The concept of “sugar level” in the mind of most people is strongly associated with diabetes. Not surprising. Indeed, for diabetics, such an indicator is vital. Deviations from the norm can provoke the development of severe complications, irreversible disorders and even coma. Therefore, diabetic patients should know which indicators are considered the norm, and which signal violations.
What is glycemia
The term “glycemia” appeared in medical practice thanks to the French physiologist Claude Bernard in the 19th century. By this, the doctor meant the blood sugar level. Since then, the concept has become firmly established in medicine and has become one of the key concepts in endocrinology.
Glycemia is not a disease or an abnormality. It is an indicator that indicates the concentration of glucose in the body.
From food entering the digestive tract, the body releases glucose. This substance provides all systems with the necessary energy. Insulin, a hormone produced by the pancreas, is responsible for the correct distribution of sugar between organs. It is he who “forces” the cells to absorb glucose, due to which the release of energy occurs . With proper synthesis of insulin, blood sugar levels always vary within normal limits. After all, as soon as the concentration of glucose increases, the brain immediately gives the command to the pancreas: to produce a hormone. Your glucose level depends on many factors:
- the age of the person;
- food intake;
- physical activity;
- psychoemotional state;
- diagnosed pathologies.
After analyzing the significant points, the doctors presented the following blood sugar norms to the population. They are shown in the table.
Women may develop gestational diabetes during pregnancy . This pathology occurs against the background of excessive stress on the body. The characteristic symptoms of diabetes may be completely absent. The woman is not worried about anything. The development of pathology can only be detected by the results of the analysis. This condition requires mandatory therapeutic correction. With gestational diabetes, the unborn baby is seriously harmed, up to and including the development of defects.
If the concentration of glucose in the blood is significantly higher than normal values, then doctors suspect the patient has diabetes. With such a pathology, metabolic processes are disrupted. As a result, blood sugar levels rise. Depending on the reason for the increase in glucose concentration, doctors distinguish the following types of pathology:
- 1 type. This form is characterized by damage to the pancreas at the cellular level. The damaged organ is unable to synthesize the required amount of insulin. Therefore, glucose entering the body is not fully distributed. To lower sugar levels in type 1 diabetes, the patient is given insulin injections.
- Type 2. With such an ailment, the pancreas synthesizes a sufficient amount of insulin. But the hormone is not perceived by the tissues of the organs. This leads to an increase in glucose levels. To reduce sugar, special hypoglycemic drugs are prescribed.
Reaching sugar levels in diabetes is very difficult, and sometimes impossible. The glucose values of a sick person will always be slightly higher than that of a healthy person. However, there are acceptable levels for diabetics. The upper limit is called the target glucose level. These are indicators recognized by doctors, at which diabetics do not develop complications of the disease. These values are presented below.
If a diabetic patient adheres to the targets, then the risk of developing nephropathy (kidney damage) is reduced by 50%, retinopathy (eye disease) by 76%, and neuropathy (nervous system disorders) by 60%.
Critical sugar levels in diabetes
For a healthy person, an increase in glucose above 7.8 mmol / L or a decrease below 2.8 mmol / L is considered critical. With such concentrations of sugar in the body, irreversible processes are triggered. If the patient has already developed diabetes, glucose values can vary widely.
The critical sugar level in such patients is considered to be 13-17 mmol / l. This is a dangerous condition for the body. Glucose is present not only in the blood, but also in the urine. In addition, acetone is found in urine. There is a risk of developing a hyperglycemic coma. A pathologically high glucose concentration is indicated by the following symptoms:
- increased urination;
- excessive hunger;
- itchy skin;
- increased water intake;
- blurred vision;
- nausea, vomiting.
To protect the diabetic patient from serious consequences, it is necessary to immediately make a subcutaneous injection of insulin.
A sudden drop in glucose levels also has a critical limit. For diabetics, it is dangerous to drop blood sugar below 3.2 mmol / l. Hypoglycemia develops. For an easy stage of pathology, the following clinical picture is characteristic:
- trembling, weakness of the limbs;
- loss of sensitivity of the tongue (usually only the tip);
- profuse sweating;
- the complexity of orientation in space and time.
