How Many Factors Actually Affect Blood Glucose?
A printable, colorful PDF version of this article can be found here. twitter summary: Adam identifies at least 22 things that affect blood glucose, including food, medication, activity, biological, & environmental factors. short summary: As patients, we tend to blame ourselves for out of range blood sugars – after all, the equation to “good diabetes management” is supposedly simple (eating, exercise, medication). But have you ever done everything right and still had a glucose that was too high or too low? In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22! – including food, medication, activity, and both biological and environmental factors. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions. As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. But after 13 years of type 1 diabetes, I’ve learned it’s just not that simple. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors. I’ve provided arrows to show the ge Continue reading >>
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- There’s Now More Evidence That Type 2 Diabetes Can Actually Be Reversed
- Diet drinks and food actually trigger weight gain and diabetes, says new study
Is High Blood Sugar Damaging And Aging Your Body Prematurely?
You don’t have to be a diabetic to suffer the damaging effects of high blood sugar. New research has shown that blood sugar much lower than that officially labelled diabetic still significantly harms your body and shortens your lifespan. Your doctor may have told you that your blood sugar is normal, but it could still be putting your health at risk. The incidence of diabetes is rising rapidly in every country on the planet. It is estimated there are currently more than 285 million people in the world with diabetes. By 2030 this figure is expected to leap to 439 million. Some researchers think this is quite a conservative estimate and in reality the figures will be much worse. It is also estimated that only around half of the people in the world with diabetes are diagnosed. You are probably well aware of the health consequences associated with diabetes: increased risk of heart attacks and strokes, blindness, kidney damage, nerve and blood vessel damage, dementia and others. However, you don’t have to be a diabetic to develop these diseases; they are all very common degenerative diseases that people associate with aging. What if your “normal” blood sugar isn’t so normal? If you have ever had a fasting blood sugar test, you may know that the so called normal reference range is 65 – 97 mg/dL (3.6 – 5.4 mmol/L). If your fasting blood sugar is 99 mg/dL (5.5 mmol/L) or higher, you are said to have insulin resistance (also called pre-diabetes, syndrome X or metabolic syndrome). Your doctor would probably not mention that because most doctors consider it unimportant and not serious. You would probably be told you are fine and healthy. You would only be diagnosed as a diabetic if your fasting blood sugar reached 125 mg/dL (6.9 mmol/L) or higher. Interestingly, resea Continue reading >>
High Blood Sugar Linked To Aging And Disease
Advanced glycation end products And Antioxidants Is it possible that by eating too many metabolically active dense carbohydrates, you are much more likely to accelerate aging and disease? Here’s why Each time we eat a meal containing carbohydrates, blood glucose levels increase. According to the insulin sensitivity theory, as we age blood glucose levels tend to increase and insulin becomes less and less effective at bringing them down. Sustained high levels of sugars in the blood ultimately cause proteins to stick together thereby damaging the function of the proteins. For example, excess blood sugar is more likely to react with proteins such as collagen in the skin which can lead to brown splotches or "age spots" as well as loss of elasticity and premature wrinkling. These sugar-damaged, very dangerous cross-linked proteins are called advanced glycation end products, or AGE! According to one of the world’s leading antioxidant researchers, Lester Packer, Ph.D., "the acronym AGE is quite appropriate, since a high number of these damaged proteins can…wreak havoc on virtually all other body tissues…and lead to premature aging."1 Some examples If excess blood sugar damages proteins in the lens of the eye, cataracts and eventual blindness can result. If collagen in the arteries suffers damage from the protein/sugar complex called AGE, fatty plaques are more likely to form. Similarly, if the collagen in our connective tissues becomes cross-linked as a result of AGE, arthritis could occur. The process of glycation (sugar damaged proteins) has even been linked as a "likely culprit" in the destruction of nerve cells in the brain that can eventually lead to Alzheimer’s and other neuro-degenerative diseases.2 Furthermore, glycation accelerates the formation of damaging f Continue reading >>
Elderly A1c Targets: Should Older People Have More Relaxed Glucose Goals?
