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Blood sugar

You have indicated that your Random Blood Glucose Level is 468. Your blood sugar level is extremely high. Please repeat the test as soon as possible. If the value is similar, then you should consult your doctor immediately as the test indicates that you may have diabetes. You can control the blood sugar level by following a well-planned diet and regular exercise.

Result - Blood Sugar Chart | Medindia The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. The body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis. Glucose is the primary source of energy for the body's cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. (There are exceptions. For example, because their dietary metabolizable carbohydrates tend to be used by rumen organisms,[2] ruminants tend to be continuously gluconeogenic;[3] consequently their hepatocytes must rely on such primary energy sources as volatile fatty acids, absorbed from the rumen, rather than glucose.) Glucose is transported from the intestines or liver to body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas. The mean normal blood glucose level in humans is about 5.5 mM (5.5 mmol/L or 100 mg/dL, i.e. milligrams/deciliter);[4] however, this level fluctuates throughout the day. Glucose levels are usually lowest in the morning, before the first meal of the day (termed "the fasting level"), and rise after meals for an hour or two by a few millimolar. The normal blood glucose level (tested while fasting) for non-diabetics, should be between 70 and 100 milligrams per deciliter (mg/dL). Blood sugar levels for those without diabetes and who are not fasting should be below 125 mg/dL. [5] The blood glucose target range for diabetics, according to the American Diabetes Association, should be 70130 (mg/dL) before meals and less than 180 mg/dL after meals (as measured by a blood glucose monitor).[6] Blood sugar levels outside the normal range may be an indicator of a medical condition. A persistently high level is referred to as hyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. Intake of alcohol causes an initial surge in blood sugar, and later tends to cause levels to fall. Also, certain drugs can increase or decrease glucose levels.[7]

The international standard way of measuring blood glucose levels are in terms of a molar concentration, measured in mmol/L (millimoles per litre; or millimolar, abbreviated mM). In the United States, mass concentration is measured in mg/dL (milligrams per decilitre).[8] Since the molecular weight of glucose C6H12O6 is about 180 g/mol, for the measurement of glucose, the difference between the two scales is a factor of 18, so that 1 mmol/L of glucose is equivalent to 18 mg/dL.[4]

Normal values in humans[edit]

Normal value ranges may vary slightly among different laboratories. Reference Values are: 1mmol/L = 18mg/dL (Merck Manual) Many factors affect a person's blood sugar level. A body's homeostatic mechanism, when operating normally, restores the blood sugar level to a narrow range of about 4.4 to 6.1 mmol/L (79.2 to 110 mg/dL) (as measured by a fasting blood glucose test).[9] Healthy non-diabetic values are also stated to be 83-85 mg/dL to avoid complications of chronic hyperglycemia (Bernstein, R.K. 2011. Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal) Blood Sugars. Despite widely variable intervals between meals or the occasional consumption of meals with a substantial carbohydrate load, human blood glucose levels tend to remain within the normal range. However, shortly after eating, the blood glucose level may rise, in non-diabetics, temporarily up to 7.8 mmol/L (140 mg/dL) or a bit more. The American Diabetes Association recommends a post-meal glucose level of less than 10 mmol/L (180 mg/dL) and fasting plasma glucose of 5 to 7.2 mmol/L (90130 mg/dL).[10] The actual amount of glucose in the blood and body fluids is very small. In a healthy adult male of 75 kg with a blood volume of 5 liters, a blood glucose level of 5.5 mmol/L (100 mg/dL) amounts to 5 grams, slightly less than two typical American restaurant sugar packets for coffee or tea.[11] Part of the reason why this amount is so small is that, to maintain an influx of glucose into cells, enzymes modify glucose by adding phosphate or other groups to it.

In general, ranges of blood sugar in common domestic ruminants are lower than in many monogastric mammals.[12] However this generalization does not extend to wild ruminants or camelids. For serum glucose in mg/dL, reference ranges of 42 to 75 for cows, 44 to 81 for sheep, and 48 to 76 for goats, but 61 to 124 for cats; 62 to 108 for dogs, 62 to 114 for horses, 66 to 116 for pigs, 75 to 155 for rabbits, and 90 to 140 for llamas have been reported.[13] A 90 percent reference interval for serum glucose of 26 to 181 mg/dL has been reported for captured mountain goats (Oreamnos americanus), where no effects of the pursuit and capture on measured levels were evident.[14] For beluga whales, the 2575 percent range for serum glucose has been estimated to be 94 to 115 mg/dL.[15] For the white rhinoceros, one study has indicated that the 95 percent range is 28 to 140 mg/dL.[16] For harp seals, a serum glucose range of 4.9 to 12.1 mmol/L [i.e. 88 to 218 mg/dL] has been reported; for hooded seals, a range of 7.5 to 15.7 mmol/L [i.e. about 135 to 283 mg/dL] has been reported.[17]

Main article: Blood sugar regulation The body's homeostatic mechanism keeps blood glucose levels within a narrow range. It is composed of several interacting systems, of which hormone regulation is the most important. There are two types of mutually antagonistic metabolic hormones affecting blood glucose levels:

catabolic hormones (such as glucagon, cortisol and catecholamines) which increase blood glucose; and one anabolic hormone (insulin), which decreases blood glucose.

