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Blood Sugar Fluctuations Within Minutes

Hypoglycemia: Low Blood Sugar

Hypoglycemia: Low Blood Sugar

(This article appeared in Voice of the Diabetic Volume 16 No. 1, Winter 2001 Edition, published by the Diabetes Action Network of the National Federation of the Blind. Updated July 2001) Diabetes mellitus, by definition, is inability to properly process blood glucose. The untreated, out-of-control diabetic has abnormally high blood sugars, and the diabetic who wishes to keep his or her blood sugars down in the normal range uses diet, exercise, oral medications, and/or insulin to get them there. For whatever reason, sometimes the sugars dip too low, and hypoglycemia results. A "hypoglycemic reaction," also called an insulin reaction, insulin shock, or low blood sugar reaction, occurs when blood glucose drops to a point where the individual becomes confused and disoriented. At what point a person is "low" varies; some health professionals say any blood sugar level below 70mg/dL is hypoglycemic, while others put the "trigger point" at 60mg/dL. Individuals vary, and hypoglycemia can affect both insulin-dependent and non-insulin-dependent diabetics, though type 1s are more at risk. Safety is paramount. Talk to your doctor about where your sugars should be running, to keep you safe. Prevention is the best treatment for low blood sugar reactions! Though the personal "threshold" varies, and some folks can function with their blood glucose down at levels that would leave others disoriented or unconscious, if your sugars stay up in the 70 to 110mg/dL range, a hypoglycemic reaction won't happen. Although exactly what is "normal" for a diabetic in good control varies between individuals, the point is to provide yourself a healthy range, while ensuring a margin of safety against "hypos." "Tight control" means doing the best possible job of keeping your blood sugar fluctuations under Continue reading >>

Hypoglycaemia (low Blood Glucose) In Non-diabetic People

Hypoglycaemia (low Blood Glucose) In Non-diabetic People

What is hypoglycaemia (low blood glucose)? Hypoglycaemia or low blood glucose is a condition in which the level of glucose (sugar) in the blood, drops below a certain point (about 2.5mmol/l). The condition manifests itself by a number of symptoms that usually disappear 10 to 15 minutes after eating sugar. People differ slightly in the exact level of blood glucose at which they begin to feel symptoms of low blood sugar. Insulin is normally produced in the pancreas and helps the cells in the body absorb glucose from the blood. Normally, the glucose level rises after a meal. Too much insulin in the blood and other diseases can cause hypoglycaemic episodes (also known as 'hypos'). What can cause hypoglycaemic episodes in non-diabetic patients? Too much insulin in the blood: reactive hypoglycaemia (see below) a tumour – very often benign – in the insulin-producing pancreas. This is a very rare condition indeed Other diseases: a disease in the adrenal glands (Addison's disease) a weakened pituitary gland a severe reduction in liver function patients who have had their stomach removed fasting, malnutrition Reactive hypoglycaemia is possibly the most common reason for hypoglycaemia in non-diabetics but is often overdiagnosed. This form of hypoglycaemia is probably caused by an overproduction of insulin from the pancreas after a large meal with a lot of carbohydrates. The insulin can still be detected even after several hours, although the level should be back to normal at this time. This condition is probably most common in overweight people and those with Type 2 diabetes, where the large demand for insulin can sometimes cause too much insulin to be produced in the pancreas. There is some evidence to suggest that reactive hypoglycaemia can precede Type 2 diabetes. What happ Continue reading >>

Do Your Bgs Bounce From Very Low To Very High?

Do Your Bgs Bounce From Very Low To Very High?

Question: My blood sugars bouce from very high to very low. For example, I can experience a low blood glucose (BG) level of 60, 50, or 43 mg/dl and then two to four hours later my BG skyrockets to 200 to 400 mg/dl? This is called the Somogyi effect or "rebound hypoglycemia". This condition results in high BG levels, and is actually is triggered by low BG levels. It is a natural defense mechanism of the body to regulate itself and counteract episodes of severe hypoglycemia. To keep it simple, we understand that the pancreas produces and regulates insulin and other hormones in response to BG fluctuations from food, activity and stress levels in the body that occur in everyday life. Every action in the body causes a reaction. Insulin is used in the body to metabolize carbohydrate content from food, which is broken down into energy units (glucose/sugars), which is used and stored as fuel. Insulin keeps the BG from rising too high. Other hormones keep us from getting too low. Some of the glucose in our bodies is stored in the liver as glycogen (a form of body glucose). In most people, whenever BG gets too low, certain hormones called counterregulatory hormones kick in and cause the BG level to rise. For example, the liver kicks in stored glycogen as a counterregulatory defense tp keep us from sinking into dangerous levels of hypoglycemia. In people without diabetes, this effect is quickly counteracted by an increase in insulin production, which lowers the glucose released by the liver, and the body self-regulates when the BG is normalized once again. In people with diabetes, when the BG dips too low due to the effects of too much insulin, or glucose depletion from moderate to vigorous exercise, or not enough glucose derived from food metabolism, the liver kicks in stored gly Continue reading >>

