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High blood sugar

High blood sugar



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High blood sugar levels

More and more people in Germany have difficulties with permanently elevated blood sugar levels. The complaints are often a result of lifestyle and with the help of a few preventive measures, it is relatively easy to avoid high blood sugar. If no countermeasures are taken, the long-term risk of developing a diabetes disease with more serious health consequences.

Definition of high blood sugar

The blood glucose (glucose) in the blood is usually referred to, whereby the blood sugar or glucose level (proportion of glucose in the blood) is to be classified as an important medical measurement. Because glucose forms an essential source of energy in the organism, which the brain, as well as the red blood cells and the kidney marrow need for energy. To supply the brain, glucose is also able to cross the blood-brain barrier.

The Normal blood sugar levels vary throughout the day with meals, with 70 to 99 milligrams per deciliter or 3.9 to 5.5 millimoles per liter being assessed as normal on an empty stomach. After a carbohydrate-rich meal, normal values ​​can go up to a maximum of 160 milligrams per deciliter (8.9 millimoles per liter). Other definitions give values ​​from 50 to 100 mg / dl fasting and a maximum of 140 mg / dl after a meal. If the blood sugar level is above the above figures, this should be classified as high blood sugar. The technical term for high blood sugar is Hyperglycemia.

Causes of high blood sugar

If the blood sugar is permanently elevated, it is usually based on diabetes, which results in impaired processing of the carbohydrates consumed through food. The lack of insulin and / or an impaired effect of the hormone disturbs the regulation of the glucose level in the organism, since insulin plays a decisive role in lowering the blood sugar concentration.

If there is not enough insulin available, blood sugar levels rise significantly more than normal after meals and remain permanently high. If the values ​​are above 126 milligrams per deciliter (seven millimoles per liter) even on an empty stomach (at least eight hours without food intake), this is a relatively clear indication of diabetes. If symptoms such as persistent thirst, frequent urination, increased susceptibility to infection or significant weight loss occur within a few months, diabetes can be safely assumed. Diabetes mellitus is a collective term for various disorders of the (sugar) metabolism, the key feature of which is excessive blood sugar.

But high blood sugar can also have other causes. For example, blood sugar levels also rise sharply in stressful situations, severe injuries, operations, infections, burns, severe pain or a heart attack, but this is by no means an indication of diabetes. In particular, the connection with stress is often underestimated, although stress-induced hyperglycemia is a well-known complaint in the professional world. Furthermore, damage to the brain due to injuries or infections, but also a stroke also lead to increased blood sugar levels. In addition, malfunction of the pituitary gland can be the cause of high blood sugar.

In addition, certain toxins and medications raise blood sugar levels, which in rare cases can lead to diabetes. The drugs are suspected, for example, of various blood pressure medications, diuretics (diuretics), some psychotropic drugs as well as hormones and hormone-like drugs (e.g. cortisone) to increase blood sugar. Certain cytostatics, asthma medications, labor pills and the more common catecholamines used in emergency clinics (e.g. adrenaline, noradrenaline) can also increase blood sugar.

The excessively high blood sugar levels usually decrease after stopping the medication, but should damage to the pancreas persist, those affected are at risk of a permanent increase in blood sugar levels and long-term development of diabetes.

Diseases of the pancreas, which damage the function of the organ, can also lead to increased blood sugar, since the pancreas is responsible for the production of insulin. Inflammation of the pancreas, pancreatic carcinomas (pancreatic cancer), injury to the organ or damage caused by iron storage disease (hemochromatosis) can also cause excessive blood sugar. The same applies to impairments of pancreatic function in the case of cystic fibrosis (cystic fibrosis) and the relatively rarely required surgical removal of the organ.

