Blood glucose, also known as blood glucose, refers toglucoseContent of.It is an important indicator to evaluate the normality of glucose metabolism and can be used for screening, diagnosis and monitoringdiabetes、HypoglycemiaAnd many other diseases with abnormal glucose metabolism.The normal level of blood glucose is closely related to the time of eating, and the blood glucose level monitored after not eating（Fasting blood glucose）And blood glucose level monitored after eating（Postprandial blood glucose）They are very important for judging the health status of the body's sugar metabolism.
High or low blood sugar levels can lead to a series of symptoms.Long term elevated blood sugar may mean the occurrence of diabetes and other sugar metabolic diseases, whose symptoms mainly include polydipsia, overeating, polyuria and weight loss.Short term low blood sugar may be related to exercise, medication, dehydration, diet and other factors. If there are repeated hypoglycemia symptoms, such as pale face, shaking hands, sweating, panic, etc., you need to see a doctor.
For abnormal blood glucose, the treatment plan will mainly consider its causes. For example, if it is caused by disease factors such as insulin resistance or abnormal pancreatic beta cell function, lifestyle intervention, diet management, drug treatment and other methods may be used to ensure that patients can effectively control blood glucose.For hypoglycemia caused by improper use of hypoglycemic drugs or insulin, drug use needs to be adjusted.
With the deepening of research on diabetes, people gradually realize that overcoming insulin resistance plays a key role in the control and reversal of the disease.In 2023, the American Diabetes Association further recommended that people over 35 years of age should be screened for diabetes every three years, regardless of whether there are obvious symptoms.For patients with impaired glucose tolerance and impaired fasting glucose, some patients can return to normal or maintain the status quo without progressing to diabetes through active and effective lifestyle intervention.For diabetic patients, blood sugar can also be better controlled through standardized diet, exercise and combined drug treatment.
Chinese name
blood sugar
Foreign name
Blood glucose
essence
A measure of glucose content in the blood
normal range
The normal value of fasting blood glucose is 4.4~6.1mmol/L
glucosestayglucose oxidase Under the catalysis of, it oxidizes to produce gluconic acid and releases hydrogen peroxide.hydrogen peroxidestayPeroxidaseIn the presence of chromogenic receptors, it releases oxygen to oxidize the chromogen into red quinones.At 505nm, the amount of quinone is proportional to the amount of glucose.
Normal value
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The blood glucose value is closely related to the eating time. According to the eating situation, it can be divided into fasting blood glucose and postprandial blood glucose. It should be noted that due to different instrument precision, different detection methods or different laboratories and other factors, the reference values of chemical test sheets issued by different medical institutions may have some differences in real life.Because the instruments and reagents used by different laboratories are different, the data detected by the same sample in different laboratories may also be different.
According to the latest standard of blood glucose in 2023
The metabolism is relatively strong, so the blood glucose standard should be more strict, the fasting blood glucose should be 4.4-6.1 mmol/L, and the blood glucose value two hours after meal should be 5.0-8.3 mmol/L.
Adults (18-65 years old)
The fasting blood glucose value is 4.4-6.1mmol/L, and the blood glucose value two hours after meal is 5.0-8.3mmol/L.
Elderly (over 65 years old)
The adaptability and disease resistance of the body have declined.Therefore, the control standard of blood glucose should be properly improved. The fasting blood glucose should be less than 7.8 mmol/L, and the blood glucose two hours after the meal should be less than 11.1 mmol/L.
The fasting blood glucose value is generally required to be controlled at 6.1-7.0mmol/L;After eating, the blood sugar should be 8.0-10.0mmol/L.
Blood glucose range of pregnant women during pregnancy
Fasting whole blood glucose: 3.1-5.1mmol/L, blood glucose 1 hour after meal:<10mmol;Blood glucose 2 hours after meal:<8.5 mmol.
