Hanako met a friend in his 40s who said he had recently increased his meal intake, was particularly prone to thirst, and urinated a lot, but did not gain weight. Went to the hospital to see a doctor and checked out diabetes. But what he didn't understand was that he had just done a physical examination 1 month ago, when his blood sugar was still normal, and he asked Huazi, will diabetes progress so fast?
Huazi told him that diabetes is a slow-progressing disease, in the prediabetes is mainly impaired glucose tolerance, postprandial blood glucose rises, but the general physical examination is to check fasting blood glucose, easy to miss diagnosis.
First, why diabetes fasting blood sugar is still normal
At the time of diagnosis of diabetes, diabetes mellitus can be diagnosed with fasting blood glucose exceeding 7 mmol/L or random blood glucose exceeding 11.1 mmol/L. However, in the early stage of diabetes, only the sensitivity of insulin secretion to blood sugar fluctuations decreases, and it is generally the blood sugar that occurs after meals.
In people with prediabetes, although blood sugar rises after a meal, after a whole night of insulin secretion, fasting blood sugar usually drops to normal in the morning. During the physical examination, if you only check the fasting blood glucose in the morning, you will get a normal blood glucose value, which will cause the missed diagnosis of diabetes.
Second, postprandial blood glucose is a sensitive indicator of blood sugar disorder
People with diabetes are mainly based on type 2 diabetes. This is a slow-progressing disease. Insulin resistance initially appears in the patient's body, but the body can still control blood sugar by increasing the secretion of insulin through compensatory action. However, as the disease progresses, insulin's sensitivity to blood sugar fluctuations decreases, and postprandial hyperglycemia begins to appear. As the condition continues to worsen, insulin secretion decreases, showing an increase in fasting blood glucose.
In general, blood glucose abnormalities are not found during the compensatory period, and only in the postprandial period when blood glucose rises. However, as long as blood glucose is actively intervened at this stage, it can also prevent or delay the occurrence of type 2 diabetes.
Third, postprandial blood glucose is more important than fasting blood sugar
The body's blood sugar reaches the highest value of blood sugar throughout the day after eating, and then slowly declines with the secretion of insulin. Healthy people will drop their blood sugar to less than 7.8mmol/L within 2 hours after a meal. However, it is difficult for diabetic patients to lower their postprandial blood glucose, which leads to a high level of glycosylated hemoglobin (HbA1c), which reflects the average blood glucose.
In the current study, the importance of postprandial blood glucose values is higher than that of fasting blood sugar. In the relevant meta-analysis, it was shown that elevated blood glucose after meals is an independent risk factor for cardiovascular and cerebrovascular diseases, and the higher the blood glucose value after meals, the higher the risk of diabetic complications such as myocardial infarction, cerebral infarction, coronary heart disease, kidney damage, and retinopathy.
Fourth, how to control postprandial hyperglycemia
For the control of postprandial hyperglycemia, α glucosidase inhibitors (acarbose, vogliflam, etc.) are usually taken at mealtimes, which can inhibit the decomposition of carbohydrate foods into monosaccharides in the diet and delay the absorption of glucose. Rapid-acting insulin and insulin secretion drugs can also be used before meals to control blood glucose after meals.
While using the drug, it is also necessary to adjust the diet structure and reduce the intake of carbohydrates. Weight should also be controlled, as obesity is a major cause of insulin resistance. Perform appropriate aerobic exercise, such as walking, square dancing, etc., about 1 hour after a meal to promote muscle consumption of glucose.
To sum up, in the early stages of diabetes, there is usually an abnormality in blood sugar after a meal, while blood sugar is normal on an empty stomach. Therefore, during the physical examination, do not forget to check the blood glucose and glucose tolerance after the meal, and intervene in time to find problems, which can prevent or delay the occurrence of type 2 diabetes.
If diabetes has been diagnosed, it is necessary to use hypoglycemic drugs to control blood sugar under the guidance of a doctor. If you have any questions about medication, consult a doctor or pharmacist. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.