Abnormality in blood sugar levels[edit]

High blood sugar[edit]
Main article: hyperglycemia If blood sugar levels remain too high the body suppresses appetite over the short term. Long-term hyperglycemia causes many of the long-term health problems including heart disease, eye, kidney, and nerve damage. The most common cause of hyperglycemia is diabetes. When diabetes is the cause, physicians typically recommend an anti-diabetic medication as treatment. From the perspective the majority of patients, treatment with an old, well-understood diabetes drug such as metformin will be the safest, most effective, least expensive, most comfortable route to managing the condition.[18] Diet changes and exercise implementation may also be part of a treatment plan for diabetes.

Low blood sugar[edit]

Main article: hypoglycemia If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia develops. Symptoms may include lethargy, impaired mental functioning; irritability; shaking, twitching, weakness in arm and leg muscles; pale complexion; sweating; paranoid or aggressive mentality and loss of consciousness.

Mechanisms that restore satisfactory blood glucose levels after extreme hypoglycemia (below 40 mg/dl) must be quick and effective to prevent extremely serious consequences of insufficient glucose: confusion or unsteadiness and, in the extreme (below 15 mg/dl) loss of consciousness and seizures. It is far more dangerous to have too little glucose in the blood than too much, at least temporarily. In healthy individuals, blood glucose-regulating mechanisms are generally quite effective, and symptomatic hypoglycemia is generally found only in diabetics using insulin or other pharmacological treatment [dubious discuss]. Hypoglycemic episodes can vary greatly between persons and from time to time, both in severity and swiftness of onset. For severe cases, prompt medical assistance is essential, as damage to brain and other tissues and even death will result from sufficiently low blood-glucose levels.

Glucose measurement[edit]
Further information: Blood glucose monitoring and Glucose meter

Sample type
Glucose is measured in whole blood, plasma or serum. Historically, blood glucose values were given in terms of whole blood, but most laboratories now measure and report the serum glucose levels. Because red blood cells (erythrocytes) have a higher concentration of protein (e.g., hemoglobin) than serum, serum has a higher water content and consequently more dissolved glucose than does whole blood. To convert from whole-blood glucose, multiplication by 1.15 has been shown to generally give the serum/plasma level. Collection of blood in clot tubes for serum chemistry analysis permits the metabolism of glucose in the sample by blood cells until separated by centrifugation. Red blood cells, for instance, do not require insulin to intake glucose from the blood. Higher than normal amounts of white or red blood cell counts can lead to excessive glycolysis in the sample, with substantial reduction of glucose level if the sample is not processed quickly. Ambient temperature at which the blood sample is kept prior to centrifuging and separation of plasma/serum also affects glucose levels. At refrigerator temperatures, glucose remains relatively stable for several hours in a blood sample. Loss of glucose can be prevented by using Fluoride tubes (i.e., gray-top) since fluoride inhibits glycolysis. However, these should only be used when blood will be transported from one hospital laboratory to another for glucose measurement. Red-top serum separator tubes also preserve glucose in samples after being centrifuged isolating the serum from cells. To prevent contamination of the sample with intravenous fluids, particular care should be given to drawing blood samples from the arm opposite the one in which an intravenous line is inserted. Alternatively, blood can be drawn from the same arm with an IV line after the IV has been turned off for at least 5 minutes, and the arm has been elevated to drain infused fluids away from the vein. Inattention can lead to large errors, since as little as 10% contamination with a 5% glucose solution (D5W) will elevate glucose in a sample by 500 mg/dL or more. Remember that the actual concentration of glucose in blood is very low, even in the hyperglycemic. Arterial, capillary and venous blood have comparable glucose levels in a fasting individual. Following meals, venous levels are somewhat lower than those in capillary or arterial blood; a common estimate is about 10%.

Measurement techniques [edit]

Two major methods have been used to measure glucose. The first, still in use in some places, is a chemical method exploiting the nonspecific reducing property of glucose in a reaction with an indicator substance that changes color when reduced. Since other blood compounds also have reducing properties (e.g., urea, which can be abnormally high in uremic patients), this technique can produce erroneous readings in some situations

