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Diabetes

Glucose tolerance test: What you should know

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The glucose tolerance test is a blood test, also known as diabetes, for diagnosing diabetes mellitus. How the body responds to glucose is seen in the test.

Diabetes is a chronic disease of the blood in which, due to insulin deficiency or resistance to insulin within cells, the body can not efficiently absorb glucose. This results in high sugar levels in the blood.

According to the Centers for Disease Control and Prevention ( CDC), diabetes is the seventh leading cause of death in the United States.

The secret to successful treatment and reducing the risk of long-term complications could be early diagnosis. The oral glucose tolerance test ( OGTT) is the most common type.

Find more about the test for glucose tolerance, any procedure complications, and other ways to confirm diabetes.

What is the test?

The glucose tolerance test can help diagnose diabetes.
The glucose tolerance test can help diagnose diabetes.

A glucose tolerance test measures glucose levels in the body.

Before and after a sugary drink, a healthcare provider can test and compare the blood glucose levels of an individual.

Because an individual conducts the test over 2 hours, it will show the doctor how glucose is absorbed by the body.

The blood glucose level in a healthy person will increase after consuming sugary food and return to normal after the glucose is absorbed by the body. Blood sugar levels can remain high in a person with diabetes.

The test measures this response.

What to expect

An individual should fast for 8–12 hours before taking the test. They do not eat or drink, but during this time, they can normally sip some water.

In advance, the person should talk to their doctor about:

  • any regular medications they are taking
  • any exercise regimes they follow
  • any other health conditions they may have

The doctor may give advice about how to take any regular medications during the time of fasting.

On the day

On the day, the healthcare provider will:

  • take a blood sample before the test begins
  • ask the person to consume a sugary drink containing glucose and water
  • take further blood samples every 30–60 minutes for a total of 2 hours

Results

The final result will indicate whether a person has or is at risk of developing diabetes:

  • Normal: Below 140 milligrams per deciliter (mg/dL)
  • Prediabetes: 140–199 mg/dL
  • Diabetes: 200 mg/dL or above

If the test result suggests prediabetes or diabetes, a doctor will discuss treatment options for addressing this.

Various factors can alter the accuracy of the test.

For reliable results, a person must:

  • have relatively stable health
  • be managing any other health conditions effectively

Some medications and other factors can lead to high blood glucose levels.

Sometimes, a person will do a different test or repeat the test, to confirm the results.

Glucose tolerance during pregnancy

The test for glucose tolerance may also assist in diagnosing gestational diabetes.

The person may take a two-part test:

Glucose screening test: Without fasting, the person has a blood test, then drinks a glucose drink and one hour later has another blood test. The doctor may prescribe a second test, the glucose tolerance test, if the result is 140 mg / dL.

Glucose tolerance test: The person will have a fasting blood test, then drink a glucose drink, and have 1, 2, and maybe 3 hours later, additional blood tests.

If the level of blood sugar is high and the person has not been diagnosed with diabetes before, it is possible that the doctor will diagnose gestational diabetes.

What is gestational diabetes?

Women may need to control their blood sugar levels during pregnancy on their own.
When the body is unable to produce all of the insulin it requires for pregnancy, gestational diabetes begins.

Low levels of insulin, combined with hormonal changes, can lead to resistance to insulin. When this happens, high levels of glucose build up in the blood.

This can lead to the following complications:

  • high blood glucose in the fetus and low levels after birth
  • difficulties during labor and the need for a cesarian delivery
  • a higher risk of vaginal tearing during the birth and bleeding after delivery
  • a risk of developing type 2 diabetes in the future

A glucose tolerance test is typically prescribed by doctors between weeks 24–28 of pregnancy. Earlier in the pregnancy, those with a higher risk may need a test.

Who is at risk?

Risk factors for gestational diabetes include:

  • having had gestational diabetes in an earlier pregnancy
  • a family history of diabetes
  • having obesity or other diabetes-related conditions
  • high blood pressure
  • being physically inactive
  • older age

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), if a person gains more weight than normal during pregnancy, this could be a sign of gestational diabetes.