You may have read that the lower your A1C level, the better. For best health, people with diabetes should aim for glucose as close to normal as possible. But some new research shows this may not be true for older people. According to these studies, seniors could decide not to shoot for tight control of blood sugar or cholesterol. One study from Japan showed that lower HbA1c levels (a measure of average glucose control over the previous 2–3 months) were actually linked with an increased the risk of frailty in older adults. Frailty was measured in the study as how much help a person needs in living, and how poorly he or she recovers from an illness or injury. Toshihiko Yanase, MD, PhD of Fukuoka University School of Medicine, Japan, reported, “The risk factors of metabolic syndrome, such as high blood glucose, obesity, high cholesterol, and hypertension, in middle age may shift from an unfavorable risk to favorable factors in old age.” The study was published in the Journal of Diabetes Investigation and reported by the online site Healio.com. Yanase and colleagues analyzed data from 132 adults aged at least 65 years with Type 2 diabetes Average age was 78. The subjects had had diabetes for an average of 17 years and their mean A1C was 7.3%. The subjects were categorized as frail or not on a 9-point clinical frailty scale (CFS). The CFS goes from 1 (very fit) to 9 (terminally ill). People who rated 5 or higher were classed as frail. Seventy-seven were not frail; 55 were. In those with higher frailty scores, HbA1c levels were found to be significantly lower. The causes of frailty are not well understood. In men, frailty is strongly associated with loss of muscle mass. As you get weaker and thinner, you become more fragile. The same is probably true of women, although Continue reading >>
Hba1c Increases With Age
HbA1c levels in the elderly rise but not in precise relationship to glucose tolerance…. In this cross-sectional analysis of adults with known diabetes, impaired glucose tolerance and HbA1c levels increased with age, even after adjusting for covariates including race, BMI, waist circumference, sagittal abdominal diameter, triglyceride/HDL ratio, and fasting and 2-hour plasma glucose levels assessed by an oral glucose tolerance test. The specificity of HbA1c-based prediabetes diagnosis decreased substantially as age increased. "For the same level of blood glucose, HbA1c is higher in the elderly, suggesting a decreased specificity for the diagnosis of diabetes with increasing age. Given that glucose levels may be normal, basing a diagnosis on HbA1c will result in more risk for hypoglycemia with treatment; on the other hand, one wonders whether the higher HbA1c reflects decreased clearance that may also apply to tissues damaged by glucose, rendering them more susceptible to damage in the presence of ‘normal’ glucose levels," said the researchers. Examining the measures of sensitivity, specificity, and negative and positive predictive value based on HbA1c criteria using the OGTT as gold standard, the researchers found a remarkable decrement in performance, predominantly sensitivity, with age. This is an issue superimposed on the well-recognized problem that the sensitivity of HbA1c for diagnosis of diabetes compared with OGTT is quite limited, clustering in most populations around 50%. Researchers concluded that in two large datasets, using different methods to measure HbA1c, the association of age with higher HbA1c levels was consistent and similar; was both statistically and clinically significant; was unexplained by features of aging; and reduced diagnostic specific Continue reading >>
Effects Of Age On Plasma Glucose Levels In Non-diabetic Hong Kong Chinese
Go to: Subjects and methods In this survey, performed in the period between April 1996 and August 1997, we recruited 17 242 adult subjects from the community of Hong Kong. The methodology has been reported before (6). Volunteer participants came to the United Christian Nethersole Community Health Service (UCHCNS) Centers for health assessment. UCNCHS is a self-funded, non-profit organization with the objective of health promotion through primary health care and education. Participants came from different districts all over Hong Kong. All of them gave verbal informed consent before the examination was performed. Participants were interviewed and examined by a nursing officer and a clinician. Demographic data, and past and present medical history were collected. Demographic data, including height and weight (measured to the nearest 0.1 kg) and blood pressure, were obtained following the standard protocol, with the