With a further decrease in glucose, the patient’s heart rate increases, a feeling of fear appears, and irritability occurs. The patient loses consciousness. He has seizures, coma or death. Such a patient needs to immediately raise the sugar level. To do this, you can give a little simple carbohydrates (a glass of sweet fruit juice, 200 ml of water with 1 tablespoon of sugar, 5-6 hard candy).
Deadly blood sugar
If the sugar rate has strict limits, then the indicators at which the patient’s death can occur are very conditional. They depend on the human body. For some diabetic patients, an increase in glucose concentration of up to 17 mmol / L leads to hyperglycemic coma. In others, with such indicators, even characteristic symptoms do not arise. An increase in glucose of more than 18 mmol / l is fraught with the development of hyperosmolar coma against the background of hyperglycemia . With this pathology, the sugar level can reach exorbitant levels (up to 55 mmol / l). The development of hyperosmolar coma is signaled by the following symptoms:
- profuse urination;
- excessive thirst (a person drinks a lot, but cannot satisfy the need for water);
- dryness of the skin, mucous membranes;
- sharpening of facial features;
No amount of home methods can help. The patient needs urgent hospitalization.
Fatal glucose levels in diabetics range from 18-55 mmol / L. It is impossible to determine which indicators will lead to death. They depend only on the individual characteristics of the organism.
Blood sugar control
Medicine has not yet created such drugs that could completely cure diabetes. Therefore, doctors strongly recommend preventing the development of the disease. One of the prevention methods is regular monitoring of sugar levels. A healthy person needs to donate blood for analysis once a year. But if the sugar indicators are far from the norm, then the delivery of biomaterial for research becomes more frequent. The regularity of blood sampling is specified individually.
With the development of diabetes mellitus, various laboratory tests can be recommended:
- Fasting blood test. This is the simplest test to determine if a patient’s sugar is normal. The study is carried out on an empty stomach. In order not to distort the results, doctors recommend eliminating physical activity and anxiety before sampling biomaterial.
- Blood test “under stress”. This diagnosis involves taking biomaterial twice. Initially, blood is taken on an empty stomach. Then the patient is offered to take glucose in the form of syrup or tablets (the dosage is calculated depending on the body weight). After 1.5-2 hours, the patient’s blood is re-taken for analysis. By such indicators, the doctor can judge the body’s tolerance to glucose. This study reveals a person’s tendency to develop diabetes.
- Study of glycated hemoglobin (HbA1c). An analysis is prescribed to determine the average blood sugar level over a long period of time (usually 3 months). The study reveals the patient’s predisposition to diabetes. And if the pathology has already developed, then laboratory diagnostics gives an idea of the course of the disease and the effectiveness of the prescribed therapy.
Indicators of glycated hemoglobin depend on the age of the patient and the presence of serious complications. In a healthy person, HbA1c ranges from 4-6%. The indicators of patients with diabetes are shown in the table.
Control with a glucometer
Patients diagnosed with diabetes mellitus need to constantly monitor their glycemia. Moreover, you need to check the sugar concentration several times a day. For this, it is recommended to purchase a blood glucose meter . The study is carried out in the following cases:
- In the morning, after getting out of bed. Testing is performed on an empty stomach. The analysis allows you to determine how the body can withstand the night and whether the dosage of the drug is correctly selected.
- Before eating. Sugar levels are measured before every meal. Such a study makes it possible to establish the effectiveness of the selected dietary food.
- 2 hours after eating. If the diet is selected correctly, then the glucose concentration during this time should return to the target values. Deviations from the norm signal the need for power correction.
- With worries, stress or deterioration of health. Such conditions cause an increase in glucose concentration. To prevent the development of severe complications, doctors recommend that blood glucose measurements be taken. Based on the results obtained, a decision is made on an additional injection of insulin (with type 1) or the use of a drug that lowers blood sugar levels (with type 2).
- Before, during and after gymnastics. These measurements give an idea of how exercise affects glucose concentration. An excessive decrease in performance signals the need for a snack before playing sports.