(5 to 15 mg/dL has been reported). The more recent technique, using enzymes specific to glucose, is less susceptible to this kind of error. The two most common employed enzymes are glucose oxidase and hexokinase. In either case, the chemical system is commonly contained on a test strip which is inserted into a meter, and then has a blood sample applied. Test-strip shapes and their exact chemical composition vary between meter systems and cannot be interchanged. Formerly, some test strips were read (after timing and wiping away the blood sample) by visual comparison against a color chart printed on the vial label. Strips of this type are still used for urine glucose readings, but for blood glucose levels they are obsolete. Their error rates were, in any case, much higher. Urine glucose readings, however taken, are much less useful. In properly functioning kidneys, glucose does not appear in urine until the renal threshold for glucose has been exceeded. This is substantially above any normal glucose level, and is evidence of an existing severe hyperglycemic condition. However, as urine is stored in the bladder, any glucose in it might have been produced at any time since the last time the bladder was emptied. Since metabolic conditions change rapidly, as a result of any of several factors, this is delayed news and gives no warning of a developing condition. Blood glucose monitoring is far preferable, both clinically and for home monitoring by patients. Healthy urine glucose levels were first standardized and published in 1965 [19] by Hans Renschler. I. CHEMICAL METHODS A. Oxidation-reduction reaction

1. Alkaline copper reduction Folin-Wu method Benedict's method NelsonSomogyi method Neocuproi ne method ShaefferHartmannSomogyi

Blue endproduct Modification of Folin-Wu method for qualitative urine glucose

Blue endproduct Yellow-orange color neocuproine[20]

* Uses the principle of iodine reaction with cuprous byproduct. Excess I2 is then titrated with thiosulfate. 2. Alkaline Ferricyanide Reduction


Colorless end product; other reducing substances interfere with reaction

B. Condensation Orthotoluidine method Anthrone (phenols) method

Uses aromatic amines and hot acetic acid Forms Glycosylamine and Schiff's base which is emerald green in color This is the most specific method, but the reagent used is toxic

Forms hydroxymethyl furfural in hot acetic acid

II. ENZYMATIC METHODS A. Glucose oxidase

Saifer Gerstenfel d method

Inhibited by reducing substances like BUA, bilirubin, glutathione, ascorbic acid

Trinder method

uses 4-aminophenazone oxidatively coupled with phenol Subject to less interference by increases serum levels of creatinine, uric acid or hemoglobin Inhibited by catalase A dry chemistry method Uses reflectance spectrophotometry to measure the intensity of color through a lower transparent film Home monitoring blood glucose assay method Uses a strip impregnated with a glucose oxidase reagent B. Hexokinase

Kodak Ektachem

Glucomete r

NADP as cofactor NADPH (reduced product) is measured in 340 nm More specific than glucose oxidase method due to G-6PO4, which inhibits interfering substances except when sample is hemolyzed

Blood glucose laboratory tests

1. 2. 3. 4. 5. 6. 7. 8.

fasting blood sugar (i.e., glucose) test (FBS) urine glucose test two-hr postprandial blood sugar test (2-h PPBS) oral glucose tolerance test (OGTT) intravenous glucose tolerance test (IVGTT) glycosylated hemoglobin (HbA1C) self-monitoring of glucose level via patient testing Random blood sugar (RBS)

Clinical correlation[edit]
The fasting blood glucose level, which is measured after a fast of 8 hours, is the most commonly used indication of overall glucose homeostasis, largely because disturbing events such as food intake are avoided. Conditions affecting glucose levels are shown in the table below. Abnormalities in these test results are due to problems in the multiple control mechanism of glucose regulation. The metabolic response to a carbohydrate challenge is conveniently assessed by a postprandial glucose level drawn 2 hours after a meal or a glucose load. In addition, the glucose tolerance test, consisting of several timed measurements after a standardized amount of oral glucose intake, is used to aid in the diagnosis of diabetes. Error rates for blood glucose measurements systems vary, depending on laboratories, and on the methods used. Colorimetry techniques can be biased by color changes in test strips (from airborne or finger borne contamination, perhaps) or interference (e.g., tinting contaminants) with light source or the light sensor. Electrical techniques are less susceptible to these errors, though not to others. In home use, the most important issue is not accuracy, but trend. Thus if a meter / test strip system is consistently wrong by 10%, there will be little consequence, as long as changes (e.g., due to exercise or medication adjustments) are properly tracked. In the US, home use blood test meters must be approved by the Federal Food and Drug Administration before they can be sold. Finally, there are several influences on blood glucose level aside from food intake. Infection, for instance, tends to change blood glucose levels, as does stress either physical or psychological. Exercise, especially if prolonged or long after the most recent meal, will have an effect as well. In the normal person, maintenance of blood glucose at near constant levels will nevertheless be quite effective.[clarification needed] Causes of abnormal glucose levels Transient Persistent hypoglycemia hyperglycemia Reference range, FBG: 70110 mg/dL Pheochromocytoma Insulinoma Adrenal cortical Severe liver disease insufficiency Addison's disease Acute stress reaction Hypopituitarism Shock Convulsions

Persistent hyperglycemia

Transient hypoglycemia Acute alcohol ingestion Drugs: salicylates, antituberculosis agents

Diabetes mellitus Adrenal cortical hyperactivity Cushing's syndrome Hyperthyroidism Acromegaly Obesity

Severe liver disease Several glycogen storage Galactosemia diseases Ectopic insulin production Hereditary fructose from tumors intolerance

Etymology and use of term[edit]

In a physiological context, the term is a misnomer because it refers to glucose, yet other sugars besides glucose are always present. Food contains several different types (e.g., fructose (largely from fruits/table sugar/industrial sweeteners), galactose (milk and dairy products), as well as several food additives such as sorbitol, xylose, maltose, etc.). But because these other sugars are largely inert with regard to the metabolic control system (i.e., that controlled by insulin secretion), since glucose is the dominant controlling signal for metabolic regulation, the term has gained currency, and is used by medical staff and lay folk alike. The table above reflects some of the more technical and closely defined terms used in the medical field.