When Your “normal” Blood Sugar Isn’t Normal (part 1)

When Your “normal” Blood Sugar Isn’t Normal (part 1)

In the next two articles we’re going to discuss the concept of “normal” blood sugar. I say concept and put normal in quotation marks because what passes for normal in mainstream medicine turns out to be anything but normal if optimal health and function are what you’re interested in. Here’s the thing. We’ve confused normal with common. Just because something is common, doesn’t mean it’s normal. It’s now becoming common for kids to be overweight and diabetic because they eat nothing but refined flour, high-fructose corn syrup and industrial seed oils. Yet I don’t think anyone (even the ADA) would argue that being fat and metabolically deranged is even remotely close to normal for kids. Or adults, for that matter. In the same way, the guidelines the so-called authorities like the ADA have set for normal blood sugar may be common, but they’re certainly not normal. Unless you think it’s normal for people to develop diabetic complications like neuropathy, retinopathy and cardiovascular disease as they age, and spend the last several years of their lives in hospitals or assisted living facilities. Common, but not normal. In this article I’m going to introduce the three markers we use to measure blood sugar, and tell you what the conventional model thinks is normal for those markers. In the next article, I’m going to show you what the research says is normal for healthy people. And I’m also going to show you that so-called normal blood sugar, as dictated by the ADA, can double your risk of heart disease and lead to all kinds of complications down the road. The 3 ways blood sugar is measured Fasting blood glucose This is still the most common marker used in clinical settings, and is often the only one that gets tested. The fasting blood glucose Continue reading >>

Lactation After Normal Pregnancy Is Not Associated With Blood Glucose Fluctuations

Lactation After Normal Pregnancy Is Not Associated With Blood Glucose Fluctuations

Breastfeeding is the preferred method of feeding infants up to 12 months of age (1). Breastfed infants experience fewer and less severe infections and may be protected against future disease development (2). Mothers who breastfeed potentially experience accelerated weight loss (3), a lower risk of breast and ovarian cancer (3), and a lower risk of type 2 diabetes than mothers who do not breastfeed (4). Breastfeeding is recommended for all women, including those with gestational (5) or pregestational (6) diabetes. However, data suggest that diabetic women may experience hypoglycemia during breastfeeding; subsequently, they have been advised to eat before or during breastfeeding to avoid hypoglycemia (6). Because data on blood glucose fluctuations in normoglycemic women are limited, we tested the hypothesis that lactation in healthy normoglycemic women will not cause significant blood glucose fluctuations. RESEARCH DESIGN AND METHODS— Women were recruited randomly from the Pregnancy Program at Brigham and Women's Hospital (BWH). The BWH Human Research Committee approved the study protocol, and all women provided informed written consent before participation. Healthy women were included if they were 18–40 years of age, 6 weeks to 6 months postpartum, free of a history of gestational or pregestational diabetes, and breastfeeding with no more than one bottle per day of supplementation. Women were excluded if they had an abnormal 1-h glucose challenge test during pregnancy (5), were taking medications known to influence blood glucose, were nursing more than one infant, or were incapable of using the continuous glucose monitoring system (CGMS). Participants presented to the general clinical research center (GCRC) of BWH, where height and weight were measured and pregnancy Continue reading >>

Hypoglycemia: Low Blood Sugar

Hypoglycemia: Low Blood Sugar

Photo: portrait. Caption: Ed Bryant Diabetes mellitus, by definition, is inability to properly process blood glucose. The untreated, out of control diabetic has abnormally high blood sugars, and the diabetic who wishes to keep his or her blood sugars down in the normal range uses diet, exercise, oral medications, and/or insulin to get them there. For whatever reason, sometimes the sugars dip too low, and hypoglycemia results. A "hypoglycemic reaction," also called an insulin reaction, insulin shock, or low blood sugar reaction, occurs when blood glucose drops to a point where the individual becomes confused and disoriented. At what point a person is "low" varies; some health professionals say any blood sugar level below 70mg/dL is hypoglycemic, while others put the "trigger point" at 60mg/dL. Individuals vary, and hypoglycemia can affect both insulin dependent and non insulin dependent diabetics, though type 1s are more at risk. Safety is paramount. Talk to your doctor about where your sugars should be running, to keep you safe. Prevention is the best treatment for low blood sugar reactions! Though the personal "threshold" varies, and some folks can function with their blood glucose down at levels that would leave others disoriented or unconscious, if your sugars stay up in the 70 to 110mg/dL range, a hypoglycemic reaction won't happen. Although exactly what is "normal" for a diabetic in good control varies between individuals, the point is to provide yourself a healthy range, while ensuring a margin of safety against "hypos." "Tight control" means doing the best possible job of keeping your blood sugar fluctuations under control it doesn't mean continuously staying below normal range. Don't just wait for symptoms of a "low" to clue you in all that shakiness, sweatiness Continue reading >>