- Before driving a car. You can get behind the wheel and go outside only if the glucose concentration meets the permissible standards.
- For the night. If your blood sugar is low, it is recommended to have a small snack before bedtime.
- At night, at about 3 o’clock. Such measurements are taken when necessary. Diagnostics gives an idea of the correctness of complex therapy. If a decrease in glucose levels is detected at night, then it is imperative to inform your doctor about this.
Paraphrasing a well-known proverb, we can say with confidence: diabetes is not so terrible as uncontrolled sugar levels. Therefore, upon hearing the verdict diagnosis, you should not give up. Even such a serious illness can be kept in check.
High blood pressure in type 1 and 2 diabetes mellitus – reasons for which pills to choose
Pressure surges in diabetes mellitus are a common condition that not only worsens the patient’s well-being, but also threatens with serious complications. Against the background of hypertension, a stroke, heart attack and other conditions that threaten the patient’s life occur. Every diabetic should know the symptoms and causes of surges in blood pressure (BP) in order to promptly eliminate the pathology and prevent sad consequences.
Type 1 diabetes blood pressure
In type 1 diabetes, 80% of patients develop hypertension (persistent increase in blood pressure). The main cause of this condition is diabetic nephropathy.
Diabetic nephropathy is damage to the vessels in the kidneys caused by an increase in blood sugar. A common complication of type 1 diabetes.
If the functionality of the kidneys is impaired, the excretion of sodium in the urine from the body slows down. This element begins to collect in the blood. The body accumulates fluid to reduce the sodium concentration by diluting the blood with water. As a result of an increase in the volume of circulating blood, patients are diagnosed with high blood pressure. Also, with a high concentration of glucose, blood volume increases, which further provokes an increase in blood pressure. It turns out that the main cause of arterial hypertension in type 1 diabetes is nephropathy. But the increase in pressure, in turn, provokes kidney disease. Often, patients with diabetes mellitus and high blood pressure are diagnosed with renal failure, which, if untreated, threatens the patient’s life.
To normalize the condition of the kidneys, you need to treat high blood pressure. But since hypertension occurs against the background of nephropathy, a vicious circle is obtained. And to break it, the patient needs to undergo comprehensive treatment.
Blood pressure in type 2 diabetes
In type 2 diabetes, hypertension occurs much earlier than high blood sugar is diagnosed. The reason for this condition is that the tissues have decreased insulin sensitivity. In medicine, this condition is called “insulin resistance”. With insulin resistance, a large amount of insulin circulates in the blood, which provokes an increase in blood pressure. Therefore, many sufferers learn about hypertension earlier than about diabetes. But insulin resistance does not stop there. Atherosclerosis caused by hypertension gradually develops. And this condition leads to a narrowing of the lumen in the vessels, which impairs blood circulation and causes thrombosis. Another reason for pressure surges in type 2 diabetes is abdominal obesity (the formation of a fatty layer around the waist). And this leads to the fact that substances that contribute to an increase in blood pressure begin to be released into the blood. The complex of these conditions is called “metabolic syndrome”. It develops only in diabetes mellitus and is detected by symptoms much earlier than diabetes itself.
It is noted that women have hypertension 2 times more often than men. But low pressure is typical for representatives of the strong half of humanity.
Causes of high blood pressure in diabetes
There are two main causes of hypertension in diabetes mellitus: nephropathy and insulin resistance. Also, an increase in blood pressure occurs against the background of cardiovascular diseases, high cholesterol. The provoking factors must be taken into account:
- heredity – it has been proven that hypertension can be inherited;
- menopause – in women during menopause, a hormonal failure occurs, which is the cause of pressure surges;
- endocrine system diseases;
- elderly age;
- chronic intoxication;
It should be borne in mind that minor fluctuations in blood pressure are normal. If, at the same time, there are no complaints of poor health, then all that remains is to control blood pressure.