Abnormal indicators
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Blood glucose reflects whether the glucose metabolism of the body is normal, including absorption, consumption, regulation, etc. Among them, fasting blood glucose and postprandial blood glucose are the most commonly used indicators for diagnosing glucose metabolism disorders. If the indicators are not within the normal range, they are abnormal indicators. However, it should be clear that abnormal indicators do not represent diabetes or hypoglycemia and other related diseases.Fasting blood glucose is higher than 6.1mmol/L, but not higher than 7mmol/L, and is in a state of hyperglycemia. The damage can be reversed by properly strengthening physical exercise, adjusting diet structure, and improving sleep quality to avoid developing into clinical diabetes.
Result error
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Some diseases and drug factors may lead to inaccurate blood glucose results.If the patient has serious hemolysis, jaundice and other systemic diseases, or is using thyroid hormone, caffeine and other drugs, it may interfere with the blood glucose test results, leading to increased blood sugar.In addition, if the blood sample is not detected in time, the detection value may decline.
Indicator interpretation
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The blood glucose results can be used to evaluate the glucose metabolism of patients, and in combination with clinical symptoms, can be used to determine whether patients havediabetes、hypoglycemiaAnd other diseases.
diabetes
The patient has typical symptoms of "more than three, less than three", that is, more drink, more food, more urine, and weight loss.The fasting venous plasma glucose value was higher or equal to 7.0 mmol/L, or the random blood glucose value was higher than 11.1 mmol/L.
Make glucose tolerance test, that is, after getting up in the morning, let the patient take 75 grams of glucose plus appropriate amount of water on an empty stomach. The blood sugar value on an empty stomach is higher or equal to 7.0 mmol/L, and the blood sugar value in two hours is higher or equal to 11.1 mmol/L.It can be diagnosed.
If the above two criteria are met, diabetes can be diagnosed.
hypoglycemia
The blood sugar of the general population is lower than 3.0mmol/L, which can be used as the standard for diagnosis of hypoglycemia. If the blood sugar level of diabetic patients receiving drug treatment is lower than 3.9mmol/l, it belongs to the category of hypoglycemia.
Patients may be accompanied by pale face, weakness, palpitations, rapid heart rate, sweating, hunger, convulsions, tremors, abnormal behavior, confusion and other symptoms, and even coma in severe cases.
Index identification
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The clinical significance of blood sugar is close to that of urine sugar. Blood sugar reflects the glucose content in the blood, and urine sugar reflects the glucose content in the urine. Normally, glucose will not be discharged from the urine when the kidney functions well. However, when the blood sugar content is too high and exceeds the ability of the kidney to absorb glucose again, glucose can be discharged from the urine, leading to an increase in urine sugar,Therefore, the higher the blood sugar value, the higher the urine sugar. However, for patients who use SGLT-2i drugs, because its mechanism is to inhibit the ability of the kidney to reabsorb glucose in the urine, medication can lead to increased urine sugar, and it is not appropriate to judge the disease changes by urine sugar.
High indicators
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Short term mild hyperglycemia may be related to exercise, medication, dehydration, diet and other factors, but continuous hyperglycemia generally indicates that the patient's glucose metabolism ability is weakenedImpaired fasting blood glucose、Impaired glucose tolerance, diabetes, etc.
Reasons for high indicators
The reason of high blood sugar is mainly due to the weakened ability of the body to deal with glucose in the blood. In addition, some drug factors and physiological factors can also lead to high blood sugar.However, it should be noted that due to the different precision of medical facilities and reagents in different places, the index results of blood glucose detection vary from person to person.
Pathological factors
insulinIt is the only hormone that can reduce blood sugar. When the islet function of the body decreases, insulin secretion is insufficient, or the sensitivity of the body to insulin decreases, and the role of insulin is relatively reduced, the ability of the body to reduce blood sugar will decrease, resulting in high blood sugar.In addition, hyperthyroidism, adrenal cortical hyperfunction and other endocrine diseases, dehydration and other diseases, as well as the disturbance of blood glucose regulation caused by the stimulation of central nervous system by increased intracranial pressure can also lead to high blood sugar.
Drug factors
Glucocorticoid(e.gprednisoneThiazide diuretics, oral contraceptives and other drugs can also cause high blood sugar.Drugs such as glucocorticoids can promote the synthesis of glucose in the liver and increase blood sugar. Thiazine diuretics can reduce the level of potassium ions in cells, affect insulin secretion and lead to increased blood sugar.