subject in light clothing without shoes. Blood pressure was measured on the right arm with a standard mercury sphygmomanometer. The Korotkoff sound V was taken as the diastolic blood pressure. Blood specimens were taken from all participants. The timing of blood taking varied depending on the availability of the patient. According to the time of blood sampling, there were three types of plasma glucose samples. Fasting plasma glucose was measured after overnight fasting for at least 10 hours, 2-hour post-prandial plasma glucose glucose was measured 2 hours after a meal of usual quantity, and random plasma glucose was collected in the time periods other than fasting or 2-hour post-prandial. Plasma glucose was measured by a hexokinase method (Hitachi 911, analyzer Boehringer Mannheim, Mannheim, Germany). The intra-assay coefficient of variation (CV) of glucose was Continue reading >>
Older Diabetics May Be Pushing Blood Sugar Too Low
(Reuters Health) – Older diabetics may sometimes do too good a job at keeping their blood sugar down, according to a new study. Regardless of age, people with diabetes are taught to keep their blood sugar below certain target levels. But many diabetics over 65 who have other health concerns may be at risk for pushing it too low, according to a new study. Particularly for older adults with multiple serious illnesses and functional limitations, the risks of low blood sugar, or hypoglycemia, may outweigh the benefits of tight blood sugar control, the authors write. “Older people are more susceptible to hypoglycemia,” said lead author Dr. Kasia J. Lipska of the Yale School of Medicine in New Haven, Connecticut. “As people age, their kidney function deteriorates and drugs (like insulin) may not be eliminated from the body as efficiently,” which can lead to low blood sugar, she told Reuters Health by email. Often, people with low blood sugar don’t realize they have it. Symptoms can include double or blurry vision, rapid heartbeat, headache, hunger, shaking or trembling, sweating, tiredness or weakness or feeling faint, trouble sleeping, unclear thinking, and other problems. Severe low blood sugar can cause seizures and brain damage. Intense diabetes treatment, which the study showed many older people are doing, increases the risk for hypoglycemia two to three fold, Lipska said. Her team used data on 1,288 diabetics age 65 or older, from the National Health and Nutrition Examination Surveys from 2001 through 2010. Based on their ability to complete activities of daily life, about half of the participants were generally healthy, 28 percent had “complex or intermediate” health and 21 percent had “poor” health. To see how tightly these patients were controllin Continue reading >>
Taste Buds, Blood Sugar And Aging: Is There A Connection To Diabetes?
It is known that 25% of Americans over the age of 65 (11.2 million) are living with diabetes. The study’s leader investigator, Chee Chia, MD stated, “The reduced number of taste buds with advancing age might be linked to the increase incidence of type 2 diabetes among older adults. Dr. Chia is a medical officer at the National Institute of Aging (NIA) in Baltimore, MD. He presented the study's findings during the joint 16th International Congress of Endocrinology and 96th Annual Meeting of The Endocrine Society held in Chicago in June 2014. The results from the National Health Interview Survey, showed less than 1% of people in the 18-24 age group reported taste impairment. In people age 85 and older taste impairment was reported at 1.7%. Furthermore, studies have shown that people with a first-degree relative with type 2 diabetes had impaired sweet taste. According to Dr. Chia’s presentation, people with a first-degree relative and type 2 diabetes needs a glucose solution to be twice as sweet before they can perceive/taste sweet. The investigators analyzed data from 353 adults who participated in the NIA’s Baltimore Longitudinal Study of Aging between 2011 and 2014. This is an observational study of community volunteers. The study (ongoing) counts the number of taste buds on the tip of the tongue after the tongue is stained with blue food dye. “Taste cells are present in the taste buds on the tongue. A taste bud is like an onion-shaped structure consisting of between 15 to 100 taste cells,” Dr. Chia illustrated. Researchers at the NIA found the hormones contained with the taste cells on the tongue in mice to be glucagon and glucagon-like peptide 1 (GLP-1). These are the hormones that help the body regulate sugar. Glucagon increases glucose levels, GLP-1 regu Continue reading >>
Are You At Risk For Diabetes?