Normal human blood pressure is 130/90. At night and in the morning, there is a decrease in tonometer readings by 10-20 points. On the contrary, after eating and physical activity, the pressure rises, but quickly returns to normal. In patients with diabetes mellitus, blood pressure does not decrease at night. Moreover, there is a tendency for the tonometer readings to increase after going to bed. And this is the main symptom of hypertension in type 1 and type 2 diabetes. Other symptoms include:
- heart palpitations;
- tingling in the limbs;
- headache (mainly in the forehead);
- nausea, vomiting.
People with diabetes need to control their blood pressure in order to prevent a serious increase in blood pressure, which can cause a stroke. For this purpose, always keep a blood pressure monitor with you.
Symptoms directly depend on the level of pressure. The higher it is, the stronger the dizziness and chills. But a headache with minor deviations from the norm manifests itself more strongly than with high pressure. Depending on what current pressure the patient has, three degrees of hypertension are distinguished:
- Lightweight. The upper pressure does not exceed 160 mm. rt. Art., and the lower – no more than 99.
- Moderate. The upper pressure is not more than 179 mm. rt. Art., and the lower – up to 109.
- Heavy. The top is above 180, the bottom is above 110.
In severe hypertension, the patient needs emergency medical attention, as this condition is life threatening.
Causes of low blood pressure in diabetes
Lowered blood pressure in diabetes mellitus is less common than high. This condition is called “hypotension” or “hypotension” and is as life threatening as hypertension. There are many reasons for low blood pressure in diabetes mellitus:
- Violation of the functionality of the autonomic nervous system. This condition belongs to congenital pathologies and greatly reduces the quality of life. Patients with diabetes mellitus and impaired ANS should constantly monitor the level of blood pressure, since it can drop to critical levels, causing serious complications.
- Disruption of the heart system. Diabetes is linked to heart function. And if there are deviations in its work, then a decrease in blood pressure occurs. In turn, low blood pressure worsens the condition of the patient with diabetes, and it affects the work of the heart. It turns out that patients need to control blood sugar levels, blood pressure and the functionality of the cardiovascular system.
- Vegetovascular dystonia. Another reason for hypotension. With VSD, the stress hormone (cortisol) is produced, which provokes weight gain and uncontrolled pressure surges.
Other causes of hypotension include:
- pancreatitis, stomach ulcer in the acute stage;
- bleeding of various localization;
- lack of vitamins and minerals in the body;
- a sharp change in weather conditions.
Reduced pressure is considered when the tonometer readings are below 110/90 mm. rt. Art. The pathological condition does not include a short-term decrease in blood pressure caused by external factors.
With a high blood sugar level, there is a decrease in performance, drowsiness, and chronic fatigue. Low blood pressure worsens the general condition of the patient. During attacks of hypotension, the following symptoms appear:
- semi-faint state;
- depressed mood.
In this state, the patient is unable to carry out the usual activities, quickly gets tired at work. There is no improvement after a night’s rest. If the patient has an VSD, then against the background of hypotension, migraine pains occur . They begin with mild discomfort in one half of the head and progress to severe attacks, accompanied by vomiting and photophobia.
Treating pressure problems
With diabetes mellitus, patients need careful selection of medications to treat surges in blood pressure. Moreover, therapy for hypertension differs from therapy for hypotension. Treatment, regardless of the pressure level of diabetes, includes:
- taking medications;
- therapeutic diet;
- weight loss;
- elimination of the cause of hypotension or hypertension.
Alternative medicine is used as an additional therapy.
What to take with hypertension, the attending physician decides. It is not worth fighting high blood pressure on your own – the body needs comprehensive support, and in the absence of competent treatment, complications develop:
- renal failure appears 25 times more often in diabetics with hypertension;
- the risk of myocardial infarction increases 5 times;
- a stroke happens 4 times more often;
- a sharp decrease in visual acuity, up to complete blindness, occurs 15 times more often.
Type 1 diabetes mellitus slows down many body systems. And at high pressure, the detrimental effect is amplified several times. To keep blood pressure under control and prevent it from rising, doctors prescribe medications from several groups:
- ACE inhibitors. Drugs from this group block a substance that constricts blood vessels and traps sodium in the blood. They are distinguished by a mild action, no contraindications for kidney disease. The drugs in this group include Captopril , Enalapril .
