbA1c. Even if glucose spikes after eating are only brief, they still have the potential to raise HbA1c over the course of the day. Most people with diabetes check their blood sugar before a meal but not afterwards or they leave it until the next mealtime. This can lead to glucose spikes being undetected and remaining high for a long period of time.

How to deal with high postprandial blood sugar levels

Be sure to check your levels at least 90 minutes after a meal. Why? By that time rapid acting analogue insulin has reached its maximum effect (as opposed to normal insulin that not only takes longer to have an effect but also acts longer).

A useful tip is to set a reminder for a specific time and you’ll automatically be reminded to test your blood sugar levels. If you have type 1 diabetes, your blood sugar should be between 5 and 9 mmol/litre at least 90 minutes after eating (NICE Guidance for type 1 diabetes in adults, 2016). Of course your doctor may recommend another postprandial level according to your personal needs and state of health.

If it’s still too high then you should look into the causes such as:

• what type of food did I eat?

• did I correctly estimate my carbs?

• is my insulin-to-carb ratio correct?

• and is the injection-meal interval correct?

How to Control Spikes After Meals

If you’re trying to manage diabetes, you already know it’s important to keep track of your blood sugar levels. But how do you handle a spike that comes after you eat? It’s called “postprandial” blood glucose, and if you take some simple steps, you can get it under control and help avoid health problems.

Why You Should Keep an Eye on It

When your blood sugar is high, you can get symptoms like a foggy-headed feeling that makes it hard to focus or think clearly. Your energy may also take a dive, and you may feel nervous or moody.

If your levels go too low, you could even pass out. In the long run, if your blood sugar stays up, you could be at risk for heart disease, stroke, kidney disease, or other problems.

How to Measure Your Spikes

The American Diabetes Association (ADA) recommends you check your blood sugar levels right before mealtime with a blood sample from a finger stick. Then do it again 1 to 2 hours after that first bite of food.

Keep this up for a week or so. Write down the time and the blood sugar number. Make a note about anything you think might affect your levels, like medicine or exercise. And don’t forget to log exactly what you ate, along with portion sizes and the amount of carbs.

What levels are too high after a meal? Experts vary on what the number should be, but the ADA says a general goal is a blood sugar level under 180 mg/dL, 1 to 2 hours after a meal. Talk to your doctor about what you should aim for, and don’t adjust your medicine without speaking to them first.

How to Manage After-Meal Spikes

Get medicine that works for you. The right insulin or medication program can make a big difference. In general, to cover after-meal spikes, those that kick in quickly and for a short time are a better choice than ones that work slowly over a long period. Your doctor can explain your options.

Keep blood sugar in check before meals. That way, even if it goes up after you eat, it won’t be so dramatic.

Watch what you eat. Limit sweets, white bread, rice, pasta, and potatoes. They tend to trigger post-meal spikes.

The type of fat you eat may play a role, as well. One study shows you may be able to curb blood sugar spikes after you eat if you skip foods with lots of butter and choose a meal made with a little olive oil instead.

Eat breakfast every morning. Even when you’re in a hurry to get out the door, don’t be tempted to skip it. A study shows that folks with diabetes who don’t eat breakfast get higher blood sugar spikes after lunch and dinner.

The ideal morning meal? It might just be one that’s packed with protein. A small study shows that when people ate a 500-calorie breakfast that was 35% protein, their post-meal blood sugar levels were lower than those who started their day with high-carb food. But check with your doctor to see what’s right for you.

Go for an after-dinner walk. It’s a healthy habit for everyone, but if you have diabetes, it’s also a good way to burn extra glucose from a meal.

Blood Sugar Monitoring | Sugar High in the Morning

“I must admit that I stopped checking my blood sugar,” Dave said. “I used to stick myself and write the numbers in a book, but I had no idea what they meant. I’d eat the same thing and get different numbers. Finally, I just gave up.”

Sound familiar? Many people dutifully check their blood glucose levels but have no idea what the numbers mean. Part of the problem is that blood glucose levels constantly fluctuate and are influenced by many factors. The other part of the problem is that no two people are alike. A blood glucose reading of 158 mg/dl in two different people might have two different explanations.

Most people know that their bodies need glucose to fuel their activities and that certain foods or large quantities of almost any food will raise blood glucose. That’s the easy part. But just as cars require a complicated system of fuel pumps, ignition timing, batteries, pistons, and a zillion other things to convert gasoline into motion, our bodies rely on an intricate system to convert glucose into energy.

—

Learn More About Blood Glucose Management >>

Back to basics

Insulin is a hormone secreted by the pancreas that helps regulate the way the body uses glucose. Its main job is to allow glucose in the blood to enter cells of the body where it can be used for energy. In people who don’t have diabetes, the pancreas changes how much insulin it releases depending on blood glucose levels. Eating a chocolate bar? The pancreas releases more insulin. Sleeping? The pancreas releases less insulin until the wee hours of the morning when the hormones secreted in the early morning naturally increase insulin resistance, so the pancreas needs to release a little more.

Insulin also controls how much glucose is produced and released from the liver. Glucose is stored in the liver in a form called glycogen. When blood glucose levels drop, the liver turns glycogen into glucose and sends glucose to the bloodstream. When there is enough glucose in the bloodstream, the pancreas signals the liver to stop sending glucose into the bloodstream. This system of signals and feedback loops keeps the delicate coordination of insulin release and blood glucose in balance.

In Type 1 diabetes, the coordination of insulin release and blood glucose is completely out of balance because the pancreas stops making insulin. Injected insulin is used to replace what is missing and supply insulin’s signals again.

With Type 2 diabetes, the pancreas makes insulin but not enough to keep up with the body’s demand. Studies have shown that Type 2 diabetes is progressive, meaning that the beta cells of the pancreas make less insulin over time. In addition, the cells of the body are unable to take glucose out of the bloodstream when needed because they resist the insulin that you need to allow glucose to enter cells. On top of that, the liver continues to send a lot of glucose into the bloodstream even when it isn’t needed because the signals telling the liver to shut off aren’t working. So there are three problems facing those with Type 2 diabetes: not enough insulin, insulin resistance, and a liver that won’t stop releasing glucose into the bloodstream.

What’s normal?

Before any blood glucose reading has meaning, you need to know what you’re aiming for. Target goals for blood glucose set by the American Diabetes Association (ADA) are 80–130 mg/dl before a meal and less than 180 mg/dl two hours after the start of a meal. The American Association of Clinical Endocrinologists (AACE) has defined stricter blood glucose target goals of less than 110 mg/dl before a meal and less than 140 mg/dl two hours after the start of a meal. Ask your health-care provider whether you should use the ADA or the AACE targets as your goal. Both guidelines are based on evidence showing the blood glucose readings that are needed to prevent the complications of diabetes.

