Sugar( glucose) plays an important role in the human body, providing it with the energy necessary for the functioning of all organs and tissues. Increase or decrease in the level of this carbohydrate in the blood speaks about serious diseases, many of which at the initial stages are asymptomatic. Control the amount of sugar in the blood helps the tests, they can be done in the laboratory or at home.
- mechanism of regulation
- sugar Why increases
- Why falls
- children during pregnancy
- Other reasons
- Improper treatment of diabetes
- Other reasons
- With increased
- With reduced
Mechanism of sugar regulationto table of contents ^
Glucose enters the body with food in complex carbohydrates, which are cleaved during digestion to simple components and secreted into the blood. After eating, the blood sugar level rises, which increases the secretion of the hormone of the insulin pancreas. The hormone promotes the absorption of glucose by cells, reducing its concentration in the blood to normal values.
However, cells use only part of the sugar that has entered the body. The main amount of this substance accumulates in the liver in the form of glycogen, from which it is expended under physical or emotional stresses. Insulin is also responsible for the synthesis of glycogen.
Reducing the level of sugar in the blood triggers the production of another hormone of the pancreas - glucagon. It enhances the breakdown of glycogen in the liver and promotes the release of glucose from the depot. A similar action is possessed by the hormone adrenal adrenaline.
Also, the increase in the level of sugar at its low values or sudden needs provides:
- Hormones that stimulate gluconeogenesis - the formation of glucose from simpler substances. These include glucagon, hormones of adrenal medulla( adrenaline, norepinephrine), hormones of the adrenal cortex( glucocorticoids).Thyroid hormone thyroxine. Growth hormone secreted by the pituitary gland.
Sympathetic nervous system, which is activated when stress requires increased energy consumption. The effect of the parasympathetic system, on the contrary, reduces blood sugar, which is most noticeable at night or in the early morning.to table of contents ^
The sugar level is measured in the morning, on an empty stomach. At the same time, the capillary blood is taken from the finger. For venous blood, the permissible values are slightly higher. In case of doubtful result, a check after loading with glucose is carried out - an oral glucose tolerance test. Also, to clarify the diagnosis, it is possible to conduct an analysis for glycated hemoglobin. In this case, the norms for women and men are the same, but in childhood and in pregnancy, deviations are possible.to table of contents ^
In fasting, the interpretation of glucose in capillary blood is as follows:
- hypoglycemia - a decrease in blood sugar concentration, observed at values below 3.5 millimoles per liter of blood;
- normal level is 3.5-5.5 millimoles in 1 liter of blood;
- impaired glucose tolerance( borderline between norm and pathology) - 5.6-6.6 millimoles;
- hyperglycemia is an increase in blood glucose levels, it is stated at rates above 6.7 millimoles per 1 liter of blood, such values are characteristic for diabetes mellitus;
- when taking blood from the veins on an empty stomach is 4.1-5.9 millimoles per liter, for elderly people the value is up to 6.4 millimoles.
After loading with glucose:
- rate - up to 7.7 millimoles per 1 liter of blood;
- impaired glucose tolerance - 7.8-11.1 millimoles;
- diabetes mellitus is 11.2 millimoles and above.
The level of glycated hemoglobin in the total amount of sugar:
- norm - 4,5-5,6%;
- presence of predisposition to diabetes mellitus - 5,7-6,4%;
- prediabetes - 6,5-6,9%;
- diagnosed with diabetes is above 7%.
At an early age, a physiological tendency to decrease the concentration of sugar in the blood is observed.
- hypoglycemia - values below 2.5 millimoles in 1 liter of blood;
- norm: in infants( children under 1 year old) - 2.78-4.4 millimoles per 1 liter of blood;in preschool children - 3.3-5 millimoles;in children of school age - 3.3-5.5 millimoles;
- hyperglycemia - above 6.1 millimoles in 1 liter of blood.
Rates for children after loading with glucose also differ from adults in the smaller side. Diabetes mellitus is diagnosed at a value of 7.7 millimoles per 1 liter of blood and higher.
In the study of venous blood in children taken on an empty stomach, the values up to 5.6 millimoles are considered normal.to table of contents ^
When pregnancy is
The sugar levels for pregnant women are the same as for other adults. However, because of the reorganization of the body in some women, insulin resistance is observed - a decrease in the reaction of tissues to insulin. In this case, the development of so-called gestational diabetes mellitus is possible. Diagnosis of the disorder is usually in the middle of pregnancy - from 4 to 8 months, the concentration of glucose exceeds 6.1 millimoles per liter of blood for fasting and 7.8 millimoles after loading with glucose.
Also about 50% of women who have had gestational diabetes become ill with type 2 diabetes for 15 years after childbirth.to contents ^
Various diseases can cause the increase and decrease of blood sugar level:to the table of contents ^
It is observed in the following cases:to the table of contents ^
It is a persistent increase in blood sugar level caused byInsulin deficiency in the body.
The main causes of its occurrence are serious pancreatic diseases:
- severe pancreatitis;
- effects of cystic fibrosis( cystic fibrosis);
- Pancreas removal.
