Good day, dear readers and guests of the blog "Sugar is normal!" Today we will focus on the state that every person with a sweet ailment experienced.
I mean the feeling of low blood sugar (hypoglycemia), you will learn more about the causes and symptoms, why glucose falls and what to do if it drops sharply.
I hope the material in the article will be useful for you and, perhaps, one day will save your life.

What does low blood glucose mean?

Low blood sugar is scientifically called hypoglycemia. As a rule, it develops when the glucose level drops below 3.3 mmol / L in adults. Among people with diabetes, the word “hypo” is used, which also means low blood sugar.

Dear friends, today I want to touch on a very serious topic that concerns all patients with. This condition can even occur in a mild form in a perfectly healthy person.

What are the risks of a temporary lack of blood sugar?

A decrease in blood sugar is referred to as an acute complication of diabetes mellitus. But is hypoglycemia always dangerous? Which is worse: intermittent hypoglycemia or chronic high glucose levels? Symptoms of low blood sugar levels can vary from mild to severe. The extreme hypo is hypoglycemic coma.

In connection with the tightening of the criteria for compensating for diabetes mellitus, which I wrote about in the article, the risk of developing hypoglycemic conditions inevitably arises. If you notice them in time and correctly stop them, then they do not carry any danger.

Mild hypoglycemia in the amount of 2-3 per week does not affect the general well-being and development of children at all. In the early part of this century, a study of children with diabetes mellitus found that children with intermittent mild episodes of low blood sugar were just as successful in school as children without diabetes.

Low blood sugar episodes are a price to pay for keeping glucose levels close to normal to avoid the more serious complications of diabetes.

What is considered low sugar

In fact, each person's threshold for sensitivity to low blood sugar depends on:

1. Age.
2. The duration of diabetes mellitus and the degree of its compensation.
3. The rate at which sugar levels fall.

Age

At different ages, the state of low sugar level occurs at different values. For example, children are less sensitive to low sugar levels than adults. In children, a glucose level of 3.8-2.6 mmol / l can be regarded as simply a deterioration in the condition without typical signs of hypoglycemia, and the first signs appear with a sugar level of 2.6-2.2 mmol / l. In newborns, this indicator is even less - less than 1.7 mmol / L, and premature babies feel hypoglycemia only at a glucose level of less than 1.1 mmol / L.

Some children do not feel the first signs of hypo at all. My son, for example, does feel weak when his blood glucose is less than 2.5 mmol / L.

In adults, everything is completely different. Already at a glucose level of 3.8 mmol / L, the patient may feel the first signs of low blood sugar. Especially sensitive are elderly and senile people, as well as those who have suffered a heart attack or stroke, since their brain at this age is sensitive to oxygen and glucose deficiency, which is associated with a high risk of developing vascular catastrophes (heart attacks, strokes). That is why such patients are not required to have ideal parameters of carbohydrate metabolism.

Hypoglycemia should be avoided in the following categories:

1. In the elderly.
2. In patients with cardiovascular disease.
3. In patients with diabetic retinopathy and a high risk of retinal hemorrhage.
4. In patients who do not feel a slight decrease in blood sugar levels. They may have a coma suddenly.

Duration of diabetes mellitus and degree of compensation

It is logical that the longer the diabetes, the less the ability to feel the initial manifestations of hypoglycemia. In addition, when there is uncompensated diabetes for a long time, that is, the glucose level constantly exceeds 10-15 mmol / l, then a decrease in glucose levels below these values ​​by several mmol / l, for example, to 5-6 mmol / l, can provoke hypoglycemic reaction.

Therefore, if you want to normalize glucose levels, then you need to do this gradually so that the body gets used to the new conditions. Very often this picture occurs with chronic insulin overdose, when.

Blood sugar drop rate

The onset of symptoms of hypoglycemia also depends on how quickly the blood glucose level decreases. For example, you had 9-10 mmol / L blood sugar, did insulin, but calculated the dose poorly, and in 30-45 minutes the sugar dropped to 4.5 mmol / L. In this case, “hypo” developed due to the rapid decline. We once had such a case when all the signs of “hypo” were obvious, and the blood sugar was 4.0-4.5 mmol / l.

Causes of low blood sugar

In fact, sugar surges occur not only in patients with diabetes, but also in other conditions and diseases, but I will not talk about this in this article, since it was written for people with diabetes. Therefore, I will tell you why and from what blood sugar drops in diabetics.