The words you use to describe blood glucose monitoring may affect how you feel about it. For example, it might help to call it a blood glucose check, not a test, because the word “test” implies pass or fail. It might also help to refer to blood glucose readings as either in or out of target range rather than “good” or “bad.”

It’s also good to remember that your blood glucose goal is to aim for a target range, not an exact number each time. Before-meal blood glucose readings of 101 mg/dl, 114 mg/dl, 126 mg/dl, and 97 mg/dl may look like they are up and down, but they’re all within the target range defined by the ADA.

When you begin to analyze your blood glucose readings, it is helpful to recognize the difference between an isolated reading and a pattern of readings. Say you check your blood glucose before lunch one day, and you get a reading of 246 mg/dl. You know that the reading is out of range, but so what? To make sense of that reading, you would need to know your pattern of blood glucose readings before lunch. If you checked three days in a row before lunch and recorded readings of 118 mg/dl, 110 mg/dl, and 113 mg/dl, you’d see that the reading of 246 mg/dl doesn’t fit your usual pattern before lunch and therefore isn’t noteworthy.

Knowing your pattern gives you a background for comparison. Isolated readings can still be helpful, especially when your blood glucose is low. But an isolated reading is meaningless without knowing the story behind it. And the story includes the factors that affect blood glucose level, including food, medicines, exercise, stress, and infection.

How often should I check?

Most people check their blood glucose level once a day, first thing in the morning. It’s a common time to check because it’s easy: You get up, check your blood glucose, take your medicines, and eat breakfast. Then you’re done with your diabetes for the day and don’t have to think about it anymore.

The problem with this routine is that it only tells you about your blood glucose pattern before breakfast. You don’t learn what is happening after meals or later in the day. To find meaningful patterns at other times of the day, you have to check at other times of day.

One option for finding more patterns is to check your blood glucose four times per day three days per week. Checking before breakfast, two hours after breakfast, before dinner, and two hours after dinner three times per week for a few weeks will help you identify your patterns throughout the day.

Try to make blood glucose monitoring a useful tool by checking your blood glucose at times that serve you. Blood glucose monitoring should help you make a decision, give you feedback about a decision, and help you learn about your usual patterns.

You also need to consider the cost of the test strips. For those who do not take insulin, Medicare pays for one strip per day, so you want to put those strips to good use. Instead of just checking before breakfast every morning, you might decide to check before and after breakfast on Monday, before and after lunch on Wednesday, and before and after dinner on Saturday. If you take insulin, Medicare and most health insurance plans will pay for the number of strips written by your health-care provider on the prescription.

There are many ways to keep track of your blood glucose readings so that you can evaluate the patterns. You can use a logbook in which you write down the readings along with any comments (such as what you had for lunch or how stressed you were feeling). Depending on what meter you use, you may be able to use computer software that displays the contents of your meter memory in graphic forms.

Here are some common patterns and probable explanations that will help you make sense of your numbers:

My blood glucose is always higher in the morning when I get up and is lower during the day.

• • Your liver might be sending a lot of glucose into the bloodstream because the signals telling it to shut off aren’t working. The drug metformin may be prescribed, because its main action is to signal the liver to shut off.

• • Your dinner or bedtime snack choices might be raising your blood glucose the next morning. Try changing your food choices and portions to learn more about their effect on your blood glucose levels.

• • Your body may be unable to handle the effect of the hormones secreted at dawn that work against insulin. This early-morning release of hormones is called the dawn phenomenon. High blood glucose that results from it can be managed with oral medicines or insulin.

• Your insulin or oral medicine dose may need to be adjusted.

My blood glucose is high all day.

• • If you have Type 2 diabetes, your cells may be resisting your insulin. Exercise, weight loss, and certain medicines will help to make your body more sensitive to insulin and lower your blood glucose.

• • If you have Type 2 diabetes, your pancreas may not be making enough insulin to meet your needs, and you may require oral medicines or insulin.

• If you have Type 1 diabetes, you may need an increase in your basal insulin doses. Basal insulin is the amount of insulin your body needs in the background all day long. Insulin glargine (brand name Lantus), insulin detemir (Levemir), or NPH can provide basal insulin. An insulin pump is also programmed to deliver basal insulin.

My blood glucose is within range before I eat but high two hours later.

• It is helpful to understand how the secretion of insulin changes in Type 2 diabetes. The pancreas secretes insulin in response to a meal in two phases. In the first 10 minutes after glucose enters the bloodstream, there is an early burst of insulin release called first-phase insulin secretion. This is followed by the second-phase insulin secretion, a sustained release of insulin that lasts for several hours. One of the early changes in Type 2 diabetes is the loss of first-phase insulin secretion following a meal. This means that not enough insulin enters the bloodstream as quickly as it is needed, resulting in high blood glucose after meals.

Certain medicines taken at mealtimes can help. Oral drugs such as nateglinide (Starlix) and repaglinide (Prandin) stimulate the pancreas to release more insulin when blood glucose levels are higher, while acarbose (Precose) and miglitol (Glyset) slow the rate at which certain carbohydrates are absorbed from the small intestine.

The rapid-acting insulin analogs lispro (Humalog), glulisine (Apidra), aspart (NovoLog), and insulin human inhalation powder (Afrezza) also work effectively to lower blood glucose after meals. Regular insulin peaks too slowly to completely lower blood glucose following meals although some people find Regular insulin is the best choice for them.

• What you eat makes a difference, too. Your blood glucose reading taken two hours after you start to eat should be about 30 mg/dl higher than before you eat. After-meal readings can tell you about the impact of food on your blood glucose levels. If your blood glucose reading was 111 mg/dl before eating two cups of pasta and 322 mg/dl two hours later, you’ve learned that two cups of pasta is too much for you. However, a reading of 157 mg/dl two hours after eating one cup of pasta tells you how much pasta you can eat to keep your after-meal readings within the target range.

Many people are shocked by how high their readings are after meals. Ralph was convinced that his large restaurant meals every night didn’t really raise his blood glucose levels because his fasting readings weren’t elevated. But when he actually checked two hours after dinner and got readings over 400 mg/dl, he decided to make some changes.

My blood glucose is usually no higher than 130 mg/dl, but for the past two days every reading is over 200 mg/dl.

• A sudden change in your blood glucose pattern is usually due to infection. The stress hormones released when you are sick tend to raise blood glucose levels. Infection is a physical stress, and when stress occurs, the body reacts by secreting more epinephrine, cortisol, and glucagon. These hormones cause extra glucose to be released from the liver to give the body added energy to cope. Most times, your blood glucose levels will rise even before you get symptoms of an infection.

