How do hyperglycemia and hypoglycemia differ. What are the symptoms of high and low blood sugar. Can you experience blood sugar imbalances without diabetes. How to prevent and manage blood sugar fluctuations.

The Basics of Blood Sugar: Hyperglycemia and Hypoglycemia Explained

Blood sugar management is crucial for overall health, especially for those with diabetes. However, even individuals without diabetes can experience blood sugar imbalances. Two key terms in this context are hyperglycemia and hypoglycemia. But what exactly do these terms mean?

Hyperglycemia refers to high blood sugar levels, while hypoglycemia indicates low blood sugar levels. Both conditions can cause significant health issues and require proper understanding and management. Let’s delve deeper into these blood sugar imbalances and explore their causes, symptoms, and prevention strategies.

Symptoms of Hyperglycemia and Hypoglycemia: Recognizing the Signs

Identifying the symptoms of blood sugar imbalances is crucial for timely intervention. Here’s a comparison of the common symptoms associated with hyperglycemia and hypoglycemia:

Hypoglycemia Symptoms:

• Hunger
• Irritability
• Difficulty concentrating
• Fatigue
• Sweating
• Confusion
• Rapid heartbeat
• Shaking
• Headache

Hyperglycemia Symptoms:

• Extreme thirst
• Dry mouth
• Weakness
• Headache
• Frequent urination
• Blurry vision
• Nausea
• Confusion
• Shortness of breath

Understanding these symptoms can help individuals recognize potential blood sugar imbalances and seek appropriate medical attention when necessary.

Hypoglycemia Without Diabetes: Causes and Risk Factors

While hypoglycemia is commonly associated with diabetes, it can occur in individuals without the condition. What causes low blood sugar in people who don’t have diabetes?

Several factors can contribute to hypoglycemia in non-diabetic individuals:

1. Prolonged fasting or skipping meals
2. Certain medications (e.g., aspirin, birth control pills, steroids, blood pressure medications, some antibiotics)
3. Binge drinking
4. Increased physical activity without adequate calorie intake
5. Medical conditions affecting insulin production (e.g., pancreatic tumors, adrenal gland disorders, hepatitis)
6. Prediabetes
7. Excessive consumption of refined carbohydrates

Understanding these potential causes can help individuals identify and address the root of their blood sugar imbalances.

Hyperglycemia in Non-Diabetic Individuals: Understanding the Triggers

High blood sugar isn’t exclusive to those with diabetes. What factors can lead to hyperglycemia in people without diabetes?

Several conditions and lifestyle factors can contribute to elevated blood sugar levels in non-diabetic individuals:

• Medical conditions like polycystic ovary syndrome (PCOS) and Cushing’s syndrome
• Infections that trigger the release of stress hormones
• Obesity
• Lack of physical activity
• Family history of diabetes
• Certain medications

Recognizing these potential triggers can help individuals take proactive steps to manage their blood sugar levels effectively.

Diabetes and Blood Sugar Imbalances: A Closer Look

For individuals with diabetes, understanding the mechanisms behind blood sugar fluctuations is crucial. How do hypoglycemia and hyperglycemia occur in diabetic patients?

Hypoglycemia in Diabetes:

In diabetic individuals, hypoglycemia can result from:

• Taking too much insulin or other diabetes medications
• Eating less than usual
• Increasing physical activity without adjusting medication or food intake

Hyperglycemia in Diabetes:

The causes of hyperglycemia in diabetes depend on the type:

• Type 1 Diabetes: The pancreas cannot produce insulin
• Type 2 Diabetes: The pancreas doesn’t produce enough insulin or the body develops insulin resistance

In both cases, hyperglycemia can occur due to:

• Not taking diabetes medication as prescribed
• Poor eating habits
• Lack of physical activity
• Infections or illnesses

Understanding these mechanisms can help diabetic individuals better manage their condition and prevent severe blood sugar fluctuations.

Complications of Untreated Blood Sugar Imbalances: Why Management Matters

Uncontrolled blood sugar levels can lead to serious health complications. Why is it crucial to manage both hypoglycemia and hyperglycemia?

Complications of Untreated Hypoglycemia:

• Seizures
• Fainting
• In severe cases, death

Complications of Untreated Hyperglycemia:

• Cardiovascular disease
• Kidney disease
• Nerve damage
• Increased risk of infections
• Bone problems
• In severe cases, amputation or death

These potential complications underscore the importance of proper blood sugar management, whether an individual has diabetes or not.

Preventing Hypoglycemia: Strategies for Diabetic and Non-Diabetic Individuals

Preventing low blood sugar is essential for maintaining overall health. How can individuals with and without diabetes prevent hypoglycemia?