Why blood sugar jumps in diabetes

• Medication or insulin overdose.
• Skipping or not eating enough food.
• Unplanned or planned, but unaccounted for physical activity.
• Chronic renal failure.
• Change from one drug to another.
• Adding another antihyperglycemic drug to therapy.
• Using complementary measures to lower blood sugar levels without reducing the dose of essential drugs.
• Taking alcohol and drugs.

Symptoms of Low Blood Sugar in an Adult

As I mentioned above, hypoglycemia can be mild or severe. Signs do not differ at all in men and women. When blood sugar drops, symptoms appear such as:

• cold sweat (head sweats over hair growth, more back of the neck)
• sense of anxiety
• hunger
• cooling of the fingertips
• slight tremors in the body
• chills
• nausea
• headache and dizziness
• numbness of the tip of the tongue

Further, the condition may worsen. There is disorientation in space, unsteadiness of gait, a sharp deterioration in mood (they may start screaming and cursing, although this has not been observed before, or there is unreasonable crying), confusion and slow speech. At this stage, the patient resembles a drunk person, and it is very dangerous, since others regard it this way, and the necessary help is not provided, and the patient himself is no longer able to help himself.

If you do not provide help, then the condition worsens even more. Convulsions appear, loss of consciousness, and coma develops. In a coma, cerebral edema develops, and the result is death.

Sometimes hypoglycemia develops at the most inopportune time, when a person is completely unprepared for this - at night. When blood sugar drops at night, it is accompanied by very characteristic symptoms.

• Attempting to get out of bed or accidentally falling out of bed.
• Nightmares.
• Walking in a dream.
• Making unusual noises.
• Anxiety.
• Sweating.

In the morning after such a night, very often patients wake up with a headache.

Signs of low glucose levels in children

As I said, children are less sensitive to low sugars, but this does not mean that they do not experience the sensation of hypoglycemia. Often small children, for example, newborns, simply cannot express typical complaints, that is, form a phrase so that we immediately understand what is at stake.


How, then, can you know if a child is experiencing hypoglycemia at a given time? You can try to catch this by indirect signs.

• Complaints of leg pain or fatigue
• Suddenly wanted to eat, complaint of stomach pain
• There is an atypical calmness and silence after a noisy game
• Retardation and procrastination in answering your question
• Sudden head sweating
• Desire to lie down and rest

How to raise blood sugar quickly

When you feel your blood sugar is dropping and you are experiencing signs of low blood sugar, then it would be ideal to take a meter reading.

If you experience such a state for the first time, then remember it, in the future this will help to accurately differentiate it, and you will also know at what values ​​you have hypoglycemia. In addition, you will need a starting value to evaluate the effectiveness of symptom relief measures.

What to do if your blood sugar is below normal

Mild hypoglycemia is usually relieved by the patient himself. In this case, you need to raise the glucose level from 2-3 mmol / L to 7-8 mmol / L with food products that quickly increase blood sugar. How much? Hmm ... this is a tricky question, since everyone has their own optimal amount of carbohydrates to eliminate hypo.

You can, of course, eat 20 g of carbohydrates = 2 XE (4 teaspoons of sugar, for example), as recommended by the guidelines, and then reduce the prohibitively high sugar level for a long time. Or, by trial and error, you can find out how much of a certain product (sugar, juice, candy, etc.) will increase the sugar level within acceptable values ​​(well, so as not to overdo it), as well as how long this sugar will increase.

I'll tell you with our example. My son has a very good sensitivity to fast carbohydrates, like all small children, so 50 g of apple juice (5-6 g of carbohydrates = 0.5 XE) raises sugar by 4-5 mmol. Therefore, this dose is enough to normalize sugar.

After you have eaten something or drank "fast" carbohydrates, it is imperative to check the sugar level again after 5-10 minutes, if no increase is observed during this time, then you need to take the same amount of carbohydrates and measure after 5 10 minutes, etc.

How to eliminate a severe glucose deficiency

A reasonable question arises: what to eat and what to drink? You can again refer to the table of foods with glycemic indices. In the previous article, I talked about foods that slowly increase blood sugar, and gave a link to download the table. If you haven't downloaded yet, do so. So, you need to eat foods from the list with a high glycemic index to stop hypoglycemia.

• refined sugar
• jam
• caramel candies
• fruit juice or lemonade

Many, feeling hungry from "hypo", begin to make themselves a sandwich with butter and sausage. This is what my grandmother does, I still can't stop her from such a habit. This is completely unacceptable in this case. Why? Because the fat in butter and sausage does not allow glucose from bread, even a loaf, to be absorbed quickly. And the loaf is bad for such cases.

