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Fall 2012 - Blood Sugar

What is blood sugar?

Blood sugar, the concentration of glucose in the blood, will change based on what you ate in the past several hours as well as on your body’s effi ciency at processing that food.

How is blood sugar measured, and what is normal?

Blood sugar is most commonly measured with a simple fi nger prick and a glucose monitor. When the sample is taken — following an overnight fast, before a meal or two hours after a meal — will determine the ideal ranges for blood sugar levels.

According to Dr. James Coxe, an endocrinologist with Capital Endocrine Consultants, for a fasting blood sugar, the ideal result would be under 100 mg/dL. A reading between 100 and 125 mg/dL would indicate pre-diabetes, and a reading of 126 mg/dL or greater would be an indicator of diabetes.

For a non-diabetic, a usual reading is in the 70 to 110 mg/dL range, he said. For a reading taken two hours after meals, a usual result is less than 140 mg/dL, generally closer to the 70 to 120 mg/ dL range, whereas a result above 200 indicates diabetes. A two-hour result in the 140 to 200 mg/dL range indicates pre-diabetes.

What are the symptoms of high blood sugar?

Most people with mild to moderate elevation of blood sugar have no symptoms. It’s once you have signifi cantly elevated blood sugar that you start to notice symptoms.

“The classic symptoms of uncontrolled diabetes would be increased urination — both frequency and volume — increased thirst, and sometimes increased appetite,” said Dr. Coxe. “If your blood sugar gets very high, you can experience dehydration, acute illness, nausea and vomiting. But the vast majority of people with high blood sugar either have no symptoms or experience the classic symptoms.”

What are the risks of high blood sugar?

The potential long-term impacts of diabetes include complications like blindness, kidney failure, and amputation. Avoiding these long-term complications should be the main goal of treatment, not “getting rid” of diabetes.

“Without the complications, it’s diabetes, and you have to do things and lead your life a little bit differently, but you can still lead a fully normal life,” Dr. Coxe said. How is high blood sugar treated?

To prevent long-term complications, it’s important to understand what causes them. It is not high blood sugar on its own that causes these complications, but elevation in glucose over time. This results in damage to tissue that ultimately leads to the complications.

“What’s more important of the two is not the degree of the elevation, but the duration,” Dr. Coxe said. “The duration of elevation seems to be more important than the degree of elevation.”

So the fi rst step is to know what your blood sugar levels are at various times throughout the day. And since high blood sugar doesn’t cause symptoms the majority of the time, the only way you can know your levels is to monitor them, usually just before and two hours after meals to give you a good idea of how high your blood sugar is following food or beverage intake.

Dr. Coxe said the first way to reduce elevated blood sugar is to get regular exercise, lose weight and maintain weight loss, and control your carbohydrate intake at meals, less or equal to 60 grams per meal.

If these lifestyle changes don’t do the trick, Dr. Coxe said the next step is oral medications, often starting with metformin. If or when you are no longer able to control your blood sugar with oral medications, then you’ll need to move to insulin.

“That’s all determined by what your blood sugar is,” said Dr. Coxe. “Not by what your family history is, not by what your body size is, but by your glucose control when you are maximally doing all of the other things.”

This article originally appeared in Heart to Heart magazine, a magazine specifically for heart patients and their families.  Subscribe to Heart to Heart today.