Prevention Strategies for Non-Diabetic Individuals:

• Avoid skipping meals
• Eat 5-6 small meals throughout the day
• Adjust calorie intake when increasing physical activity
• Learn to recognize symptoms of low blood sugar
• Be aware of medications that may affect blood sugar levels

Prevention Strategies for Diabetic Individuals:

• Follow prescribed medication regimens carefully
• Monitor blood sugar levels regularly
• Adjust insulin doses as needed, under medical supervision
• Plan meals and snacks to maintain steady blood sugar levels
• Communicate with healthcare providers about any changes in diet or activity levels

By implementing these strategies, individuals can significantly reduce their risk of experiencing hypoglycemic episodes.

Managing Hyperglycemia: Tips for Blood Sugar Control

Controlling high blood sugar is crucial for preventing long-term health complications. What strategies can help manage hyperglycemia effectively?

For Non-Diabetic Individuals:

• Maintain a healthy weight
• Engage in regular physical activity
• Follow a balanced diet rich in whole foods
• Limit intake of refined carbohydrates and sugary foods
• Manage stress through relaxation techniques
• Get regular check-ups to monitor blood sugar levels

For Diabetic Individuals:

• Adhere to prescribed medication regimens
• Monitor blood sugar levels as recommended by healthcare providers
• Follow a diabetes-friendly meal plan
• Engage in regular physical activity, as approved by a doctor
• Manage stress effectively
• Attend regular check-ups and diabetes education sessions

Implementing these strategies can help individuals maintain better control over their blood sugar levels and reduce the risk of hyperglycemia-related complications.

The Role of Diet in Blood Sugar Management: Making Informed Choices

Diet plays a crucial role in maintaining stable blood sugar levels. How can dietary choices impact blood sugar management?

Key Dietary Considerations for Blood Sugar Control:

• Choose complex carbohydrates over simple sugars
• Incorporate fiber-rich foods to slow sugar absorption
• Balance carbohydrates with protein and healthy fats
• Practice portion control
• Stay hydrated with water instead of sugary beverages
• Consider the glycemic index of foods when planning meals

By making informed dietary choices, individuals can significantly improve their blood sugar control and overall health.

Exercise and Blood Sugar: Finding the Right Balance

Physical activity can have a significant impact on blood sugar levels. How does exercise affect blood sugar, and what precautions should be taken?

Effects of Exercise on Blood Sugar:

• Short-term decrease in blood sugar levels
• Improved insulin sensitivity over time
• Potential risk of hypoglycemia during or after intense exercise

Exercise Precautions for Blood Sugar Management:

• Monitor blood sugar before, during, and after exercise
• Adjust medication or carbohydrate intake as needed
• Stay hydrated during physical activity
• Carry a fast-acting carbohydrate source for emergencies
• Wear medical identification indicating diabetes or hypoglycemia risk

By understanding the relationship between exercise and blood sugar, individuals can safely incorporate physical activity into their daily routines while maintaining stable glucose levels.

Stress and Blood Sugar: Understanding the Connection

Stress can have a significant impact on blood sugar levels. How does stress affect glucose regulation, and what strategies can help manage stress-related blood sugar fluctuations?

The Stress-Blood Sugar Connection:

• Stress hormones like cortisol can increase blood sugar levels
• Chronic stress may contribute to insulin resistance
• Stress-induced behaviors (e.g., emotional eating) can disrupt blood sugar balance

Stress Management Strategies for Blood Sugar Control:

• Practice relaxation techniques such as deep breathing or meditation
• Engage in regular physical activity
• Prioritize adequate sleep
• Seek support from friends, family, or mental health professionals
• Consider stress-reducing activities like yoga or tai chi

By implementing effective stress management techniques, individuals can better control their blood sugar levels and improve overall health.

Monitoring Blood Sugar: Tools and Techniques

Regular blood sugar monitoring is essential for effective management. What tools and techniques are available for tracking blood glucose levels?

Blood Sugar Monitoring Methods:

• Traditional glucose meters with test strips
• Continuous glucose monitoring (CGM) systems
• HbA1c tests for long-term blood sugar averages
• Urine tests for ketones (in cases of very high blood sugar)

Tips for Effective Blood Sugar Monitoring:

• Establish a regular testing schedule
• Keep accurate records of blood sugar readings
• Learn to interpret results and identify patterns
• Share monitoring data with healthcare providers
• Adjust monitoring frequency based on individual needs and medical advice

By utilizing appropriate monitoring tools and techniques, individuals can gain valuable insights into their blood sugar patterns and make informed decisions about their management strategies.

When to Seek Medical Help: Recognizing Emergencies

While many blood sugar fluctuations can be managed at home, some situations require immediate medical attention. When should individuals seek emergency care for blood sugar-related issues?