Other things that CANNOT be used to boost sugar quickly:

• cakes
• ice cream
• chocolate and chocolates
• sweetened products
• fruits
• "Slow" carbohydrates (cereals, bread, pasta)
• next meal (first you need to eliminate "hypo", and only then sit down for lunch)

If you do not take in enough carbohydrates or ignore the deterioration of the condition (once my grandmother suffered "good" hypoglycemia only because she was ashamed to start eating at the table when no one else is eating), there are 2 possible outcomes:

1. or the decrease in blood sugar will continue and the condition will worsen so much that the help of strangers or an ambulance will be required
2. or in response to a decrease in sugar, counter-insular hormones (a kind of defenders against low sugar) will be released into the bloodstream, which will release glucose from the liver and thereby increase blood sugar levels

But this process cannot be called an ideal protector, because when this protective mechanism starts up, it cannot stop for a long time. A hormonal storm rages in the body that makes sugar control unpredictable. Such a storm can last for several days until the sugars return to their normal values.

To prevent this, you need to constantly carry a glucometer and "fast" carbohydrates with you, because not everywhere, where hypoglycemia hits you, you can quickly buy what you need. There is an alternative to products - dextrose tablets, which begin to act in the oral cavity when absorbed. They are quite convenient to carry with you.

How to respond when hypoglycemia has gone very far

Only relatives who know others or the medical staff can help here. If a person is still conscious, he needs to be drunk with sweet tea, in the hospital they make 40% glucose intravenously. If a person is already unconscious, then in no case put anything in his mouth, so you can only harm. In this state, a person may choke on what you have invested or poured into him. It is better to call an ambulance and indicate that the patient has diabetes and that he is likely to have hypoglycemia.

While waiting for an ambulance, you can put the victim on his side with your upper leg bent at the knee. This way he will not suffocate with his own tongue. If you own a nursing business and you have 40% glucose at home, then you can safely inject 20 ml of the solution. You can also inject 0.5 ml of adrenaline, which will release glucose from the liver. If the person has glucagon (an insulin antagonist), give it. Not all at once, but one thing, for example, glucose and adrenaline or glucose and glucagon.

Attention! If you see a diabetic unconscious, never inject insulin. Such an unconscious person is in a hypoglycemic coma in 99.9% of cases. And if you give him insulin, then you will only aggravate the situation and he may never leave it. In this case, it is better and more correct to introduce as much of a 40% glucose solution as possible. Even if it is not a hypocoma, your actions will not cause serious harm.

It can overtake you anywhere, and it is important that the people around you are aware of your illness and are trained on what to do and NOT to do in such a situation. It would be quite nice to carry with you something like a note in your passport or wallet with documents for the car, where your details and, most importantly, your diagnosis with recommendations will be indicated.

Nowadays many young people get tattoos with the inscription “I am a diabetic” or wear bracelets that indicate the diagnosis and tell what to do if their owner is found unconscious.

This concludes the article. I wish you never to be in the place of victims of hypoglycemia. Click on the social media buttons under the article, and see you soon!

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

17.03.2016

The normal functioning of the body depends on how much sugar is in the blood. It enters the bloodstream along with food containing carbohydrates. Carbohydrates in the body break down to glucose. It is partly absorbed into the bloodstream, partly processed into glycogen, most of which is concentrated in the liver. When it is necessary to increase energy expenditure, glycogen is broken down into glucose. The pancreas produces insulin, a hormone that regulates blood sugar and supplies it to tissues and organs as an energy source. Thus, glucose, which is more often called simply sugar, is the main participant in carbohydrate metabolism and a carrier of energy required for many processes in the body.

Acceptable glucose level

Fluctuations in glucose levels can cause an unhealthy lifestyle, which is more typical for men, hence the misconception that the sugar rate in men is higher. In fact, this is a delusion, and the norms for men are the same as for women.

Acceptable norms differ depending on age. Normal blood sugar values ​​for children are lower:

• from birth to one month, the norm is 2.8 to 4.4 mmol / l,
• from one month to 14 years - in the range from 3.3 to 5.6 mmol / l.

Up to 59 years for women and men, the norm is 4.1 to 5.9 mmol / L, starting from 60 years for men and women - 4.6 to 6.4 mmol / L, and annually increases by 0.056 mmol / L. For pregnant women, the upper limit reaches 6.6 mmol / L.

The given parameters apply to finger-test. If a study of blood taken from a vein is carried out, then the indicators will be approximately 12% higher. The analysis of venous blood is more informative and accurate.

Rates of glucose concentration vary depending on age, physical activity, time of day, stress, food intake. At night or during the day, in between meals, sugar goes down, after a meal, with exertion and stress, it rises.