A research released in 2015 states that 14% of pregnancies are affected by gestational diabetes every year.

Treatment

a Pregnant lady preparing low-sugar diet
Whether diabetes occurs during pregnancy or not, a healthful, low-sugar diet is essential.

If results suggest that blood sugar levels are high, the doctor may recommend the following:

  • following a healthful diet that is suitable for gestational diabetes
  • getting enough exercise
  • monitoring blood sugar levels
  • attending more frequent screening and seeking medical help if glucose levels go up
  • insulin use, in some cases

The healthcare professional will advise on the needs and treatment plan of each person, because diabetes affects everybody differently.

Risks and side effects

No side effects from glucose testing are encountered by most people, and severe complications are uncommon.

The glucose tolerance test could cause nausea, light-headedness, shortness of breath, and sweating in some individuals because it involves fasting and blood testing.

The doctor uses a needle to draw blood, so some can feel mild pain from the injection.

Risks that are more extreme but less frequent include:

  • excessive bleeding
  • fainting
  • blood collection under the skin
  • infection

Other diabetes tests

The glucose tolerance test is not the only method to diagnose diabetes. For diagnosis and monitoring of the condition, physicians use other tests.

Hemoglobin A1C

Average blood glucose over 2–3 months is assessed by this test. It indicates the percentage of blood sugar in the red blood cells that is attached to hemoglobin, the protein that carries oxygen. Normal levels are 5.6 percent or below, 5.7-6.4 percent indicates prediabetes, and diabetes is suggested by 6.5 percent and above.

Fasting plasma glucose

While a person is fasting, this test tests blood glucose levels. For at least 8 hours in advance, the person will not be able to eat or drink anything, except sips of water.

Glucose levels greater than or equal to 126 mg / dL indicate diabetes. The levels of prediabetes are 100-125 mg / dL, and the normal concentrations are below 100 mg / dL.

Random blood sugar test

At any time, and not just while fasting, a doctor takes a blood sample. This test may be done for people who have severe symptoms of diabetes. This means that diabetes is present if blood glucose levels are 200 mg / dL at any time.

People with diabetes should use a home test kit or continuous glucose monitor to monitor their blood glucose levels periodically.

Takeaway

A significant diagnostic method for diabetes identification is glucose tolerance testing. This can suggest diabetes if blood glucose levels are above 140 mm / dL.

For those with risk factors , such as obesity, previous gestational diabetes, or a family history of diabetes, Current guidelines recommend regular screening for individuals from the age of 45 years or younger.

Alzheimer's / Dementia

Uses of vitamin B-12 level test: Normal ranges, and results

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The amount of vitamin B-12 in the blood or urine is measured in a vitamin B-12 level test to determine the body’s overall vitamin B-12 reserves.

Vitamin B-12 is required for a variety of body functions, including neuron function, DNA and red blood cell formation.

Treatment is required if a person’s vitamin B-12 levels fall outside of the usual range. Vitamin B12 deficiency can cause neurological symptoms as well as fatigue, constipation, and weight loss. B-12 levels that are too high could indicate liver disease, diabetes, or another condition.

Continue reading to learn more about B-12 testing and what the results indicate.

Purpose of a vitamin B-12 level test

worried lady

The vitamin B-12 level test determines the amount of vitamin B-12 in your body. Doctors can use the data to see if low vitamin B-12 levels are causing symptoms.

If a person exhibits any of the following symptoms, a doctor may recommend a vitamin B-12 level test:

Vitamin B-12 insufficiency

Vitamin B-12 deficiency is thought to affect up to 15% of people in the United States, according to research. The following are signs and symptoms of a deficiency:

  • fast heartbeat
  • numbness and tingling in the hands and feet
  • poor memory
  • a sore mouth or tongue
  • confusion
  • dementia
  • depression
  • difficulty maintaining balance

Vitamin B-12 deficiency in infants can cause them to underachieve. They may have mobility issues in addition to developmental delays.

Pernicious anaemia

A vitamin B-12 level test may be required for people who have signs of low iron. Pernicious anaemia is caused by a lack of vitamin B-12 absorption, resulting in poor red blood cell causes.