Hormonal disorders that are not insulin-based can also have a negative impact on blood sugar levels. Some hormones cancel the effect of the insulin and cause excessive blood sugar. If such hormones are released in excess, as is the case with various tumors, for example, the blood sugar levels rise significantly. For example, the growth hormone somatropin, cortisol, aldosterone (natural steroid hormone) and some thyroid hormones are known as blood sugar increasing hormones. Glucagon and somatostatin are also suspected of increasing blood sugar.

At the hormonal level, there are numerous connections with the blood sugar and if there are signs of a hormone-related increase in blood sugar, the values ​​of the suspected hormone should be checked by a doctor.

Diagnosis and blood sugar measurement

Blood tests are primarily used to check blood sugar, although in the past the glucose level was also frequently checked by means of an analysis of the urine. Due to the diabetic's need for an uncomplicated test procedure, the blood glucose meters have been continuously improved in recent decades and are now available in extremely handy versions that can be carried at any time. Blood sugar is usually measured using a blood sample from capillary blood.

Today's blood glucose meters cannot ensure the same accuracy of results as a laboratory test, but the precision is easily sufficient for diabetics who want to estimate their insulin dose.

The measuring devices indicate the blood sugar either in milligrams per deciliter (more common in Germany) or in millimoles per liter (more common worldwide). The procedures offer patients at risk the opportunity to monitor their blood sugar at any time and to monitor the development of blood sugar levels throughout the day. In the current treatment guidelines for diabetes, values ​​between 100 and 125 mg / dl on an empty stomach and 140 to a maximum of 199 mg / l after a meal are set as judge values ​​for the blood sugar level.

High blood sugar - health risks

When it comes to the health risks of high blood sugar, all possible impairments of diabetes have to be mentioned. Above all, the damage to the blood vessels due to the permanently increased blood sugar and the high blood pressure that occurs in most patients play a special role here. They are also the reason why diabetes patients are at a significantly increased risk of stroke, heart attacks, coronary heart diseases and other secondary diseases. It is therefore strongly recommended that those affected regularly check their blood pressure.

If the blood sugar level is permanently too high, kidney diseases up to acute kidney failure and damage to the peripheral nervous system are also promoted. Another consequence is what is known as diabetic retinopathy, damage to the retina caused by so-called microangiopathy (disease of the small blood vessels). In the long term, retinopathy can cause significant impairment of vision and, in the worst case, complete blindness. A cure is not possible with diabetic retinopathy, but there are various therapeutic approaches that can significantly delay the course of the disease.

Another health consequence of permanently high blood sugar is the so-called diabetic foot or diabetic foot syndrome. According to estimates by the German Diabetes Society (DDG), around ten percent of diabetes patients have symptoms with their feet in the course of their illness. According to the DDG, around 29,000 amputations due to diabetic foot syndrome have to be performed annually, in which parts of the foot or leg are removed. The diabetic foot syndrome is in itself the result of other impairments that are triggered by increased blood sugar levels and is therefore only indirectly due to the high blood sugar.

Damage to the blood vessels in combination with the increased susceptibility to infections, poorer healing and nerve damage are usually the cause of diabetic foot syndrome. Even small injuries and pressure points in the area of ​​the feet lead to dangerous ulcers, which in case of doubt make an amputation necessary. Since the damage to the vessels and the susceptibility to infection or poorer wound healing are directly caused by the excessively high blood sugar levels, diabetic foot syndrome should also be mentioned as a risk in the event of increased blood sugar levels.

Another typical symptom of high blood sugar is an increased urge to urinate, which may also result in dehydration (internal dehydration) of those affected. There is also chronic fatigue and dizziness (especially in the morning after getting up).

If the blood sugar levels are massively above normal, this can also cause a loss of consciousness, the so-called hyperosmolar coma. However, this only threatens with blood sugar levels of around 1,000 milligrams per deciliter or 55.5 millimoles per liter. As mentioned above, high blood sugar is also associated with an increased susceptibility to infections. If the increased blood sugar manifests itself as diabetes, there are also more side effects of insulin deficiency such as a massive weight loss, abdominal pain, the smell of acetone in the air we breathe or nausea and vomiting.