Are You Non-diabetic? Your After-meal Blood Sugar Spikes May Be Killing You Softly

Are You Non-diabetic? Your After-meal Blood Sugar Spikes May Be Killing You Softly

Something millions of people don’t realize is that non-diabetics do experience blood glucose spikes after meals. Yes, non-diabetics get blood sugar highs believe it or not. They just don’t know it and this phenomenon has implications for your health. Your doctor won’t tell you how important your blood glucose control is as a non-diabetic. I will. The reason your doctor fails to tell you this is mainly because it is generally thought that until a diagnosis of diabetes is made, you are assumed to be metabolically competent. But that is not always the case. In actual fact, this is the reason why a lot of prediabetes cases are missed. Prediabetes is the abnormal metabolic stage before type 2 diabetes actually bites. And before the prediabetes stage, you also develop insulin resistance which is largely silent as well. Doctors don’t pay attention to metabolic health in a run-of-the-mill consultation even if the consultation is for a wellness overview. There are so many individuals with insulin resistance, prediabetes and frank type 2 diabetes walking around totally unaware they have any of those conditions. If only we paid just a little attention to our metabolic health, we could prevent millions of cases of type 2 diabetes raging around the globe like a wild summer forest fire. Do non-diabetics have blood sugar spikes? I often get asked about whether non diabetics have blood sugar highs i.e blood sugar spikes. The short answer is they do but there is a caveat there. Not every non diabetic does. It all depends on what I call metabolic competence along with other variables. Before I talk about the variables involved, let me draw your attention to this study carried in Ulm University in Germany. They recruited 24 healthy volunteers into the study and made them eat simil Continue reading >>

What You Can Do To Stop The Blood Sugar Rollercoaster

What You Can Do To Stop The Blood Sugar Rollercoaster

If you find that your blood sugars often fluctuate from too high to too low (and vice versa), you’re on the blood sugar rollercoaster. To learn how to eliminate the extremes, you’ll have to do a little sleuthing on your own. Get out your blood glucose meter, and for a week try testing before and after a variety of meals, activities, and destressors to figure out what’s making it go up and down to stop it for good! Your blood sugars are affected by a large number of things, including what you ate (especially refined “white” carbohydrates), how long ago you ate, your starting blood glucose level, physical activity, mental stress, illness, sleep patterns, and more. If you take insulin and use it to treat highs, you can easily end up overcompensating and developing low blood sugars. If you develop a low, it’s easy to overeat and end up high again. Large fluctuations in blood sugars may make you feel cruddy and are bad for your long-term health, so it’s time to learn how to stop the rollercoaster! Physical Activity Effects: During this week, your goal is to do at least 30 minutes of physical activity on three days at varying times of day, and check and record your blood glucose levels before and after the activity. Physical Activity Trial #1: For this first activity, pick one that you normally do (like walking or cycling) and try to do it at your usual time of day. Check and record your blood sugar immediately before starting and within an hour of completing the 30 minutes of activity. You will find that your body responds differently to varying types of physical activities, particularly when the time of day varies as well. If you exercise first thing in the morning (before breakfast and medications), it is not unusual to experience a modest increase in blood s Continue reading >>

Does Hand Sanitizer Impact Blood Glucose Readings?

Does Hand Sanitizer Impact Blood Glucose Readings?