Who Gets Diabetes and How to Manage It Diabetes is a metabolic disease that can lead to serious health complications if left untreated. Several factors, such as body weight, family history and race and ethnicity may increase your risk of diabetes. Diabetes can be effectively managed by exercising and eating a healthy diet. What is diabetes? Diabetes (medically known as diabetes mellitus) is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. Diabetes usually can’t be cured. Left untreated—or poorly managed—it can lead to serious long-term complications, including kidney failure, amputation, and blindness. Moreover, having diabetes increases your risk for cardiovascular disease, including heart attack and stroke. Your body and sugar To understand diabetes, it’s helpful to understand the basics of how your body metabolizes (breaks down) sugar. Most of the cells in your body need sugar as a source of energy. When you eat carbohydrates, such as a bowl of pasta or some vegetables, your digestive system breaks the carbohydrates down into simple sugars such as glucose, which travel into and through your bloodstream to nourish and energize cells. A key player in the breakdown of sugar is the pancreas, a fish-shaped gland behind your stomach and liver. The pancreas fills two roles. It produces enzymes that flow into the small intestine to help break down the nutrients in your food—proteins, carbohydrates, and fats—to provide sources of energy and building material for the body’s cells. It makes hormones that regulate the disposal of nutrients, including sugars. Cells in Continue reading >>
Rising Blood Sugar: How To Turn It Around
Image: Thinkstock Rising blood sugar signals a need for weight loss and more exercise. Whenever you have routine blood tests at a physical exam, chances are one of the numbers will be a measurement of your glucose, or blood sugar. A normal blood sugar level is less than 100 milligrams per deciliter of blood (mg/dL) after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher. But between those two numbers lie many opportunities for action. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Continue reading >>
Type 2 Diabetes In Seniors: Symptoms & Care
My career working with older people began 25 years ago at Community Services for the Blind, where friends, staff, volunteers and clients had lost their sight due to complications from diabetes. Some died at an early age. Today we know much more about the prevention, diagnosis and treatment of type 2 diabetes than we did then. Nevertheless, the disease has reached epidemic proportions in the U.S., afflicting more and more people at younger and younger ages. Type 1 diabetes affects 5% of all people with diabetes and occurs mostly in people under the age of 20. In this condition, the pancreas produces insufficient insulin to maintain normal glucose (blood sugar) levels. The vast majority of people with diabetes have type 2 diabetes, which is characterized by hyperglycemia (excess blood sugar) and insulin resistance. It can cause not only vision loss, but kidney failure, nerve damage, cardiovascular (heart and other artery blockage) disease, as well as increased infections and slowed healing, sometimes resulting in the need for amputation. Type 2 diabetes in seniors is particularly problematic. Type 2 Diabetes Symptoms The most common initial symptoms of type 2 diabetes are increased thirst and frequent urination. Excess glucose in your bloodstream sucks water from tissues, forcing you to want to take in more liquid. Type 2 diabetes is frequently asymptomatic for many years, before initial tell-tale signs of the disease emerge. These include: Flu-like Fatigue Feeling lethargic, tired or chronically weak can be a sign of type 2 diabetes. When your body can't process sugar properly, you'll have chronically low energy. Weight Loss or Weight Gain Because your body is trying to make up for lost fluid and fuel, you may eat more. The opposite can also happen. Even though you eat m Continue reading >>
Blood Sugar Levels For Adults With Diabetes
Each time you test your blood sugar, log it in a notebook or online tool or with an app. Note the date, time, results, and any recent activities: What medication and dosage you took What you ate How much and what kind of exercise you were doing That will help you and your doctor see how your treatment is working. Well-managed diabetes can delay or prevent complications that affect your eyes, kidneys, and nerves. Diabetes doubles your risk for heart disease and stroke, too. Fortunately, controlling your blood sugar will also make these problems less likely. Tight blood sugar control, however, means a greater chance of low blood sugar levels, so your doctor may suggest higher targets. Continue reading >>
