The danger of having high blood sugar and how to avoid diabetes

The problem is that It is a silent disease, which usually debuts in adulthood and one in two people is unaware of it.. In fact, in Spain, Almost a third of people with diabetes are undiagnosed, according to data from the International Diabetes Federation (FID). Due to the risk that this poses for the development of other pathologies, including cardiovascular diseases, it is necessary to make an early diagnosis to be able to carry out adequate control and minimize the risk.

As confirmed to CuídatePlus Miguel Turégano, secretary of the Regional Board of Directors of the Spanish Society of Primary Care Physicians (Semergen) Extremadura, indeed, “there is a significant underdiagnosis in type 2 diabetes. So much so, that almost a third of people (specifically 30.3 %) who live with diabetes in Spain are not diagnosed and This causes a greater risk of complications in the short, medium and long term that reduce the quality of life of patients and increase healthcare costs.”.

In the opinion of Elsa Fernández Rubio, member of the Spanish Diabetes Society (SED) and expert from the Endocrinology and Nutrition Service of the Cruces University Hospital, Barakaldo, “this underdiagnosis is produced, fundamentally, by the absence of analysis with determination of glucose in risk populations such as patients with obesity, overweight or in anyone over 45 years of age.” Thus,”It is necessary to raise awareness among the population about the importance of performing periodic tests, and this is especially important for those people with other risk factors,” says Turégano.

Diabetes is a disease that is closely linked to glucose. In fact, In people with diabetes there is excess glucose in the blood (hyperglycemia), since it is not distributed properlywhich gives rise to significant problems at the cardiovascular level.

However, Not all “high blood sugar” is diabetes.

When we say that we have high blood sugar, explains Turégano, “we mean that blood glucose levels (also called glycemia) are highs, since the body cannot produce enough insulin to reverse these glucose levels.”

As he explains, having high blood glucose “can occur in people with diabetes, especially in poorly controlled patients, but high blood glucose does not necessarily imply diabetes”. In this sense, he points out that “it is worth noting that there may be cases of altered basal blood glucose levels or prediabetes that can also lead to high blood glucose levels and that do not per se imply a diagnosis of diabetes.”

So, When we say that a person has high blood sugar, we may be referring to two conditions, according to Fernández Rubio:

1. Mellitus diabetes. This is diagnosed when high sugar levels are confirmed (fasting glucose ³ 126 mg/dl, glycated hemoglobin ³ 6.5% or glucose after oral glucose load test ³ 200 mg/dl) in 2 determinations or by 2 parameters different in people without symptoms of diabetes. The symptoms of type 1 diabetes would be: urinating a lot, drinking a lot of water or losing weight.
   
2. Prediabetes: This term refers to people who, without meeting the criteria for diabetes, have glucose (sugar) levels higher than normal.

Prediabetes: what it is and how do I know if I have it?

The term prediabetes It refers to an intermediate state between normal glucose and diabetes. As Fernández Rubio explains, “it groups together those situations in which glucose is not high enough to meet the diagnostic criteria for diabetes mellitus, but they are above normal.” According to the [email protected] study (previously commented) around 14.8% of the population has prediabetes (glucose intolerance, altered basal glycemia or both), “which should be encouraged even more in the prevention of this clinical situation,” says the Semergen doctor.

According to this, How do we know we have prediabetes? “While the diagnosis of diabetes in asymptomatic people requires two high analytical determinations,” indicates the SED expert, “in the case of prediabetes, a single elevated determination is already considered diagnostic of this situation”.

The definition of prediabetes varies depending on the guides we consult. In general, “in our environment, Prediabetes is considered the appearance of a fasting blood glucose between 110 and 125 mg/dl, a blood glucose after oral glucose overload between 140 and 199 mg/dl or an HbA1c between 6 and 6.4%.”.

On the other hand, for the diagnosis of diabetes, the criteria are somewhat higher: “Basal fasting blood glucose equal to or greater than 126 mg/dl, blood glucose greater than 200 mg/dl two hours after an oral glucose resistance test or HbA1c equal to or greater than 6.5%,” says Turégano. For the diagnosis of diabetes, he adds, “two determinations on different days of any of these 3 criteria are needed.”

Is high sugar treated?

Prediabetes is one of the main risk factors for the development of type 2 diabetes mellitus, which is why it is key to detect it and put measures in place to help prevent progression towards this disease.

In general, points out Fernández Rubio, “the treatment of prediabetes will consist of changes in lifestyle”:

• Diet modifications to follow a healthy eating pattern
  
• Perform at least 150 minutes a week of aerobic physical exercise
  
• Avoid tobacco
  
• Avoid overweight or obesity).

With these changes, the specialist assures that “glucose levels can return to normal levels.” However, “it will be advisable to continue with the periodic monitoring indicated by the healthcare team given the increased risk of diabetes in cases in which prediabetes has been detected.”

At a pharmacological level, Turégano reports, “it is not necessary to use any treatment” although, as Fernández Rubio points out, “In some cases, the healthcare team may recommend starting drugs to treat this condition.”