Diabetes and Diet

Essentials of a Diabetic Diet The diabetic diet has to be used wisely in combination with insulin doses or with oral hypoglycemic drugs. The main objective of diabetic diet is to maintain the ideal body weight, by providing adequate nutrition and also regulating the blood sugar levels within the normal range. The diet plan for a diabetic is based on the bodys BMI, age, sex, physical activity and type of diabetes. While planning the diet certain complications such as high blood pressure, high cholesterol levels are taken into consideration. Based on the above criteria the dietician will assess the total daily calorie intake.

As such there is no common diabetic diet plan that will work for everyone. Nor is there any particular diet plan that works perfectly for a diabetic for a long duration. Changes have to be made periodically depending on various aspects

While planning the diet for a diabetic we should consider certain important factors, like: Fiber intake should at least be 40 gm/day (1.4 oz / day) Small frequent meals (5 to 6) are to be planned. Whole grain and high fibre foods should be encouraged over refined foods, sweets and fried foods and bakery products,. Carbohydrates should be avoided 2 hours before bedtime. More of fresh fruit and vegetables should be eaten A diabetic should have food that is high in nutrition and low in calories. The 1800 calorie diabetic diet plan is helpful to people with diabetes mellitus. During the entire day, the total calorie intake should be 1500-1800 calories 60% carbohydrate, 20% fat and 20% proteins. If you are on calorie-restricted diet, make sure to take 50-60% of calories as complex carbohydrate (whole cereals). Glucose is a sugar released from carbohydrates so, in order to control the blood sugar levels the consumption of simple carbohydrates should be limited.Also with consumption of simple carbs there is sudden rise in the insulin levels. Immediate peaking of insulin, over a period of time leads to increase in fat mass and other long standing disease conditions. As whole grains, fruits and vegetables are in rich in fibre, a diabetic diet should majorly comprise of above

food groups. Diabetes and Exercise

The exercise program should be aimed at achieving and maintaining a healthy weight. Accordingly, one should target an energy expenditure of 700-2000 calories per week through the various exercises that they may choose. Aerobic exercise, involving large muscle groups, for 30 minutes a day is beneficial, while resistance exercises (weights, elastic resistance bands, or strength training machines) can be an option for people with low cardiac risk. Before commencing any physical activity the following parameters need to be given consideration: Intensity of exercise: How intense should the physical activity be? This generally depends on the tolerance of an individual. Frequency of exercise: How many days in a week should an individual exercise? Generally, 5 days in a week is preferred, unless one needs to lose weight, in which case it should be more. Exercise done for a short duration must be done more often. For example, one can take three brisk 10-minute walks, one shortly after each meal. Since keeping blood glucose within the target range is the aim, the duration between two exercise sessions should be less than 3 days. Diabetics on insulin should be regular with exercise since the blood glucose levels can increase on the days exercise is not performed. Duration of exercise: This refers to how long an individual exercise session should last. This is normally related to the intensity of the exercise. High intensity exercises should be of shorter duration and vice versa. It is not advisable for an individual to indulge in long exercise sessions as blood glucose levels may fall below the desired range. Timing of exercise: When should exercise be done? The health care team and the patient together usually should decide this aspect and this depends on the individual's daily routine. However, exercising immediately after major meals (breakfast, lunch, and dinner) should be avoided. Exercising during peak insulin action (for those on insulin) is not recommended. This depends on the type of insulin being used and hence it is best to check with the doctor.

Diabetes - Type 1, Type 2 Diabetes - Causes, Symptoms, Diagnosis & Treatment of Diabetes All of us know someone suffering from diabetes. This sums up the prevalence of diabetes. It is, apart from being one of the most prevalent diseases in the world, also a disease that opens up a Pandora's box of many complications. No wonder it is a dreaded disease and people who are diabetic end up getting other medical problems as well. Diabetes is a group of diseases with one thing in common - a problem with insulin. The problem could be that your body doesn't make any insulin, doesn't make enough insulin or doesn't use insulin properly.