Physiological factors
Physiological factors such as excessive intake of high sugar foods exceeding the metabolic capacity of the body, strenuous exercise, and excessive tension can also lead to high blood sugar, which is generally a short-term slight increase.
Indication for medical treatment with high indicators
The guidelines issued by the American Diabetes Association (ADA) in 2023 mentioned that even if there are no obvious symptoms, it is also recommended that all people ≥ 35 years old should receive diabetes screening every three years.Screening indicators can be selectedglycosylated hemoglobin（HbA1c）、Fasting blood glucose(FPG) orOGTT(oral glucose tolerance test) - 2h screening.
When patients have abnormal blood glucose related indicators, they need to seek medical advice in time for risk assessment. It is generally believed that through active and effective lifestyle intervention, some patients with impaired fasting blood glucose and impaired glucose tolerance can return to normal or maintain the status quo without progressing to diabetes.
When the patient is diagnosed with diabetes, it is advisable to seek medical treatment as soon as possible, and carry out lifestyle intervention and drug treatment under the professional guidance of the doctor.
When the patient has symptoms such as excessive drinking, eating, urination and fatigue, nausea and vomiting, blood sugar level higher than the target range, rotten apple smell in breath, dyspnea, abdominal pain, confusion, etc., he should seek medical advice immediately, and call 120 emergency doctors if necessary.
Other inspections with high indicators
When the patient has high blood sugar, the doctor may recommend furtherSugar tolerance test、Urine sugar、glycosylated hemoglobin、Saccharified albumin, C-peptide level determination, etc., to evaluate the function of pancreatic islet β cells, so as to determine whether the patient can be diagnosed with diabetes and the recent blood sugar status.
Treatment mode with high indicators
After finding that the blood sugar is on the high side, the doctor may carry out a series of examinations to determine the cause of the patient's blood sugar rise, assess the degree of blood sugar rise, and determine whether the patient is suffering from impaired fasting blood sugar, impaired glucose tolerance, or diabetes. If the patient is diagnosed with diabetes, depending on the overall situation of the patient, diabetes education, medical nutrition treatment, exercise treatmentDrug therapy and other methods are used alone or in combination to ensure that patients can effectively control blood sugar.
Dietary guidance for high indicators
There are corresponding precautions on diet for elevated blood sugar:
Diet recommendation
Control of staple food intake: The main ingredients of staple food such as rice and flour are starch, which can be digested and absorbed by the human body and become glucose in the blood, which can cause blood sugar to rise. Therefore, it is necessary to control the intake of staple food such as rice and flour in diet and increase the intake of mung beans and other cereals.
Increase the intake of fresh vegetables: vegetables are rich in vitamins, dietary fiber and a variety of nutrients with antioxidant effects, and the daily intake should be about 500g, of which dark vegetables should be more than half.
Increase the richness of food: increase the intake of bean products, nuts, yogurt and other foods
Food taboos
It is not suitable to drink sugary drinks, reduce the amount of oil used in cooking, limit the amount of salt and soy sauce, and avoid smoking, baking and other processed meat products.
High indicators Daily attention
In addition to diet, we can also pay attention to the following items in our daily life.
motion
Through exercise to control weight, the normal body mass index in China is between 20 and 24. It is generally recommended that young diabetic patients<24 and elderly diabetic patients<28.
It should be avoided that those who exercise too intensely and are in suitable physical conditions can take 150 minutes of moderate intensity exercise every week under the guidance of a doctor, but patients with high blood sugar, extremely unstable blood sugar, high blood pressure and unsuitable physical conditions should not exercise.
Quit smoking and drinking
Research has proved that diabetic patients who often smoke will aggravate the phenomenon of insulin resistance.
In addition, patients with high blood sugar should monitor their blood sugar by themselves and take regular re examinations to assess their blood sugar control after finding high blood sugar.