Two heads are better than one

Dave stopped checking his blood glucose levels because the numbers didn’t mean anything, but some people stop checking simply because the numbers upset them. It’s especially hard when you’ve been following all the rules, eating right, exercising, and taking your medicines and the numbers are still high.

Learning what the numbers mean and evaluating the patterns are tools that can help you cope. It’s also helpful to remember that there are blood glucose readings that defy explanation. Sometimes we just don’t know why a reading is out of range. That’s why it is wise to team up with a diabetes educator or your health-care provider who can offer guidance and a fresh perspective. What do the numbers tell you? The answer lies in knowing your targets, patterns, and who to call when you have a question.

Want to learn more about maintaining target blood sugar levels? Read “What Is a Normal Blood Sugar Level?” and “Blood Sugar Monitoring: When to Check and Why” and see our Blood Sugar Chart.

Originally Published July 20, 2006

Blood Sugar

Fasting Blood Sugar (FBS or Fasting Glucose)

A test that measures blood sugar levels. Elevated levels are associated with diabetes and insulin resistance, in which the body cannot properly handle sugar (e.g. obesity).

Goal values:

• Less than 100 mg/dL = normal
• Between 110–125 mg/dL = impaired fasting glucose (i.e., prediabetes)
• Greater than 126 mg/dL on two or more samples = diabetes

Preparation

This test requires a 12-hour fast. You should wait to eat and/or take a hypoglycemic agent (insulin or oral medication) until after test has been drawn, unless told otherwise.

Eating and digesting foods called carbohydrates forms glucose (blood sugar). Glucose is needed by your body to provide energy to carry out your normal activities. Insulin is needed by the body to allow glucose to go into the cells and be used as energy. Without insulin, the levels of glucose in the blood will rise. Diabetes is a disease that occurs when either the pancreas (an organ in your body) is not able to produce insulin or the pancreas makes insulin, but it does not work as it should. Fasting blood sugar is a part of diabetic evaluation and management. An FBS greater than 126 mg/dL on more than one occasion usually indicates diabetes.

Glycosylated Hemoglobin or Hemoglobin A1C (HbA1C)

Reflects average blood sugar levels over the preceding 90-day period. Elevated levels are associated with prediabetes and diabetes. Individuals with diabetes have an increased risk of a cardiac event. A diabetic person’s risk for heart attack is the same as a non-diabetic person, who has experienced one heart attack, having a second heart attack. Aggressive global preventive risk reduction efforts, such as lower LDL targets, diet, exercise and blood pressure control, are recommended.

Goal values (per American Diabetes Association guidelines):

• A range of 5.7-6.4 percent indicates an increased risk for development of diabetes (i.e., prediabetes), and lifestyle interventions may be beneficial.
• A value equal or greater than 6. 5 percent is considered diabetic.

Preparation

This test may be measured any time of the day without fasting.

Glycosylated hemoglobin is blood glucose attached to hemoglobin (a component of blood). This test is often called the “diabetic report card.” It reflects the average blood sugar for the two to three month period before the test.

To calculate the average blood glucose level from the HbA1C:

HbA1C level x (multiplied by) 33.3 – 86 = average blood glucose level for the past 90 days. HbA1C can be helpful to track diabetic control over time.

Gestational diabetes – Diagnosis and treatment

Diagnosis

If you’re at average risk of gestational diabetes, you’ll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy.

If you’re at high risk of diabetes — for example, if you’re overweight or obese before pregnancy or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes early in pregnancy, likely at your first prenatal visit.

Routine screening for gestational diabetes

Screening tests may vary slightly depending on your health care provider, but generally include:

• Initial glucose challenge test. You’ll drink a syrupy glucose solution. One hour later, you’ll have a blood test to measure your blood sugar level. A blood sugar level of 190 milligrams per deciliter (mg/dL), or 10.6 millimoles per liter (mmol/L) indicates gestational diabetes.

  A blood sugar below 140 mg/dL (7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, you’ll need another glucose tolerance test to determine if you have the condition.

• Follow-up glucose tolerance testing. This test is similar to the initial test — except the sweet solution will have even more sugar and your blood sugar will be checked every hour for three hours. If at least two of the blood sugar readings are higher than expected, you’ll be diagnosed with gestational diabetes.

More Information

Show more related information

Treatment

Treatment for gestational diabetes includes:

• Lifestyle changes
• Blood sugar monitoring
• Medication, if necessary

Managing your blood sugar levels helps keep you and your baby healthy. Close management can also help you avoid complications during pregnancy and delivery.

Lifestyle changes

Your lifestyle — how you eat and move — is an important part of keeping your blood sugar levels in a healthy range. Doctors don’t advise losing weight during pregnancy — your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy.

Healthy diet

A healthy diet focuses on fruits, vegetables, whole grains and lean protein — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. A registered dietitian or a diabetes educator can help you create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.

Stay active

Regular physical activity plays a key role in every woman’s wellness plan before, during and after pregnancy. Exercise lowers your blood sugar, and as an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping.

With your doctor’s OK, aim for 30 minutes of moderate exercise on most days of the week. If you haven’t been active for a while, start slowly and build up gradually. Walking, cycling and swimming are good choices during pregnancy. Everyday activities such as housework and gardening also count.

Monitor your blood sugar

While you’re pregnant, your health care team may ask you to check your blood sugar four or more times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range.

Medication

If diet and exercise aren’t enough, you may need insulin injections to lower your blood sugar. Between 10% and 20% of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe an oral medication to control blood sugar, while others believe more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.

Close monitoring of your baby

An important part of your treatment plan is close observation of your baby. Your doctor may check your baby’s growth and development with repeated ultrasounds or other tests. If you don’t go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.

Follow-up after delivery

Your doctor will check your blood sugar after delivery and again in six to 12 weeks to make sure that your level has returned to normal. If your tests are normal — and most are — you’ll need to have your diabetes risk assessed at least every three years.

If future tests indicate type 2 diabetes or prediabetes, talk with your doctor about increasing your prevention efforts or starting a diabetes management plan.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

It’s stressful to know you have a condition that can affect your unborn baby’s health. But the steps that will help control your blood sugar level — such as eating healthy foods and exercising regularly — can help relieve stress, nourish your baby and help prevent type 2 diabetes in the future.

You may feel better if you learn as much as you can about gestational diabetes. Talk to your health care team, or read books and articles about gestational diabetes. Some women find a support group for women with gestational diabetes helpful.

Preparing for your appointment

You’ll likely find out you have gestational diabetes from routine screening during your pregnancy. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.

Here’s some information to help you get ready for your appointment and know what to expect from your doctor or other health professional.

