Database of diseases - Diabetes

NORMALIZATION OF GLUCOSE LEVEL IN BLOOD - NORMOGLIKEMIA


What should we know about the permissible blood glucose concentration in young people?
In young people who usually have type 1 diabetes (dependent on insulin injections), blood glucose should be sought after - both under fasting and fed conditions - close to the levels found in healthy people. This means that fasting and pre-meal glucose should be in the range of:

1. before meals, 70-120 mg / dl (3.9-6.6 mmol / l)
2. in 1 hour after a meal - less than 160 mg / dl (8.9 mmol / l)
3. in 2 hours after a meal - less than 140 mg / dl (7.8 mmol / l)

 

Diabetes is now recognized by the most popular glucometer:

- when the fasting glucose level in double measurement exceeds 126 mg / dl (7.0 mmol / l)

- when the plasma concentration in an accidental measurement is greater (or equal to) 200 mg / 100 ml (11.1 mmol / l) and there are typical symptoms of diabetes mellitus.

And here it is desired to achieve with insulinotrapy - ideal and acceptable blood glucose levels before and after meals in people with type 1 diabetes:
 

Season, designation

Concentration of glucose correct (ideal) in mg / dl (mmol / l)

Glucose concentration allowed in practice in mg / dl (mmol / l)

Before breakfast

70 -105mg / dl (3.9-5.8)

70-120mg / dl (3.9 - 6.6)

Before dinner and the first supper and the second dinner

 

70 -110mg / dl (3.9-6.1)

 

70-120mg / dl (3.9 - 6.6)

1 hour after meals

less than 140 mg / dl (7.8)

less than 160 mg / dl (8.9)

2 hours after meals

less than 120 mg / dl (6.6)

less than 140 mg / dl (7.8)

Between 2 o'clock and 4 o'clock at night

less than 100 mg / dl (5.5)

less than 120 mg / dl (6.6)

Values ​​recommended by professors of diabetologists Jan Tatonia and Anna Czech - Source: how to live with diabetes requiring insulin injections? - PZWL, 2001.

In older people - especially those suffering from type 2 diabetes (without insulin injections), for fear of hypoglycaemia, the requirements for the size of glycaemia are less stringent.

The permissible blood sugar level for 70-year-olds is slightly higher than for young people. It should not exceed 140 mg / dl (7.8 mmo / l) on an empty stomach, after eating it can not exceed 180 mg / dl (10 mmol / l)
Note: There should be no glucose or acetone in the urine!

What do we learn by studying the presence of glucose in the urine?

If the blood glucose concentration exceeds 180 mg / dl (10 mmol / l), i.e. the so-called, renal threshold for glucose - then it passes into the urine. By noting a high concentration of glucose in the urine, we detect not only high glucosuria and exceeding the kidney threshold. For example, if we test urine from so-called night collections - this proves nocturnal hyperglycemia. However, it should be remembered that in the elderly the renal threshold is typical, so that many patients do not have glycosuria even at blood glucose levels exceeding 200 mg / dl. This test should therefore be performed mainly by those patients who for important reasons (the nature of diabetes, lack of a glucometer) can not measure blood glucose.

GLYCEMIA MEASUREMENT - GLUCOMETER

What should we know about the glucometer - an electronic instrument for measuring the level of glucose in the blood?

The modern glucometer reads changes in glucose concentration by the electrochemical method and enables measurements to be made quickly, precisely and simply. The exact result is obtained in less than a minute. All you need to do is insert a test strip into the device, designed only for this type of device, apply a small drop of blood to its end and read the result on a large, legible display. The device constructed in this way does not require wiping the belt in a specific time, as in manual stripe tests to eliminate the error.