It usually affects the elderly or people who are deficient in intrinsic factor. Intrinsic factor is a gastric material that binds to vitamin B-12 and allows it to be absorbed by the body.

The following are signs and symptoms of pernicious anaemia:

  • pale skin
  • weakness
  • weight loss
  • constipation
  • fatigue
  • loss of appetite

High levels of folate in the blood

The level of folic acid in the blood is known as serum folate. High levels of serum folate might disguise the signs and symptoms of vitamin B-12 deficiency, exacerbating the neurological symptoms.

They can also make you more susceptible to anaemia.

Symptoms of other illnesses

Vitamin B-12 levels that are unusually high can be a symptom of liver disease, diabetes, or certain types of leukaemia. The findings of a vitamin B-12 test may be used by a doctor to help them make a diagnosis.

Risk factors

Vitamin B-12 deficiency is more common in some people than in others, especially those with low stomach acid or other digestive problems. Stomach acid helps the body absorb vitamin B-12 more effectively by separating it from meals.

Low vitamin B-12 levels are more common in the following groups of people than in others:

  • people with conditions that reduce vitamin B-12 absorption, including celiac disease and Crohn’s disease
  • people who have had gastric bypass surgery
  • those who are breast-feeding
  • people who are taking medicines such as chloramphenicol, proton pump inhibitors, or H2 blockers
  • older adults
  • children
  • vegans and vegetarians
  • people with diabetes

How does the B-12 vitamin level test work?

Vitamin B-12 status is normally determined by a blood test, but home urine tests are now available. Vitamin B-12 levels can be checked as part of a routine blood test by a doctor.

Although fasting is not required before a B-12 test, it may be necessary if the doctor is utilising the test to check at other blood components.

It is important that patients inform their doctors about any medications or supplements they are taking, as some may have an impact on the outcome.

Acknowledging the results

The following are possible results:

  • Low. Vitamin B-12 levels below 200 pg/mL are considered low. This indicates that you may have a vitamin B-12 deficiency, pernicious anaemia, or an overactive thyroid. Neurological symptoms are common in people who have low vitamin B-12 levels.
  • High. Anything over 900 pg/mL is considered excessively high vitamin B-12 status. This result could indicate problems with the liver or kidneys, diabetes, or certain types of leukaemia.

Because the ranges of results differ from one laboratory to the next, it’s important to talk to a doctor about the results and what they signify.

To rule out vitamin B-12 deficiency, the doctor may measure levels of methylmalonic acid (MMA) and other chemicals. These lab results aid in the early detection of vitamin B-12 deficiency.

Vitamin B-12 deficiency treatment

Vitamin B-12 injections are frequently required by people who have low amounts of the vitamin. These shots are more successful at boosting vitamin B-12 levels than supplements, especially when people have medical issues that make supplements difficult to absorb.

High doses of vitamin B-12 supplements may help some people improve their B-12 status. Supplements are sold in the form of capsules or liquids in pharmacies, supermarkets, health food stores. It may also be beneficial to consume extra vitamin B-12-rich foods.

Treatment for high vitamin B-12 levels

There is no upper limit on vitamin B-12 consumption because high amounts do not cause problems. Having naturally high levels of vitamin B-12 in the body, on the other hand, could be cause for alarm, since it could indicate a serious underlying condition. Doctors will focus on treating the underlying medical condition rather than the vitamin B-12 levels.

Vitamin B-12  foods.

Eggs are rich in vitamin B-12.
Vitamin B-12 is abundant in eggs.

Although low vitamin B-12 levels are frequently caused by absorption problems and other medical conditions, some people may be deficient because they do not acquire enough vitamin B-12 through their food. This is especially true for vegans and vegetarians who have been vegetarian for a long time.

Vitamin B-12-rich foods include:

  • fortified plant-based dairy alternatives
  • fortified breakfast cereals
  • fortified nutritional yeast
  • fish and seafood
  • meat
  • eggs
  • dairy products

Vitamin supplements can help vegans and strict vegetarians make up for dietary deficiencies. Older persons should seek to achieve their vitamin B-12 needs through fortified meals and vitamin supplements, as supplements are simpler for their bodies to absorb than naturally occurring vitamin B-12.

