To diagnose diabetes, it is difficult to focus only on clinical signs, since not one of them is typical only for this disease. Therefore, the main diagnostic criterion is elevated blood sugar.
The traditional screening method (selection method) for diabetes mellitus is a blood test for sugar, which is recommended on an empty stomach.
Many diabetics in the initial period of the disease may not show deviations from normal values when taking blood before eating, but hyperglycemia is detected after a meal. Therefore, you need to know what the rate of sugar in the blood after 2 and 3 hours after eating a healthy person in order to recognize diabetes.
What affects the concentration of glucose in the blood?
The body's glucose level is maintained by hormonal regulation. Its constancy is important for the functioning of all organs, but the brain is especially sensitive to fluctuations in glycemia. His work is completely dependent on nutrition and sugar level, because his cells are deprived of the ability to accumulate glucose reserves.
It is normal for a person if blood sugar is present in a concentration of 3.3 to 5.5 mmol / l. A slight drop in the level of sugar manifests itself in general weakness, but if glucose is lowered to 2.2 mmol / l, a disturbance of consciousness, delirium, convulsions develops and there may be a danger to life - hypoglycemic coma.
An increase in glucose usually does not lead to a sharp deterioration of the condition, as the symptoms increase gradually. If blood sugar is higher than 11 mmol / l, then glucose begins to be excreted in the urine, and signs of dehydration progress in the body. This is due to the fact that according to the laws of osmosis, a high concentration of sugar attracts water from the tissues.
This is accompanied by increased thirst, increased urine volume, dry mucous membranes, and skin. With high hyperglycemia, nausea, abdominal pain, severe weakness, the smell of acetone in exhaled air appears, which can turn into a diabetic coma.
Glucose is maintained due to the balance between its entry into the body and the uptake of tissue by cells. Glucose can enter the bloodstream in several ways:
- Glucose in products - grapes, honey, bananas, dates.
- From food containing galactose (dairy), fructose (honey, fruit), since glucose is formed from them.
- From the reserves of glycogen of the liver, which, with a decrease in blood sugar splits to glucose.
- Of complex carbohydrates in food - starch, which breaks down to glucose.
- From amino acids, fats and lactate, glucose is formed in the liver.
The decrease in glucose occurs after insulin is released from the pancreas. This hubbing helps glucose molecules pass through the cells in which it is used to form energy. The brain consumes the most glucose (12%), the second place is the intestines and muscles.
The rest of the glucose, which at the moment is not required by the body, is deposited in the liver in glycogen. Glycogen reserves in adults can be up to 200 g. It is formed quickly and there is no increase in blood glucose when carbohydrates are slowly increased.
If the food contains a lot of quickly digestible carbohydrates, the concentration of glucose increases and causes insulin release.
Hyperglycemia that occurs after eating is called nutritional or postprandial. It reaches a maximum within an hour, and then gradually decreases, and two or three hours later, under the action of insulin, the glucose content returns to the figures that were before the meal.
Blood sugar is normal, if after 1 hour after a meal its level is about 8.85-9.05, after 2 hours the indicator should be less than 6.7 mmol / l.
The action of insulin leads to a decrease in blood sugar, and such hormones can cause an increase:
- From pancreatic islet tissue (alpha cells),
- Adrenal glands - adrenaline and glucocorticoids.
- Thyroid gland -triodothyronine and thyroxin.
- Growth hormone pituitary gland.
The result of the work of hormones is the constancy of the glucose level in the normal range of values.
Why do you need to know the level of sugar after a meal?
Diagnosis of diabetes mellitus is carried out only according to the results of determining the concentration of glucose in the blood. If the patient has pronounced metabolic disturbances, then the diagnosis does not cause difficulties.
In such cases, they are guided by obvious signs: increased appetite and thirst, abundant urination and sharp weight fluctuations. At the same time, there is an increased level of sugar in the blood on an empty stomach above 7 mmol / l, in any period of time it is above 11.1 mmol / l.
The development of type 2 diabetes often does not give at first expressed clinical symptoms and is manifested by moderate hyperglycemia before meals and postprandial (after eating) elevated sugar levels.
Studies of possible cases of increased blood sugar led to the release of several options for disorders of carbohydrate metabolism: hyperglycemia on an empty stomach, after eating, or simultaneous combination thereof. At the same time, an increase in glucose before and after meals has different mechanisms of occurrence.