What you can do

• Be aware of pre-appointment restrictions. When you make your appointment, ask if you need to fast for lab tests or do anything else to prepare for diagnostic tests.
• Write down symptoms you’re having, including those that may seem unrelated to gestational diabetes. You may not have noticeable symptoms, but it’s good to keep a log of anything unusual you notice.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medications, including over-the-counter drugs and vitamins or supplements you’re taking.
• Take a family member or friend along, if possible. Someone who accompanies you may remember something that you missed or forgot.

Questions to ask your doctor

Make a list of questions to help make the most of your time with your doctor. For gestational diabetes, some basic questions to ask your doctor include:

• What can I do to help control my condition?
• Can you recommend a dietitian or diabetes educator who can help me plan meals, an exercise program and coping strategies?
• Will I need medication to control my blood sugar?
• What symptoms should prompt me to seek medical attention?
• Are there brochures or other printed materials I can take? What websites do you recommend?

What to expect from your doctor

Your doctor is also likely to have questions for you, especially if you’re seeing him or her for the first time. Your doctor may ask:

• Have you experienced increased thirst or excessive urination? If so, when did these symptoms start? How often do you have them?
• Have you noticed other unusual symptoms?
• Do you have a parent or sibling who’s ever been diagnosed with diabetes?
• Have you been pregnant before? Did you have gestational diabetes during your previous pregnancies?
• Did you have other problems in earlier pregnancies?
• If you have other children, how much did each weigh at birth?

Aug. 26, 2020

90,000 Fasting blood sugar or postprandial blood sugar, which is more important? I don’t know, your blood sugar is wasted

Lao Zhang bought this blood sugar second week after the ceremony.

“I don’t understand. Some time ago, a medical examination showed that the blood sugar level was not very good. After the doctor adjusted the treatment plan for me, even the blood sugar level monitor. The time has changed.”

57-year-old Zhang is very irritable.He went to the hospital once a week to check his fasting blood glucose level. Since his last physical examination, not only was the post-meal blood glucose test added, but the pre-dinner blood glucose test was also added.

“This is too much of a problem, can we not monitor it as often?” asked Dr. Lao Zhang.

Diabetes Patient From the point of view of people, checking the blood sugar level seems to be a mandatory course before and after a meal. Full patient I do not even understand why this blood glucose control cannot be prescribed once a day? Such a frequent operation is really troublesome.

XNUMX. Why is blood glucose measurement strictly timed?

Blood glucose monitoring is a diagnosis 糖尿病, Gold indicator for assessing blood sugar control According to the blood glucose monitoring time, it is divided into: Fasting Blood glucose level, blood glucose 2 hours after a meal and random level blood glucose.

This is a graph of postprandial blood glucose changes:

We clearly see that the peak blood sugar level in normal people begins to rise about half an hour to 1 hour after eating, which is associated with digestion of the gastrointestinal tract after eating.However, the different functions of human insulin secretion are slightly different, and fluctuating values ​​will also vary, usually in the range of 6.7-9.4 mmol / L, which is the normal peak.

When food is absorbed and insulin secreted, blood sugar reaches the “top of the mountain” and begins to descend from the mountain. About 2 hours after eating, blood sugar levels gradually decrease, so doctors will use this time as a temporary knot to assess blood sugar levels …

Except 2 hours after meals, Diabetes mellitus Patients also need to monitor fasting blood glucose levels.Fasting blood glucose refers to the blood sugar level after an overnight fast (at least 8 to 10 hours without food). At this time, the human body can better maintain the secretion function of human insulin due to a lack of rice water. Fasting ≥7.0 mmol / L diabetes is diagnosed. If the blood glucose level is 6.1-7.0 mmol / L, although diabetes cannot be diagnosed, it also indicates a dysfunction in the regulation of blood glucose.

In addition, the glycosylated hemoglobin index is especially important. It can reflect the average blood sugar level over 2-3 months and is not affected by diet during the test. It can be checked at any time, which is why it is also called random blood sugar.

The measured values ​​will also differ at different points in time when monitoring blood glucose levels. Only a comprehensive comparison can better reflect the patient’s physical condition.

XNUMX.Is it important to control fasting blood sugar or post-meal blood sugar?

Currently, monitoring of patients with diabetes mainly focuses on two important indicators: fasting blood glucose and blood glucose after meals. In real life, many patients value one of the values, so which of the two is more important?

Xiao Miao explained above that fasting blood glucose ≠ blood glucose from hunger. Some patients think that fasting blood glucose is the blood glucose level before a meal, or they are monitored after they are hungry during the day.The body of the human body has a powerful adjustment function: when the body is hungry, all the treasures in the body will change, which will distort the collected samples.

A person’s blood sugar fluctuates with food, activity, etc. Usually, the blood sugar level remains constant during 8-10 hours of fasting so that the true blood sugar concentration can be determined.

Fasting blood sugar can help determine if you have diabetes or other blood sugar if Only control fasting blood sugar, It cannot prevent diabetic macrovascular complications.

The importance of postprandial blood sugar lies in ischemic heart disease The risk is associated. Studies have shown that in patients with type 2 diabetes, postprandial blood glucose has a stronger predictive effect on cardiovascular events, and the predictive value of mortality is higher than in fasting blood glucose or glycosylated hemoglobin.

What if you focus on post-meal blood sugar control only, focusing only on the post-meal value, you will find that there is no basis for fasting blood sugar and it will be difficult to find a benchmark for whole blood sugar.In diabetes management, fasting blood glucose control is the foundation and key to lowering total blood glucose. Blood glucose control is focused over the entire period of time, and the value of post-meal blood glucose feedback is limited. Reducing hypoglycemia requires more than postprandial blood glucose levels, but also fasting blood glucose levels.

Therefore, postprandial blood glucose control is just as important as fasting blood glucose control.We should not give preference to one over the other. Blood glucose monitoring and blood glucose control must be all-weather. Only when blood glucose levels are maintained at or near normal levels around the clock can be considered truly satisfactory blood glucose control.

XNUMX. After a meal, my blood sugar is normal, but my fasting sugar is higher than normal What is the reason?

Ms. Yang is a one-year-old diabetic patient.After taking hypoglycemic drugs for a long time, her blood sugar levels stabilized, so Ms. Yang began to reduce the dose and gradually stopped taking the drug.

Ms. Yang recently found that her blood glucose was within the normal range 2 hours after stopping the drug, but her fasting blood glucose was above 8.4 mmol / L (normal range <6.1 mmol / L). Ms. Yang was taken aback.

Fasting blood sugar is higher than post-meal blood sugar, which is actually due to the following reasons: 1.Weight Loss: Many diabetic patients will have linear weight loss due to the effects of hypoglycemic drugs. Keys took the medication for one year, now it has dropped from 120 dzin to 105 dzin. According to diabetes guidelines, if you lose at least 5-10% of your body weight, your blood sugar can rise significantly.

2. Diet changes: After learning that they have diabetes, patients themselves limit their sugar intake and focus on a light diet. Diet changes can also affect blood sugar levels.