Vitamin B-12 dietary recommendations

Vitamin B-12 is required in 2.4 micrograms (mcg) per day for adults and adolescents over the age of 14. During pregnancy, this rises to 2.6 mcg, and breast-feeding raises it to 2.8 mcg.

Conclusion

Vitamin B-12 is an essential nutrient that is necessary for good health. The status of a person’s vitamin B-12 is determined by a vitamin B-12 level test. This test may be recommended by a doctor to people who have symptoms of a deficiency or who are at risk of having low vitamin B-12 levels in their bodies.

Vitamin B-12 deficiency can be avoided by eating a well-balanced diet that includes many sources of the vitamin on a daily basis, or by taking supplements. If they have trouble absorbing vitamin B-12 from food, oral supplements or injections can help them avoid symptoms and consequences.

Sources:

  • https://academic.oup.com/qjmed/article/106/6/505/1538806
  • https://labtestsonline.org/tests/methylmalonic-acid
  • https://www.medicalnewstoday.com/articles/322286
  • https://academic.oup.com/nutritionreviews/article-abstract/71/2/110/1940320
  • https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  • https://www.hsph.harvard.edu/nutritionsource/b-12-deficiency/

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Diabetes

Symptoms, stages, causes, and treatment of diabetic nephropathy

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Diabetic nephropathy is a type of kidney disease that affects people who have diabetes for a long time. It happens when a person’s kidneys are damaged by high blood glucose levels.

Diabetic nephropathy is a type of chronic kidney disease caused by diabetes. The kidneys aid in the regulation of fluid and salt levels in the body, which is critical for blood pressure control and cardiovascular health.

When a person has diabetes, whether type 1 or type 2, or gestational diabetes, their bodies are unable to use or manufacture insulin properly. Gestational diabetes is a kind of diabetes that develops during pregnancy and increases the risk of developing type 2 diabetes later in life.

High blood sugar levels are a symptom of diabetes. High glucose levels can harm several parts of the body over time, including the cardiovascular system and the kidneys. Diabetic nephropathy is the term for the kidney damage that occurs as a result of diabetes.

Diabetic nephropathy is a leading cause of chronic kidney disease and end-stage renal disease in people with diabetes (ESRD). The kidneys in ESRD are no longer able to satisfy the demands of daily life. Kidney failure can occur as a result of ESRD, which can be life-threatening.

This page examines how diabetes affects the kidneys, as well as the treatment options and ways to prevent the risk.

Definition

alzheimer’s patients

Because nephropathy is caused by damage caused by high blood glucose levels, it can affect people with any kind of diabetes.

High blood glucose levels have an effect on the arteries in the body, and the kidneys filter the blood that passes through them.

According to the authors of a 2016 study, 20–40 percent of people with diabetes suffer renal disease.

A person’s tests may reveal one or both of the following:

High levels of albumin in the urine: When the kidneys are in good shape, the urine should include no albumin protein.

A low glomerular filtration rate (GFR): The kidneys’ primary role is to filter the blood. Their ability to do so is hampered by kidney disease. The kidneys should ideally function at 100% or have a GFR of 100Trusted Source. A doctor will not diagnose renal disease unless the GFR is 60 percent or higher. Kidney disease affects 15–60% of the population. Kidney failure is indicated by a percentage of less than 15%.

The end stage of renal disease is ESRD. In the United States, diabetic nephropathy is the most common cause of ESRD. Diabetes is responsible for 40–50% of all occurrences of ESRD, according to Trusted Source. Dialysis will be required if a person has ESRD.

Controlling blood sugar levels can help to lower the risk. Whether you have type 1 or type 2 diabetes, you can lower your risk of diabetic nephropathy by doing the following:

  • blood glucose levels should be monitored and kept within the target range
  • consuming a nutritious, low-sugar, low-salt diet
  • exercising on a regular basis
  • adhering to a treatment plan that may include the use of insulin or other drugs
  • keeping a healthy weight is important.

