Why It Is Important To know Your Blood Sugar Level.
Combating the Glucose threat — Diabetes Mellitus.
The other day, my aunty called to complain about:
- increased frequency in urination of about 5–6 times every night which started last month.
- increased intake of water because she easily gets thirsty.
- Increase in urine Volume with increased foam in urine.
All of this started in July and she started categorically that all these were the first time she was experiencing it hence she panicked. As a Doctor in training, I had read about symptoms like this pointing most especially to Diabetes Mellitus.
When my aunt called, the very first thing that came to mind to confirm my suspicion was to tell her to do a random blood sugar test (RBS), the result wasn’t surprising as the glucometer read 237mg/dl (normal — 200mg/dl).
The next test I intend for her to perform is the Oral Glucose Tolerance Test which is a definitive diagnosis for Diabetes Miletus (DM).
What is Diabetes Mellitus?
The term diabetes describes a group of metabolic disorders characterized and identified by the presence of hyperglycaemia (increased blood sugar) in the absence of treatment.
The heterogeneous action-pathology includes defects in insulin secretion, insulin action, or both, and disturbances of carbohydrate, fat, and protein metabolism.
The long-term specific effects of diabetes include retinopathy, nephropathy, and neuropathy, among other complications.
Mellitus is the term for ‘sweet’. This, therefore, puts forth the fact that Diabetes Mellitus (D.M) is a condition that affects sugar or glucose metabolism in the body which can result in various long-term medical conditions.
The organ pancreas secretes the hormone ‘insulin’ responsible for sugar control. It is the major culprit here. And there are two types of D.M. — Type 1 and Type 2.
In type 1 D.M, the individual is totally dependent on exogenous insulin which is insulin that has to be administered by injection. Most persons with this condition are trained on how and when to administer the drug.
I call this kind of D.M (type 2) condition 'starving in the midst of plenty'. This is because individuals with this condition tend to have more than enough glucose in their system but the body doesn't seem to be absorbing it despite the insulin due to the inability of the cells to be sensitive to insulin.
Major break through in medicine that has helped to overcome this challenge has been the production of drugs such as Metformin that help to make the cells sensitive to insulin required for driving the glucose into the body.
Type 2 D.M mainly depends on adequate drug intake coupled with appropriate-monitored diet as recommended by a dietician.
What is Glucose?
Let me briefly expatiate and bring you up to speed on 'glucose’, its importance and the reason it seems to be the culprit here.
Importance Of Glucose To The Human Body.
The fact that the human body depends on glucose cannot be overemphasized. This is due to its wide range of importance it has on the body organs and tissues.
Brain Fuel
The brain normally relies almost exclusively on glucose to fuel its energy needs. Because of its high energy demands and inability to store glucose, the brain requires a constant supply of the sugar.
The body possesses multiple mechanisms to prevent a significant drop in blood glucose, or hypoglycemia. Should such a drop occur, however, brain functions can begin to fail.
Common brain-related symptoms of hypoglycemia include headache, dizziness, confusion, lack of concentration, anxiety, irritability, restlessness, slurred speech and poor coordination. A sudden, severe drop on blood glucose can lead to seizures and coma.
Muscle Fuel
The skeletal muscles normally constitute approximately 30 to 40 percent of total body weight, although this varies based on sex, age and fitness level.
The skeletal muscles utilize large amounts of glucose during exercise. Unlike the brain, the skeletal muscles store blood sugar in the form of glycogen, which is quickly broken down to supply glucose during physical exertion.
Muscle tissue also normally absorbs large amounts of glucose from the bloodstream during exercise.
Although skeletal muscles can utilize fat-derived molecules for energy production, depletion of glucose stores during prolonged exercise can lead to sudden fatigue.
Fuel for Other Tissues and Organs
The various organs and tissues of the body have the capacity to utilize different fuels. In addition to the brain and skeletal muscles, some other important organs and tissues also rely on glucose as their primary or sole fuel.
Examples include the cornea, lens and retina of the eyes, and the red and white blood cells.