3. Increase Exercise: To control blood sugar, diabetic patients will continue to exercise in addition to improving their diet. However, if your calorie intake during exercise is lower than your calorie intake, your postprandial blood sugar will be lower than your fasting blood sugar.

4. Abnormal insulin secretion: patients with diabetes, especially those with type 2 diabetes, will have excessive insulin secretion and peak delay.High insulin levels can lower your blood sugar, and then your postprandial blood sugar will be lower than your fasting blood sugar.

5. Under the influence of hypoglycemic drugs: To speed up the treatment process, some patients increase the amount of drugs taken without permission, which leads to a significant drop in blood sugar after a meal.

Diabetics should focus on monitoring their blood glucose levels in their daily lives, rather than focusing on one of the indicators.Only by lowering the average blood sugar level can real effective control be achieved. When abnormal blood sugar levels are detected, in addition to lifestyle adjustments, it is also necessary to actively cooperate with the prescription drugs prescribed by the doctor.

Source: Wonderful Materia Medica

Like it, support, please forward and share ↓ Follow us Editor: Zhao Lingyun

Glucose level in the blood after meals

The first rise in sugar levels after the introduction of carbohydrates reflects the strength of reflex stimulation of the sympathetic nerves that occurs when glucose enters the alimentary canal.A further increase in sugar concentration, as a rule, is associated with the rapid absorption of carbohydrates, determined by the state of the intestinal wall, liver function. In a healthy person, the value of blood sugar in an hour after exercise exceeds the level of fasting blood sugar by 50-75%. The descending part of the glycemic curve reflects the production of insulin and depends on the state of the parasympathetic nervous system of the subject, the function of the pancreas, liver and other organs. This segment of the glycemic curve is called the hypoglycemic phase.The last point on the glycemic curve, determined after 2.5-3 hours, is due to the state of equilibrium of all body systems involved in the regulation of blood sugar. Normally, it should coincide with the blood sugar level of the subject on an empty stomach. In patients with diabetes mellitus, fasting blood glucose is elevated, the increase in the glycemic curve is slower, reaching a significant value in 60-150 minutes (more than 1.8 times higher than [c.159]

After the injection of insulin, a hypoglycemic state develops, which, however, is quickly eliminated with the introduction of glutamic acid.Explain why glutamic acid normalizes blood glucose levels. Explain the answer with a diagram. [c.412]

Test for glucose tolerance. The rate of insulin secretion is regulated by blood sugar levels. After eating food rich in sugar, blood sugar levels temporarily rise. This stimulates the secretion of insulin by the pancreas11, which in turn leads to a decrease in blood sugar levels. This pattern underlies the diagnostic test for diabetes. If there is a suspicion of the possibility of diabetes mellitus (as a result of the determination of glucose in the urine using the Benedict reaction), the patient’s glycemic curve is examined (glucose tolerance test).He is given a massive dose of glucose – 1 g per kg of body weight – and blood sugar levels are measured at regular intervals for several hours. In the beginning, regardless of whether the person has diabetes or not, the blood sugar level rises rapidly.In a normal body, insulin secretion increases as a result, and after about an hour, the blood sugar level returns to its original level. With the introduction of large doses of glucose, it can even drop to a hypoglycemic level, since in this case too strong stimulation of the pancreas may occur.With diabetes, blood sugar levels rise and remain elevated for several hours. Typical glycemic curves for both cases are shown in FIG. 107. [c.385]

Lactic acid is formed in muscles under anaerobic conditions and is the end product of glycolysis. The amount of lactic acid formed is equivalent to the amount of decomposed glucose. It was found that the content of lactic acid in the blood of humans and animals increases after muscular work.A particularly sharp increase in the amount of lactic acid is observed after vigorous muscle exercise. However, the level of lactic acid in the blood decreases rapidly as it is absorbed by the liver and converted there to glycogen. The resynthesis of glycogen from lactic acid cannot proceed spontaneously and is carried out only if it is coupled with oxidative processes that provide energy. According to Pasteur and Meyerhof, glycogen resynthesis is associated with the oxidation of some part of lactic acid to carbon dioxide and water.The bulk of lactic acid is converted into glycogen. It has now been established that under aerobic conditions, with a sufficient supply of oxygen, glycogen and glucose are oxidized through the stage of pyruvic acid to CO2 and H2O, bypassing the formation of lactic acid (see p. 172). [c.254]

Case 1. The patient does not tolerate milk. As soon as he drinks it, he immediately starts vomiting and diarrhea. Lactose tolerance test performed.(The subject receives a certain amount of lactose, after which the concentration of glucose and galactose in the blood plasma is measured at appropriate intervals, Normally, the level of these sugars increases to a maximum after about an hour, and then decreases,) In the patient in this test, the concentration of glucose and galactose in the blood did not increase, but remained constant. Explain why in healthy people the concentration of glucose and galactose in the blood first increases and then decreases. Why does the patient have no such changes Case 2.In a patient with mental retardation, milk causes vomiting and diarrhea. The blood glucose concentration is low, and the concentration of reducing sugars is much higher than normal. Galactose is found in the urine. What explains the high concentration of reducing sugars in the blood Why is galactose found in urine [c. 475]

The normal fasting glucose concentration is 80 mg / 100 ml (4.4 mM). During the day, the blood glucose concentration normally ranges from 80 mg / 100 ml before meals to about 120 mg / 100 ml after meals.How is a relatively constant level of glucose maintained despite significant changes in its supply and use? We have already discussed the main regulatory elements above, so now we will consider them in interaction. The content of glucose in the blood is regulated primarily by the liver, which can absorb and release large amounts of glucose into the blood in response to hormonal signals and to the very change in glucose concentration (Fig. 23.18). An increase in the concentration of glucose in the blood that occurs after ingestion of a food rich in carbohydrates, in turn, causes an increase in the content of glucose-6-phosphate in the liver, since only under these conditions the catalytic sites of glucokinase are filled with glucose.Recall that glucokinase, in contrast to hexokinase, has a high Km for glucose (10 mM, while the fasting blood glucose concentration is 4. 4 mM) and is not inhibited by glucose-6-phosphate. As a result, with an increase in blood glucose, the rate of formation of glucose-b-phosphate in the liver increases. The further fate of glucose-6-phosphate is regulated mainly by the oppositely directed actions of glucagon and insulin. Glucagon triggers a cascade regulation mechanism, [c.292]

Food glucosuria.It is a short-lived type of glucosuria that results from ingestion of large amounts of sugar. Sugar is absorbed so quickly that the body cannot convert it quickly enough to glycogen and thus keep blood sugar below the kidney threshold. After excretion of excess sugar, glucose levels return to normal. [c.365]