What is chronic kidney disease? Find out more here.

Causes

Kidney damage puts a strain on these critical organs, preventing them from functioning normally.

When this occurs:

  • the kidneys cannot maintain healthy fluid levels in the body
  • the kidneys cannot remove waste products from the blood
  • the body starts to lose protein through the urine

Diabetic nephropathy takes time to develop. According to one study, 15 years after a diabetes diagnosis, a third of people have high levels of albumin in their urine. Only about half of these people will acquire complete nephritis.

Kidney disease is uncommon in people who have had diabetes for less than ten years, according to statistics. Also, if a person does not get nephropathy 20–25 years after diabetes begins, they have a low probability of developing it later.

Diabetic nephropathy is less likely if a diabetic’s blood glucose levels are well controlled.

Because of the damage to blood vessels, high blood glucose levels raise the risk of high blood pressure. Hypertension, or high blood pressure, can aggravate kidney disease.

Other potential dangers

Other aspects to consider are:

Smoking: A relationship between smoking and increased levels of inflammation may cause kidney injury. While the exact link between smoking and diabetes is unknown, people appear to have a higher risk of diabetes, as well as hypertension and kidney disease.

Age: Kidney disease, particularly a low GFR, is more common in people over the age of 65.

Sex: The condition is more common in men than in women.

Ethnicity, race, or both: African Americans, Native Americans, and Asian Americans are more likely to have it.

Conditions of health: Obesity, chronic inflammation, high blood pressure, insulin resistance, and high blood lipids (fats) are all risk factors for kidney disease.

Some of these risks are or appear to be contributing factors to diabetes or complications.

Diabetic nephropathy is distinct from diabetic neuropathy, a condition that affects the nerve system.

Stages and symptoms

A person with diabetic nephropathy may not experience any symptoms in the early stages. Changes in blood pressure and fluid balance in the body, on the other hand, may already be evident. Waste materials can accumulate in the blood over time, causing symptoms.

Stages

Depending on the GFR, which also measures the proportion of functional kidney function, a clinician may divide renal disease into phases.

Stage 1: Kidney damage is present, but kidney function is normal and the GFR is 90 percent or higher.

Stage 2: Kidney impairment, with some function loss and a GFR of 60–89%.

Stage 3: Mild to severe function loss, with a GFR of 30–59%.

Stage 4: Severe impairment of function with a GFR of 15–29%.

Stage 5: Kidney failure with a GFR of less than 15%.

Symptoms

A person may not detect any symptoms in the early stages. They may feel sick and exhibit the following symptoms at stage 4 or 5:

  • fatigue due to lack of oxygen in the blood
  • nausea or vomiting
  • a metallic taste in the mouth
  • swollen ankles, feet, lower legs, or hands due to water retention
  • darker urine due to blood in the urine
  • shortness of breath

Cardiovascular disease is a complication of late-stage renal disease.

Following a diabetic treatment plan and getting frequent health checks can help a person with diabetes maintain their blood sugar levels, lower their risk of kidney problems, and detect problems early.

A urine test is used to check for proteins in the urine during screening. Protein in the urine, on the other hand, does not always indicate kidney disease; it could also be the result of a urinary tract infection.

Treatment

Diabetic nephropathy can be delayed or prevented with early treatment.

The major goal of treatment is to keep blood glucose and blood pressure under control. This may entail the administration of drugs.

Drug treatment

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can help to control blood pressure, protect renal function, and avoid future damage.

In individuals with CKD associated with type 2 diabetes, Kerendia (finerenone) is a prescription drug that can minimize the risk of persistent GFR decline, end-stage renal disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure.

In addition, because people with kidney disease generally have low vitamin D levels, a doctor may give vitamin D or a statin to lower cholesterol levels.

For people with type 2 diabetes and CKD, the American College of Cardiology issued guidelines in 2018 supporting the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RAs). These medications may lower the risk of CKD progression, heart attacks, or both.