Fasting hyperglycemia is associated with the work of the liver and reflects the resistance of its cells to insulin. It does not depend on insulin production by the pancreas. The increase in blood glucose after a meal reflects insulin resistance, as well as impaired secretion of this hormone.
The greatest danger in relation to the development of complications of diabetes mellitus is precisely elevated sugar levels after a meal. A pattern has been revealed between the level of glucose after eating and the risk of developing such diseases:
- Damage to the vascular wall of arteries and capillaries.
- Myocardial infarction.
- Diabetic retinopathy.
- Oncological diseases.
- Decreased memory and mental abilities. Diabetes mellitus and dementia are inextricably linked.
To prevent the destruction of the circulatory and nervous system in diabetes mellitus, it is not enough to reach fasting normoglycemia. It is necessary to measure sugar and 2 hours after a meal. This interval is recommended by most professionals who treat diabetes.
Reducing blood sugar is achieved by a complex of measures: insulin therapy, taking sugar-lowering tablets, combined use of insulin and tablets (with type 2 diabetes), non-drug methods.
The main method to control diabetes is the joint use of diet therapy and medication. Patients are advised to stick to a diet from which simple carbohydrates and animal fats are excluded.
Forbidden products include:
- Sugar and the products in which it is included.
- Wheat flour, pastries, bread products, except black bread.
- Rice, pasta, couscous, semolina.
- Sweet fruits, juices from them, especially grape.
- Bananas, honey, dates, raisins.
- Fatty meat, offal.
- Canned food, sauces, juices and soda drinks with sugar.
For the successful treatment of diabetes, it is recommended to include in the daily routine of moderate exercise in the form of exercises, gymnastics, swimming, walking or any sport, taking into account the individual level of fitness and general health.
If the treatment is carried out correctly, the result is a stabilization of the glycemia level after a meal, which after 2 hours does not exceed 7.8 mmol / l and there are no attacks of hypoglycemia.
Glucose monitoring is carried out in the hospital for the optimal choice of treatment regimen, and at home, self-control is optimal. In case of diabetes mellitus type 1 and during insulin therapy in patients with type 2 diabetes, it is necessary to control blood glucose at least three times a day.
If the patient takes only tablets, then self-control is carried out depending on the severity of fluctuations in blood sugar and the group of medicines that is used. The frequency of measurement should be such that it is possible to reach the target values of indicators on an empty stomach and 2 hours after a meal.
The criteria for the successful management of diabetes mellitus proposed by the International Diabetes Federation include: fasting plasma glucose not more than 6.1 mmol / l, after 2 hours from eating less than 7.8 mmol / l, glycated hemoglobin is less than 6.5%.
During the day, a person from only 3.00 to 8.00 stays in a “fasting state”, the rest of the time - after eating or in the process of assimilation.
Therefore, measuring glucose just before breakfast is not informative for assessing compensation, changing treatment and diet therapy.
Drugs that reduce hyperglycemia after eating
Since the role of postprandial high blood sugar in the development of diabetes mellitus has been established, a special group of drugs, prandial glucose regulators, is used to correct it.
One of them is the drug acarbose (Glucobay). It inhibits the breakdown of complex carbohydrates, the absorption of glucose from the intestinal contents. Since hyperglycemia does not occur after a meal, insulin release decreases, which improves metabolic processes, especially in obesity. The advantages of the drug include a low risk of developing attacks of hypoglycemia.
Currently, actively using drugs that help prevent an increase in blood glucose after a meal, while not lowering it to the level of hypoglycemia. These include derivatives of the amino acids nateglinide and repaglinide. They are released under the trade names Starlix and Novonorm.
Starlix stimulates insulin secretion, which is close to physiological and appears only in the presence of hyperglycemia. Novonorm acts in a similar way, but when it is taken it does not release growth hormone and glucagon, which have the opposite effect. The beginning of its action in 10 minutes, and the peak comes within an hour.
The use of such drugs has proven efficacy, which manifested itself in a decrease in the content of glycated hemoglobin, and use only during meals saves patients from the problems associated with attachment to the time of eating.
Treatment rates are increased when co-administered with Metformin, as they have a complementary effect on carbohydrate metabolism. The video in this article will tell you why you need a blood test for sugar.