Glucose accumulates in the animal body in the form of glycogen, which is easily converted by enzymes back into glucose in the liver and muscles.Glycogen in muscles is quickly consumed during work and is restored during rest, its concentration can vary from 0.1 to 1%. The amount of glycogen in the liver can also vary greatly, depending on nutritional status. In emaciated animals, its amount can be less than 1%, and in animals with good nutrition it reaches 15% of the weight of fresh liver. When muscles need more glycogen, they get glucose from the blood and use enzymes to convert it to glycogen.At the same time, the liver replenishes the blood with the same amount of glucose that was taken by the muscles in such a way that the total amount of glucose in the blood remains unchanged. The minimum concentration, called the hungry level, is on average about 0.1% in a healthy person, however, in adults, the glucose concentration can fluctuate within 0.08-0.14% and in small children it can drop to 0.06%. The amount of glucose in a normal person can increase to a maximum of 0.18% after eating carbohydrates.The term hypoglycemia is used when the blood sugar is below the normal fasting level. The term hyperglycemia refers to a condition where blood sugar levels are above normal after eating a large amount of carbohydrates. Hyperglycemia usually appears with diabetes p [c. 189]

The blood glucose level after a 40-hour fast is maintained at the expense of [c.385]

Food monosaccharides are represented mainly by glucose and fructose, which are found in many fruits , honey and are called sugars.They enter the body in free form or are formed in the process of digestion from di- and polysaccharides of food. The intake of a large amount of free glucose into the body and its rapid absorption into the blood (within 15–20 minutes after eating it is found in the blood) leads to blood hyperglycemia, which activates the function of the pancreas, which secretes the hormone insulin, which ensures the supply of glucose to the tissues. where it is used for the synthesis of glycogen, and with a significant excess – for the synthesis of fats.After the action of insulin, the level of glucose in the blood decreases, which can lead to hypoglycemia and general weakness. Systematic activation of the pancreas can contribute to the development of diabetes mellitus. Therefore, the amount of monosaccharides in the diet of people, especially in old age, should be limited and not exceed 25-35% of the total amount of carbohydrates consumed. [c.448]

The concentration of glucose in the blood of an adult is normally maintained in the range of 4.4-6.0 mmol L or 80-120 mg% (in 100 ml of blood) despite significant changes in its consumption and intake during the day (Fig.61). The constant level of glucose in the blood is regulated primarily by the liver, which can absorb or release glucose into the blood depending on its concentration in the blood and in response to hormones. An increase in blood glucose after a carbohydrate meal activates the enzymatic process of glycogen synthesis in the liver, and a decrease in its level enhances the breakdown of glycogen in the liver to glucose, followed by its release into the blood. [c.166]

In humans, between meals, the concentration of glucose in the blood varies from 80 to 100 mg / 100 ml. After eating a meal rich in carbohydrates, the glucose concentration increases to 120-130 mg / 100 ml. During fasting, the glucose concentration drops to approximately 60-70 mg / 100 ml. In the normal state of the body, the level of glucose in the blood fluctuates within the specified limits. In ruminants, the glucose concentration is much lower — about 40 mg / 100 ml in sheep and 60 mg / 100 ml in cattle. This is apparently due to the fact that in these animals, practically all carbohydrates supplied with food are broken down to lower (volatile) fatty acids, which replace glucose as a source of energy in tissues during normal nutrition. [c.222]

The most informative indicator of the state of carbohydrate metabolism is the level of glucose in the blood. In the post-absorptive period (after the end of the digestive period), usually in the morning after sleep, the normal glucose concentration is 3.3-5.5 mmol / l. [c.283]

There is one more aspect that should be kept in mind when considering gluconeogenesis from the point of view of human biology and medicine. The consumption of large amounts of alcohol dramatically inhibits gluconeogenesis in the liver, as a result of which the level of glucose in the blood decreases.This condition is called hypoglycemia. This effect of alcohol is especially pronounced after heavy physical exertion or on an empty stomach. If a person drinks alcohol after long and hard physical work, the blood glucose level can drop to 40 and even up to 30% of the norm. Hypoglycemia adversely affects brain function. It is especially dangerous for those areas that control body temperature, so that, for example, under the influence of hypoglycemia, the body temperature can drop by 2 ° C or more (when measured in the rectum).If a person in this state is given a glucose solution to drink, then normal body temperature will quickly recover. The old custom, which prescribed giving whiskey or brandy to those who were saved at sea or in the desert, to hungry or exhausted people, is physiologically unjustified and even dangerous in such cases, glucose should be given. [c.611]

When the pancreas secretes insufficient insulin, the body is unable to oxidize glucose or convert it at a normal rate into glycogen.As a result, glucose builds up in the blood. The rise in blood sugar depends on carbohydrate intake and the extent of damage to the pancreas. In severe cases of diabetes, ingestion of 1 g of glucose per kg of body weight can lead to an increase in sugar levels of up to 0.4-0.5% within 1 hour. In contrast to normal people, sugar levels in diabetics can remain high for several hours and exceed 0.2% after an overnight fast. [c.190]

Glucose.In the portions of urine received before exercise, glucose is practically absent. After the completion of training, a significant content of glucose (glucosuria) is often found in the urine of athletes by conventional methods, which may be due to two main reasons. First, as already noted, during exercise, the level of glucose in the blood rises (hyperglycemia) and it can exceed the renal threshold, as a result of which part of the glucose will not be reabsorbed in the convoluted tubules of the nephron and will remain in the urine. Secondly, due to damage to the renal membranes, the process of glucose reabsorption in the kidneys is directly disrupted, which also leads to the development of glucosuria. [c.163]

Doctor. So. You decided to take care of yourself and did some exercises one morning. What happened to your body For a while, the blood flow rate increased, and if you measure your blood glucose immediately after charging, it will probably drop slightly. As for the vital capacity of the lungs and the mass of your body, after one lesson, as you perfectly understand, they practically will not change.It is quite another matter if you begin to exercise every day, and even take walks in the fresh air every day. In a word, significantly change your lifestyle. Then, in a few months, your oxygen consumption by body tissues, metabolic rate, the number of mitochondria in your cells will noticeably increase, which means that your Similarity Parameter will increase. Now, in full accordance with (4. 32), your body fat will decrease, the vital capacity of your lungs will increase, the blood glucose and cholesterol levels will decrease, and the level of autoimmune processes that are very dangerous for the body will decrease (see.rice. 4.7). [c.96]

The most important carbohydrate in the blood is glucose. Its content is small, on average it is about 100 mg per 100 ml. In cattle, glucose is even less — 40–70 mg. After feed intake, the level of the monosaccharide in the blood temporarily rises. Other carbohydrates can be found in very small amounts in the blood in conjunction with protein. [c.162]

