Tuesday, January 24, 2017

Blood Sugar Level

Blood sugar level over 400 mg/dl

DANGEROUSLY HIGH 
Blood Sugar Levels OVER 400 (mg/dL)
22.2 (mmol/L)

SEVERE DIABETES

Your last measurement found blood glucose level over 400 mg/dL.

What does it  mean?? 

Blood sugar level over 400mg/dl is classified as severe diabetes. It is a condition which seeks immediate treatment.

Among the classic symptoms of diabetes, such as fatigue, increased thirst, increased urination, fatigue, blurred vision, drowsiness etc, these levels of blood sugar can develop two serious, life-threatening complications such are DKA (diabetic ketoacidosis) and HHS (hyperosmolar hyperglycemic state).

The treatment of such hyperglycemia is immediate rehydration and administration of rapid insulin in order to lower the levels of glucose as soon as possible.

Prevention includes lifestyle changes, drinking water and continuous measurement of blood glucose and ketones in the urine.

Most of the times, blood sugar level over 400 mg/dl is due to uncontrolled diabetes, in people who are unaware that suffer from diabetes.

But, blood glucose level over 400 mg/dl can also be due to extreme stress or intake of certain medications.



Blood sugar level over 400 mg/dl - Prevention.

Patients who have experienced blood sugar level over 400 mg/dl should drink plenty of water, check their urine for ketones and talk to their doctor to take precautions in order to prevent a further increase of the blood sugar level.

The lifestyle changes are very important. The following lifestyle changes will help keep blood glucose within the normal range:



1.    Eating a healthy diet - this means cutting off fat and caloric foods, and eating fiber-rich foods instead, such as legumes, whole grain products, all kind of vegetables and fruits.

2.    Weight loss - Losing weight lowers your glucose levels. A loss of only 7 % of your total body weight significantly decreases glucose levels.

3.    Exercising - Exercising not only lowers your glucose levels, but it also improves blood circulation and lowers fats in the bloodstream. Exercise at least 45-60 min every day. Consider brisk walking, bike riding, swimming laps, playing your favorite sport etc. DO NOT exercise if you have ketones in the urine.

4.    Quitting smoking and alcohol



Random blood glucose test Results

What is the random glucose test?  When can I perform it? How to read and interpret its results?

Actually, this random sugar test is also called a simple glucose test.

You use to do it by yourself when you want to measure your blood sugar levels at any time during the day.

It’s very easy to perform it, that’s why called simple (random) blood glucose test is. You can use any glucose meters that can be found in the market.

Basically, this is a test that you perform to get to know what the levels of your blood glucose are at any time of the day to better monitor your diabetes.

So, the normal results you should get are between 70 to 100 mg/dL .



But if you’re a diabetic, your acceptable figures could be till 130 mg/dL.

It’s very important to get always steady results from this test. This can show that you’re having a good control on diabetes.

In case the figures you get can be higher than 200 mg/dL , than you must remind when did you eat the last time before performing the test.

If it’s less than 2 hours, than you must wait for a while and repeat the test after 2 hours you’ve had a meal.

But if it’s 2 hours and above, that shows that you haven’t had you medications, or the ones you got didn’t lower your blood glucose levels.

So, you may need additional medications to reduce high glucose level.

Most important think I want to remind you is : BETTER PREVENT THAN MEDICATE.

Thus, it’s better for you to prevent the high glucose levels onset, than to lower it.

If you follow better diet strategy, and make some lifestyle changes, for sure you’ll not get these high figures anymore.

Even in case you’re not a diabetic, you can perform this test to get to know if you have diabetes or not. Especially if you:

-are older than 50 years old.
-have a family history of diabetes.
-being part of high risk population.


In the above cases you can do this test. If you get results higher than 120 mg/dL but lower than 150 mg/dL, you may consider yourself a pre-diabetic.

That means that you don’t have diabetes yet, but you’ve high risk of having it in the future.But if you watch your diet strategy and what lifestyle changes you may do, you may consider yourself safe of diabetes.

If you get results higher than 180 mg/dL, than you should repeat the test again and perform other tests to fully diagnose you’re a diabetic.


Is 122 mg/dl Fasting blood glucose level a sign of diabetes ??
I'm 19 years old, 160cm & 70kg 

I started to diet but by chance I measured my glucose randomly and it was 173 mg/dl 

So I did a fasting test and came 122 mg/dl 
Is this dangerous or do i have diabetes?? 


ANSWER: Hi Huda, 

Thank you for sharing your concern with us.

You are reporting to :
- have a height of 160 cm
- weight of 70 kg
- just started to diet
- random blood glucose 173 mg/dL
- fasting blood sugar 122 mg/dL

As per your description, I see you are overweight and on diet to improve your weight. I suppose your diet is very poor in sugar and carbs.

In such circumstance, when you suddenly measured your random glucose and it was 173 mg/dl, I may say that in your case it can be normal.

You have been on diet without taking any sugar with food and this has served as a signal to your body to release sugar from the glucose deposits in order to feed the tissues with fuel.

This extra sugar comes from your fat that is metabolizing and sending glucose to blood circulation.

Your fasting test was 122mg/dl normally it is 80-100. As you have been dieting I still think it's because of your diet too.


So, in other words, such slightly high blood sugar levels do not indicate you have diabetes, neither prediabetes. Your fast glucose test has showed high levels because of your diet.

Prediabetes itself even when diagnosed is not dangerous. You can take good control of it and prevent easily its progression to diabetes.