- Calcium blockers. It is recommended to take drugs of this group for high blood pressure only at a low heart rate. Their action is aimed at blocking calcium channels. These include Verapamil , Diltiazem.
- Diuretics. In type 1 and type 2 diabetes, it is recommended to take diuretics together with ACE inhibitors. This is necessary to remove excess fluid from the body, which often causes high blood pressure. The drugs from this group include Acripamide , Bufenox , Veroshpiron. But with type 1 and type 2 diabetes mellitus, it is recommended to take herbal remedies: lingonberry, lovage, burdock.
- Beta blockers. Drugs from this group are prescribed to patients whose blood pressure rises against the background of heart disease. Beta blockers lower your heart rate and normalize your heart after a heart attack or stroke. For drugs in this group include: Trandat , Nebilet , Dilatrend .
- Alpha blockers. Block alpha- adrenergic receptors , which are responsible for increasing blood pressure in type 1 and 2 diabetes. In addition to the main action, these drugs normalize blood sugar levels and improve the general well-being of the patient. These include Prazosin, Terazosin , Doxazosin .
You can take drugs from the listed groups only under the supervision of a doctor. Medication names are for informational purposes only.
Alternative medicine can be used as additional therapy. Just be careful with them – not many herbs are allowed for diabetes and not all are equally useful. Several types of plants can be used to reduce blood pressure in diabetes:
Lemon and cinnamon for blood pressure are proven and effective ingredients in drinks and meals that can help you lower blood pressure in type 1 and type 2 diabetes.
With arterial hypotension, the main treatment is to eliminate the disease that causes a decrease in blood pressure. A consultation with a neurologist and a cardiologist will be required, who, depending on the diagnosis, will recommend pressure pills. How to raise blood pressure in type 1 and 2 diabetes at home:
- In the morning on an empty stomach, drink a glass of warm green tea. But it is better to refuse coffee.
- Dissolve 30 drops of ginseng in a glass of water and drink.
- Salty cheese helps with low blood pressure. Just don’t overdo it – one piece will be enough.
- A contrast shower helps a lot.
- Physical activity and even a regular walk increase blood pressure.
If blood pressure falls irregularly, then you can do without pressure pills. In other cases, you must adhere to the doctor’s recommendations and take the prescribed drugs. Whether a particular drug can lower blood pressure depends on the patient’s condition . Doctors advise taking 1 tablet of ascorbic acid and 2 tablets of green tea extract with a sharp decrease in pressure.
How to choose pressure pills for diabetes mellitus?
The medicine cabinet should contain pressure pills in the event of a hypertensive crisis. This condition is characterized by a sharp increase in blood pressure, severe headaches. In this case, you should take a Captopril or Captopres tablet , which has the ability to quickly normalize blood pressure. If you feel bad, but the pressure is not very high (exceeded by 10-20 mm Hg), then take half a pill. The rest of the medicines need to be selected only with the attending physician. In type 1 and type 2 diabetes, it is important that medications meet several requirements:
- do not increase blood sugar;
- do not increase the concentration of “bad” cholesterol;
- have a small number of side effects;
- do not affect the liver, kidneys and heart.
The drugs are selected taking into account the type of diabetes mellitus: types 1 and 2 require a different approach. It is imperative to consider how the medicine affects the kidneys and heart.
Prevention of pressure drops in diabetes
Dealing with pressure drops in type 1 and type 2 diabetes is much more difficult than preventing their occurrence. First of all, it is necessary to control the blood sugar level and prevent it from rising. To do this, follow the recommendations of your doctor, do not skip taking medications. What to do at home to prevent blood pressure surges:
- give up cigarettes and alcoholic beverages;
- get enough sleep, allocating at least 8 hours for a night’s rest;
- eat right, giving preference to healthy and natural products;
- take vitamin and mineral complexes;
- exercise regularly;
- measure blood pressure daily with a tonometer to determine if it rises during the day.
How to reduce and how to increase blood pressure, only the doctor decides. Be sure to consult a specialist in case of unstable tonometer readings and symptoms of hypertension or hypotension.