Elevated blood sugar, or hyperglycemia, occurs for a variety of reasons. Normally, the sugar level should not be higher than 5.5 mmol/l. The severity of hyperglycemia is determined by two main factors: the total amount of glucose in the blood and the rate at which it increases. In medical practice, the pathological condition in question is classified according to two criteria: fasting hyperglycemia and afternoon hyperglycemia.
Glucose is necessary for the cells of the human body, but if its level exceeds the norm, this can lead to irreversible consequences. The person himself may not notice the symptoms of this condition for a long time if it is mild. If the sugar level is significantly elevated, characteristic signs appear that are important to recognize in time and consult a doctor. In our clinic you can always get advice from competent specialists, take the necessary tests and undergo a course of treatment.
Causes of high blood sugar
High blood sugar may be associated with certain diseases:
- diabetes mellitus and other endocrine pathologies;
- liver diseases;
- dysfunction of the pancreas;
- severe infectious diseases;
- obesity.
Diabetes mellitus is considered the most common cause of hyperglycemia, which is long-lasting and negatively affects almost all internal organs and systems of the body.
Factors that contribute to hyperglycemia that are not associated with pathologies of the body are also identified:
- overeating, predominance of simple carbohydrates in the diet;
- stress;
- severe premenstrual syndrome in women;
- alcohol abuse;
- hereditary predisposition.
Steps on the path to health. Sugar slightly increased. Is it so harmless?
Yes, this “triad” - excess weight, high blood sugar, cardiovascular diseases - always appears together. And most importantly, everything grows very gradually, unnoticed over a long time and often without symptoms. And at some point in your life, as always at the wrong time, you are given a diagnosis, which is followed by multiple changes in the body. After all, type 2 diabetes mellitus is a chronic disease associated with metabolic disorders, accompanied by a malfunction of the endocrine system and at least one cardiovascular disease, for which, in fact, you see a doctor. But the most unpleasant thing can happen later, when complications of type 2 diabetes mellitus - the result of just an unhealthy lifestyle - lead to irreversible consequences and disability. People tend to be afraid of type 1 diabetes (insulin-dependent), but in fact, type 2 diabetes is more insidious, dangerous and more common among all types of diabetes.
According to the International Diabetes Federation, by 2040, 642 million people will suffer from diabetes. The rapid increase in the incidence of diabetes mellitus was the reason for the adoption of the UN Resolution (61\225 of December 20, 2006 “On diabetes mellitus”), and in 2011 the UN Political Declaration addressed to national health care systems.
The results of a large-scale Russian epidemiological study (NATION) confirm that only 50% of cases of type 2 diabetes are diagnosed, and that the real number of patients in the Russian Federation is at least 8–9 million people (about 6% of the population).
In response to the rapid increase in the number of diabetes cases worldwide, the International Diabetes Federation and the World Health Organization declared November 14 as World Diabetes Day in 1991.
The most dangerous consequences of diabetes mellitus (DM) are systemic vascular lesions and complications: nephropathy (vascular lesions in the glomeruli of the kidneys), damage to the mitral vessels of the heart (vessels that supply the heart itself), brain, peripheral vessels of the lower extremities (often leading to amputation). It is these complications that cause disability and mortality in patients with diabetes.
According to the International Diabetes Federation, every 12 minutes a patient with diabetes suffers a stroke, every 19 minutes a heart attack, every 90 minutes a loss of vision, every 30 minutes a loss of a leg, and every 10 minutes doctors record a death caused by complications of this terrible disease. .
In order to prevent the development of irreversible processes in the body, it is necessary that an accurate diagnosis be made as early as possible. As early as possible, you should start taking measures to prevent the development of diabetes: losing weight and establishing a healthy lifestyle, reducing all elevated indicators (it is always better to focus on the average or lower level of the norm) - sugar, cholesterol, uric acid and others. After all, a diagnosis is already a disease, and action must be taken during the pre-illness period.
I have already mentioned in my articles that diabetes is a consequence of impaired insulin secretion, insulin action, or both of these factors and is accompanied by hyperglycemia.
Chronic hyperglycemia (consistently elevated blood sugar) always leads to damage and dysfunction of various organs: especially the eyes, kidneys, nerves, heart and blood vessels.
This type of diabetes mellitus is caused by a decrease in the sensitivity of cells to the action of insulin (insulin resistance), which in the initial stages of the disease is synthesized by the pancreas in normal and even increased quantities. It does not require lifelong insulin administration. Correction of blood sugar levels is possible only through physical activity, diet or a balanced diet.
In addition to diabetes mellitus of the first (insulin-dependent) and second (non-insulin-dependent) types, diabetes mellitus of the third type is now distinguished, which occurs with chronic or acute damage to the pancreas itself: pancreatitis/inflammation, trauma, neoplasms, cystic fibrosis, fibrocalculous pancreapathy, surgical operations. It is not associated with obesity or heredity, but only with the pathology of the pancreas itself.
It should be noted that the so-called gestational diabetes mellitus .