"Diabetes is a wonderful affection, not very frequent among men, being a melting down of the flesh and limbs into urine. The patients never stop making water, but the flow is incessant, as if from the opening of acqueducts. The nature of the disease, then, is chronic, and it takes a long period to form; but the patient is short-lived, if the constitution of the disease be completely established; for the melting is rapid, the death speedy." -

The pancreas, which is an organ present in the abdominal cavity of the body, secretes this hormone insulin. This hormone is the key to the way your body processes food because it helps maintain the proper level of a sugar (glucose) in your blood. Glucose is your body's fuel. Cells use glucose to produce energy to grow and function. Glucose is escorted by insulin through your bloodstream and insulin helps in unlocking cells to allow glucose to enter. In diabetes, lack of insulin or the resistance of your cells to insulin prevents the right amount of glucose from entering your cells. The unused glucose builds up in your blood, a condition called hyperglycemia. The disease occurs in two types: Type 1 diabetes: This is the type of diabetes that generally affects young people and requires treatment with insulin. Type 2 diabetes: This type of diabetes generally develops after age 40. Diabetes can develop gradually, often without symptoms, over many years. It may reveal itself too late to prevent damage. In fact, you may first learn you have diabetes when you develop one of its common complications - heart disease, kidney disease or vision problems. Today, better methods of diabetes control, new medications and easier ways to take insulin enable most people who develop type 1 or 2 diabetes to live a long and healthy life.

Frequently asked questions about Diabetes How to identify gestational diabetes? Several symptoms are associated with the disease and they may vary from patient to patient. Increased thirst and urination, weight loss despite of increased appetite, frequent infections including bladder, vaginal, and skin are among the symptoms. How insulin helps diabetes? Insulin lowers blood sugar by allowing it to leave the blood stream and enter the cells. People with type I diabetes cannot make their own insulin in the body and must take insulin injections to meet the regular requirement. They can survive without insulin injections, but many may take insulin injections to control blood glucose levels more effectively. Insulin is taken as an injection. Patients who need insulin is taught to give his/her injections themselves. In type II diabetes, the patient's body makes insulin, but is not able to use it effectively. They use medicines to control blood sugar in the form of pills, usually once or twice a day. These medicines work by preventing the body from sending sugar into the bloodstream when the naturally produced insulin is not working properly, releasing more Insulin into the bloodstream, and helping the body's own insulin move glucose from the bloodstream into the cells. Some people need insulin in addition to oral medicines. Some people no longer need medicines if they lose weight because their own insulin output is sufficient after reducing weight, fat, and sugar. Insulin is taken as an injection. It is not available in tablet form. What to eat when your blood sugar level is not normal? Diet planning for diabetes includes choosing healthy foods, eating the right amount of food at the right

time. Meal plans differ depending on the type of diabetes. In insulin-dependent diabetes (Type I), following a fixed time daily to eat and the amounts and kind of food eaten is very important to allow food and insulin to work together to regulate blood glucose levels. If meals and insulin are out of balance, extreme variations in blood glucose can occur. In Non insulin-dependent diabetes (Type II), weight control is the most important principle in addition to a well-balanced diet. The doctor and dietician will help you to chalk out a diet plan to follow. What happens if you miss a dose of insulin? In insulin-dependent diabetics when a dose of insulin is missed or if infection is present, weakness, drowsiness, headache, double vision, lack of coordination and convulsions or unconsciousness can occur. Why diabetics should give more care to their feet? People with diabetes are prone to foot problems because of complications caused by damage to large and small blood vessels and nerves, and decreased ability to fight infection. To prevent injury to the feet, diabetics should regularly checkup their feet. Do sugars cause diabetes? So far the researchers do not know why diabetes occurs, but they know sugars do not cause it. During physical activity, they are the main energy source. Diabetes is a disorder in the way the body handles sugars. People with diabetes do not make enough insulin. Or they cannot use the insulin their bodies do make.
What Is The Normal Range For Blood Sugar Levels, And What Blood Sugar Level Constitutes A True Emergency? Question:What is the normal range for blood sugar levels, and what blood sugar level constitutes a true emergency?

Answer:Now, in a normal individual we measure blood sugar under different circumstances. What we call fasting blood sugar or blood glucose levels is usually done six to eight hours after the last meal. So it's most commonly done before breakfast in the morning; and the normal range there is 70 to 100 milligrams per deciliter. Now when you eat a meal, blood sugar generally rises and in a normal individual it usually does not get above a 135 to 140 milligrams per deciliter. So there is a fairly narrow range of blood sugar throughout the entire day. Now in our diabetic patients we see both low blood sugar levels that we call hypoglycemia, or elevated blood sugars, hyperglycemia. Now, if the blood sugar drops below about 60 or 65 milligrams per deciliter, people will generally get symptoms, which are some shakiness, feeling of hunger, maybe a little racing of the heart and they will usually be trenchant or if they eat something, it goes away right away. But if blood sugar drops below 50 and can get down as low as 40 or 30 or even 20, then there is a progressive loss of mental function and eventually unconsciousness and seizures. And of course that is very dangerous and a medical emergency. On the other side, if blood sugar gets up above 180 to 200, then it exceeds the capacity of the kidneys to reabsorb the glucose and we begin to spill glucose into the urine. And if it gets way up high, up in the 400s or even 500s, it can be associated with some alteration in mental function.