Checking blood sugar levels is a way of measuring how well the body uses glucose (GLOO-kose), a sugar that is the chief energy source for cells. After a meal, blood glucose rises. A hormone called insulin helps transport the sugar into cells, where it can be used as fuel. Blood sugar then gradually drops back to normal. Blood sugar levels that remain higher than normal signal two problems: (1) cells are “starving” because they are not absorbing enough glucose and (2) the extra sugar circulating in the blood can damage the eyes, kidneys, nerves, heart and blood vessels. Current guidelines establish two categories of higher-than-normal blood sugar: Prediabetes or “borderline diabetes.” Blood sugar is elevated but not high enough to meet criteria for diabetes. The formal terms for this condition are “impaired fasting glucose” or “impaired glucose tolerance,” depending on how blood sugar is measured. Those with prediabetes are at increased risk of developing cardiovascular disease and diabetes in the future. Diabetes. There are two main types Type 1, in which specialized cells in the pancreas lose their ability to produce insulin. Type 1 diabetes is relatively uncommon and usually occurs in children and young adults. Type 2, in which cells throughout the body lose their ability to respond to insulin About 90 to 95 percent of individuals with diabetes have Type 2. The risk for Type 2 increases with age, although it is diagnosed with growing frequency in all age groups. Other risk factors for Type 2 diabetes include overweight, lack of exercise, high blood pressure, family history of diabetes, and being an African-American, Hispanic American, Native American, Asian American or Pacific Islander. Experts estimate many Americans with Type 2 diabetes have not been Continue reading >>
Age And Glucose Intolerance
Effect of fitness and fatness The fact that glucose intolerance increases with age has been apparent for over 30 years, leading to the suggestion at one time that the diagnostic criteria for diabetes be amended to account for this inevitable consequence of the aging process (1). However, these earlier findings did not differentiate the effects on the plasma glucose response to an oral glucose challenge of age per se from those due to the impact of a number of age-related variables (2). In this context, the article by Imbeault et al. in this issue of Diabetes Care (3) provides additional information concerning the effect of body fat on glucose tolerance, as apparently healthy volunteers grow older. However, the potential effect of differences in fitness, an age-related variable of comparable magnitude, was apparently not considered in their study. Maneatis et al. (4) quantified the impact of differences in age-related variables on the plasma glucose response to a mixed meal in healthy volunteers between the ages of 47 and 90 living in a retirement community. When adjusted for differences in body weight and physical activity, they found no significant correlation between age and plasma glucose response in men, and differences in age could account for no more than 6% of the variability in glucose response in women. Similarly, when adjusted for differences in weight, physical activity, and use of diabetogenic drugs, age only accounted for 6% of the variance in plasma glucose response to an oral glucose challenge in men and 1% in women in a study of 732 Italian factory workers aged 22–73 years (5). Perhaps the most definitive information in this regard is the results of the Baltimore Longitudinal Study of Aging (6), performed in 743 healthy individuals, comparing glucose t Continue reading >>
Sugar May Be Sapping Your Memory
Print Font: Do you ever forget people's names? Enter a room and forget why you went there? Forget a word mid-sentence? As we get older, these types of "senior moments" happen more often. Many of the people I evaluate worry that these slips mean they are getting Alzheimer's disease. In most cases, they aren't. They're just part of normal, age-related memory decline. Starting at about age 30, our ability to process and remember information declines with age. But though these cognitive changes are common, cognitive decline is not inevitable. Recent research has identified specific brain alterations that underlie this kind of age-related cognitive decline. And the good news is that many of these brain changes can be prevented with healthy lifestyle practices. A key finding: Elevated blood sugar contributes to cognitive decline. The details: It has long been known that problems with short-term memory are related to age-related decreases in blood flow in a part of the brain called the hippocampus. Recently, researchers at Columbia University Medical Center discovered that decreased blood flow to the hippocampus is related to elevated blood sugar levels. Scott Small, MD, the lead investigator, said the effects can be seen even when levels of blood sugar, or glucose, are only moderately elevated. This finding may help explain normal age-related cognitive decline, since our body's ability to regulate blood glucose levels worsens with age. Your brain's primary fuel is glucose. If your blood sugar level drops too low, you'll have trouble paying attention, learning, and remembering information. But if your sugar level is consistently too high, the body pumps out excess insulin, which causes inflammation and oxidative stress that prematurely age your brain. So, a cup of coffee with Continue reading >>