The risk group includes young women (usually without excess body weight) who experience periodic increases in blood sugar associated with diet (the so-called impaired glucose tolerance). Which, in the presence of a hereditary predisposition (which they may not even know about), can lead to severe complications and the development of type 1 diabetes during pregnancy.
Why does gestational diabetes develop? The reason is the so-called “counter-insulin” effect - blocking the action of insulin by hormones that are produced in a woman’s body during pregnancy and are involved in maintaining the required blood sugar level. Typically, gestational diabetes mellitus begins to appear between 20 and 24 weeks of pregnancy. This is facilitated by overwork, unbalanced nutrition, half-starvation, stress, and various diseases.
If a pregnant woman’s fasting blood sugar level is more than 5.3 mmol/l, and 2 hours after eating it reaches 6.8 mmol/l or more, then it is necessary to consult a specialist to clarify the diagnosis and correct the condition.
Why don't all pregnant women develop GDM? Because this is facilitated by a hereditary predisposition, which is realized under the influence of certain risk factors:
- overweight and obesity;
- the presence of diabetes mellitus in relatives (a genetic analysis can be done to determine a hereditary predisposition to diabetes);
- first pregnancy complicated by GDM; the birth of a child weighing more than 4000 g, with a large abdominal circumference;
- age over 25 years;
- chronic miscarriage (more than three times) in the 1st or 2nd trimester;
- fetal stillbirth; developmental defects in previous children.
When planning a pregnancy, it is important to pay attention to your blood sugar levels by reviewing your previous tests. Normally it is 3.5–4.5 mmol/l.
It is very important to control blood pressure in type 2 diabetes mellitus, since type 2 diabetes mellitus and hypertension almost always go hand in hand. And a blood pressure level of 130/80 in combination with diabetes mellitus and prolonged hyperglycemia is accompanied by a high risk of microvascular complications.
71% of people with diabetes suffer from hypertension, and very few undergo adequate drug therapy to lower blood pressure levels, and many do not think about the consequences and complications at all, ignoring the recommendations of doctors. Patients with type 2 diabetes mellitus have an increased tendency to thrombosis, which contributes to the progression of atherosclerosis and its complications.
A companion to type 2 diabetes is also coronary heart disease (CHD) - myocardial damage due to tissue ischemia (impaired nutrition and oxygen supply to the heart).
What are the features of cardiac ischemia in type 2 diabetes mellitus?
- The disease is asymptomatic, the so-called “silent” painless forms of coronary artery disease and myocardial infarction.
- The risk of development is the same in men and women over the age of 45 years.
- High risk of sudden death.
- High incidence of post-infarction complications: congestive heart failure, heart rhythm disturbances.
Guarantees of a severe course of IHD will be: the presence of high cholesterol levels, constantly elevated blood pressure (160–180 mmHg); duration of diabetes mellitus more than 15 years; the presence of vascular complications: nephropathy and retinopathy.
That is, if blood sugar is elevated for a long time, it means that by the age of 40–45, a person already has at least one of the cardiovascular diseases. Often this is hypertension or asymptomatic ischemic heart disease detected during examination.
According to statistics, the presence of diabetes mellitus increases the risk of coronary artery disease by 2–4 times, and with the initial detection of diabetes, diffuse damage to the coronary arteries supplying the heart is often already observed. In diabetes, there is a high probability of stenosis at the site of stent implantation. Mortality due to the development of acute coronary syndrome in patients with diabetes mellitus is 2–3 times higher.
Obesity is a classic factor that provokes the development of diabetes mellitus and aggravates its course. With a decrease in body weight, insulin resistance decreases, and the cells begin to better perceive insulin and receive glucose. Blood pressure and cholesterol levels improve.
The statistics are that 90% of patients with diabetes are obese. Long-term weight loss in patients with type 2 diabetes mellitus is possible through an integrated approach: lifestyle changes, a balanced diet, and a developed individual plan for physical exercise and exercise.
No less dangerous complications of a long-term increase in blood sugar are: diabetic nephropathy, rhinopathy, the appearance of glycated hemoglobin and neuropathy. What it is? Diabetic nephropathy is kidney damage in the area where urine is filtered, which disrupts the water and electrolyte balance and leads to even more negative consequences.
Diabetic rhinopathy is vascular changes in the retina that threaten vision loss.
Damage to the renal glomeruli occurs in parallel with damage to the vessels of the fundus (80%). Advanced diabetes mellitus “hits” the eyes and kidneys.
We know that hemoglobin in red blood cells carries oxygen to tissues and to the brain. In diabetes mellitus, glycated hemoglobin is determined in the blood. What does this mean? This is a specific combination of red blood cell hemoglobin with glucose. Its concentration reflects the average blood glucose level over the past three months. Hemoglobin must carry oxygen, but when there is a lot of sugar, it combines with glucose, and the space for binding oxygen in it decreases. Glycated hemoglobin is a very stable compound (breaks down slowly), which is not very good for the body, its tissues and brain.