Interestingly, although the cells of the small intestines are responsible for absorbing glucose from food and passing it into the bloodstream, they primarily use another molecule called glutamine for fuel. This leaves more glucose for other organs and tissues that are more reliant on the sugar.
The above importance places glucose as what I would like to term the 'energy currency of the body'.
Predisposing Factors To Diabetes Mellitus
The following below are the common risk factors or indicators which predisposes one to D.M:
- Family history (parent or sibling) of prediabetes or Type 2 diabetes.
- Being African-American, Hispanic, Native American, Asian-American race or Pacific Islander.
- Being overweight.
- Having high blood pressure.
- Having low HDL cholesterol (the “good” cholesterol) and high triglyceride level.
- Being physically inactive.
- Being age 45 or older.
- Having gestational diabetes or giving birth to a baby weighing more than 9 pounds.
- Having polycystic ovary syndrome.
- Having a history of heart disease or stroke. Being a smoker.
(Excerpts from cleveclinic.org)
The three very common signs include;
When you observe you:
1. urinate too frequently (Polyuria).
2. drink water often than normal due to excessive thirst (Polydipsia)
3. urinate very often than normal (2 times) at night may be up to 4 to 6 times. That it disturbs your sleep.
All the signs above along with:
- easy fatigue without any physical activity
- repeated infections
- delayed wound healing are clear indications of the fact that one needs to go for a medical checkup.
Below is the international standard test and their values which aids in guiding the physician in making a proper diagnosis:
Random plasma glucose test:
A blood sample for a random plasma glucose test can be taken at any time. This doesn’t require as much planning and is therefore used in the diagnosis of type 1 diabetes when time is of the essence.
Fasting plasma glucose test:
A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.
The NICE (National Institute of Health Care and Excellence) guidelines — the United Kingdom based science research and health body — regards a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes.
The American Diabetes Association (ADA) after series of tests and research places the diagnosis of D.M as ≥126 mg/dl (7.0 mmol/l) for Fasting Plasma Glucose (and confirmed the long-standing diagnostic 2-hours Plasma Glucose value of ≥200 mg/dl (11.1 mmol/l).
Oral Glucose Tolerance Test (OGTT):
An oral glucose tolerance test involves first taking a fasting sample of blood and then taking a very sweet drink containing 75g of glucose.
After having this drink you need to stay at rest until a further blood sample is taken after 2 hours.
HBA1c test for diabetes diagnosis:
An HbA1c test does not directly measure the level of blood glucose, however, the result of the test is influenced by how high or low your blood glucose levels have tended to be for 2 to 3 months.
Indications of diabetes are given under the following conditions:
Normal: Below 42 mmol/mol (6.0%) Prediabetes: 42 to 47 mmol/mol (6.0 to 6.4%) Diabetes: 48 mmol/mol (6.5% or over)
The term Prediabetes here refers to the preceding stage for diabetes.
Research has revealed that people with type 2 diabetes almost always had prediabetes first. But it doesn’t usually cause symptoms.
About 84 million people over age 20 in the U.S. have prediabetes, but 90% don’t know that they have it this makes regular check up important especially if the common signs seems to manifest.
(Excerpts from diabetes.uk.co and WebMD).
Control, Prevention and Treatment.
In as much that the Type 1 D.M is genetic, however, Type 2 and other forms of D.M can be controlled and prevented.
I would emphasize that prevention is better than cure.
Here are some ways it can be managed:
- Healthy Social lifestyle, which includes:
- Reduced or no alcohol intake
- Physical exercise
- No smoking.
- Avoiding injuries as much as possible.
2. Eating Habits and nutrition, which includes:
- Eating more vegetables
- Reduction in refined and carbohydrates diets
- Drinking enough water.
- Don’t overeat
3. Medication, which involves:
- Going for full-body Medical tests occasionally.
- Taking medically prescribed diabetic drugs.
- Taking insulin with food as instructed.
In Conclusion,
Having Diabetes is not a death sentence in as much as it has its complications. However, one must take all the necessary steps to ensure a healthy lifestyle is a focus.
Thanks for reading.
References.