And in this situation, if it persists for a long time, we can actually see mental changes as well. So either too low or very exceedingly high can cause changes in mental function. Question: What does fasting blood sugar mean and what does it tell you? Answer: Fasting blood sugar is what it means -- it's fasting, you haven't eaten, and usually in the diabetes world that means that you haven't eaten for about eight hours before you have the test done. Fasting blood sugar's really very important particularly in diagnosing diabetes and oftentimes in therapeutic management, and it's important because the system is clean of at least any sugar you've eaten prior to that test, because, when you're measuring blood sugar levels, depending on what you eat that adds to that number. So if you want a clean, cleansed number, a 'fasting' is a very good barometer.

Mechanisms of blood sugar regulation[edit]

Blood sugar levels are regulated by negative feedback in order to keep the body in homeostasis. The levels of glucose in the blood are monitored by the cells in the pancreas's Islets of Langerhans. If the blood glucose level falls to dangerous levels (as in very heavy exercise or lack of food for extended periods), the Alpha cells of the pancreas release glucagon, a hormone whose effects on liver cells act to increase blood glucose levels. They convert glycogen into glucose (this process is called glycogenolysis). The glucose is released into the bloodstream, increasing blood sugar levels. When levels of blood sugar rise, whether as a result of glycogen conversion, or from digestion of a meal, a different hormone is released from beta cells found in the Islets of Langerhans in the pancreas. This hormone, insulin, causes the liver to convert more glucose into glycogen (this process is called glycogenesis), and to force about 2/3 of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood through the GLUT4 transporter, thus decreasing blood sugar. When insulin binds to the receptors on the cell surface, vesicles containing the GLUT4 transporters come to the plasma membrane and fuse together by the process of exocytosis, thus enabling a facilitated diffusion of glucose into the cell. As soon as the glucose enters the cell, it is phosphorylated into Glucose-6-Phosphate in order to preserve the concentration gradient so glucose will continue to enter the cell.[1] Insulin also provides signals to several other body systems, and is the chief regulatory metabolic control in humans. There are also several other causes for an increase in blood sugar levels. Among them are the 'stress' hormones such as epinephrine (also known as adrenaline), several of the steroids, infections, trauma, and of course, the ingestion of food. Diabetes mellitus type 1 is caused by insufficient or non-existent production of insulin, while type 2 is primarily due to a decreased response to insulin in the tissues of the body (insulin resistance). Both types of diabetes, if untreated, result in too much glucose remaining in the blood (hyperglycemia) and many of the same complications. Also, too much insulin and/or exercise without enough corresponding food intake in diabetics can result in low blood sugar (hypoglycemia).

Hormones that influence blood glucose level[edit]

Hormone Tissue of Origin Metabolic Effect Effect on Blood Glucose


1) Enhances entry of glucose into cells; 2) Enhances storage of glucose as glycogen, or conversion to fatty acids; 3) Enhances synthesis Pancreatic Cells of fatty acids and proteins; 4) Suppresses breakdown of proteins into amino acids, of adipose tissue into free fatty acids. Pancreatic Cells 1) Suppresses glucagon release from cells (acts locally); 2) Suppresses release of Insulin, Pituitary tropic hormones, gastrin and secretin. 1) Enhances release of glucose from glycogen; 2) Enhances synthesis of glucose from amino acids or fatty acids. 1) Enhances release of glucose from glycogen; 2) Enhances release of fatty acids from adipose tissue. 1) Enhances gluconeogenesis; 2) Antagonizes Insulin. 1) Enhances release of cortisol; 2) Enhances release of fatty acids from adipose tissue. Antagonizes Insulin 1) Enhances release of glucose from glycogen; 2) Enhances absorption of sugars from intestine





Pancreatic Cells



Adrenal medulla


Cortisol ACTH

Adrenal cortex Anterior pituitary

Raises Raises Raises Raises

Growth Hormone Anterior pituitary Thyroxine Thyroid

Food and blood sugar regulation[edit]

How the Blood Sugar of Diabetes Affects the Body
Diabetes mellitus leads to persistently elevated blood sugar levels. Over time, high sugar levels damage the body and can lead to the multiple health problems associated with diabetes. But why are high blood sugars so bad for you? How much sugar in the blood is too much? And what are good sugar levels, anyway? WebMD takes a look at how your sugar level affects diabetes and your health. Recommended Related to Diabetes Five Ways to Control Type 2 Diabetes About two years ago, when Anne Tierney learned she had type 2 diabetes, it galvanized her. My diagnosis came as a shock, says Tierney, who was then about 40 pounds overweight. I used to eat chocolate all the time. Th e day I was diagnosed, I quit. She also consulted a nutritionist and hired a personal trainer. I knew I had to take action, recalls Tierney, 51, director of corporate gifts for Halls Crown Center in Kansas City, Mo. Her action plan was in keeping with the latest research on... Read the Five Ways to Control Type 2 Diabetes article > > Diabetes and Normal Blood Sugar Levels At present, the diagnosis of diabetes or prediabetes is based in an arbitrary cut-off point for a normal blood sugar level. A normal sugar level is currently considered to be less than 100 mg/dL when fasting and less than 140 mg/dL two hours after eating. But in most healthy people, sugar levels are even lower. During the day, blood glucose levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dL. In some, 60 is normal; in others, 90. Again, anything less than 100 mg/dL while fasting is considered normal by today's standards.