Homeostatic blood glucose level Ob), the maximum deviation from it (Ymax) and the total load on the body after glucose gfiema (V) increased by 8, 25 and 46%, respectively.Such changes in carbohydrate metabolism have led to a noticeable increase in the number of patients with diabetes mellitus. [c.150]

Control of the synthesis and breakdown of glycogen in the liver is central to the regulation of blood glucose. Normally, this level ranges from 80 to 120 mg per 100 ml. The liver is sensitive to the concentration of glucose in the blood if the blood glucose exceeds the threshold level, the liver absorbs glucose if its level is below this level, the liver releases glucose.The amount of phosphorylase a in the liver decreases rapidly with glucose infusion (Fig. 16.10). After the lag period, the amount of glycogen synthase a increases, which leads to the synthesis of glycogen. It has recently been found that phosphorylase serves as a glucose sensor-sensing element for glucose in liver cells. The binding of glucose to phosphorylase a shifts the allosteric equilibrium from the R-state to the T-state (see Fig. 16.5). As a result, the phosphoryl group at serine-14 becomes available for hydrolysis by phosphatase.In this case, a significant role is played by the fact that phosphatase, closely binding to phosphorylase a, exerts its catalytic action only after the transition of the latter to the T-state under the action of glucose. [c.128]

In adipose tissue, glucose utilization decreases and the inhibitory effect of insulin on lipolysis decreases, fat is mobilized in the form of free fatty acids and glycerol. Free fatty acids are transported to other tissues, where they are either oxidized or esterified.After activation (conversion to glycerol-3-phosphate), glycerol enters the carbohydrate pool (mainly in the liver and kidneys). During the transition from satiety to starvation, endogenous glucose production (from amino acids and glycerol) lags behind its utilization and oxidation, liver glycogen stores are depleted and blood glucose levels fall. Fat mobilization increases for several hours, then the content of free fatty acids in plasma and blood glucose stabilizes at the level characteristic of the state of starvation (0.7-0.8 µmol ml and 60-70 mg / 100 ml, respectively).It can be assumed that at this level of glucose in the animal’s blood, its entry into the tissues provides the needs for utilization and oxidation. The compensatory increase in the oxidation of fatty acids and ketone bodies reduces the level of oxidation [c.297]

In humans, a fiber-rich diet has a beneficial effect, contributing to water retention during the passage of food through the intestines and the formation of bulky soft feces. This diet reduces the likelihood of diverticulosis, colon cancer, cardiovascular disease, and diabetes.Low solubility fibers such as cellulose and lignin found in wheat bran work well for colon function, while the more soluble fibers found in fruits and vegetables, such as gums and pectins, lower blood cholesterol levels, possibly due to binding of bile acids and food cholesterol. Soluble fiber also interferes with gastric emptying, slowing down and reducing the rise in blood glucose after a meal, followed by a decrease in insulin secretion.This effect is especially beneficial for diabetics and those on a diet, because under such conditions, the degree of subsequent fall in blood glucose levels (rebound phenomenon), which stimulates appetite, is reduced. [c.278]

At the end of the 19th century, it was discovered that after surgical removal of the pancreas, dogs develop a condition close to diabetes mellitus in humans (Chapter 24). In these animals, as in people with diabetes, the level of glucose in the blood is increased, i.e.That is, there is hyperglycemia. At the same time, glucose is excreted in the urine in large quantities, giving it a sweet taste, i.e. there is glucosuria. (At one time, diabetes insipidus and diabetes insipidus were distinguished by the taste of urine, since another symptom, namely the excretion of large volumes of urine, is inherent in both conditions.) Attempts to treat dogs with a removed pancreas by feeding them untreated pancreatic tissue obtained from healthy animals have not were successful, but injecting normal pancreatic extracts into operated dogs reduced their diabetes symptoms.After many unsuccessful attempts in 1922, it was still possible to isolate in its pure form the active factor present in the extract of the pancreas. It was named insulin (i.e., islet substance), since by that time it was already known that it was the insulin that was the source of the hormone. Soon insulin began to be used for the treatment of people with insulin-dependent diabetes mellitus for a long time. After a visit to a doctor and a thorough examination, insulin therapy was prescribed.After 2 months, the concentration of glucose in the blood on an empty stomach is 85 mg / dl, the level of glycated hemoglobin is 14% of the total hemoglobin level (the norm is 5.8-7.2%). [c.428]

After eating a meal rich in carbohydrates, excess sugar is deposited in the liver in the form of glycogen. However, the liver’s ability to store glycogen is limited. If the blood sugar level rises to 150-180 lgg /%, then the kidneys cannot cope with the reabsorption of glucose into the blood and alimentary (food) hyperglycemia sets in, which may be accompanied by glucosuria, i.e.e excretion of glucose in the urine. Hyperglycemia and glucosuria caused by an abundant intake of eachar with food are short-lived and disappear a few hours after a meal. [c.317]

The concentration of glucose in arterial blood during the day is maintained at a constant level of 80-100 mg / dL (3.3-5.5 mmol / L). After ingestion of carbohydrate food, the blood glucose level rises within 0.5-1 h to 120-140 mg / dL (= 8 mmol / L alimentary hyperglycemia), then (after about 2 h) returns to normal levels (see.rice. 6.2). [c.384]

First aid. It consists in removing a substance from the body, delaying its oxidation and combating asthma. In case of acute poisoning through the mouth, it is necessary to thoroughly wash the stomach with a 2% sodium bicarbonate solution, warm water (8-12 liters), even 1-2 days after ingestion. Inside 2-A l and intravenously 1 liter of 5% baking soda. 500 ml of 5% glucose under the skin. For the subsequent fight against acidosis – every 30 minutes, 5 g of baking soda, drink plenty of fluids. The main antidote is ethanol (it prevents the oxidation of methanol).Its use is mandatory if the level of methanol in the blood is more than 20 mg% is injected in / in 1 liter of 5% ethanol on 40% glucose or isotonic sodium chloride solution. In addition, every hour to drink 40-60 ml of 10-20% ethanol, then repeat the intravenous administration of ethanol. With redness of the face – a high position of the head, coldness to the head. With visual impairment, a good effect was obtained with repeated injections of calcium chloride every 6 hours on the first day and with the use of vitamin B1 [c.583]

To resolve the issue of the participation of glucosamine in the exchange of ammonia and glucose, we investigated 1) glucosamine synthesis by brain slices under conditions of hyperoxia 2) the level of readily hydrolyzable glucosamine in the cerebral cortex of rabbits in normal conditions and after exposure to high oxygen pressure on animals; 3) the glucosamine content in the blood serum under the same experimental conditions; and 4) the activity of brain enzymes synthesizing glucosamine. [c.143]

five ways of prevention – Rossiyskaya Gazeta

In Europe, if a patient with diabetes mellitus violates the procedure for treatment and admits a hypoglycemic crisis, he can be punished by depriving him of his driver’s license. So strict is the approach to a person’s responsibility for their health and treatment. We do not always manage to “drive” the people to the prophylactic medical examination. That is why “untreated” diabetes in Russia accounts for 85% of the total number of patients. Such is the alarming statistic.