Diabetes is now recognized by the most popular glucometer:

- when the fasting glucose level in double measurement exceeds 126 mg / dl (7.0 mmol / l)

- when the plasma concentration in an accidental measurement is greater (or equal to) 200 mg / 100 ml (11.1 mmol / l) and there are typical symptoms of diabetes mellitus.
Index of glycated hemoglobin

High variability of blood glucose concentration impairs self-esteem in longer time intervals. However, there is a method that allows you to precisely determine the "average" concentration of glucose, e.g. in two months. This is served by the assessment of the blood level of the so-called glycated hemoglobin. Although this method can not be used at home, it can only be used to assess whether the self-monitoring methods used are effective in the long-term.
Glycated hemoglobin - a long-term indicator of diabetes control

What is the typical pattern of self-control carried out by a person with insulin-dependent diabetes mellitus?

The profile of the daily glycemic profile is determined by measuring glucose glucose several times a day - on an empty stomach, 2 hours after breakfast, before each main meal and at 3 am, when the glucose concentration is the lowest. This type of self-control is helpful not only in adjusting the dose of insulin, but also in determining whether the malaise at the time caused hypo or hyperglycemia.

Can the symptoms of excess blood sugar or hypoglycemia be a valuable complement to the above biochemical measurements?

Yes - in patients with type 1 diabetes, as a signal with a high level of glucose in the blood. Well-balanced diabetes does not cause any discomfort. Only with significant hyperglycaemia (high blood glucose levels) clinical symptoms appear. These include: increased thirst, polyuria, increasing weakness, tendency to infections, sometimes weight loss. Although many of these ailments may also occur in people with other diseases (these are not symptoms specific to diabetes) - their occurrence in a person with diabetes is an important alarm signal. Do not allow symptoms of hypoglycaemia (hypoglycaemia).



LACK OF GOOD SELF-CONTROL CAUSES HEALTH DAMAGES

Very low blood sugar, or severe hypoglycaemia, happens every fourth person who suffers from type 1 diabetes and only a few patients with type 2 diabetes.

Most often it results from an unconscious drop in the glucose level. In type 2 diabetes mellitus, the organism is gradually getting accustomed to periodic sugar deficiencies, which reduces the severity of the symptoms of hypoglycaemia and dulls the alertness of the patients. Meanwhile, frequent incidents of hypoglycaemia damage the nervous system, especially the brain that is particularly susceptible to damage resulting from insufficient glucose supply.


Lack of insulin initiates intensive energy gain from fat, which threatens the patient's life.

The body is trying to use fat accumulated in the liver to produce energy. And this leads to the production, as byproducts of ketone bodies acting like poisons. Excess ketone bodies can lead to dangerous disease - acidosis and ketoacid coma, and consequently even death of the patient. Such a threat affects especially young children during the period of parents' unconscious incubation of type 1 diabetes; as well as in the case of serious errors in the treatment of diabetes; and lonely elderly people.
Dangerous hypoglycaemia or hypoglycaemia


A chronic excess of glucose in the blood is also a health hazard.

In type II diabetes (not requiring insulin injections), excess sugar causes the nervous system to weaken the rate of conduction. This exemption is progressive and every year the conductivity decreases by nearly 1 m / sec. In type I diabetes (requiring insulin injections) - the deterioration of nerve fiber activity occurs the fastest, immediately after the appearance of diabetes. Over the next 2-3 years this process is released.
Neuropathy or damaged "nerves"


Excess glucose in the blood threatens diabetic nephropathy.

Diabetic neuropathy is most common in poorly treated patients with diabetes for many years, who have excessively high blood glucose and urine levels and elevated glycated hemoglobin values ​​(long-term diabetes control). The high real risk of this complication is that the disease develops in nearly 40% of patients with type 1 diabetes (requiring insulin injections) and in 5-40% of patients with type II diabetes (not requiring insulin injections).
Kidney complications - or diabetic nephropathy
 

Excess glucose damages the eyesight

High blood glucose is the direct cause of damage to the retina's blood vessels. The resulting leakage from the vessels collects in the central part of the retina, i.e. in the macula causing it to swell. Macular edema causes loss of visual acuity
Diabetic retinopathy

ed. red