High index Curability
Patients with mild hyperglycemia but not reaching the level of diabetes can recover their blood sugar level to normal through lifestyle management, diet management and other measures, which may be cured. However, patients with diagnosed diabetes are usually difficult to fully recover to normal, which cannot be completely cured at present. However, with the deepening understanding of diabetes,At present, scholars in the industry are exploring ways to reverse diabetes by reducing the degree of insulin resistance.
Indicators are low
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The transient low blood sugar of normal people may indicate that the patient has insufficient glucose intake or excessive consumption and conversion, which needs to be judged comprehensively in combination with symptoms. However, recurrent low blood sugar may indicate that the patient has abnormal glucose metabolism and intake, which may be related to disease factors such as excessive insulin secretion, and exogenous factors such as hypoglycemic drugs or excessive insulin, and reduced eating.
Reasons for low indicators
Low blood sugar is mainly caused by disease factors such as abnormal insulin secretion, improper use of hypoglycemic drugs, and physiological factors such as insufficient sugar intake and excessive exercise intensity.
Pathological factors: Many diseases, such as pancreatic and liver diseases, and abnormal thyroid hormone secretion, can cause blood sugar to decrease.Pancreatic related diseases such as islet β cell proliferation can lead to excessive insulin secretion and lower blood sugar;Thyroid hormone, adrenaline and other hormones can promote the increase of blood sugar. When suffering from endocrine diseases such as hypothyroidism and adrenal cortical dysfunction, blood sugar can also be reduced.
Drug factors: useHypoglycemic drugsInappropriate insulin can lead to excessive drop of blood sugar and hypoglycemia.In addition, some non hypoglycemic drugs such as sulfonamides, indomethacin and other drugs can also cause hypoglycemia.
Physiological factors: Physical factors such as intense exercise without timely supplement of calories, pregnancy, lactation, and excessive hunger can also lead to low blood sugar.
Functional hypoglycemia: After eating, pancreatic islet β cells secrete too much insulin, which leads to low blood sugar, such as reactive hypoglycemia, which is rare.
Indication for medical treatment with low indicators
When the fasting blood glucose of the general population is less than 3.0mmol/L, and the symptoms such as pale face, shaking hands, sweating, and panic repeatedly occur, the general population should go to the hospital in time when it is relieved after eating.
Or if the blood sugar of diabetic patients is less than 3.9mmol/L, it is called hypoglycemia, and they should go to the hospital for treatment.
Other inspections for low indicators
When the patient has low blood sugar, the doctor may suggest to check the blood C-peptide level to determine whether the low blood sugar is caused by abnormal pancreatic islet function, and may also carry out CT examination or abdominal B-ultrasound examination to determine whether there is insulinoma. If the above examination fails to determine the cause of low blood sugar, insulin autoantibodies, liver and kidney functionsThe adrenal cortex function was examined to find the cause.
Treatment methods for low indicators
After finding that the blood sugar is low, the doctor may first let the patient eat to increase the blood sugar. If the patient has severe blood sugar reduction or even coma, he may take intravenous glucose supplement and other treatments, and then use glucagon, glucocorticoid and other drugs depending on the patient's situation.
Low index diet guidance
When it is found that blood sugar is low, it is necessary to eat three meals regularly, and take some high sugar foods with you, such as milk sugar, chocolate, honey, biscuits, so as to supplement in time when blood sugar is low.
Low indicators Daily attention
In addition to diet, we can also pay attention to avoiding empty stomach exercise in our daily life. Exercise should not be too intense, especially running, climbing stairs and other strenuous exercises
Low index Curability
Whether the blood sugar is low or not is generally cured is generally related to the etiology, congenital enzyme defectsMalignant tumorThe hypoglycemia caused by insulinoma is generally incurable, while the hypoglycemia caused by insulinoma can be cured after tumor resection. The hypoglycemia caused by functional hypoglycemia and diabetes related hypoglycemia can be quickly corrected by taking sugar. If the diet and medication are properly controlled, it will not recur.
test method
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In November 2022,The National Academy of Science and Technology in Ulsan, South Korea, reported a new method to measure blood glucose level without drawing bloodmethod。