I encourage to keep dieting and stay healthy as you are doing now because you do not have diabetes.

Hope it was helpful,
Dr.Albana 



Sep 19, 2016
One good test to confirm the diabetic is HbA1c. It gives the last three months average blood sugar.


Sep 23, 2016
Dear Dr. Alba,

Thank you very much for your valuable and so precise test review. As I always believed that type 2 diabetes is purely life style issue. 

5 years back I was advused by Dr. to start glucophase as pre_diebetic case since my fasting glucose measured 168 dc/ml. 

However I stopped the medication and concentrated on my diet, exercise and meditation and now my random sugar reeads 123.

I thought I will share my experience so may help.

Thank you Dr. Alba.


Nov 20, 2016
Hi Mr. Huda, 

Thank you for following us and decided to share your experience. 

Indeed, spikes in blood sugar levels depend on what you: 
- consume (eat/drink) 
- do (physical activity) 
- take (drugs) 

I hope other diabetic readers will follow your example and have the same success as you. 

All the best.




Confused by GTT and Insulin Resistance results
I recently had the GTT and Insulin resistance tests done and my blood sugar before Glucose administration was 5.2 and 2 hours after the Glucose was given it was 9.2. My insulin resistance is 20.2 
Please advise.


Thank you.

**********************
Jan 21, 2017
by: Dr.Albana 

Hello Yolanda, 

I read your message and understood your problem. 

The results you sent me are: 

-OGTT test blood sugar before glucose administration=5.2 after administration=9.2 

-insulin resistance=20.2 


Before the glucose administration, the blood glucose levels were found 5.2 which is considered normal (<7 .8mmol="" font="" nbsp="">

After the glucose administration, they were 9.2 which indicates an impaired glucose tolerance or pre-diabetes (the range 7.8-11.1 mmol/L stands for pre-diabetes). The insulin resistance is also normal. 


I may say that your numbers are quite normal. The fact that your glucose levels after administrating glucose were a little high maybe is because you have been fasting for too long before drinking the glucose. 

This has caused a rapid rise of glucose in blood in order to maintain the proper levels for organ functioning. 

It is sure that you don't have diabetes. The normal insulin resistance(tolerance) test means that there are no problems in the hypothalamic-pituitary-adrenal axis. So there are no other diseases related to other glands. 

My advice is that you must do another test which is HbA1c test to complete all the chart of numbers. 



Hope this is helpful. 

In the last 3 decades, there has been a dramatic rise in the number of people with diabetes worldwide.1 In Southeast Asia, it has been estimated that one out of every 12 adults already has the disease or will develop it in their lifetime.2
Compared to people from Western countries, Asians are known to develop diabetes at a younger age, and at lower body weights.3 Over-nutrition and eating patterns characterised by consumption of high-energy foods, have been identified as key contributors to the risk of developing diabetes.3


Blood sugar is tightly controlled in the body – released when the body needs energy, and stored when the body is resting, or when there is an excess of sugar. In people with diabetes, this control mechanism is faulty, resulting in high levels of blood sugar. Over time, high blood sugar causes irreparable damage to the body, particularly to the eyes and kidneys.4


People with diabetes have the same nutritional needs as anyone else. However, with a deranged glucose control system, it is important for patients with diabetes to pay particular attention to the type and amount of carbohydrate intake as this can affect blood sugar levels faster than protein or fat does.

The measure of glucose absorption into the bloodstream after intake of food is called the glycaemic index (GI).5 Carbohydrate-containing foods with a low GI are absorbed slower, resulting in greater control of blood sugar level.5 Patients with diabetes may thus benefit from preferential intake of food with low GI.6 The GI of carbohydrates can be reduced when taken with fibre.7 Large, complex sugars also called “non-starch polysaccharides”, can also function like fibre, providing bulk which promotes bowel movement, and help normalize blood glucose and insulin levels, making these kinds of polysaccharides a useful component dietary plans for people with diabetes.8

Equally important as the GI, is the glycaemic load, which is a measure of the food’s available carbohydrate content. Whereas GI provides a measure of carbohydrate quality, glycaemic load takes into account the amount of carbohydrates and its effect on blood sugar levels.9 Simply put, both the amount of carbohydrate as well as the type of carbohydrate in a food influence blood glucose level.

Choosing foods or nutritional supplements with low glycaemic index and low glycaemic load will go a long way towards better control of diabetes.

1.Nanditha A, Ma RC, Ramachandran A, et al. Diabetes Care. 2016;39:472-485.

2.International Diabetes Federation. Diabetes in south east asia. http://www.idf.org/regions/sea/regional-data. Accessed 3 March, 2016.

3.Ramachandran A, Snehalatha C, Shetty AS, Nanditha A. World J Diabetes. 2012;3:110-117.

4.Forbes JM, Cooper ME. Physiol Rev. 2013;93:137-188.

5.Jenkins DJ, Kendall CW, Augustin LS, et al. Am J Clin Nutr. 2002;76:266S-273S.

6.Greenwood DC, Threapleton DE, Evans CE, et al. Diabetes Care. 2013;36:4166-4171.

7.Scazzina F, Siebenhandl-Ehn S, Pellegrini N. Br J Nutr. 2013;109:1163-1174.

8.Kumar V, Sinha AK, Makkar HP, de Boeck G, Becker K. Crit Rev Food Sci Nutr. 2012;52:899-935.


9.Sheard NF, Clark NG, Brand-Miller JC, et al. Diabetes Care. 2004;27:2266-2271.

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