What's a low sugar level? It varies widely, too. Many people's sugar levels won't ever fall below 60 mg/dL, even with prolonged fasting. When you diet or fast, the liver keeps sugar levels normal by turning fat and muscle into sugar. A few people's sugar levels may fall somewhat lower. Without taking diabetes medicine, though, or having uncommon medical problems, it's difficult to drop sugar levels to an unsafe point. Sugar Levels, Diabetes, and Prediabetes Sugar levels higher than normal mean either diabetes or pre-diabetes is present. There are several ways diabetes is diagnosed: The first is known as a fasting plasma glucose test. A person is said to have diabetes if his or her fasting blood sugar level is higher than 126 mg/dL after not eating -- fasting -- for eight hours. The second method is with an oral glucose tolerance test. After fasting for eight hours, a person is given a special sugary drink. That person is said to have diabetes if two hours after the drink he or she has a sugar level higher than 200. The third way is with a randomly checked blood sugar level. If it is greater than 200, with symptoms of increased urination, thirst, and/or weight loss, that person is said to have diabetes. A fasting sugar level or oral glucose tolerance test will be needed to confirm the diagnosis. But diabetes is not like a switch that gets turned on and off -- healthy one day, diabetic the next. Any sugar levels higher than normal are unhealthy. A blood sugar higher than normal, but not meeting the above criteria for full-blown diabetes, is called prediabetes. According to the American Diabetes Association, 79 million people in the U.S. have prediabetes. People with prediabetes are five to six times more likely to develop diabetes over time. Prediabetes also increases the risk for cardiovascular disease, although not as much as diabetes does. It's possible to prevent the progression of prediabetes to diabetes, with diet and exercise. Sugar and Your Body Why are high blood sugar levels bad for you? Glucose is precious fuel for all the cells in your body -- when it's present at normal levels. But persistently high sugar levels behave like a slow-acting poison. 1. High sugar levels slowly erode the ability of cells in the pancreas to make insulin. The pancreas overcompensates, though, and insulin levels remain overly high. Gradually, the pancreas is permanently damaged. 2. All the excess sugar is modified in the blood. The elevated sugar in the blood causes changes that lead to atherosclerosis, a hardening of the blood vessels. Because high sugar levels are everywhere, the body can be damaged anywhere. Damage to blood vessels, in particular, means no area is safe from too much sugar. High sugar levels and damaged blood vessels cause the multitude of complications that can come with diabetes: Kidney disease or kidney failure, requiring dialysis Strokes Heart attacks Visual loss or blindness Immune system suppression, with increased risk for infections Erectile dysfunction Nerve damage, called neuropathy, causing tingling, pain or decreased sensation in the feet, legs, and hands Poor circulation to the legs and feet, with poor wound healing In extreme cases, because of the poor wound healing, amputation is required. Keeping sugar levels closer to normal can prevent many of the complications of diabetes. The American Diabetes Association's goals for glucose control in people with diabetes are sugar levels of 70 to 130 mg/dL before meals, and less than 180 mg/dL after meals.

Blood Sugar Level Ranges

Understanding blood glucose level ranges is key to both diabetes diagnosis and diabetes self-management.

This page states 'normal' blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes. If a person with diabetes has a meter, test strips and is testing, it's important to know what the blood glucose level means. Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team. In addition, women may be set target blood sugar levels during pregnancy. The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individuals target range should be agreed by their doctor or diabetic consultant. Recommended target blood glucose level ranges The NICE recommended target blood glucose levels are stated below alongside the International Diabetes Federation's target ranges for people without diabetes. [19] NICE recommended target blood glucose level ranges Target Levels by Type Non-diabetic Type 2 diabetes Type 1 diabetes Children w/ type 1 diabetes Before meals (pre prandial) 4.0 to 5.9 mmol/L 4 to 7 mmol/L 4 to 7 mmol/L 4 to 8 mmol/L 2 hours after meals (post prandial) under 7.8 mmol/L under 8.5 mmol/L under 9 mmol/L under 10 mmol/L

NB: There are differening opinions about the ideal blood glucose level range. You should discuss your own individual needs with your healthcare team. Normal and diabetic blood sugar ranges For the majority of healthy individuals, normal blood sugar levels are as follows:

Normal blood glucose level in humans is about 4 mM (4 mmol/L or 72 mg/dL) When operating normally the body restores blood sugar levels to a range of 4.4 to 6.1 mmol/L (82 to 110 mg/dL) Shortly after a meal the blood glucose level may rise temporarily up to 7.8 mmol/L (140 mg/dL)

For people with diabetes, blood sugar level targets are as follows:

Before meals: 4 to 7 mmol/L for people with type 1 or type 2 diabetes After meals: under 9 mmol/L for people with type 1 and 8.5mmol/L for people with type 2

As is visible from the NICE targets, children with type 1 diabetes have a greater upper limit for their blood sugar levels by 1mmol/L. How are blood sugar level ranges used to diagnose diabetes? There are 2 main tests which are conducted to determine whether someone has diabetes. Impaired fasting glycemia test When being tested for diabetes by a impaired fasting glycemia test, blood sugar levels will normally be taken after around eight hours of fasting. During this blood sugar levels are put into the following categories:

Normal: 4.0 to 5.9 mmol/l (70 to 107 mg/dl) Prediabetes or Impaired Glucose Glycemia: 6.0 to 6.9 mmol/l (108 to 126 mg/dl) Diagnosis of diabetes: more than 6.9 mmol/l (126 mg/dl)

Impaired glucose tolerance test An impaired glucose tolerance test involves taking a concentrated amount of glucose and then measuring blood sugar levels after two hours. Impaired glucose tolerance or diabetes is diagnosed as follows:

Normal: under 7.8 mmol/l (140 mg/dl) Prediabetes or Impaired Glucose Tolerance: 7.9 to 11.1 mmol/l (141 to 200 mg/dl) Diagnosis of diabetes: more than 11.1 mmol/l (200 mg/dl)

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The chart below gives you an idea of what your blood sugar level should be. Your goal blood sugar (or glucose) range may be different from another person's and will change throughout the day. Your health care provider will tell you what range is good for you. Is Your Type 2 Diabetes Under Control? Is Your Type 2 Diabetes Under Control? Recommended Blood Sugar Range for People With Diabetes* Time of Test Before meals Goal plasma glucose 70-130 mg/dL (milligrams per deciliter)

Before bedtime snack (1-2 hours after a meal/postprandial) less than 180mg/dL Every 3 months HbA1c *Source: American Diabetes Association, 2007 For women with gestational diabetes, experts recommend the following goals for diabetes management: A fasting glucose less than 105 mg/dL (plasma) or less than 95 mg/dL (whole blood) A 2-hour post meal less than 130mg/dL (plasma) or less than 120 md/dL(whole blood) less than 7%

When to Call the Doctor About Your Blood Sugar If your blood sugar is less than 70 mg/dL, and you have more than one unexplained low blood sugar reaction in one week, call your health care provider. If your blood sugar is more than 180 mg/dL for more than a week, or if you have two consecutive readings greater than 300 mg/dL, call your health care provider. In most cases, your health care provider will suggest changes in your diabetes management.

Blood Glucose

Blood glucose and blood sugar both refer to the same thing

Blood Glucose in the Forum

Eating importance Blood sugar goes up in the morning on its own! Do I have more than 30 years? Query pre-diabetes

Blood glucose and blood sugar are interchangeable terms, and both are crucial to the health of the body; especially for people with diabetes. Most diabetics will be familiar with the terms blood glucose, blood glucose test, blood glucose level and blood glucose meter, but what does blood glucose really mean? Why do blood sugar levels need to be controlled?

What are blood glucose levels?

Blood sugar levels are literally the amount of glucose in the blood, sometimes called the serum glucose level. Usually, this amount is expressed as millimoles per litre (mmol/l) and stay stable amongst non-diabetic people at around 4-8mmol/l. Spikes in blood sugar will occur following meals, and levels will usually be at their lowest in the early mornings. When it comes to diabetics, blood sugar fluctuates more widely.

Why do blood glucose levels need to be controlled?

High levels of glucose present in the blood over a sustained period of time end up damaging the blood vessels. Although this does not sound too serious, the list of resultant complications is. <a href="http://www.ad-net.co.uk/a.aspx?ZoneID=601&amp;Task=Click&amp;Mode=HTML&amp;SiteID=4&amp;PageID=97957" target="_blank"> <img src="http://www.adnet.co.uk/a.aspx?ZoneID=601&amp;Task=Get&amp;Mode=HTML&amp;SiteID=4&amp;PageID=97957" width="300" height="250" border="0" alt=""></a> Poorly controlled blood glucose levels can increase your chances of developing diabetes complications including nephropathy, neuropathy, retinopathy and cardiovascular diseases. The time-scale for the development of these complications is usually years, but be aware that type 2 diabetes is often not diagnosed until a relatively late stage.

How do I find out what my blood glucose levels are?

You can use home testing kits, although before doing so read our guide to blood glucose monitors. Measure levels by putting a drop of blood on a strip and placing it into the BGM (blood glucose meter). Prick your finger with a specially designed lancet to draw blood.
Blood Glucose