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“Sugar” - have you got it already?
“Sugar Diabetes” is a serious ailment, which can arise
for many reasons, and can affect many systems in the human body. Diabetes,
often just called “sugar” by many people, is diagnosed and monitored mainly
through a simple blood test - the Blood Glucose level (AKA Blood Sugar
level).
Glucose is a type of sugar found in fruits and many other foods (this
includes lactose and fructose). It is the main source of energy used by the
body. Most of the carbohydrates that people eat (like cakes) are also turned
into glucose, which can be used for energy or stored in the liver and
kidneys as glycogen.
To stop the sugar levels just increasing daily, a balance is achieved
through a hormone called Insulin which helps the body use and control the
amount of glucose in the blood. Insulin is produced in areas of the pancreas
called ‘islets’ and released into the blood when the level of glucose in the
blood rises. In simple terms, people who do not produce enough insulin
develop Diabetes. People can also develop diabetes if they do not respond
normally to the insulin their bodies produce. This occurs most commonly when
a person is overweight, and since obesity is on the rise, so are various
types of Diabetes.
Normally, blood glucose levels increase slightly after a person eats a meal.
This increase causes the pancreas to release insulin so that blood glucose
levels do not get too high. Blood glucose levels that remain high over time
can cause damage to the eyes, kidneys, nerves, and blood vessels, which
explains why good glucose control is important.
There are many ways to carry out blood glucose tests, including Fasting
Blood Sugar (FBS). This is a measurement of blood glucose after fasting for
12 to 14 hours. For an accurate fasting blood sugar test, do not eat or
drink for 12 to 14 hours before the blood sample is taken, however, water
should be freely taken, as otherwise hemoconcentration occurs to give a
falsely high reading. This is often the first test done to detect diabetes,
and explains why fasting blood tests are usually done when having a medical
check-up.
The other common test is called the Random Blood Sugar (RBS). A random blood
sugar measurement may also be called a casual blood glucose test. This is a
measurement of blood glucose that is taken regardless of when the person
last ate a meal. Sometimes several random measurements are taken throughout
a day. Random testing is useful because glucose levels in healthy people do
not vary widely throughout the day, so wild swings may indicate a metabolic
problem.
Glucose Tolerance Testing can also be done, usually to confirm a condition
known as Gestational Diabetes, which can occur during pregnancy. An oral
glucose tolerance test is simply a series of blood glucose measurements
taken after a person drinks a liquid containing a specific amount of
glucose; however, this test is not used to diagnose diabetes.
To monitor the treatment of diabetes, there are another couple of tests
which can be carried out. The commonest is Glycated Hemoglobin, otherwise
referred to as HbA1c. This test actually is an indicator of the average
glucose concentration over the life of the red blood cells (which is taken
as over the previous three months).
Another is the Serum C-Peptide which is used to investigate low blood sugar
levels, done by measuring the C-Peptide which is produced by the Beta cells
in the pancreas.
“Normal” levels may vary from lab to lab, but generally the range taken for
FBS is that the level should be less than 110 milligrams per deciliter
(mg/dL).
Diagnosis of diabetes needs a fasting blood glucose level higher than 125
mg/dL on two separate days.
A fasting glucose level below 40 mg/dL in women or below 50 mg/dL in men
that is accompanied by symptoms of hypoglycemia (low blood sugar) may
indicate an insulinoma, a tumor that produces abnormally high amounts of
insulin. Lower than expected glucose levels can also indicate Addison’s
disease, an underactive thyroid gland or pituitary gland, liver disease
(such as cirrhosis), malnutrition, or a problem that prevents the intestines
from absorbing the nutrients in food.
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