The glucose level is constantly regulated: it decreases or increases based on the needs of the body. Insulin controls this process, to a lesser extent - adrenaline produced by the adrenal glands. Diseases of the pancreas or adrenal glands violate this mechanism and cause a failure of all metabolic processes, and subsequently entail irreversible pathological changes in the organs and systems of the body.
If the concentration of sugar in the blood is different from the norm, you need to find out what is the cause of these changes.

Lowered blood sugar

With a low sugar level, the body does not receive nutrition in the required amount. This is especially reflected in the brain, a lack of glucose in it can cause coma. A condition where sugar drops to a critical level is called hypoglycemia.
The main reason for the decrease in sugar is a limited diet. The body does not have enough energy, it begins to spend internal resources, first of all, carbohydrates accumulated in the liver are consumed.

• Sugar decreases if you do not eat for a long time - the body does not receive carbohydrates for a long time. Therefore, in the morning, blood sugar is lower.
• Sugar levels can drop with intense physical activity, even if the diet is adequate. The amount of consumed carbohydrates in this case can exceed the amount consumed, as a result of which there is a deficit of energy.
• Sweets and alcohol quickly increase sugar levels. But after a sharp increase, it also declines rapidly.
• In men, most often, hypoglycemia can be caused precisely by the use of alcoholic beverages, ethanol. At the same time, a decrease in sugar in men is less common than in women.

High blood sugar

When the blood glucose level rises significantly, this is hyperglycemia.
The most common cause of this condition:

• diabetes,
• overweight,
• heredity,
• binge eating,
• high content of light carbohydrates in food, stress,
• infectious diseases,
• an unhealthy lifestyle of a person can also lead to hyperglycemia.

High sugar affects the eyes, kidneys, limbs, damaging the vessels that feed them. With a prolonged condition, retinal stratification may occur, subsequently the optic nerves atrophy, and glaucoma occurs.

Kidneys - remove excess glucose from the human body. If there is too much of it, damage to the renal vessels occurs, which disrupts the functioning of the kidneys. This leads to the fact that important substances are also excreted from the body, and renal failure develops.

Damaged blood vessels, as a result of excess sugar, can cause inflammation and lead to the formation of wounds, gangrene, and tissue necrosis.

Causes of a short-term increase in sugar:

• epileptic seizures,
• traumatic brain injury,
• liver damage
• acute myocardial infarction,
• burns, stress,
• taking some medications.

In men, high sugar affects sexual function - there is a disorder of sexual desire, reproductive function is impaired. High sugar in men lowers testosterone, which in turn regulates sugar content. For this reason, the treatment of diabetes in men is aimed at increasing testosterone.

In men, fat is deposited in the abdomen and presses on internal organs, including the liver and pancreas. Therefore, it is enough for them to gain quite a bit of excess weight so that their blood sugar rises.
In middle-aged women, high blood sugar is much less common than in men.

Blood sugar test

Even if a person is not worried about anything, you should periodically donate blood for analysis. After 40 years, this should be done every three years, with overweight and in cases where close relatives have diabetes - once a year.

To establish the sugar content, there are many tests: venous or capillary blood is examined, with and without stress, and others. Indicators depend on what kind of blood is being tested.
If blood from a finger was examined, then the value from 5.6 to 6.1 mmol / l confirms that there is a failure of the carbohydrate metabolism process, a condition close to diabetes mellitus, which is diagnosed with a value exceeding 6.2 mmol / l.

Some health centers check blood with a blood glucose meter, which can be used at home as well. But the result of such an express test is considered preliminary, its accuracy is lower than that carried out in laboratory conditions.

Another test is with a "sugar load". Blood for analysis is donated for the first time on an empty stomach, then again with glucose intake. During the break between donating blood for analysis, you cannot eat, drink, move a lot, or vice versa - lie down. All of this will skew the results. With this research method, the values ​​change: the norm is 7.9 mmol / l, above this and up to 11.00 mmol / l - it means that there is a predisposition to diabetes, and indicators exceeding this value confirm the development of diabetes.

Before being tested for sugar content - you should not stop eating sweets, go on a diet, over-pass. All this will lead to a biased result.

How to keep sugar normal

A number of factors can alter the concentration of sugar. Excessive consumption of sweets can cause the body to impair its ability to regulate glucose over time.
There are foods that do not contain sugar, but can cause it to rise in the blood. They contain fats, carbohydrates, starch. A very popular Chinese cuisine is oversaturated with fats and a large amount of carbohydrates, which retain high sugar for a long time, which poses a danger to the human body. This also applies to fast food.