Dietary changes

If you have kidney disease, your doctor may advise you to track the following nutrients:

Water: Although necessary, drinking too much water or fluid can lead to edema and high blood pressure.

Sodium: Because it is a salt component, it might elevate blood pressure.

Protein: Protein can cause waste to build up in the blood, putting extra strain on the kidneys in people who have kidney disease.

Phosphorus: This can be found in a variety of protein and dairy sources. Phosphorus overload can weaken bones and put strain on the kidneys.

Potassium: Potassium levels in people with kidney disease can be greater than they should be, which can harm nerve cells.

Keeping blood sugar levels in check

This is critical for reducing the risk of diabetes complications such as renal disease, cardiovascular disease, and diabetic neuropathy, a nerve system disorder.

These disorders can also lead to additional difficulties. Blood sugar control can also help prevent these problems from arising.

Late-stage treatment options

Diabetic nephropathy can proceed to end-stage renal disease (ESRD), which necessitates dialysis or a kidney transplant. They will very certainly require dialysis for the remainder of their lives or until a kidney donation becomes available.

Dialysis

Kidney dialysis is a process that separates waste items from the blood and removes them from the body using a machine. Dialysis is used to replace a healthy kidney.

Dialysis comes in a variety of forms:

Hemodialysis: Blood is drawn from the body by a needle in the forearm and transported to a dialysis machine via a tube. The blood is filtered outside the body by the machine, then returned through a tube and needle.

Depending on the choice selected, a person may need to do this three to seven times a week and spend two to ten hours per session.

Dialysis can be done at a dialysis facility or at home, and in some cases, overnight alternatives are available. People are increasingly able to incorporate dialysis into their work and personal routines because to flexible choices.

Peritoneal dialysis: The peritoneum, or lining of the abdomen, is used to filter blood inside the body.

  • Dialysis fluid enters the abdomen by a catheter in continuous ambulatory peritoneal dialysis (CAPD). Before draining out, the fluid lingers inside for several hours, filtering waste materials. It takes 30–40 minutes to drain.
  • Continuous cycler-assisted peritoneal dialysis (CCPD), also known as automated peritoneal dialysis, involves a person sleeping linked to a dialysis machine for 8–10 hours. The fluid drainage is controlled by the machine.

Peritoneal dialysis can be done at home, at work, or while traveling. It provides flexibility and gives the individual some control over their condition. If a person is going to travel, for example, they will need to learn how to operate the essential equipment and make sure they have all of the necessary materials.

Kidney transplant

If diabetic nephropathy has progressed to the point where a kidney transplant is necessary and a qualified donor is available, a doctor may propose it. It may take some time to find a donor.

Because a person can live with only one functioning kidney, some people offer to donate a kidney to a loved one.

The individual who receives the kidney, on the other hand, may find that their body rejects the new organ. The body has the best chance of accepting a kidney donation from a family member.

To lessen the risk of the new kidney being rejected by the body, the individual who has had a kidney transplant will need to take medicine. This can have some negative consequences, such as raising the risk of infection.

Financial help

Many people can get financial assistance. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Medicare and Medicaid normally cover kidney failure treatment.

If all of the following apply, a person can acquire Medicare for ESRD at any age:

  • Their kidneys are no longer functional.
  • They require dialysis on a regular basis or have had a kidney transplant.
  • They have worked for Social Security, the Railroad Retirement Board, or as a government employee for the required amount of time.
  • They are receiving Social Security or Railroad Retirement payments or are eligible for them.
  • They are the dependent kid or spouse of someone who fits one of the aforementioned criteria.

The individual should discuss their options with their insurance provider or their doctor.

Prevention

Controlling blood sugar and blood pressure is the greatest strategy for someone with diabetes to lower their risk of diabetic nephropathy.

This can be aided by making the following lifestyle changes:

  • checking blood glucose levels regularly
  • following any treatment plan their doctor suggests
  • limiting stress where possible
  • eating a nutritious diet that is high in fiber and low in sugar, processed carbohydrates, and salt
  • exercising regularly
  • limiting alcohol intake
  • avoiding tobacco

Learning as much as possible about diabetes and related consequences, such as kidney disease, can make a person feel more confident and in charge of their condition and prevention options.

