“Sugar Diabetes” is a serious ailment, which can arise for many reasons, and can
affect many systems in the human body. Diabetes, often just called “sugar” by
some patients, is diagnosed and monitored mainly through a simple blood test -
the Blood Glucose level.
Glucose is a type of sugar found in fruits and many other
foods (this includes lactose and fructose). It is the main source of energy used
by the body. Most of the carbohydrates that people eat are also turned into
glucose, which can be used for energy or stored in the liver and kidneys as
glycogen.
To stop the sugar levels just increasing daily, a balance is
achieved through a hormone called Insulin which helps the body use and control
the amount of glucose in the blood. Insulin is produced in areas of the pancreas
called ‘islets’ and released into the blood when the level of glucose in the
blood rises. In simple terms, people who do not produce enough insulin develop
Diabetes. People can also develop diabetes if they do not respond normally to
the insulin their bodies produce. This occurs most commonly when a person is
overweight, and since obesity is on the rise, so are various types of Diabetes.
Normally, blood glucose levels increase slightly after a
person eats a meal. This increase causes the pancreas to release insulin so that
blood glucose levels do not get too high. Blood glucose levels that remain high
over time can cause damage to the eyes, kidneys, nerves, and blood vessels,
which explains why good glucose control is important.
There are many ways to carry out blood glucose tests,
including Fasting Blood Sugar (FBS). This is a measurement of blood glucose
after fasting for 12 to 14 hours. For an accurate fasting blood sugar test, do
not eat or drink for 12 to 14 hours before the blood sample is taken; however,
water should be freely taken, as otherwise hemoconcentration occurs to give a
falsely high reading. This is often the first test done to detect diabetes, and
explains why fasting blood tests are usually done when having a medical
check-up.
The other common test is called the Random Blood Sugar (RBS).
A random blood sugar measurement may also be called a casual blood glucose test.
This is a measurement of blood glucose that is taken regardless of when the
person last ate a meal. Sometimes several random measurements are taken
throughout a day. Random testing is useful because glucose levels in healthy
people do not vary widely throughout the day, so wild swings may indicate a
metabolic problem.
Glucose Tolerance Testing can also be done, usually to
confirm a condition known as Gestational Diabetes, which can occur during
pregnancy. An oral glucose tolerance test is simply a series of blood glucose
measurements taken after a person drinks a liquid containing a specific amount
of glucose; however, this test is not used to diagnose diabetes.
To monitor the treatment of diabetes, there are another
couple of tests which can be carried out. The commonest is Glycated Hemoglobin,
otherwise referred to as HbA1c. This test actually is an indicator of the
average glucose concentration over the life of the red blood cells (which is
taken as over the previous three months).
Another is the Serum C-Peptide which is used to investigate
low blood sugar levels, done by measuring the C-Peptide which is produced by the
Beta cells in the pancreas.
“Normal” levels may vary from lab to lab, but generally the
range taken for FBS is that the level should be less than 110 milligrams per
deciliter (mg/dL).
Diagnosis of diabetes needs a fasting blood glucose level
higher than 125 mg/dL on two separate days.
A fasting glucose level below 40 mg/dL in women or below 50
mg/dL in men that is accompanied by symptoms of hypoglycemia (low blood sugar)
may indicate an insulinoma, a tumor that produces abnormally high amounts of
insulin. Lower than expected glucose levels can also indicate Addison’s disease,
an underactive thyroid gland or pituitary gland, liver disease (such as
cirrhosis), malnutrition, or a problem that prevents the intestines from
absorbing the nutrients in food.