Energy drinks with increased physical activity allow the body to quickly recover, due to the sugar in the composition. For professional athletes who consume a lot of energy, this is necessary, but in other cases they should not be consumed so as not to cause an excess of glucose.

Physical activity is essential to keep sugar in the normal range. It doesn't have to be a long workout, you just need to move more. Even walking, cleaning the house, or working in the country can lower glucose levels.

Avoiding meat, milk and eggs in favor of plant-based foods can normalize sugar content. This is due to the fiber content in plant foods, which can slow down the breakdown of carbohydrates, which contributes to the slow and controlled absorption of sugar into the blood.

Even with minor deviations in blood sugar from the norm, you should consult a doctor for examination.

Synonyms: Glucose (in blood), plasma glucose, blood Glucose, blood sugar.

Scientific editor: M. Merkusheva, St. Petersburg State Medical University named after acad. Pavlova, general medicine.
September, 2018.

General information

Glucose (a simple carbohydrate, monosaccharide) enters the body with food. In the process of splitting saccharide, a certain amount of energy is released, which is necessary for all cells, tissues and organs of a person to maintain their normal vital activity.

The concentration of glucose in the blood is one of the main criteria for assessing the state of human health. A change in the balance of blood sugar in one direction or another (hyper- or hypoglycemia) has the most negative effect on both general well-being and the functionality of all internal organs and systems.

In the process of digestion, sugar from food breaks down into individual chemical components, among which glucose is the main one. Its blood level is regulated by insulin (a pancreatic hormone). The higher the glucose content, the more insulin is produced. However, the amount of insulin secreted by the pancreas is limited. Then the excess sugar is deposited in the liver and muscles in the form of a kind of "sugar reserve" (glycogen), or in the form of triglycerides in fat cells.

Immediately after a meal, blood glucose levels rise (normal) but quickly stabilize due to the action of insulin. The indicator may decrease after prolonged fasting, intense physical and mental stress. In this case, the pancreas secretes another hormone, an insulin antagonist (glucagon), which increases glucose levels by forcing liver cells to convert glycogen back into glucose. This is how the body self-regulates the blood sugar concentration. The following factors can violate it:

• genetic predisposition to diabetes mellitus (impaired glucose metabolism);
• violation of the secretory function of the pancreas;
• autoimmune damage to the pancreas;
• overweight, obesity;
• age-related changes;
• unhealthy diet (predominance of simple carbohydrates in food);
• chronic alcoholism;
• stress.

The most dangerous condition is when the concentration of glucose in the blood rises sharply (hyperglycemia) or decreases (hypoglycemia). In this case, irreversible damage to the tissues of internal organs and systems develops: heart, kidneys, blood vessels, nerve fibers, brain, which can be fatal.

Hyperglycemia can also develop during pregnancy (gestational diabetes). If the problem is not identified in a timely manner and measures are not taken to eliminate it, then a woman's pregnancy can proceed with complications.

Indications

A biochemical blood test for sugar is recommended to be done once every 3 years for patients over 40 years old and once a year for those who are at risk (heredity for diabetes, obesity, etc.). This will help prevent the development of life-threatening diseases and their complications.

• Preventive examination of patients at risk for diabetes mellitus;
• Diseases of the pituitary gland, thyroid gland, liver, adrenal glands;
• Monitoring the state of patients with type 1 and 2 diabetes mellitus receiving treatment, together with analysis for glycated hemoglobin and C-peptide;
• Suspected development of gestational diabetes (24-28 weeks of gestation);
• Obesity;
• Prediabetes (impaired glucose tolerance).

Also, an indication for an analysis is a combination of symptoms:

• intense thirst;
• frequent urge to urinate;
• rapid weight gain / loss;
• increased appetite;
• excessive sweating (hyperhidrosis);
• general weakness and dizziness, loss of consciousness;
• the smell of acetone from the mouth;
• increased heart rate (tachycardia);
• visual impairment;
• increased susceptibility to infections.

Diabetes risk groups:

• Age from 40 years;
• Overweight; (abdominal obesity)
• Genetic predisposition to diabetes.

An endocrinologist, gastroenterologist, therapist, surgeon, pediatrician and other narrow specialists or general practitioners can interpret the results of a blood sugar test.

Blood glucose rates

Important! Rates vary depending on the reagents and equipment used in each specific laboratory. Therefore, when interpreting the results, it is necessary to use the standards adopted in the laboratory where the analysis was submitted. You also need to pay attention to units.

