Hua Zi met a friend in his 40s who asked for help. He said that he had recently increased his appetite and was particularly thirsty and urinated a lot, but he did not gain weight. Went to the hospital to see a doctor and was diagnosed with diabetes. But what he didn’t understand was that he had just had a physical examination a month ago, and his blood sugar was still normal at that time. He asked Hua Zi, will diabetes progress so quickly?
Hua Zi told him that diabetes is a slowly progressive disease. In pre-diabetes, the main problem is impaired glucose tolerance and postprandial blood sugar rises. However, the general physical examination is to check fasting blood sugar. Missed diagnosis.
1. Why is fasting blood sugar normal in diabetes?
Diabetes can be diagnosed when fasting blood glucose exceeds 7mmol/L or random blood glucose exceeds 11.1mmol/L. However, in the early stage of diabetes, the sensitivity of insulin secretion to blood sugar fluctuations is decreased, and the abnormal blood sugar usually occurs first after meals.
In people with prediabetes, although blood sugar rises after a meal, fasting blood sugar usually drops to normal in the morning after insulin is secreted overnight. In the physical examination, if you only check the fasting blood sugar in the morning, you will get a normal blood sugar value, which will cause the missed diagnosis of diabetes.
Second, postprandial blood glucose is a sensitive indicator reflecting blood glucose disorders
People with diabetes, predominantly with type 2 diabetes. This is a slowly progressive disease. Insulin resistance initially occurs in the patient, but the body can still control blood sugar by compensating by increasing insulin secretion. However, as the disease progresses, insulin sensitivity to blood sugar fluctuations decreases, and postprandial hyperglycemia begins. As the disease continued to worsen, insulin secretion decreased, showing an increase in fasting blood sugar.
Generally speaking, abnormal blood sugar will not be found in the compensation period, only in the stage of postprandial blood sugar increase, will abnormal blood sugar be found. However, as long as blood sugar is actively intervened at this stage, it can also prevent or delay the occurrence of type 2 diabetes.
Three, postprandial blood sugar is more important than fasting blood sugar
The body’s blood sugar peaks throughout the day after a meal, and then slowly declines as insulin is secreted. In healthy people, blood sugar will drop below 7.8mmol/L within 2 hours after a meal. However, it is difficult for diabetic patients to lower postprandial blood sugar, which will lead to high glycated hemoglobin (HbA1c), which reflects the average blood sugar.
Based on current research, postprandial blood glucose levels are more important than fasting blood glucose levels. In a related meta-analysis, it was shown that postprandial hyperglycemia is an independent risk factor for cardiovascular and cerebrovascular diseases. The risk of complications from diabetes, such as retinopathy, is higher.
Four, how to control postprandial hyperglycemia
For the control of postprandial hyperglycemia, alpha-glucosidase inhibitors (acarbose, voglibose, etc.) are usually taken with meals, It can inhibit the decomposition of carbohydrates in the diet into monosaccharides and delay the absorption of glucose. Rapid-acting insulin and insulin secretion-stimulating drugs can also be used before meals to control postprandial blood sugar.
At the same time of using drugs, it is also necessary to adjust the diet structure and reduce the intake of carbohydrates. Also Control your weight, as obesity is a major cause of insulin resistance. Appropriate aerobic exercise about 1 hour after meals, such as walking, square dancing, etc., promotes the consumption of glucose by muscles.
To summarize, in the early stages of diabetes, postprandial blood sugar is usually abnormal, while fasting blood sugar is normal. Therefore, during the physical examination, don’t forget to check the postprandial blood glucose and glucose tolerance. If any problem is found, timely intervention can prevent or delay the occurrence of type 2 diabetes.
If you have been diagnosed with diabetes, you will need to use hypoglycemic drugs to control your blood sugar as directed by your doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.