Hyperglycemia - Diabetes Sugar Levels - Health Article

Hyperglycemia - Diabetes Sugar Levels

What is hyperglycemia?


The term hyperglycemia indicates a pathologically increased amount of glucose in the blood (blood sugar). It has been established acute hyperglycemia by the determination of glucose, long-term by the level of HbA1c in the blood.

Hyperglycemia is the cardinal symptom of diabetes mellitus (sugar diabetes), in accordance with the necessary regulation of the nutrient glucose is disturbed, so that it is then excreted from a height of about 200 mg / dl, the so-called renal threshold also in the urine. The symptoms related to hyperglycemia rich short of thirst and dry mouth of increased urine excretion (polyuria) and visual disturbances up to the untreated fatal hyperglycemic coma. In the long term hyperglycemia is significantly involved in the classical consequences of a sugar disease such as stroke, loss of vision or kidney failure. Your treatment consists in a regulation of glucose levels in the blood by means of suitable measures, such as the administration of insulin.

Historically, the concept of hyperglycemia was subjected to great changes. So the medicine went to the end of the 19th century assumed that any occurrence of sugar in the blood must be regarded as pathological. In 1885 it was recognized that sugar also occurs in the blood of healthy people and increased urine excretion occurs as symptoms only at a value of about 210 to 260 mg / dl. The blood sugar level is by today's definition of healthy sober not more than 100 mg / dl and after a glucose tolerance test (OGTT) not more than 140 mg / dl. In diabetics, he is sober about 125 mg / dl and at OGTT than 200 mg / dl. The "gray area" between them is referred to as intermediate hyperglycemia and holds statistically increased risk of diabetes mellitus cancer.

Occurrence


Blood sugar levels should be sober (ie, at least 8 hours after the last caloric intake) in healthy persons under 100 mg / dl and after a glucose tolerance test at 140 mg / dl. If the body on food, then glucose and other sugars, with some exceptions, absorbed through the intestine and out through the portal circulation to the liver before they reach the blood stream. By various regulatory mechanisms of blood sugar levels is held there in healthy long term at about 70 to 80 mg / dl constant. Is now rising due to a carbohydrate-rich food supply in glucose levels in the enterohepatic circulation, the beta cells of the pancreas are stimulated to distribute insulin to keep blood sugar levels constant. Failing this regulation, it comes to short or long-term hyperglycemia.

Hyperglycemia is the cardinal symptom of diabetes mellitus, this is however not a safe criterion. Even a Cushing's disease (elevated cortisol levels), acromegaly (elevated growth hormone levels), pheochromocytoma (increased levels of adrenaline and noradrenaline), hyperthyroidism (for example as a result of Graves' disease), iron deposits in the beta cells of the pancreas (hemochromatosis) and drugs can they trigger. You can also dealing with infection after heart attack, stroke or anesthesia occur. In the females, due to high progesterone levels occur in the Zwischenbrunst to a rise in blood sugar in the blood, stress in cats can cause a long-lasting hyperglycemia.

Hyperglycemia treatment


In the treatment between acute intervention and long-term treatment (treatment of diabetes mellitus) must be distinguished. Moreover, it is dependent on the severity of hyperglycemia.

Be found for example in the context of a screening slightly elevated blood sugar levels, so no acute hypoglycemic action is appropriate, but the supply of patients for further diagnosis. Is a blood sugar test load impaired glucose tolerance revealed without the HbA1c level is increased as dietary measures with particular attention to the glycemic index of foods are usually sufficient improvements in lifestyle. Is simultaneously HbA1c levels increased within the meaning of manifest diabetes mellitus moderate so is to examine to what extent dietary measures are sufficient, or the administration of drugs is necessary.

At high values from about 250 to 300 mg / dl is a swift action with the aim to normalize blood sugar and thus prevent a diabetic coma, also appear in the absence of accompanying symptoms. For acute therapy, particularly the administration of insulin is.

Is there already a diabetic coma, as a emergency medical intervention is necessary.

Prevention and cure views


In healthy individuals, no specific prevention is displayed (apart from generally applicable rule for a healthy life), but the body on its own in a position to keep blood sugar levels within normal limits. However, there is a sugar metabolism disorder, so regular checks with good adherence to therapy are essential not only in terms of a coma prevention, but particularly with regard to the best possible prevention of concomitant diseases and complications, in particular the glycosylation of different proteins and the associated changes of the basement membrane of the capillaries (see also section pathology).

History


The best-known effect of hyperglycemia, the occurrence of polyuria was known already in antiquity. One of the earliest known descriptions comes from Aretaeus in the 2nd century. BC .. The occurrence of honey-like tasting urine has long been known, but the initial detection of sugar in urine led until 1776 by Matthew Dobson. The sugar in urine was carried out at the time by so-called yeast fermentation samples.

The presence of sugar in the blood, especially by diabetics, in the first half of the 19th century has been the subject of scientific investigation. With the then usual method of blood examination after William Hyde Wollaston such proof could be performed.

1839 Friedrich Ludwig H├╝nefeld describes the use of sulfuric acid for the examination of the urine for sugar (Runge) as sensitive as the fermentation and maintains the use of this method to an investigation of blood possible. The first actual chemical sugar test, also called Trommersche sample was introduced in 1841 by Karl August Trommer. The first chemical method that allowed a useful assessment of blood glucose levels, was the Pettenkofersche sugar sample. After addition of bile solution and sulfuric acid to the blood serum occurs by heating it to a discoloration that is dependent on blood sugar levels. This method was described in 1844 by Pettenkofer and 1847 mentioned in the context of casuistry, that used clinically.

In 1868 a correlation between the level of blood sugar and the polyuria was doubted. But there were already corresponding theses.

In the same year, it was argued that "... the organism, the presence of sugar in the circulation do not condone, but always attempts the same through the urinary excretion bring. ... "(Quoted by Schultz). The medicine was still in the 70 years of the 19th century believed that the blood sugar is not a Healthy and thus its mere presence is to be regarded as pathological in the sense of the concept of hyperglycemia. In this context, it should be noted however, that at that time the scientists were still trying to diabetes, so the Harnruhr by the galenic humoral doctrine, to explain as black bile excretion, which tastes sweet unergr├╝ndlicherweise. In the 1880s, then the idea of Carlsbad physician Carl Hertzka was taken up, as the symptom of an underlying disease and not as a disease postulated the elimination of sugary urine in excessive quantity per se. The stage before the onset of Harnruhr he called "passive stage of diabetes". He ultimately opened the door to today's understanding of hyperglycemia as a symptom of diabetes mellitus, although it also failed him establish a connection between blood sugar levels and the appearance of Glukos- / polyuria.

1885 normal blood was then described as sugary and also noted that with an increase in its sugar content to 0.25 to 0.30% (equivalent to about 210 to 260 mg / dl after today's nomenclature) temporarily excreted sugar in the urine, which was indeed already in previous years as pathological. So it took until this time, until it was established that sugar circulates in the blood Healthy (normoglycemia) and that above a certain amount (currently this limit is called the "renal threshold") sugar is locate in the urine and thus hyperglycemia (ie a morbid excess of sugar in the blood) was defined. 1952 describes Herder's folk lexicon as normal value 3.0 grams of sugar (0.07%) in the blood fluid (2800 ml) of 5 liters of blood. Which corresponds to the common units today about 60 mg / dl. In 1959, the normal blood sugar level was already as between 70 and 120 mg% (equivalent to mg / dl) lying defined (Hagedorn-Jensen method - reducing sample against Ferricyankali), which corresponded to an almost the present standards.

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