Glucose norms, according to L. Danilova's reference book, 2014:

Reference values ​​taken from the reference book by A. Kishkun, 2007:

Important! The interpretation of the results is always carried out in a comprehensive manner. It is impossible to make an accurate diagnosis based on only one analysis.

High glucose (hyperglycemia)

• Diabetes:
  • 7.0 mmol / l and above on an empty stomach;
  • 11.1 mmol / L and above 2 hours after a meal.
• Gestational diabetes during pregnancy
• Disorders of the endocrine system and pancreas;
• Hormonal disbalance;
• Pancreatitis (inflammation of the pancreas) in chronic or acute form;
• Pancreatic oncology;
• Dysfunction of internal organs: liver, kidneys, adrenal glands;
• Chronic renal failure
• Hyperthyroidism (hypersecretion of iodinated hormones);
• Itsenko-Cushing's syndrome (increased production of the hormone cortisol by the adrenal glands);
• Acromegaly (dysfunction of the anterior pituitary gland).

Provoking factors:

• stress as a result of severe trauma, complex surgery, heart attack or stroke, painful shock;
• unbalanced diet (predominance of foods containing a large amount of carbohydrates in the menu);
• taking medications: diuretics, antidepressants, corticosteroids, hormones, salicylates, lithium preparations, dilantin, epinephrine, etc.

According to recent research, elevated blood glucose levels increase the risk of liver cancer in people with prediabetes and diabetes.

Low glucose (hypoglycemia)

• Disruption of the pancreas;
• Hypothyroidism (insufficient production of thyroid hormones);
• Insulinoma (usually a benign neoplasm that can secrete insulin);
• Diseases of the liver, kidneys, adrenal glands, incl. malignant;
• adrenal insufficiency (Addison's disease);
• Hypopituitarism (violation of the secretion of hormones by the pituitary gland);
• Glycogenosis (a group of hereditary diseases caused by a violation of the process of synthesis and breakdown of glycogen due to the existing defects of various enzymes).

Provoking factors:

• prolonged fasting, adherence to a strict diet or fasting;
• disruption of the gastrointestinal tract, autonomic disorders, postoperative conditions;
• overdose of insulin or other hypoglycemic drugs;
• intoxication (poisoning) with arsenic;
• alcohol abuse;
• feverish conditions;
• taking medications: steroids, amphetamine, etc.

Preparation for analysis

The biomaterial for the study is venous or capillary blood, the collection of which is carried out according to standard algorithms.

• Blood sampling is performed in the morning (8.00 - 11.00) and strictly on an empty stomach. The last meal should be at least 8-14 hours before the procedure;
• On the eve, you can not abuse sweets, fatty and fried foods;
• Also, the day before the test, it is necessary to exclude the use of alcohol, energy drinks;
• It is not recommended to smoke 3-4 hours before blood sampling;
• On the day of the examination, you need to protect yourself from any physical and psycho-emotional stress.

Analysis for sugar at home

At home, it is possible to conduct an express test using a glucometer.

A drop of capillary blood from a finger is placed on a test strip, which is installed in a device that reads the information and processes the result within a few minutes. This type of diagnosis is most convenient for patients with established diabetes mellitus, since it allows you to independently control blood sugar levels at any time and in any place.

An alternative way to monitor blood glucose is to detect breath acetone using a portable device with disposable sensor slides. However, this method shows false positive results in smokers, since acetone is also a product of the combustion of tobacco smoke.

Blood glucose values ​​are inconsistent throughout the day, depending on muscle activity, intervals between meals, and hormonal regulation. In a number of pathological conditions, the regulation of blood glucose levels is impaired, which leads to hypo- or hyperglycemia. Measurement of blood glucose is the main laboratory test in the diagnosis, monitoring of diabetes mellitus treatment, and is used to diagnose other disorders of carbohydrate metabolism. Increased serum glucose (hyperglycemia):

diabetes mellitus in adults and children;

physiological hyperglycemia (moderate physical activity, strong emotions, stress, smoking, adrenaline rush during injection);

endocrine pathology (pheochromocytoma, thyrotoxicosis, acromegaly, gigantism, Cushing's syndrome, somatostatinoma);

diseases of the pancreas (acute and chronic pancreatitis, pancreatitis with mumps, cystic fibrosis, hemochromatosis, pancreatic tumors);

chronic liver and kidney disease;

cerebral hemorrhage, myocardial infarction;

the presence of antibodies to insulin receptors;

taking thiazides, caffeine, estrogens, glucocorticoids.