Signs of Severe Hypoglycemia Requiring Immediate Action:

• Loss of consciousness
• Seizures
• Inability to eat or drink
• Confusion or disorientation that doesn’t improve with glucose intake

Signs of Severe Hyperglycemia Requiring Medical Attention:

• Blood sugar levels consistently above 300 mg/dL
• Presence of ketones in urine
• Persistent vomiting or abdominal pain
• Signs of dehydration
• Difficulty breathing or shortness of breath

Recognizing these warning signs and seeking timely medical help can prevent serious complications and ensure proper treatment of severe blood sugar imbalances.

The Future of Blood Sugar Management: Emerging Technologies and Treatments

As medical science advances, new technologies and treatments are emerging to improve blood sugar management. What innovations are on the horizon for individuals dealing with blood sugar imbalances?

Promising Developments in Blood Sugar Management:

• Artificial pancreas systems for automated insulin delivery
• Smart insulin patches for controlled release
• Non-invasive glucose monitoring devices
• Gene therapy approaches for diabetes treatment
• Gut microbiome-based interventions for blood sugar regulation

These emerging technologies and treatments hold the potential to revolutionize blood sugar management, offering hope for improved quality of life for individuals dealing with diabetes and other blood sugar disorders.

Understanding the complexities of blood sugar regulation is crucial for maintaining overall health. Whether you have diabetes or not, being aware of the factors that influence blood glucose levels can help you make informed decisions about your lifestyle and health management strategies. By recognizing the symptoms of hyperglycemia and hypoglycemia, implementing preventive measures, and seeking appropriate medical care when needed, individuals can effectively manage their blood sugar levels and reduce the risk of associated complications.

Hyperglycemia vs. Hypoglycemia: What’s the Difference?

Hyperglycemia is high blood sugar, while hypoglycemia is low blood sugar. Because both can cause major health problems for people with diabetes, it’s important to keep blood sugar within a healthy range.

But high and low blood sugar doesn’t affect only people with diabetes. It can also occur in people who don’t have diabetes.

Here’s what you need to know about hypoglycemia and hyperglycemia, including symptoms, causes, and how to prevent it from happening to you.

Hypoglycemia and hyperglycemia might sound similar, but these conditions occur under different circumstances — depending on whether you have diabetes.

How does hypoglycemia occur without diabetes?

Hypoglycemia usually happens to people living with diabetes, but it’s possible to have low blood sugar without diabetes.

Blood sugar, or glucose, is what your body uses for energy. After eating a meal or drinking a beverage, the hormone insulin allows sugar to enter your body’s cells, where it’s used for energy. Insulin is a hormone produced by your pancreas.

Hypoglycemia occurs when you have too much insulin in your bloodstream. This might happen if you don’t eat for several hours, such as 8 hours or more. A drop in blood sugar means there isn’t enough glucose in your bloodstream to fuel your brain and body.

Low blood sugar without diabetes can also occur if you take a medication that lowers your blood sugar. These include pain relievers like:

• aspirin
• birth control pills
• steroids
• blood pressure medication
• some antibiotics

Other causes of low blood sugar without diabetes include binge-drinking (it affects how your liver releases glucose into your blood) and increased physical activity.

Plus, some medical conditions can increase the amount of insulin your pancreas produces. These include a pancreatic tumor, adrenal gland disorders, and hepatitis.

You could also experience low blood sugar if you have prediabetes, or if you eat a lot of refined carbohydrates, such as white bread, pasta, and pastries.

How does hypoglycemia occur with diabetes?

If you have diabetes, hypoglycemia can occur when you take too much insulin or another diabetes medication. Too much medication in your bloodstream causes your body’s cells to absorb too much glucose.

Hypoglycemia with diabetes can also occur when you eat less than normal or increase your level of physical activity.

How does hyperglycemia occur without diabetes?

Similarly, hyperglycemia can occur in people with and without diabetes.

If you don’t have diabetes, various factors can cause high blood sugar, either suddenly or gradually. For example, some medical conditions increase blood sugar. These include polycystic ovary syndrome and Cushing’s syndrome.

If you have an infection, your body might also release a high amount of stress hormones like adrenaline and cortisol. Too much of these hormones can interfere with your body’s ability to use insulin properly. As a result, your blood glucose level increases.

Other factors that can lead to hyperglycemia without diabetes include obesity and a lack of physical activity. You might also have higher blood sugar if you have a family history of diabetes.

How does hyperglycemia occur with diabetes?

The reason for hyperglycemia with diabetes depends on whether you have type 1 diabetes or type 2 diabetes.

If you have type 1 diabetes, your pancreas is unable to produce insulin. If you have type 2 diabetes, your pancreas doesn’t produce enough insulin to stabilize your blood sugar. In both conditions, glucose can build up in your bloodstream, resulting in hyperglycemia.

Your diabetes medication keeps your blood sugar within a safe range. If you don’t take your medication as instructed, you might experience blood sugar spikes. This can also occur due to poor eating habits, inactivity, or an infection.