Diabetes also occurs due to diseases accompanied by increased secretion of counterinsulant hormones that block the work of insulin, reduce its production and promote rapid disintegration:
- hormoneally active glucagonoma - accompanied by the production of glucagon;
- acromegaly, gigantism - increased secretion of growth hormone;
- thyrotoxicosis - increased thyroid hormone levels;
- tumor of adrenal medulla of pheochromocytoma - is formed with adrenaline hyperactivity;
- in Isenko-Cushing syndrome, the level of hormones of the cortex of the adrenal gland grows.
Other causes of
Also, the growth of blood glucose may beThe following states are provoked:
- physiological - increased sugar is caused by food intake, intense training or psychological stress;
- severe pain syndrome;
- burns or frostbite;
- epileptic seizure;
- severe attack of angina;
- acute myocardial infarction;
- operations on the stomach and duodenum - cause rapid absorption of glucose from the intestine into the blood;
- craniocerebral injury with hypothalamus damage - the ability of tissues to utilize glucose decreases;
- severe liver damage - provoke a disruption in the ability to synthesize glycogen from glucose;
- long-term administration of medications - corticosteroids, thiazide diuretics, some hypotensive and psychotropic drugs, estrogen-containing drugs( including oral contraceptives), catecholamines;
- genetic predisposition, which is realized with obesity, stress, malnutrition, low mobility, smoking, alcoholism, concomitant pathologies( atherosclerosis, hypertension).
The most severe complications of high sugar are coma, which develop gradually, but often lead to death.to the table of contents ^
The reasons for the reduction in blood sugar are:to the table of contents ^
Incorrect treatment of diabetes mellitus
Among the incorrect actions:
- overdose of drugs;
- improper administration of medications - for example, intramuscular injection of insulin instead of subcutaneous;Inaccuracies in the diet - prolonged fasting;
- diarrhea or vomiting;
- alcohol intake;
- use of certain drugs - acetylsalicylic acid, certain antibiotics, antihistamines, sulfonamides.
Other causes of
Also hypoglycemia is possible in the following conditions:
- disease, accompanied by malabsorption syndrome, which makes it difficult to absorb glucose into the blood;
- severe diseases of the liver parenchyma, preventing the release of glucose from the depot - hepatic necrosis in toxic or infectious lesions;
- endocrine pathologies with a decrease in the synthesis of contrinsular hormones: hypopituitarism - pituitary hypofunction, Addison's disease - lack of hormones of the adrenal cortex, hypothyroidism, increased insulin production.
The main symptoms are sweating, nausea, hunger, anxiety, inability to concentrate. Prolonged hypoglycemia can lead to loss of orientation in space and inadequate behavior. Absence of therapy leads to hypoglycemic coma.to contents ^
The glucose level is never stable, even in a healthy person. Many factors influence its change and, in order to obtain reliable data, it is necessary to adhere to certain rules:
- it is necessary to take the test on an empty stomach, 8-12 hours after eating;
- for 8 hours before the test you can drink only water;
- 2-3 days prior to blood sampling do not consume alcohol, exclude from the diet fatty, acidic, spicy dishes;
- for a few days not to engage in intensive training, avoid stressful situations;
- in the morning before the test, you can not brush your teeth and use chewing gum;
- , as long as possible, do not smoke before testing( the recommended minimum is 1 hour);
- a week before taking blood to stop taking medication, if it is impossible - to warn about the medications taken by the attending physician;
- results of the analysis may distort the short-term ultrasound, x-ray, physiotherapy, massage, bath or sauna visit;
- in case of poor health, the study should be postponed until recovery.
If the analysis is performed after a meal, between the intake of food and blood sampling should take at least 1-1.5 hours - during this time the food is absorbed and the sugar enters the blood.
For the test at home, using the meter, there are also rules:
- before blood collection it is advisable to warm hands - wash with warm water or hold it by the battery, it will improve blood circulation;
- puncture site should be pre-dried, otherwise the blood will mix with water, which can distort the result;
- puncture is done on the pads of the inner surface of the fingers, to reduce pain it is better to do it not in the center, but slightly laterally;
- with frequent analysis of the need to change the site of the fence - this will help to avoid thickening of the skin and inflammation;
- should not be strongly squeezed finger, otherwise the blood may mingle with the tissue fluid and distort the data;
- the first drop of blood is not used for the test, it must be gently wiped with a dry cotton pad;
- to remove a drop of blood is necessary, until it is smeared so that it absorbed into the test strip.
Types of assays
The following methods are used to determine blood sugar level:to table of contents ^
- Laboratory is a collection of capillary or venous blood in medical institutions for subsequent biochemical research. Often included in the general analysis of blood.
- Express method - carried out using a special portable device( glucometer).Measurement is possible at home, but if the test strips are not properly stored or the batteries become dead, the result will be incorrect. The method is suitable for people with diabetes mellitus to control the course of the disease.
