Glucose management levels 

Causes of different types of Diabetes

1. Type 1 Diabetes is due to autoimmune destruction of pancreatic beta cells and total absence of insulin. Autoimmune antibodies like GAD, Islet cell antibodies will be present in the blood, and C peptide assay will be low or absent.

2. Type 2 Diabetes is a chronic metabolic lifestyle disorder characterised by varying levels of insulin resistance and the relative absence of effectively functioning insulin levels. Paradoxically there are high insulin levels for which body cells are resistant to allow glucose entry into the cells. Hence glucose does not enter cells to give energy, and sugar increases in the blood.

3. Gestational Diabetes occurs when high sugars are detected during the second or third trimester of pregnancy. The cause is high placental hormones which increase insulin resistance.

Diagnosis of Diabetes

American Diabetes Association and the American Association of clinical endocrinology have various recommendations.

Condition	Recommended blood glucose level
Normal	Less than 100mg/dl
Pre-Diabetes	100mg/dl to 125mg/dl
Diabetes	126md/dl or higher

When is the ideal time to do a blood sugar test?

• Fasting after 8 to 12 hours in the morning
• Post prandial sugar after 2 hours post breakfast (calculate 2 hours from the start of your eating breakfast)

• Bedtime ( if you develop low blood sugars during sleep or early morning)

• Random blood sugar – not an ideal way but, can be done during emergency.

• Before any meals followed by 2 hours after meal like lunch, and dinner when requested by your treating doctor.

Blood sugar can be checked at home using a home glucometer. Many commercial brands are available, and it is reliable.

Factors which increase blood sugar level

1. High carbohydrate consumption
2. Failure to take antidiabetic medicines and insulin injections
3. Lack of sleep
4. Stress
5. Lack of physical activity
6. Infections
7. Certain medicines like steroids

Factors which decrease blood sugar

1. Skipping meals
2. Increased physical activity
3. Fasting
4. GIT illnesses like vomiting, Diarrhoea
5. Use of alternative medicines along with allopathy medicines
6. Low carbohydrate diet

What happens with low blood sugar?

It is called Hypoglycemia. Low blood sugar occurs when the body drops blood sugar levels fall below 60-70mg/dl. This is a dangerous health condition that requires immediate treatment.

When the body has low blood sugar symptoms like

• Sweating
• Pale skin
• Fatigue 
• Hunger 
• Increased heartbeat 
• Anxiety 
• Mood changes 
• Headache 
• Difficulty in sleeping 
• Blurry vision 
• Loss of consciousness seizures 
• Coma

How to treat low blood sugar?

A conscious patient with low blood sugar can be treated orally with 15 Grams of fast-acting carbohydrate like Hypotabs, glucose gels, table sugar, hard candy, glucose and fruit juices followed by carbohydrate-containing food.

An unconscious patient is immediately shifted to the hospital. If a Glucagon pen is available, a dose of 0.5mg is injected subcutaneously or intramuscularly.  

Tips for managing your blood sugars

Below are the 5 pillars for ideal blood sugar levels.

Diet

Diet is the most important part of good sugar control.

• Low carbohydrate diet

• Low glycemic load and low glycemic index food

Glycaemic index is a number indicating the measure of how quickly carbohydrates break down and the body is able to absorb them. This will affect how quickly the blood sugar level rises in the body. 

The GI categorises food into high, medium and low by ranking them on a scale of 1-100.

Food with a low glycaemic index is food that has a ranking of 55 or less. 

For example, barley, oats, beans, legumes, whole-wheat pasta and non-starchy vegetables Greek yoghurt, are food with low or medium GI scores. 

1. High fibre intake in the form of green, non-starchy vegetables.
2. High protein like lentils, pulses, eggs, fish.
3. Normal fat content. Low-fat products are unhealthy.
4. Adequate micronutrient content is important. Minerals like selenium and chromium are important for cellular-vital functions.
5. Fruits are necessary because of their antioxidants, minerals, vitamins and fibre content. They play a vital role in preventing diabetic complications. Avoid fruit juice.

Drug

Antidiabetic medicines should be eaten at the right time and daily according to your treating doctor’s advice. Insulin injections should be given subcutaneously at the site and wait for a specific time depending upon the type of insulin before food. Do not skip even a single dose, even if travelling outside.

Physical Activity

Any physical activity for a period of 30 minutes 5 days a week is recommended. Two days of strengthening exercises is to be added to this regime to build up muscles and increase insulin resistance.

Some of the other useful exercises that lower blood sugar are 

• Weightlifting
• Walking
• Running
• Dancing
• Hiking
• Sports like swimming and any outdoor activities

Sleep

Poor sleep increases blood sugar levels. So, develop healthy sleep hygiene to control your blood sugars.

To improve sleep, a person can

• Stick to the sleep schedule
• Eliminating caffeine and alcohol later in the day
• Cutting down screen time before bed
• Regular exercise 
• Having a bedtime routine 
• Sleep in a soothing atmosphere 
• Using calming scent 
• Taking a bath before bed.

Stress

Stress increases blood sugar levels very drastically. So pay attention to your stress levels. Develop your personalised ways to manage them.

1. Listening to music
2. Meditation
3. Breathing exercises
4. Hobby
5. Social networking
6. Gratitude journaling
7. Spirituality

Consume food rich in Vitamin D, Magnesium, Selenium, Chromium

Micronutrient deficiencies in the body may also lead to high blood sugar levels. Therefore, including food that is rich in magnesium and chromium can improve fat and carbohydrate metabolism. 

This will regulate the blood sugar level in the body. Some foods like meat, whole grains, vegetables, fruits and nuts are rich in chromium, dark leafy vegetables, pumpkin seeds, tuna, dark chocolate, bananas and beans are rich in magnesium.

Ideal body weight

Maintaining a healthy weight promotes optimal blood sugar levels and reduces the risk of developing various heart diseases and Diabetes.

Various research conducted revealed that a significant reduction in body weight can improve blood sugar regulation and reduce the possibility of requiring Diabetes medications. 

Why is the maintenance of blood sugar very important?

This is the only way to prevent diabetic complications and lead a longer, healthier life. This is the healthiest way of living. Diabetes is not a disease. It is a disorder of metabolism. It is easy to correct it and even reverse Diabetes.