Low blood sugar and high blood sugar can lead to serious diabetes complications. Untreated hypoglycemia can cause seizures, fainting, and even death.

Complications of untreated hyperglycemia include:

• cardiovascular disease
• kidney disease
• nerve damage
• infection
• bone problems
• amputation or death

How to prevent hypoglycemia with and without diabetes

If you don’t have diabetes, one of the best ways to prevent low blood sugar is to not skip meals. Eat five to six small meals throughout the day to keep your blood sugar within a healthy range.

If you increase your level of physical activity, you might need additional calories during the day to maintain your energy. Plus, learn how to recognize symptoms of low blood sugar, especially if you’re taking a medication that affects your blood sugar.

If you have diabetes, monitor your blood sugar level frequently, and talk with your doctor if you’re having symptoms of low blood sugar.

It’s important to monitor your glucose level if you make any changes to your eating schedule or if you increase physical activity. Ask your doctor about fast-acting carbohydrates like glucose tablets. If your blood sugar drops suddenly, a tablet can raise it to a safe level.

How to prevent hyperglycemia with and without diabetes

If you don’t have diabetes, you can prevent hyperglycemia with regular physical activity. Aim for 30 minutes at least 5 days per week.

Maintaining a healthy weight also keeps blood sugar within a safe range. This includes eating fewer refined carbohydrates, and eating more fresh fruits and vegetables.

If you have diabetes, always take your medication as directed. You can talk with your doctor, a diabetes educator, or a dietitian about healthy diabetes meal plans. You should also regularly monitor your blood sugar.

If you’re thinking about starting a new exercise routine, talk with your doctor first. They may need to adjust your medication.

Mild hypoglycemia and hyperglycemia are usually treatable at home.

If you have mild hypoglycemia, consuming a small amount of glucose (like a glucose tablet, fruit juice, or a piece of candy) can quickly raise your blood sugar.

If you skipped a dose of medication and have symptoms of mild hyperglycemia, taking your insulin or diabetes medication can help stabilize your blood sugar level.

Hypoglycemia is an emergency if you experience confusion, blurry vision, or seizures.

Hyperglycemia is an emergency if you have:

• shortness of breath
• confusion
• coma
• nausea and vomiting
• fruity-smelling breath (a sign of ketoacidosis)

See a doctor if you’ve taken measures to keep your blood sugar within a healthy range, yet you still experience hypoglycemia or hyperglycemia.

Make an appointment if your blood sugar level persistently remains above 240 mg/dL, or if you have severe symptoms of hypoglycemia.

Hypoglycemia and hyperglycemia might sound similar, but these conditions are different.

Low blood sugar and high blood sugar can both lead to life threatening complications. So, it’s important that you learn how to recognize symptoms of each.

See a doctor if you develop severe symptoms, or if you’re unable to keep your blood sugar within a normal range — regardless of whether you have diabetes.

Hyperglycemia vs. Hypoglycemia: What’s the Difference?

Hyperglycemia is high blood sugar, while hypoglycemia is low blood sugar. Because both can cause major health problems for people with diabetes, it’s important to keep blood sugar within a healthy range.

But high and low blood sugar doesn’t affect only people with diabetes. It can also occur in people who don’t have diabetes.

Here’s what you need to know about hypoglycemia and hyperglycemia, including symptoms, causes, and how to prevent it from happening to you.

Hypoglycemia and hyperglycemia might sound similar, but these conditions occur under different circumstances — depending on whether you have diabetes.

How does hypoglycemia occur without diabetes?

Hypoglycemia usually happens to people living with diabetes, but it’s possible to have low blood sugar without diabetes.

Blood sugar, or glucose, is what your body uses for energy. After eating a meal or drinking a beverage, the hormone insulin allows sugar to enter your body’s cells, where it’s used for energy. Insulin is a hormone produced by your pancreas.

Hypoglycemia occurs when you have too much insulin in your bloodstream. This might happen if you don’t eat for several hours, such as 8 hours or more. A drop in blood sugar means there isn’t enough glucose in your bloodstream to fuel your brain and body.

Low blood sugar without diabetes can also occur if you take a medication that lowers your blood sugar. These include pain relievers like:

• aspirin
• birth control pills
• steroids
• blood pressure medication
• some antibiotics

Other causes of low blood sugar without diabetes include binge-drinking (it affects how your liver releases glucose into your blood) and increased physical activity.

Plus, some medical conditions can increase the amount of insulin your pancreas produces. These include a pancreatic tumor, adrenal gland disorders, and hepatitis.

You could also experience low blood sugar if you have prediabetes, or if you eat a lot of refined carbohydrates, such as white bread, pasta, and pastries.

How does hypoglycemia occur with diabetes?

If you have diabetes, hypoglycemia can occur when you take too much insulin or another diabetes medication. Too much medication in your bloodstream causes your body’s cells to absorb too much glucose.