Applied for questionable results of the main tests:
- On glycated ( glycosylated) hemoglobin - reveals the presence of hemoglobin compounds in the blood with glucose molecules. If such complexes are found in large numbers, the patient is confirmed to have diabetes or a predisposition to it. You can conduct the study at any time, regardless of the meal, but it is preferable to do it on an empty stomach.
- With load( glucose tolerance test) - shows the susceptibility of the body to glucose. To do this, blood sampling is carried out 4 times for two hours - first on an empty stomach, then the person is given a drink of 75 grams of sugar dissolved in a glass of water and takes blood after 1, 1.5 and 2 hours.
To correct the level of sugar in the blood helps the use of certain products.to table of contents ^
To reduce glucose, a low-carbohydrate diet should be followed:
- The use of carbohydrates, particularly digestible, must be limited or eliminated. Under ban enter fast foods, carbonated drinks, sugar, sweets, jam. When controlling the sugar level, you can eat honey in the amount of 1-2 teaspoons a day.
- Fats of animal origin( butter, fat, smalets) should be replaced with vegetable oils - olive, linseed, sunflower.
- Metabolic disorders, nutritional limitations and decreased ability to digest useful substances lead to a lack of vitamins and minerals in the body. Therefore, the diet should include many vegetables, fruits, cereals.
- Cabbage, aubergines, beets, carrots, tomatoes, cucumbers, Bulgarian pepper, onions, garlic, parsley, dill, lettuce, celery, spinach, beans, mushrooms do not cause a rise in blood sugar.
- Fruits and berries should be consumed after the main meal, preferably sour-sweet or sour varieties with a minimum content of simple carbohydrates - apples, cranberries, strawberries, strawberries, blueberries, watermelons, grapefruits, oranges, lemons. Dried fruits( raisins, dried apricots, figs), as well as grapes and bananas are undesirable.
- Buckwheat, oatmeal, pearl barley, wheat, rice are useful among the grains. Under the ban falls manna.
- From bakery products are allowed protein-wheat bread, as well as rye and bran, bread from wholemeal flour. The use of white bread, biscuits, cookies and cakes is recommended to be excluded.
- Meat should be a diet, not fatty varieties - veal, rabbit, chicken, turkey, sea fish.
- Egg consumption should be limited.
- From dairy products it is allowed to use curd casseroles, as well as yogurts, kefir, curdled milk, skim milk, but not more than 1-2 glasses a day. From cheese, cream and sour cream should be discarded.
- Drink water, green and herbal teas, not strong coffee without sugar. If it's hard to give up compotes, preference should be given to rowan, from dried pears, rose hips - they help reduce blood sugar. The amount of liquid drunk should be about 2 liters per day.
- Food should be divided, consist of 5-6 small portions per day.
- Food should be steamed, boiled or baked.
- Overeating is strictly prohibited.
- It is important to observe the regularity of food intake, if it is not possible to eat fully at the usual time, you need to make a small snack.
- You should stop using alcohol and smoking.
The low glucose diet depends on the causes of the disorder and the stability of this condition. With reactive hypoglycemia, when the fall of sugar is caused by a feeling of hunger, a sweet drink, a spoon of honey or jam will help. The improvement is noticeable after only 10-15 minutes, at this time it is desirable to take more complex carbohydrates - to eat an apple or a piece of bread.
For special cases when a prolonged drop in glucose is observed, special dietary rules are developed:
- It is necessary to increase the intake of complex carbohydrates - vegetables, cereals, pasta from durum wheat, whole grain bread.
- Fiber slows the absorption of glucose, so the ration should contain bran, corn, peas, asparagus, beans, potatoes, cabbage, beets, radish, cucumbers.
- Fruits should preferably be selected with a moderate sugar content.
- As sources of protein, fish, beans, nuts, chicken or rabbit meat, low-fat milk are preferable.
- Alcohol, lemonade, coffee, fatty and spicy dishes, sweets, muffins, semolina should be excluded from the menu.
- The food should be in fractional, small portions.
If the blood sugar levels deviate from the norm, it is important to know the causes of the abnormalities, first of all the therapy will be aimed at their elimination:
- abolition of medications that led to pathology;
- removal of a tumor that synthesizes contrinsular hormones;
- treatment of the underlying disease affecting the amount of glucose.
If the cause of the violation can not be eliminated, as well as in primary diabetes mellitus, compensatory treatment is prescribed, which may include:
- Taking insulin and other drugs that reduce the amount of glucose: sulfonylurea tablets - promote the synthesis of insulin by the pancreas;biguanides - accelerate the absorption of glucose from the blood;inhibitors that block glucose uptake in the intestine.
- Diet, adherence to work and rest.
- Continuous monitoring of blood sugar levels.
- Regular, not exhausting physical exercises - walking, cycling, fitness, swimming.
- Application of teas, decoctions and infusions of herbs - chicory, cinnamon, ginger, bean pods, burdock root, bilberry leaves, strawberry, currant, nettle, bay leaves, birch buds.
In the case of a coma, emergency medical attention is required.