Diabetic neuropathy is damage to nerve tissue. Occurs due to a malnutrition of the nervous tissue, again with the participation of capillaries.
Associated symptoms
A pronounced increase in blood sugar levels manifests itself with characteristic symptoms, which are especially clearly visible in patients with diabetes:
- constant thirst and dry mouth;
- increased urge to urinate;
- dizziness;
- headache;
- increased appetite, weight gain or sudden weight loss (this symptom is typical mainly for patients with type 1 diabetes);
- skin itching, furunculosis, prolonged wound healing;
- increased blood pressure due to impaired renal function;
- increased irritability;
- drowsiness;
- apathetic state;
- difficulty concentrating;
- decreased vision;
- susceptibility to infectious diseases.
Having noticed such manifestations in yourself, you may suspect hyperglycemia, but only a qualified doctor will make an accurate diagnosis. In our clinic you can undergo a full range of examinations to identify acute and chronic diseases. An experienced endocrinologist will develop effective treatment tactics to eliminate pathological symptoms and return you to good health.
Preventing Gestational Diabetes
Unfortunately, there are no 100% effective measures that would protect against this disease.
But the more useful habits a woman develops before pregnancy, the easier pregnancy and childbirth will be:
- From the first days of pregnancy, eat healthy foods: choose foods high in fiber and low in fat. Focus on vegetables and whole grains. Strive for variety and watch portion sizes.
- Stay active. Try to devote 30 minutes to sports every day. Take daily walks, ride a bike, or go swimming.
- Plan your pregnancy at a healthy weight and don't gain more than recommended. Excessively rapid weight gain can increase the risk of gestational diabetes.
Although there is no universal protection against GDM, you can reduce your risk of developing it through a healthy lifestyle. The most important thing is to detect the problem in time and prevent it from developing.
Diagnostics in our clinic
Diagnosis of hyperglycemia includes taking a medical history, analyzing clinical symptoms and a number of laboratory tests. A blood sugar test is taken in the morning on an empty stomach. In some cases, it becomes necessary to repeat the analysis after a few days to exclude possible stress factors.
In modern medicine, several methods of testing blood for sugar are used:
- rapid test for determining the approximate glucose concentration - can be carried out at home, but does not provide one hundred percent accuracy;
- analysis for glycated hemoglobin - allows you to determine the average glucose level over a certain period of time (1-3 months);
- Glucose tolerance test is a comprehensive study that involves taking blood from a finger prick four times over two hours (on an empty stomach and after taking glucose).
In a healthy person, the glucose level is 3.5-5.5 mmol per liter of blood. An indicator of 6 mmol is considered a prediabetic state. If the glucose concentration exceeds this value, the doctor has reason to diagnose diabetes mellitus.
When performing a glucose tolerance test, a result of up to 7.9 mmol/l is considered as normal. Diabetes mellitus is indicated by a value of over 11 mmol per liter.
Risk factors for gestational diabetes
- Age under 18 and over 30 years old.
- Unbalanced diet with a lot of fast carbohydrates.
- Bad habits (smoking, alcohol abuse).
- Overweight and obesity. Excess weight obviously implies a violation of metabolic processes.
- Lack of physical activity.
- Previous gestational diabetes or prediabetes. The tendency to diseases of this series does not disappear over time.
- Polycystic ovary syndrome.
- A close relative has diabetes. The risk of gestational diabetes increases twofold or more if close relatives have any form of diabetes.
- Previous birth of a child over 4 kg or a large fetus during the current pregnancy.
- Race. Caucasians have the lowest risk of developing gestational diabetes, and black women are most likely to suffer from this problem.
Unfortunately, GDM can develop in a completely healthy woman without risk factors, so you need to visit a doctor and not skip recommended screenings.
Principles of treatment
If you have high blood sugar, you will need treatment to avoid life-threatening conditions. The complex of therapeutic measures includes:
- adherence to the principles of proper nutrition;
- regular monitoring of blood sugar levels - for this you can purchase a special device for home use - a glucometer. It is recommended to carry out the test several times a day. Urgent consultation with an endocrinologist is required if sugar levels increase repeatedly over a short period;
- regular physical activity;
- weight normalization;
- regular monitoring of blood pressure and cholesterol levels;
- taking medications to reduce blood glucose concentrations (insulin secretagogues, alpha-glucosiade inhibitors, etc.).
Treatment tactics are always selected individually depending on the reasons that led to the increase in blood sugar.
Causes of Gestational Diabetes
The exact mechanism of the disease is still not completely clear.
Doctors are inclined to believe that the hormones responsible for the proper development of the fetus block the production of insulin, which leads to disruption of carbohydrate metabolism. During pregnancy, more glucose is required for both the woman and the baby. The body compensates for this need by suppressing insulin production. There are other possible causes of gestational diabetes, such as autoimmune diseases that destroy the pancreas. In principle, any pancreatic pathology can increase the risk of diabetes during pregnancy.