The National Kidney Disease Education Program of the National Institute of Diabetes and Digestive and Kidney Diseases provides a downloadable record of test results that can assist a person maintain track of their kidney testing and development.

Outlook

The outlook for diabetic nephropathy people will be determined by how well they manage their blood sugar and blood pressure levels, as well as the stage at which they are diagnosed. The sooner therapy begins, the better the outlook.

Diabetic nephropathy can be slowed or stopped with treatment. People with diabetes should have their blood pressure checked as recommended by their doctor and take precautions to prevent kidney disease from worsening.

Sources:

  • https://www.nejm.org/doi/full/10.1056/NEJMoa2025845
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment
  • https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/eating-right
  • https://www.kidney.org/atoz/content/gfr
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297507/
  • https://www.medicalnewstoday.com/articles/319686
  • https://www.ahajournals.org/doi/10.1161/JAHA.116.003280
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/kidney-transplant
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206379/
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis
  • https://www.medicare.gov/information-for-my-situation/signing-up-for-medicare-if-you-have-esrd
  • https://www.jwatch.org/fw114803/2018/11/27/sglt2-inhibitors-glp-1ras-recommended-type-2-diabetes-and

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Blood / Hematology

Exercise-induced hypoglycemia: Things to know

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The medical name for low blood sugar during or after exercise is exercise-induced hypoglycemia (EIH). The condition can cause itself in a variety of ways, including weakness, shakiness, and extreme exhaustion.

The body’s major source of energy is glucose. The body requires more energy during activity and hence uses more glucose. EIH is caused by an increase in the desire for glucose. Other factors could also be at play.

The symptoms, causes, treatment, and prevention of EIH are all covered in this article. It also covers if EIH is an indication of diabetes and when EIH should be treated.

When to ask assistance

If blood glucose levels go too low, hypoglycemia can be fatal. If you have one or more of the following symptoms, you should get medical help right away:

  • loss of consciousness
  • confusion
  • symptoms that persist despite resting or consuming more food
  • seizure

If people commonly develop EIH or hypoglycemia at other times, they should see a doctor. If the person has diabetes, this could indicate that they are taking too much insulin or that their diabetes medicine dosage is inaccurate.

What is EIH?

Exercise-induced hypoglycemia

Hypoglycemia is a condition in which the blood glucose level is insufficient to supply the body’s energy requirements. Hypoglycemia is defined as a blood glucose level of less than 70 milligrams per deciliter (mg/dl) according to doctors. Most people, however, do not experience hypoglycemia symptoms until their blood glucose levels fall below 55 mg/dl.

Carbohydrates are broken down into glucose by the body. The glucose then enters the bloodstream, prompting the pancreas to produce insulin in response. Insulin aids glucose entry into the body’s cells, allowing it to be used as fuel.

Because active muscles require more fuel, exercise raises glucose demand. Exercise may also make a person more insulin sensitive, which means the insulin works more efficiently and lowers blood glucose levels faster. These factors, when combined, can cause in EIH.

If a person has the following characteristics, they are more prone to develop EIH:

  • have insulin sensitivity or take insulin
  • already have low blood glucose, such as from hunger or from diabetes medication
  • do an intense workout that demands more energy

Symptoms of EIH

Glucose fuels the majority of major bodily activities. As a result, EIH symptoms can vary. The following are some probable signs and symptoms:

  • weakness
  • confusion
  • anxiety
  • fainting
  • shaking
  • dizziness

Hypoglycemia that lasts for a long time or is severe might be fatal. It could result in the following:

Causes

Exercise increases the body’s energy demands, causing it to respond by burning more glucose. People with low glucose levels or those whose bodies metabolize glucose quickly can develop hypoglycemia.

EIH can be caused by a number of reasons, including:

  • exercising immediately after a meal
  • being sick
  • drinking too much alcohol without food
  • using insulin or other diabetes medications
  • not eating enough, or fasting
  • not consuming enough carbohydrates

Exercise causes a significant increase in insulin, which eliminates glucose from the blood, in certain people. Even if a person is well-nourished and does not take blood glucose-lowering drugs, this rise might cause hypoglycemia.