Hypoglycemia with diabetes can also occur when you eat less than normal or increase your level of physical activity.

How does hyperglycemia occur without diabetes?

Similarly, hyperglycemia can occur in people with and without diabetes.

If you don’t have diabetes, various factors can cause high blood sugar, either suddenly or gradually. For example, some medical conditions increase blood sugar. These include polycystic ovary syndrome and Cushing’s syndrome.

If you have an infection, your body might also release a high amount of stress hormones like adrenaline and cortisol. Too much of these hormones can interfere with your body’s ability to use insulin properly. As a result, your blood glucose level increases.

Other factors that can lead to hyperglycemia without diabetes include obesity and a lack of physical activity. You might also have higher blood sugar if you have a family history of diabetes.

How does hyperglycemia occur with diabetes?

The reason for hyperglycemia with diabetes depends on whether you have type 1 diabetes or type 2 diabetes.

If you have type 1 diabetes, your pancreas is unable to produce insulin. If you have type 2 diabetes, your pancreas doesn’t produce enough insulin to stabilize your blood sugar. In both conditions, glucose can build up in your bloodstream, resulting in hyperglycemia.

Your diabetes medication keeps your blood sugar within a safe range. If you don’t take your medication as instructed, you might experience blood sugar spikes. This can also occur due to poor eating habits, inactivity, or an infection.

Low blood sugar and high blood sugar can lead to serious diabetes complications. Untreated hypoglycemia can cause seizures, fainting, and even death.

Complications of untreated hyperglycemia include:

• cardiovascular disease
• kidney disease
• nerve damage
• infection
• bone problems
• amputation or death

How to prevent hypoglycemia with and without diabetes

If you don’t have diabetes, one of the best ways to prevent low blood sugar is to not skip meals. Eat five to six small meals throughout the day to keep your blood sugar within a healthy range.

If you increase your level of physical activity, you might need additional calories during the day to maintain your energy. Plus, learn how to recognize symptoms of low blood sugar, especially if you’re taking a medication that affects your blood sugar.

If you have diabetes, monitor your blood sugar level frequently, and talk with your doctor if you’re having symptoms of low blood sugar.

It’s important to monitor your glucose level if you make any changes to your eating schedule or if you increase physical activity. Ask your doctor about fast-acting carbohydrates like glucose tablets. If your blood sugar drops suddenly, a tablet can raise it to a safe level.

How to prevent hyperglycemia with and without diabetes

If you don’t have diabetes, you can prevent hyperglycemia with regular physical activity. Aim for 30 minutes at least 5 days per week.

Maintaining a healthy weight also keeps blood sugar within a safe range. This includes eating fewer refined carbohydrates, and eating more fresh fruits and vegetables.

If you have diabetes, always take your medication as directed. You can talk with your doctor, a diabetes educator, or a dietitian about healthy diabetes meal plans. You should also regularly monitor your blood sugar.

If you’re thinking about starting a new exercise routine, talk with your doctor first. They may need to adjust your medication.

Mild hypoglycemia and hyperglycemia are usually treatable at home.

If you have mild hypoglycemia, consuming a small amount of glucose (like a glucose tablet, fruit juice, or a piece of candy) can quickly raise your blood sugar.

If you skipped a dose of medication and have symptoms of mild hyperglycemia, taking your insulin or diabetes medication can help stabilize your blood sugar level.

Hypoglycemia is an emergency if you experience confusion, blurry vision, or seizures.

Hyperglycemia is an emergency if you have:

• shortness of breath
• confusion
• coma
• nausea and vomiting
• fruity-smelling breath (a sign of ketoacidosis)

See a doctor if you’ve taken measures to keep your blood sugar within a healthy range, yet you still experience hypoglycemia or hyperglycemia.

Make an appointment if your blood sugar level persistently remains above 240 mg/dL, or if you have severe symptoms of hypoglycemia.

Hypoglycemia and hyperglycemia might sound similar, but these conditions are different.

Low blood sugar and high blood sugar can both lead to life threatening complications. So, it’s important that you learn how to recognize symptoms of each.

See a doctor if you develop severe symptoms, or if you’re unable to keep your blood sugar within a normal range — regardless of whether you have diabetes.

Artificial intelligence in the treatment of diabetes – Science

Monitoring the condition of people with diabetes is one of the most important tasks of an endocrinologist. The rapid development of information technology gives doctors fundamentally new opportunities.

Frederick Banting and Charles Best, 1921

Photo: Getty Images

Frederick Banting and Charles Best, 1921

Photo: Getty Images

In a healthy person, insulin secretion is finely regulated depending on the concentration of glucose in the blood: after eating, the glucose level increases, and insulin secretion also increases; on the contrary, a decrease in glucose levels stops secretion.

