The feedback from high blood sugar it is a frequent finding, especially in adults or the elderly. To have fasting values high blood sugar does not automatically mean being diabetic, although it is a wake-up call that must lead to further investigation. The main ones causes of hyperglycemia I am the diabetes type 2 and type 1 mellitus, the use of drugs containing glucose or cortisone, and, trivially, not being fasted before taking the measurement. THE symptoms main of high glucose it is frequent urination, thirst
High blood sugar
Have you withdrawn the results of the blood tests and found a high blood sugar? In the following article the topic is addressed in all its facets. If you still have any doubts at the end of the reading, ask your question in the comments at the end of the article.
What is glucose
Glucose is one sugar simple having molecular formula C6H12O6; with its 6 carbon atoms, it is classified as a hexose carbohydrate, a sub-category of monosaccharides. Glucose is obtained by hydrolysis of carbohydrates such as lactose, cellulose, glycogen and sucrose.
The term blood sugar is used to indicate blood glucose levels. THE blood glucose values depend on the introduction of glucose in the diet, on the use of glucose by the muscle tissues, on the hepatic reserves of glycogen and on the intervention of hormones responsible for regulating the glycemic level in the blood such as glucagon, which has a hyperglycemic effect ( raises blood sugar), and insulin, which has a hypoglycemic action (lowers blood sugar).
Combined with other monosaccharides, glucose gives rise to disaccharides such as sucrose, composed of glucose and fructose, maltose and lactose (the main sugar in milk).
What is glucose used for
Glucose is the monosaccharide most used by living organisms. A possible explanation for this is its lower tendency, compared to other hexose sugars, to react with the amino groups of proteins. This reaction, called glycation, impairs or destroys enzymatic activity, causing many of the complications of diabetes, such as peripheral neuropathy, kidney failure or blindness.
In addition to being the end product of photosynthesis, glucose is a ubiquitous fuel in biology used as an essential energy source for red blood cells, muscles and the brain.
Through glycolysis, glucose is broken down into simpler molecules, releasing energy mainly in the form of ATP.
Organisms use glucose as a precursor for the synthesis of various important substances. Starch, cellulose and glycogen are common glucose polymers (polysaccharides). Some of these polymers (starch and glycogen) act as energy stores, while others (cellulose and chitin) have structural roles.
Body regulation of blood glucose: secretion of insulin and glucagon
Hormonal reactions regulate the concentration of sugar in the blood. The normal range of blood glucose is between 60 and 110 mg / dL (milligrams of glucose per deciliter of blood); the main hormones involved in regulating blood sugar are insulin and glucagon. These are produced in the pancreas, the endocrine gland most involved in glucose metabolism and, in particular, in the Lagerhans islands.
Glucagon. When blood glucose levels drop to dangerous levels (as in the case of prolonged fasting), the alpha cells of the pancreas release glucagon, a hyperglycemic hormone. Glucagon is also involved in glycogenolysis, that is, in the conversion of hepatic reserves of glycogen into glucose.
Insulin. When blood glucose rises, even as a result of glycogen conversion or digestion of a carbohydrate-rich meal, the beta cells in the Lagerhans islets release another hormone, insulin, which causes the liver to convert glucose into glycogen. (glycogenesis) and that muscle and fat cells use plasma glucose via the transporter GLUT 4, thus lowering blood sugar.
High blood glucose values
As can be seen in the tables of blood glucose values, when fasting blood glucose is in the range of 100-125 mg / dL we are talking about impaired fasting blood glucose (IFG), while if measured 2 hours after a meal it is between 140 and 200 mg / dL glucose (IGT). In both cases, it is a prediabetes condition that occurs when glucose levels are higher than normal, but not high enough for a diagnosis of diabetes (<126 mg / dL fasting) and carries an increased risk of developing diabetes. type 2.
Even in the presence of hyperglycemia, the body is able to keep the situation under control by holding more insulin and inhibiting the release of glucagon.
However, when this self-regulating mechanism does not work, the overshooting of the glycemic rate causes disturbances.
Diagnosis of diabetes: criteria with glycemia and glycated hemoglobin
Diagnosis of diabetes is currently based on fasting blood glucose testing, OGTT (Oral Glucose Tolerance Test), which involves monitoring blood glucose 2 hours after administering 75 g of glucose, and random blood glucose detection .
We are in the presence of diabetes mellitus when:
- there fasting blood sugar is equal to or greater than 126 mg / dL;
- there is a blood sugar from oral glucose load greater than or equal to 200 mg / dL
- glycated hemoglobin (HbA1c) is greater than 48mmol / mol (i.e. greater than 6.5% according to the new unit of measurement)
- there random blood sugar is> = 200 mg / dL in at least two different findings or associated with the main symptoms of hyperglycaemia.
L'glycated hemoglobin HbA1c is a laboratory test that allows you to evaluate the effectiveness of the therapy in progress, as it gives an idea of the average glucose levels in the 2-3 months prior to the measurement.
This test measures the percentage of “glycated” hemoglobin, ie bound to glucose. The higher the concentration of glycated hemoglobin, the lower the control of diabetes and the higher the risk of complications.
High blood sugar: causes
The etiology of hyperglycemia is multifactorial. The main cause of high fasting blood sugar or after a meal it is diabetes mellitus, caused by an absolute or relative deficiency of insulin. Diabetes mellitus can be:
Type 1 diabetes: appears in young subjects and is characterized by a lack of insulin production;
Type 2 diabetes: affects people of any age (but especially the elderly), often obese, and is caused by the inability of cells to use insulin (insulin resistance). In patients with type 2 diabetes mellitus, therefore, insulin values can be normal or even elevated: only in the advanced stages of the disease does the pancreas lose its ability to secrete insulin.