Decreased serum glucose (hypoglycemia):

diseases of the pancreas (hyperplasia, adenoma or carcinoma, beta cells of the islets of Langerhans - insulinoma, deficiency of alpha cells of the islets - glucagon deficiency);

endocrine pathology (Addison's disease, adrenogenital syndrome, hypopituitarism, hypothyroidism);

in childhood (in premature babies, children born to mothers with diabetes mellitus, ketotic hypoglycemia);

overdose of hypoglycemic drugs and insulin;

severe liver disease (cirrhosis, hepatitis, carcinoma, hemochromatosis);

malignant non-pancreatic tumors: adrenal cancer, stomach cancer, fibrosarcoma;

fermentopathy (glycogenosis - Gierke's disease, galactosemia, impaired fructose tolerance);

functional disorders - reactive hypoglycemia (gastroenterostomy, postgastrectomy, autonomic disorders, impaired gastrointestinal motility);

eating disorders (prolonged fasting, malabsorption syndrome);

poisoning with arsenic, chloroform, salicylates, antihistamines, alcohol intoxication;

taking anabolic steroids, propranolol, amphetamine.

Reference values:

For the diagnosis of diabetes, the following cut-off values ​​are generally accepted:

in a random study (i.e., independent of the time of the previous meal) plasma glucose > 11.1 mmol / L;

fasting plasma glucose > 7.0 mmol / L;

plasma glucose level 2 hours after taking glucose when performing a glucose tolerance test > 11.1 mmol / L.

2.8. Cholesterol and cholesterol fractions

Cholesterol is synthesized in the body everywhere and is a necessary component of cell membranes, is part of lipoproteins, is a precursor for the synthesis of bile acids and steroid hormones. The diagnostic value of measuring cholesterol is to assess the risk of coronary heart disease and atherogenesis. However, the determination of cholesterol fractions is of greater prognostic value. About 25% of total serum cholesterol is transported in the HDL fraction. HDL transports cholesterol from tissues and other lipoproteins to the liver. LDL performs the opposite function - transporting cholesterol synthesized in the liver into the tissues. There is a clear inverse relationship between HDL cholesterol levels and the incidence of coronary heart disease. HDL is believed to have anti-atherogenic effects, so low HDL cholesterol is an indicator of a high risk factor for coronary artery disease and atherosclerosis, regardless of the concentration of total cholesterol. High LDL cholesterol is atherogenic and indicates a high risk of cardiovascular disease.

Reference values:

Cholesterol
Normal values	< 5,2 ммоль/л
Border	5.2 - 6.2 mmol / l
High	> 6.2 mmol / l
α-Cholesterol
High risk	< 1,03 ммоль/л
"Negative" risk	> 1.55 mmol / l
β-Cholesterol
Optimal	< 2,6 ммоль/л
Normal	2.6 - 3.3 mmol / l
Borderline	3.4 - 4.1 mmol / l
High	4.1 - 4.9 mmol / l
Very tall	> 4.9 mmol / L

The blood glucose level is an indicator that reflects the state of carbohydrate metabolism. Its value varies depending on physiological and pathological factors. It is necessary to monitor the sugar level in order to significantly reduce the risk of developing heart disease, stroke, glaucoma, atherosclerosis.

Diabetes mellitus is not diagnosed on time by doctors, because the first symptoms of the disease are nonspecific: frequent urination, dry skin, thirst, irritability and fatigue. Therefore, when a similar clinical picture appears, it is necessary to conduct a complete examination of the patient, including the required studies of the concentration of sugar in the blood.

In children under one year of age, this indicator is low, due to the peculiarities of metabolism. When a child begins to grow, the need for an energy substrate increases, which is manifested in an increase in the amount of glucose. By the age of five, the value of sugar figures in a child is comparable to the indicator that an adult has and is indispensable for maintaining good health.

In adults, all metabolic processes slow down, the sensitivity of body tissues to insulin decreases, which leads to a decrease in its production. There is also a decrease in the synthesis of incretin, which is synthesized in the duodenum and jejunum.