Regulation of blood sugar levels

The hormone insulin makes an important contribution to the regulation of blood sugar levels. It determines the breakdown of glucose by promoting the storage of blood sugar in the cells, using the excess blood sugar to build up energy storage glycogen (especially in the liver) and inhibiting the production of glucose from protein fragments. Insulin is the most important hormone for the utilization and storage of blood sugar, whereby it also makes a significant contribution to the build-up of adipose tissue.

An excessively high blood sugar usually results from an insufficient distribution or an impaired function of the insulin. However, other hormones also contribute to the regulation of blood sugar. For example, glucagon often also plays an important role in high blood sugar levels. Glucagon increases blood sugar, among other things by promoting the breakdown of the glucose storage glycogen to glucose. Furthermore, glucagon stimulates the production of glucose from protein fragments and promotes fat loss, whereby the fat is also converted into glucose. Elevated blood sugar levels could also be due to excessive glucagon release.

The hormones already mentioned in the "Causes of high blood sugar" section also have a not insignificant effect on the regulation of blood sugar, although their importance in relation to insulin is less important. The so-called catecholamines adrenaline and noradrenaline have the greatest influence. They raise the blood sugar level considerably within a very short time, among other things by activating the reserves of glucose storage in the liver.

Growth hormones also increase blood sugar because they inhibit the storage of glucose in muscle and fat cells and stimulate the breakdown of the glucose storage glycogen. Cortisol also interferes with blood sugar regulation, whereby the hormone promotes the build-up of glucose from protein components and thus increases the blood sugar level.

The regulation of blood sugar always refers to the breakdown of glucose ingested through food and the use of glucose stores in the organism. The carbohydrates in the food contain glucose, which is released during the digestive process and causes the blood sugar level to skyrocket. As a result, the insulin takes on the effects described above and the blood sugar level drops again.

The organism uses the glucose storage (glycogen) to keep the blood sugar level constant even in (longer) phases without eating. The glycogen stored in muscles and liver can be reactivated at any time and ensure the body's energy supply for a limited time. However, the reserves last a maximum of 24 hours. After this, fat and protein are increasingly converted into glucose, but it is not possible to provide enough blood sugar to keep glucose levels constant in the long term.

High blood sugar treatment

Since the blood sugar values ​​are essentially related to the carbohydrates consumed through food, adherence to a strict diet is the basis of a promising treatment. The diet plan should be drawn up in close consultation with the therapist and with regular monitoring of blood sugar levels. If diabetes has already manifested, the milder forms can also be tackled on the basis of a consistent diet combined with exercise therapies for high blood sugar.

The physical training in the context of movement therapy also has the consequence that more blood sugar is absorbed by muscle cells, so that the blood sugar level drops. In addition, exercise therapy helps to reduce obesity, which in turn has a negative impact on blood sugar levels. If the excessively high blood sugar levels cannot be reduced by the diet in connection with exercise therapies, medication is necessary to stabilize the blood sugar levels.

The diets recommended for high blood sugar primarily provide a balanced whole food, taking into account the carbohydrate and fat intake. The individual's energy and nutrient requirements based on age, gender, occupation and leisure activities must also be taken into account. The calorie content of the food can also be used as a guide. Ideally, food intake should be spread over several smaller meals (up to seven a day) instead of three main meals.

The basic recommendation on the composition of the diet provides for a percentage distribution of 50 percent carbohydrates, 35 percent fats and 15 percent protein. The proportion of monosaccharides (white flour, sugar) should be kept as low as possible and the proportion of polysaccharides (potatoes, whole grains, rice) increased instead. Avoid glucose, sucrose and honey as much as possible. Here, other sweeteners such as the extract of the stevia plant can serve as a substitute.