A few weeks ago I had breakfast with Jessica Apple at a cafe near Bryant Park in New York City. I perused the menu and was tempted by the list of carby desserts masquerading as “brunch.” Nevertheless, I ordered the quiche. Jess did too. I was in good company. I was ready to test my blood sugar and bolus. But after riding the subway and handling menus, I was desperate to clean my hands before pricking my finger. I guess you could call me a germaphobic diabetic. Not the most charming description, but I’ll take it. Invisible germs scare me. That is why I avoid public restrooms. Of course, that’s where most restaurants keep the soap and water, but I always feel dirtier on my way out of the restroom than I did when I walked in. Even if the faucet has an automatic sensor, I still have to touch the door handle when I exit. I know the tricks. Hold it with a paper towel. Pry it open with your shoe. Wait for a fearless person who scoffs at germs to hold the door for you. But still. Thankfully I had packed hand sanitizer in my bag. No need to plan a restroom escape. I pulled it out and squirted a few drops onto my hands. I offered a squeeze to Jess and she happily cleaned her hands, too. I went on to test my blood sugar. It’s always a treat to dine with other people with diabetes (especially germ-conscious ones). You don’t have to prick your finger under the table, or even worse, in the dirty bathroom. And you don’t have to explain your food choices. After lathering up the hand sanitizer, Jess had an interesting thought: she wondered if the hand sanitizer could impact blood glucose readings. It was a great question that I never considered. I decided to find out. *** Over the course of a week, I completed ten back-to-back blood sugar tests to see if hand sanitizer aff Continue reading >>

Numerical Simulation Of The Effect Of Rate Of Change Of Glucose On Measurement Error Of Continuous Glucose Monitors

Numerical Simulation Of The Effect Of Rate Of Change Of Glucose On Measurement Error Of Continuous Glucose Monitors

Go to: Abstract A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl−1•min−1 (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl−1•min−1 (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone. Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy. The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose. The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions. Keywords: continuous glucose monitoring system, glucose, glucose monitoring, glucose sensors, Navigator Continue reading >>

Normal Blood Sugar Levels

Normal Blood Sugar Levels

Maintaining normal blood sugar levels is critical to good health and longevity. According to the International Diabetes Federation, a normal blood sugar range for people without diabetes and who are not fasting should be between 82 mg/dL (4.4 mmol/L) and 110 mg/dL (6.1 mmol/L) with 82 mg/dl being optimal. However, you blood sugar levels can vary widely depending on what you eat as well as other health factors like exercise, fatigue, illness, adrenal health and how hydrated you are. Because what you eat is really the biggest factor that effects your blood sugar levels, normal blood sugar levels are reported based on how long it has been since you have eaten. Please note: The international standard way of measuring blood glucose levels are in terms of a molar concentration, measured in millimoles per litre (mmol/L). However, the United States and many other countries express glucose concentrations in terms of milligrams per deciliter (mg/dL). Optimal Normal Blood Sugar Levels A 2006 study conducted by Dr. J.S. Christiansen found that the blood sugar levels in healthy individuals were quite a bit lower than those commonly recommended by doctors. Specifically, that even after a high carbohydrate breakfast the blood sugar in healthy people does not go over 125 mg/dL (6.9 mmol/L) . In addition, blood sugar levels return back to normal much faster after eating than the two hours after eating measurement that is often recommended. Specifically after consuming a high carbohydrate breakfast blood sugar levels droped back under 100 mg/dL (5.6mmol/L) within one hour and fifteen minutes after eating. By one and three quarters of an hour blood sugar had dropped back under 85 mg/dL (4.7 mmol/L) . This is significantly lower than the current recommendation that blood sugar should be le Continue reading >>

What Should Your Blood Sugar Level Be In The Morning?

What Should Your Blood Sugar Level Be In The Morning?

Fasting blood sugar readings can set the tone for your entire day. When your morning blood glucose is high or low, you have to adjust your number before you can get your day started. Understand what your morning target should be and the other factors that may contribute to problem readings. Tight control starts with managing your overnight and morning readings. Video of the Day The American Diabetes Association recommends a fasting blood sugar between 70 and 130 for diabetics. A morning blood sugar reading below 70 indicates a hypoglycemic reaction, or low blood sugar condition. Blood sugar readings over 130 are considered high readings and should be treated according to your care team's recommendations. Gestational Diabetes Gestational diabetes occurs when a woman who has never been diagnosed with diabetes develops high blood sugar during pregnancy. High blood sugar levels during pregnancy can cause your baby to be larger than average at birth, have low blood sugar problems after delivery and possibly have respiratory problems. Keeping your blood glucose levels within the target range will protect you and your baby. The National Institute of Diabetes and Digestive and Kidney Diseases recommends that women with gestational diabetes keep morning glucose numbers below 95. Your doctor or diabetic educator may have a different recommendation based on your pregnancy and medical history. Testing your blood sugar within 10 to 15 minutes of waking up will help ensure that you receive an accurate reading. Wash your hands before you test to eliminate any contaminants that can cause errors or inaccuracies. Do not eat or drink anything before you test. Caffeine may cause increases in blood sugar, so avoid coffee before testing. If you suffer with high morning blood sugar numbers wi Continue reading >>