Scylla and Charybdis of insulin therapy

The need to maintain glucose within the physiological “corridor” is primarily determined by the needs of the brain. The brain is the main consumer of glucose: on an empty stomach, it accounts for 40–45% of all glucose utilized. A drop in glucose below normal levels is a life-threatening situation that leads to impaired brain activity. To reduce the concentration of glucose in blood plasma below 3.5–3.9mmol/l per liter, the body reacts by releasing stress hormones such as adrenaline and norepinephrine. Therefore, the first manifestations of hypoglycemia: trembling in the body, sweating, palpitations, severe weakness, hunger, anxiety and fear are due to the action of these hormones. If the glucose level under the influence of hormones is not restored, symptoms of neuroglycopenia (energy starvation of the brain) occur: lethargy, disorientation, inappropriate behavior, convulsions and loss of consciousness.

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Throughout the 100-year history of insulin therapy, scientists have focused on making insulin preparations safer. In the 80s of the last century, genetically engineered human insulins appeared, and then insulin analogs, the action profile of which is as close as possible to physiological. However, hypoglycemia remains one of the major barriers to achieving good diabetes control to this day. Repeated hypoglycemia increases the risk of cardiovascular complications and leads to a decrease in the cognitive functions of the brain. People who have had several episodes of hypoglycemia lose the ability to recognize low blood glucose levels.

What is hypoglycemia

The molecular mechanisms of the damaging effects of hypoglycemia are being actively studied. Scientists from the Novosibirsk Academgorodok approached the solution of this problem with the help of bioinformatics and artificial intelligence. The implementation of the project, supported by a grant from the Russian Science Foundation (20-15-00057), is carried out by a research team, including endocrinologists, bioinformatics and mathematicians from the Federal Research Center Institute of Cytology and Genetics (ICiG) of the Siberian Branch of the Russian Academy of Sciences and the Institute of Mathematics. S. L. Soboleva of the Siberian Branch of the Russian Academy of Sciences (project leader – Doctor of Medical Sciences, Professor of the Russian Academy of Sciences V. V. Klimontov).

One of the areas of research is the study of the damaging effects of hypoglycemia using the construction and analysis of gene networks. A gene network is a group of coordinated functioning genes that provide a particular biochemical process or phenotypic trait of an organism. To build gene networks, the researchers used the ANDSystem computer system developed at the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences (Dr. V. A. Ivanisenko). The system performs intellectual analysis of texts (text-mining) of scientific publications indexed in the Medline database, followed by a structured presentation of information in the form of graphs of molecular genetic networks. The system database contains more than 40 million facts extracted from 28 million Medline abstracts that describe genetic regulation, protein-protein interactions, catalytic reactions, transport pathways, associations of genes, proteins, metabolites with diseases, phenotypes and biological processes. With the help of ANDSystem, a hypoglycemia gene network was built (Ph.D. O.V. Sayk). The reconstructed network includes 141 genes and 2467 interactions. The genes of this network are involved in the regulation of insulin secretion, glucose homeostasis, regulation of programmed cell death, intracellular signaling, and other processes.

Genes associated with hypoglycemia are overrepresented in the gene networks for complications of diabetes mellitus: retinopathy, nephropathy, neuropathy and macroangiopathy, as well as cognitive dysfunction and Alzheimer’s disease. At the same time, 14 genes were common for all the studied disorders, 11 biological processes were overrepresented in all reconstructed networks. The results obtained expand our understanding of the molecular mechanisms underlying the adverse effects of hypoglycemia on the target organs of diabetes: the retina, kidneys, cardiovascular and nervous systems. They also confirm the role of disorders of glucose metabolism in the decline of intellectual functions and the development of Alzheimer’s disease.

Night is the hardest time

Predicting and preventing hypoglycemia is one of the most important tasks for diabetologists. A particular problem is hypoglycemia during sleep. Healthy people usually respond to nocturnal hypoglycemia by waking up, but this ability is reduced in people with type 1 diabetes receiving insulin. Therefore, almost half of all cases of severe hypoglycemia develop during nocturnal sleep. Episodes of nocturnal hypoglycemia can be manifested by nightmares, weakness and headache in the morning, chronic fatigue. In rare cases, nocturnal hypoglycemia provokes a fatal heart rhythm disorder (death in bed syndrome).

For a long time, nocturnal hypoglycemia has been predicted by measuring blood sugar before bedtime. However, due to the fact that the dynamics of glucose levels during the night can be different, the value of this method is limited.

The advent of continuous glucose monitoring technologies has been a major breakthrough in the diagnosis of nocturnal hypoglycemia. With continuous monitoring, a sensor is installed in the subcutaneous tissue of the patient, which determines the level of glucose in the intercellular (interstitial) fluid every five minutes. Thus, up to 360 glucose measurements are carried out per day. The introduction of continuous monitoring technologies into clinical practice has shown that nocturnal hypoglycemia is much more common than previously thought.