If a person has persistent EIH, a doctor may prescribe medicine to help them recover. Most people, however, can solve the problem by making proper lifestyle modifications.

Is EIH a sign of diabetes?

EIH is not always a symptom of diabetes. Exercise by itself can significantly lower blood glucose levels. People with diabetes, on the other hand, have increased risk factors for hypoglycemia.

Hyperglycemia, or high blood glucose, is a complication of untreated diabetes. If people who take diabetes drugs take more than they need, they are more likely to develop hypoglycemia. It’s also possible that you’re not getting enough nourishment to match your exercise level.

Also, if people with diabetes take diabetic medicine while fasting or commencing a restrictive diet, they may develop hypoglycemia.

Treatment for EIH

Mild EIH normally does not necessitate therapy. In many cases, the condition arises as a result of a person not eating enough food before exercising. Individuals should consume a carbohydrate-rich meal 1–2 hours before a workout to avoid EIH.

Chronic EIH might occasionally indicate a problem with insulin manufacturing. A doctor may administer diazoxide to treat low blood sugar in people who have chronic EIH.

A doctor may consider removing a portion of the pancreas to reduce insulin production in rare circumstances.

Prevention in people with diabetes

People who take diabetic drugs to control their blood glucose levels should check their blood glucose levels before exercising, according to the American Diabetes Association (ADA). If their blood glucose level is below 100 mg/dl, they should consume 15–20 grams (g) of carbs to raise it.

Among the possibilities are:

  • 4 glucose tablets
  • 1 glucose gel tube
  • 1 tablespoon of honey or sugar
  • 4 ounces (oz) of soda or juice

The American Diabetes Association recommends that a person recheck their blood glucose after 15 minutes. If the blood sugar level stays below 100 mg/dl, they should eat another 15 g carbohydrate portion. They should do this every 15 minutes until their blood glucose level reaches at least 100 mg/dl.

Anaerobic exercise, such as high intensity interval training (HIIT), may reduce the incidence of hypoglycemia in people with diabetes, according to a 2019 review. Short bursts of intensive activity are followed by a rest and then another brief burst of intense activity in HIIT.

Prevention in people without diabetes

People without diabetes can usually avoid EIH by doing the following:

  • avoiding drinking alcohol before a workout
  • eating regular meals throughout the day
  • gradually building up to new exercise routines to give the body time to adapt

Stop and take a break if you start to feel unsteady or dizzy throughout your workout. They should drink 4 oz (113 g) of juice or eat a slice of toast before continuing their workout.

Conclusion

Hypoglycemia occurs when blood glucose levels fall too low to meet a person’s body’s energy needs. Hypoglycemia that happens during or after exercise is known as EIH. The condition can affect both people and non-diabetics.

Diabetes patients are more likely to develop EIH, especially if they use insulin or other blood glucose-controlling drugs. In such circumstances, a person should consult a doctor to see whether their drug amounts can be adjusted.

EIH is most commonly caused by not eating enough before exercising or not giving the body enough time to acclimatize to a new exercise schedule in people who do not have diabetes. If a person continues to have regular EIH despite following the necessary precautions, they should seek medical advice to establish the underlying cause.

Sources:

  • https://www.diabetes.org/healthy-living/fitness/getting-started-safely/blood-glucose-and-exercise
  • https://www.frontiersin.org/articles/10.3389/fendo.2019.00326/full
  • https://drc.bmj.com/content/6/1/e000578.abstract
  • https://www.medicalnewstoday.com/articles/exercise-induced-hypoglycemia-what-to-know
  • https://www.cdc.gov/diabetes/basics/insulin-resistance.html
  • https://www.ncbi.nlm.nih.gov/books/NBK534841/
  • https://www.hormone.org/diseases-and-conditions/diabetes/non-diabetic-hypoglycemia
  • https://www.frontiersin.org/articles/10.3389/fendo.2020.00578/full

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