In order to stabilize the blood sugar levels, the food should also have a high fiber content, since fiber delays the release of carbohydrates into the intestine. In this way, a disproportionate increase in the course of daily meals can be prevented. Further information on the possible diet approaches that enable a lowering of the blood sugar level can be obtained, for example, in the course of medical advice or nutritional advice.

If no therapeutic success can be achieved with the help of diet and exercise therapy, various medications can help to lower blood sugar. If the increased blood sugar is due to a reduced insulin production, it is advisable, for example, to carry out oral medication therapy, whereby different prescription active ingredients are available. These include sulfonylureas (medication: Rp Gluborid® or Rp Euglucon®), which cause an increased insulin release in the pancreas and thus lower blood sugar.

However, oral medication therapy is not sufficient in the severe forms of diabetes to stabilize blood sugar levels in the long term. In these cases, insulin therapy is usually used. Patients regularly inject insulin to lower their blood sugar levels. A distinction is made between short-acting insulins, delayed insulins, long-term insulins and mixed insulins. Today, insulin is usually obtained as genetically produced human insulin.

Furthermore, certain active ingredients can be used to combat the consequences of high blood sugar, such as the SGLT-2 inhibitor empagliflozin against the progression of diabetic nephropathy.

Naturopathy and holistic medicine

In naturopathy and holistic medicine, there are numerous treatment methods for treating high blood sugar levels, which in the past have delivered promising results. Since the increased blood sugar levels put the organism of the affected person under oxidative stress, orthomolecular therapy with the intake of antioxidative vitamin C or vitamin E is used to counteract this. Orthomolecular therapy also uses zinc to increase insulin intensity and thus lower blood sugar.

The administration of brewer's yeast can increase the glucose tolerance due to the contained chromium, strengthen the effect of the insulin and lower the blood sugar values ​​in the long term. B vitamins are usually used in parallel to reduce the risk of nerve damage.

In addition, naturopathy knows various medicinal plants that are used in the context of phytotherapy against high blood sugar levels. For example, dandelion is considered beneficial for blood sugar levels due to its detoxifying effect and boosting liver metabolism. The liver plays an essential role in regulating blood sugar levels.

Thanks to its stimulating effect on the upper abdominal organs, the spleen, pancreas and liver, the control room (Cichorium intybus) also has a positive effect if the blood sugar is too high. The same applies to the so-called centaurium (Centaurium erythraea). Artichoke (Cynara scolymus) is also said to counteract increased blood sugar.

Furthermore, osteopathy is sometimes used to treat high blood sugar levels, which may seem strange at first glance. However, mechanical intervention with the hands can stimulate the function of the pancreas. In conjunction with the other naturopathic methods to lower blood sugar, osteopathy has a supportive effect.

Last but not least, homeopathy is sometimes used to combat disorders of the (sugar) metabolism, whereby an individually suitable selection of remedies should always be put together by experienced therapists.

Important: In the course of naturopathic treatment, regular checks of the blood sugar level must be carried out, whereby in case of doubt there is no way around conventional medicinal therapy (insulin) to avoid the long-term risks of high blood sugar. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • AWMF: National Care Guideline for Therapy of Type 2 Diabetes (accessed 04.10.2019), awmf.org
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  • Antje Gottschalk, Hannah Listing, Laura Reader, Bjorn Ellger: Controlling Blood Sugar - Is Ideal Ideally Optimal ?; in: Intensivmedizin up2date, Volume 13, Issue 01, page 51-61, 2017, thieme-connect.com
  • John Clore, Linda Thurby-Hay: Glucocorticoid-induced hyperglycemia; in: Endocrine Practice, Volume 15, Issue 5, July 2009, journals.aace.com
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  • Simon Mifsud, Emma L Schembri, Mark Gruppetta: Stress-induced hyperglycaemia; in: British Journal of Hospital Medicine, Volume 79, No. November 11, 2018, magonlinelibrary.com


Video: High and Low Blood Sugar Symptoms (August 2022).