Using data from continuous glucose monitoring and cluster analysis, Novosibirsk scientists identified patterns of nocturnal glycemic dynamics associated and not associated with a decrease in glucose levels below the normal level (3.9 mmol/l).

Nine patterns included episodes of nocturnal hypoglycemia. In rare situations, hypoglycemia developed soon after going to bed. In most cases, hypoglycemia was observed at 2-4 am. At the same time, glucose levels after midnight were normal, but there was a downward trend. If the glucose level at the beginning of the night was elevated and a downward trend was observed, hypoglycemia developed closer to the morning, at 4-6 am.

Variable dynamics of glucose levels in different patients at night clearly demonstrates the difficulty of predicting hypoglycemia.

Nocturnal hypoglycemia in a patient with diabetes mellitus. Continuous glucose monitoring data. Source: Klimontov V. V., Myakina N. E. Glycemic variability in diabetes mellitus. Novosibirsk: NSU Publishing House, 2018

How can artificial intelligence protect natural intelligence?

The next step was to use CGM data and machine learning algorithms to predict nocturnal hypoglycemia. These algorithms operate on large arrays of accumulated data (in our case, the results of glucose monitoring), identify patterns in them, and, based on them, build a forecast for a future event (in our case, hypoglycemia). An important advantage in this case is personification: the forecast is based on the data of a particular person.

Machine learning belongs to the field of artificial intelligence. The term “artificial intelligence” is used to express the ability of various devices to perform human cognitive functions, such as learning, reasoning, forecasting, and solving intellectual problems. Artificial intelligence and systems based on it are one of the most important scientific achievements of the modern era. Even in everyday life, a person encounters many things that are somehow related to artificial intelligence: a voice assistant in a mobile device, car navigators, smart watches, computer chess, etc. Artificial intelligence is no less widely used in specialized areas of activity: driving a car , recognizing objects in photographs, making decisions in stock trading… The list of applications of artificial intelligence is very wide and is constantly updated with new areas.

Historically, the emergence of artificial intelligence is associated with the emergence of electronic-mechanical devices, the behavior of which can be programmed in accordance with a set of certain rules applied in accordance with the input data and the internal logic of actions. The need for artificial intelligence systems was due to the emergence in the 40s and 50s of the 20th century of tasks that were difficult or impossible to solve for a person, but which were quite within the power of electronic devices of that time: decoding enemy secret messages, planning military operations, etc. The further development of artificial intelligence received a theoretical basis in the form of fundamental works by A. Turing, C. Shannon, J. McCarthy, F. Rosenblatt and other researchers, in which the main provisions of the theory of algorithms, machine learning, information theory, artificial neural networks, programming languages.

Example-based machine learning assumes that the data contains hidden patterns that can be detected and analyzed to make predictions and make decisions. In machine learning, the apparatus of probability theory and mathematical statistics, Bayesian inference, the concept of Markov chains are widely used. One of the main learning technologies is artificial neural networks that simulate the functioning of biological neurons during the processing of signals received by them.

Forewarned is forearmed

When developing algorithms for predicting nocturnal hypoglycemia using machine learning technologies, a number of issues need to be addressed. The first concerns the choice of forecasting horizon. What is the optimal time before an episode occurs for prediction—in other words, how long before an event should the algorithm make a reliable prediction? Machine learning algorithms trained on continuous glucose monitoring data can predict hypoglycemia in the near future. Obviously, in the case of nocturnal hypoglycemia, the algorithm should not work too early, otherwise it will lead to a violation of the quality of sleep. On the other hand, the patient or others should have enough time to take measures to prevent hypoglycemia. Fortunately, in most cases, this dangerous situation can be prevented by eating carbohydrate foods. Most researchers believe that a horizon of 15–60 minutes is quite acceptable for forecasting. A research group of Novosibirsk scientists (D. Sc. V.B. Berikov et al.) created models for predicting nocturnal hypoglycemia in patients with type 1 diabetes mellitus with a forecasting horizon of 15 and 30 minutes.

When developing the algorithm, we had to face the problem of sample imbalance. The fact is that hypoglycemia does not develop in every patient and not every night. Therefore, the number of records with hypoglycemia is a small proportion of the total volume of observations. Because of this, the resulting predictive solutions may suffer from the overfitting effect, be unstable and undergo strong changes when some observations are added or excluded. To overcome this difficulty, the project developed an approach based on sampling methods as an artificial enrichment of the minority class (oversampling) or, conversely, reducing the share of the majority class (undersampling), taking into account the specifics of the considered series of continuous glucose monitoring.