Other factors on which a high glucose level depends are:
- liver disease
- myocardial infarction
- metabolic syndrome with insulin resistance
High blood sugar: symptoms
The following symptoms are generally associated with acute or chronic high blood sugar; the first 3 constitute the classic hyperglycemic triad:
- polyuria (frequent urination)
- polydipsia (intense feeling of thirst)
- polyphagia (feeling of exaggerated hunger)
- blurred vision
- dry mouth
- dry skin
- erectile dysfunction
- recurrent infections
- cardiac arrhythmia
High blood sugar: consequences
Chronic hyperglycemia can produce a wide range of serious late complications such as damage to the kidneys, vision, and cardiovascular system.
- Diabetic nephropathy (impairment of kidney function): a poor glycemic control protracted for many years (15-20 years) can cause a state characterized by reduced glomerular filtration due to damage to the capillaries. Diabetic nephropathy, which irreversibly compromises renal function, most frequently affects type 1 diabetics and involves microalbuminuria, renal failure, high blood pressure.
- Diabetic retinopathy: Also known as diabetic eye disease, it is a systemic disease that affects patients many years after the onset of diabetes.
Diabetic retinopathy is the result of damage to the small blood vessels of the retina. In the non-proliferating form, the vessels have dilated walls and, subsequently, edema and / or ischemia may occur due to the occlusion of the capillaries. In the non-proliferating form, the disease is characterized by the abnormal growth of new blood vessels that bleed easily, leading to detachment of the retina. If neglected, diabetic retinopathy can lead to a variable reduction in vision, even blindness. To prevent this condition it is essential to undergo regular eye exams.
- Diabetic cardiomyopathy: Diabetes is associated with an increased incidence of diabetic cardiomyopathy, a disease of the heart muscle that can impair the functioning of the heart.
However, most heart failure in diabetic people is the result of coronary artery disease and it is therefore more correct in these cases to speak of ischemia or myocardial infarction. Initially symptom-free, cardiomyopathy involves dyspnoea (disturbed breathing), aching chest, ascites (fluid buildup in the abdomen), fatigue, cough, pulmonary or peripheral edema.
High blood sugar: remedies
What to do in the presence of high blood glucose? High blood sugar can be controlled through nutrition and exercise. In severe cases, drugs are used and, in particular, in the case of type 1 diabetes and advanced type 2 diabetes, the administration of insulin. Here are the main measures and foods to avoid in the presence of high blood sugar:
- Exercise: increasing physical activity is a very effective way to lower high blood glucose and to prevent 40% from developing diabetes. In fact, during exercise, the muscles are able to absorb blood glucose even in the absence of insulin as the transfer of the GLUT 4 transporter is favored. However, it is not recommended to play sports in case of ketones in the urine as it could further raise blood sugar.
- Diet: The postmeal glycemic peak suggests that proper nutrition is essential to keep blood glucose within the normal range. The diabetic diet must be high in nutrients and low in fat and calories. The key elements are fruits, vegetables and whole grains. Complex carbohydrates should be divided into the 3 main meals. The foods to limit are those rich in fats or carbohydrates such as pizza, pasta, bread and in general all starchy foods.
- Oral hypoglycemic therapy: if diet and exercise are not enough to keep high blood sugar at bay, it is advisable to intervene with an appropriate pharmacotherapy that acts by stimulating the production of insulin or enhancing its effectiveness. Among the main oral hypoglycemic agents are drugs that increase insulin sensitivity, such as biguanides, alpha-glucoside inhibitors, incretin enhancers and sulfonylureas, which promote insulin production. These drugs are suitable for type 2 diabetes, but are ineffective in the case of total inability of the prancreas to produce insulin.
- Insulin therapy with subcutaneous insulin: when the body is unable to secrete insulin, as occurs in type 1 diabetes, it is necessary to administer the hormone from the outside. It is the doctor, based on the personal characteristics of the patient, who determines the type of insulin and the amount to be administered.
The only method of administration currently used is subcutaneous injection with syringes or pens; intramuscular or intravenous injection, which would cause a hypoglycemic crisis, should be avoided.
Nutrition and diabetes
The type 2 diabetic diet consists of eating healthy food in moderate quantities, consuming 3 meals a day at regular times.
The purpose of this diet is to help keep blood glucose content within a safe range, while controlling weight and reducing the risk of hypertension and high triglycerides.
High blood sugar what to eat: the foods allowed are fruit (limiting the consumption of the most sugary fruits such as grapes or bananas), vegetables, whole grains, legumes (beans, peas and lentils), milk and skimmed yogurt.
Fish, to be eaten at least twice a week, is a good alternative to meat. Fish like salmon, mackerel, tuna, sardines and oily fish are rich in omega-3 fatty acids, which promote heart health by reducing triglycerides.
Foods containing the so-called "good fats", ie monounsaturated and polyunsaturated, help to reduce the cholesterol. These include avocados, almonds, walnuts, olive oil, etc.
High glycemic foods to avoid: foods not allowed are white sugar, jam, sugary drinks, confectionery products (candies, cakes, pastries, etc.), sugary drinks, fatty cheeses, fatty meats, butter, sausages, snacks.