Diagnosis of diabetes mellitus in our country in 4.5 million people. But in reality there are at least twice as many patients – up to 10 million. Moreover, 85% of them, as doctors say, “do not reach the goal of treatment,” that is, they are either not treated at all, or are treated ineffectively.

Why is this happening? Yes, because diabetes can already dominate the body with might and main, but a person does not suspect about it and “earns” serious complications. He comes to the doctor because his eyesight has deteriorated or heart problems have worsened, and only after being examined, he learns that diabetes is to blame.

Rule of halves

So, out of 9-10 million Russians with diabetes, only half have been diagnosed. Of these 4.5 million, only half (about 1.5 million people) achieve the goal of treatment (and the goal is quite specific – to reduce and maintain normal blood glucose levels). And only every second of these 1.5 million lives without complications. So doctors are sounding the alarm and talking about an “epidemic”, because every year there are more and more patients. By 2030, according to forecasts of the International Diabetes Federation (IDF), the incidence in Russia will grow 1.5 times.

Achieving diabetes management goals is not always easy. This is bad news. But there is also a good one: this is such a disease, the course of which largely depends on the patient himself. And such doctor’s advice, how to take care of proper nutrition, give up bad habits and do not forget about physical activity, are the most necessary medical prescriptions.

Of course, effective medicines are also needed. In type 1 diabetes, when the body completely stops producing insulin, it must be injected into the body constantly. But 90-95% of all cases of the disease are type 2 diabetes, when insulin is not produced enough or is poorly absorbed. Here sometimes drugs are needed to lower glucose levels. And in some advanced cases, insulin is also indispensable. But it is better not to bring it to a serious condition. To do this, you need to follow five simple steps.

1. Assess the degree of risk

Age. Typically, type 2 diabetes occurs after age 40. Symptoms appear gradually, so a person does not suspect that he is sick for a long time.

Heredity. If either parent has diabetes, the risk is greater.

Overweight. Many people with type 2 diabetes have been overweight for a long time. But adipose tissue is, in fact, another hormonal organ that affects metabolism. The cells of the adipose tissue do not absorb insulin well, and as a result, the level of glucose in the blood rises.

Unhealthy diet, physical inactivity. This is a direct path to fat people with the ensuing consequences.

Stress, smoking, bad ecology.All this increases the risk of getting sick. Two out of three people with diabetes are urbanites.

2. Taking care of proper nutrition

Food should be varied, complete proteins are needed, including those of animal origin – lean meat, fish, milk, dairy products.

The norm of vegetables and fruits is five servings per day. A serving is a volume that fits in a handful. This is one small or half a large apple, a couple of tangerines, a small cup of salad.

Saturated fat should be no more than 1/3 of the daily value, the rest should be vegetable oils.It is necessary to limit the amount of sour cream, butter, fat cheese, sausages with sausages, because they contain a lot of “hidden” fat.

“Fast” carbohydrates are bad – sugar, candy, baked goods, ice cream, soda – less is better. Eat correctly – fractionally, 5-6 times a day in small portions (about a glass).

Normal rate of weight loss: 0.5-1 kg per week, it does not harm your health.

3. Remember about physical activity

The main task is without fanaticism, but regularly.You don’t need to exhaust yourself with training. But to pick up a pleasant activity and engage in at least 30 minutes 3-4 times a week – that’s what the WHO recommends. Physical activity is one of the best ways to stabilize blood glucose levels.

If you are not yet friends with sports, start small: for example, walking. Just 30 minutes of this activity 5 days a week protects against the development of type 2 diabetes. Before you start exercising, ask your doctor to assess your physical condition and choose the optimal exercise.

Regular moderate exercise is much more beneficial than intense, but infrequent. That is, it is better 5 times a week for half an hour than 2.5 hours at a time.

Choose an activity to your liking: you need to do it with pleasure, and not under a stick. If there is no company, get a dog and walk it in the morning and evening. At the same time you “walk” yourself.

4. Listen to your body

There are symptoms that we may not pay attention to for a long time, but they, like red flags, indicate that you may have diabetes.

You should be on your guard if you have:

Great thirst often occurs.

Frequent urination.

If you are hurt, scratches and wounds take longer to heal than usual.

Vision has deteriorated.

You feel weak, weak, lethargic, no strength for anything.

5. Do not postpone the visit to the doctor

If you have any of the listed symptoms, see an endocrinologist. The doctor will conduct the necessary research, diagnose and begin treatment.

By the way, the simplest blood sugar test can be done on your own. After 40 years, this “control” test should be performed regularly.

How are they

Diabetes threatens both developed and poor countries alike. This is a global problem. In Europe, China, North Africa, as well as in Russia, the incidence rate is approximately 9% of the total population. In India it is slightly lower – 8.5%, in the USA and Canada – higher, about 12.9%. Such data were presented at the international conference on diabetes in Copenhagen.

“For the population of developed countries, especially urban dwellers, a similar lifestyle with low physical activity and unbalanced nutrition is characteristic,” the head of the Danish pharmaceutical company, Professor Lars Fruergor Jorgensen, explained to RG. they consume carbohydrates, sugar in excess, and protein in the daily diet is often lacking. ”

According to the professor, even in developed Europe there are problems with early diagnosis.“In Russia there is a prophylactic medical examination program, and this is important: if a person goes through it, they do the necessary tests and diagnose the disease on time,” Lars Jorgensen noted. the need for such studies is not a doctor’s right. In our country, everyone is responsible for himself. road “.

In European countries, they are increasingly thinking about the need for early detection of diabetes. Denmark has a special fund that finances the diabetes prevention program. DKK 7 billion is spent not only on improving diagnostics, but also on working with patients to ensure their adherence to treatment. It is important that the patient observes the rules of nutrition, actively moves, constantly independently monitors the level of glucose in the blood and regularly undergoes examinations, and fulfills all the doctor’s prescriptions.

Technical innovations come to the aid of patients: for example, a syringe pen for injecting insulin with a memory function has already been developed, which “tells” the patient that it is time to give an injection. And in Sweden, they are now testing a pilot program, thanks to which the patient and the doctor will be able, by entering data on the treatment regimen and the patient’s lifestyle, to obtain a prognosis of the development of the disease.

Infographics “RG”: Leonid Kuleshov / Irina Nevinnaya

Infographics “RG”: Leonid Kuleshov / Irina Nevinnaya

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