Which machine learning algorithms are most accurate in predicting? A number of methods have been explored for building a predictive model, including linear regression with regularization, a decision tree algorithm (random forest), and artificial neural networks. All three algorithms “worked” with data from continuous glucose monitoring obtained during hospitalization. The prediction was based on various mathematical characteristics of the series of glucose values ​​before the onset of hypoglycemia.

As expected, the most difficult task was to predict nocturnal hypoglycemia with the longest forecast horizon (30 minutes). However, in this case, the forecast quality metrics on the test samples turned out to be quite acceptable – on average, the sensitivity and specificity were more than 87%. The most accurate prediction was given by the decision tree algorithm.

Researchers have tried to improve the quality of prognosis through the clinical characteristics of patients. To do this, glucose monitoring data were supplemented with information on sex, age, body mass index, duration of diabetes mellitus, the presence of complications and concomitant diseases, the type of insulin used, and laboratory data. It turned out that the inclusion of additional clinical parameters in the model can improve the quality of the prognosis within 1–2%.

The developed algorithm can be further used during continuous glucose monitoring, for example, as a mobile application. Numerous mobile apps are becoming an increasingly popular option in diabetes management. The use of algorithms that can recognize in advance the dynamics of glucose levels, fraught with a high risk of hypoglycemia, should contribute to a more effective and safe treatment of this disease.

Prepared by Petr Kharatyan

Rapid glucose test (capillary blood)

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Rapid glucose test allows you to determine the excess or lack of glucose in the blood in 1 minute. For its implementation, capillary blood from a finger is used.

The rapid glucose test is considered the baseline test for suspected carbohydrate metabolism disorders in the body.

Rapid glucose test benefits:

• Instant diagnosis with fast results.
• The test is completely safe and painless.
• No absolute contraindications.
• The ability to detect disorders of carbohydrate metabolism at an early stage.

How the procedure works

The test uses a glucometer and test strips.

A drop of blood is placed on a special test strip, which is then inserted into a glucometer (a device for measuring blood sugar levels). The result will be known in 1 minute.

Why is it important to control glucose levels?

Glucose is a simple carbohydrate (sugar) that provides the cells of a living organism with energy. It enters the body with food in the form of complex carbohydrates, after splitting it enters the thin section of the gastrointestinal tract, then into the bloodstream.

Excess and lack of sugar in the blood contributes to the development of various metabolic disorders, which can lead to hyperglycemia – an increase in blood sugar levels (diabetes mellitus), or vice versa to hypoglycemia – a decrease in its level (pancreatic diseases, kidney failure):

• Hyperglycemia is manifested by symptoms of diabetes mellitus: weakness, thirst, dry mouth, frequent urination, skin itching. Immunity decreases, wounds heal poorly, kidney function is disrupted.
• Hypoglycemia is clinically manifested by weakness, migraine, chills, palpitations. A sharp decrease in blood glucose levels can have a serious negative effect on the central nervous system, up to hypoglycemic coma.

Timely detection of a lack or excess of glucose in the blood allows diagnosing diseases at an early stage, which will help to conduct effective therapy and avoid serious complications.

Results

For adults, when donating blood on an empty stomach, the norm is 3.9–5.9 mmol/L.

Possible reasons for the increased rate:

• Physical activity.
• Stress.
• Excess consumption of sugar-containing products immediately before the study.
• Diabetes mellitus.
• Endocrine diseases.
• Diseases of the pancreas.
• Injuries.
• Operations.
• Brain tumor.

Reasons for the low rate:

• Prolonged fasting.
• Excessive and prolonged physical activity.
• Insulin overdose.
• Insulinoma.
• Endocrine diseases.
• Diseases of the liver.
• Fermentopathies.
• Intestinal malabsorption.

The attending physician is responsible for interpreting the results and prescribing treatment.

You can make an appointment with a specialized specialist in one of our clinics. Go to the “Doctor’s Appointment” section – here you can choose a doctor of the desired specialty, read patient reviews and choose a convenient appointment time.

Indications for examination

Indications for a rapid glucose test:

• Clinical symptoms of hypo- or hyperglycemia.
• Pregnancy.
• Diabetes mellitus.
• Suspicion of carbohydrate metabolism disorders, including diabetes mellitus.

Doctors recommend a blood glucose test every six months for people over 40, children, and those who are overweight or have a family history of diabetes.

Preparation for examination

Recommended preparation for rapid glucose test:

• During the day, avoid physical and psychological stress, avoid alcoholic drinks and overeating.
• Avoid coffee, tea, juices 2 hours before the procedure. It is acceptable to drink a small amount of clean water without gas.
• Do not smoke for at least two hours before the test.
• Blood should be taken in the morning on an empty stomach: at least 8 hours must have passed since the last meal.

To control the level of glucose in dynamics, it is recommended to take the test at the same time under the same conditions.

There are no absolute contraindications to performing a rapid glucose test.

Code:

982004

Price:

200
R.

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