Erratic Blood Glucose Levels

Erratic Blood Glucose Levels

Stress i definitely a factor impacting the results during the run-in period for the disease to develop into a steady state of T1DM. In patients, gluconeogenesis may contribute as much as 60-70% of the glucose handled by their bodies during 24 hours. Hence, stress and gluconeogenesis should be kept to a minimum. Whenever glocose levels alter rapidly, both insulin and stress hormones try to stabilize blood glucose levels as rapid as possible. Hence, there will be "overshoots" in both directions, bringing about large undulations in blood glucose levels. Another method to evaluate the loss of beta-cell function would be to administer glucagon (enhancing blood glucoseand levels) and analyse C-peptide in plasma some 4-8 min thereafter, as a measure of total beta-cell residual activity. This is done to evaluate anti-autoimmune therapy given to patients with T2DM helping the patients to dose both rapidly acting insulin and depot insulin (mimicking phase 2 = not meal-responsive) of insulin secretion. The results with C-peptide is very consistent, giving good statistics for small populations. Relying on blood glucose alone and/or glucose intolerance analysis does not yield statistically valid information unless the T1DM is manifest and that ALL animals have lost some 80-85% of their beta-cells. I feel that average values of random blood glucose levels several times a day is much more reliable (despite the stress experienced by the animals, which is fading away upon more frequent handling) as a parameter to see when the animals reach a steady state levels consistent with T1DM. Continue reading >>

Why Meters Can't Tell Us Our Blood Sugar Levels

Why Meters Can't Tell Us Our Blood Sugar Levels

Diabetes advocate and author Riva Greenberg has been on a "meter accuracy kick" lately — researching the heck out of this controversial topic. Very timely considering I've been seeing loads of expensive TV ads for Accu-Chek's new Nano meter, claiming that it's "23% more accurate" (!) Riva recently published a piece at the Huffington Post on why meter accuracy is both less, and more, critical than you might think. Truth is, she tells us, meter accuracy is only one part of a much larger story. A Guest Post by Riva Greenberg After being lucky enough to receive an iBGStar meter from Sanofi the day before its launch, I ran a few comparison tests between it and the Bayer Contour USB, which I'd been using the past two years, and discovered that the iBGStar consistently gave me a reading 20-25 points higher. So I took out all my meters. There were several, (Sanofi studies show most people use 4 meters on average) and I even ordered two new free meters from FreeStyle. I checked my blood sugar several times on my collection of 7 meters (some think I was a little obsessed) and saw it was rare when two meters gave me the same number! Given that I feel like my meter is my lifeline, I wanted to find out how meters work and why different meters give different results. I talked with a number of Chief Medical Officers, MDs and Medical Safety Officers at several meter manufacturers and I'm going to tell you what I learned in layman's terms. To better understand the science behind meter and strip technology, you can google "meter accuracy" for white papers and posts that would delight even the geekiest engineer. To better know how accurate your own meter is (in percentage terms), you can "check the package insert that comes with the strips and look online at prescribing information," sa Continue reading >>

Are Your Blood Sugar Readings Accurate?

Are Your Blood Sugar Readings Accurate?

Glucose meters are an important part of blood sugar control. Find out how to interpret the numbers to effectively monitor blood sugar and help lower A1C. If you have type 2 diabetes, testing blood sugar levels regularly — and understanding what the numbers on each reading mean — can help you monitor blood sugar and better manage the condition. These numbers are important because blood sugar test results can help you figure out how your diet, exercise, and medications might be affecting your diabetes. When you master blood sugar readings, you’ll be on your way to better blood sugar control and, ultimately, better results on your A1C test, the blood test your doctor orders to track blood sugar control over time. Maintaining good blood sugar control over a long period, such as a decade, could significantly reduce your risk of diabetes complications like heart attack and stroke. Understanding Blood Sugar Fluctuations Even with highly effective modern technologies such as digital glucose meters, people with diabetes still worry about testing accuracy. Although you want to get the best results for each skin prick, when you’re new to blood sugar testing it can be confusing to watch those results change throughout the day. “It’s helpful to understand that blood sugar changes minute by minute,” says certified diabetes educator Karen A. Chalmers, MS, RD, CDE, diabetes services program manager in the section of endocrinology, diabetes and nutrition at Boston Medical Center in Massachusetts. For example, a person might test before coming to a medical appointment and then be surprised to find that his or her blood sugar is higher or lower by the time the doctor tests it. At first, this can lead to self-doubt and asking yourself, “Am I testing right?” or confusion a Continue reading >>

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