Types of analyzes

Types of research that are used in patients with suspected diabetic condition:

• Blood chemistry. It is used to represent the glucose level in a healthy person, as a prophylaxis, it is prescribed during medical examinations.
• Determination of the concentration of fructosamine. It is a specific method that can identify the glucose indicator that a person had half a month before testing. Its use every three months allows you to correct the sugar level with an unstable picture of diabetes, during hormonal changes in women.
• Determination of C-peptide. It is an insulin precursor molecule, this test evaluates the functional activity of pancreatic b-cells and is able to determine what type of diabetes a particular person has.
• Fasting glucose tolerance test after sugar load in adults. First, the test is performed on an empty stomach, then the patient takes sweetened water and donates blood every half hour for two hours. The method is highly informative and shows disorders of carbohydrate metabolism.
• Pregnancy glucose tolerance test. It is carried out at 22-26 weeks of the term by analogy with the above. Identifies gestational diabetes that begins five and a half months after conception. It should be borne in mind that if a woman had an increase in blood sugar before pregnancy, this speaks in favor of a congenital or acquired form of the disease.
• The amount of lactic acid (lactate) in the blood. It is an additional method capable of detecting metabolic disorders (lack of oxygen in tissues and oxidation of the pH of the environment).
• Analysis for glycated hemoglobin. A specific research method that allows you to compare glucose that was a few months ago with new results. A feature is that it can give up both on an empty stomach and after a hearty breakfast, however, the following can affect the test result: emotional experiences, bad habits, hard physical labor, drug therapy, and a decrease in the immune status.

Preparing the patient for blood donation

The analysis is taken on an empty stomach, 8 hours before you can drink only water. Alcoholic beverages, smoking, massages and physical activity should be excluded in a few days, as they can provoke an increase in blood sugar, which can be confused with hyperglycemia with a somatic illness.

If the patient is currently taking a drug for any disease, he will be obliged to inform his attending physician about it in order to avoid misunderstandings. For 8 hours before the analysis, you can not use toothpaste for cleaning teeth and chewing gum. The blood glucose level is considered normal if it is in the range of 3.3 - 5.5.

How to donate blood

The method for determining glucose is chosen by the doctor who is assigned to the patient. For quick diagnosis, choose an express test carried out using a glucometer. Its advantage is that it can be done at home. The results are not always reliable and accurate, however, it is successfully used in patients with a high sugar content, as it allows you to control its daily changes.

To obtain more accurate data, it is necessary to donate capillary and venous blood on an empty stomach. Normally, daily fluctuations in glucose do not reach high values.

Fasting glucose

A blood glucose test is taken early in the morning when the patient has not eaten in the past 8 hours, chewed gum, or used toothpaste. The accuracy of this method increases the avoidance of stressful experiences and physical overload immediately before the procedure. Alcohol, smoking, and the use of drugs are excluded, if there is no need for them, a few days before the analysis.

Glucose with stress

This method of laboratory research is carried out in two ways: injecting a glucose-containing mixture intravenously or orally through the gastrointestinal tract. The first method is very informative, since the amount of sugar in the blood rises quickly, but no one knows what reaction will follow from the body. Therefore, the second method is used more often. It allows you to reduce the risk of possible complications.

If the intravenous type of solution is used, then it is administered within 3 minutes. When taken orally, the patient drinks sweet water on an empty stomach for 5 minutes, and then his blood is taken for 2 hours 4 times.

Normal values ​​of glucose in venous blood and from a finger:

Glucose 5 is an average. The blood glucose rate should not exceed 5.5 in capillary blood and 6.1 in venous blood.

The concentration of carbohydrates is affected by hormones of the pancreas and thyroid glands, adrenal glands, and the anterior pituitary gland. Therefore, even healthy people are subject to insignificant daily fluctuations in sugar. A normal blood glucose level helps to improve the energy metabolism of cells, which is why it is so important to supply it to the body.

With a deficiency of carbohydrates, the depletion of cellular structures occurs, they become functionally defective up to their self-destruction. Excess sugar leads to its deposition in other organs and systems, which also leads to undesirable consequences and complications.

Reasons for deviations from the norm

Exceeding the level or hyperglycemia can be triggered by an alimentary factor, that is, in case of a violation of the diet, it can be observed with insufficient physical activity, with prolonged stressful effects and with the abuse of alcoholic beverages.

In addition to physiological reasons, an increase is often associated with pathology of the thyroid and pancreas and with some liver diseases, for example, such as hepatitis or cirrhosis. Sometimes the factor that provokes this condition is the intake of hormonal drugs.

Decreased levels or hypoglycemia can also be both physical and pathological in nature. The first reasons for the occurrence of this ailment include: prolonged fasting, excessive strength load, a large amount of stress, large intervals between meals, diet, a decrease in sugar levels in the morning on an empty stomach.

Other factors are diseases of the internal organs that can affect the production and absorption of insulin (for example, hepatitis, type 1 and 2 diabetes, glomerulonephritis).

Each patient has an individual sugar tolerance threshold, so the doctor must calculate how much carbohydrates should be in the diet in order to treat existing diabetes.