Nutrition: Carbohydrates Chapter 11

Blood Sugar Gone Awry


Blood Sugar, High and Low

We are made entirely of cells, and the cells of the body depend on sugar in the blood, derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood-sugar (glucose) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher than normal levels hyperglycemia. READ MORE

Hypoglycemia, indicated around 70 mg/dL and lower, can be traced to three causes. The body may be using up the available blood sugar (glucose), or the glucose ingested may be released into the blood stream too slowly. It’s also possible that too much insulin is being released.

Hyperglycemia is the hallmark of prediabetes (between 100 and 125 mg/dL) and diabetes (126 mg/dL and higher). It is caused by either too little insulin being released by the pancreas or the body’s inability to use insulin properly. LESS


Diabetes Types 1 and 2

What is Type 2 Diabetes?

The basis of type 2 diabetes is simple, though its effects on one’s life are at the very least complex and at the very worst, devastating. The condition is marked by either an inability to produce enough insulin or the incapacity of the cells to recognize and receive the hormone (“insulin resistance”). Without insulin, glucose cannot make its way into the body’s cells to nourish and energize them.

What is Type 1 Diabetes?

Type 1 diabetes was formerly known as juvenile diabetes due to its being diagnosed predominantly in children and young adults. In type 1, which is far less common than type 2, the body does not produce the hormone insulin.

Resistance Risks

The result of insulin resistance, wherein the hormone insulin is literally “resisted” by the cells, is often diabetes. But not always. Sometimes there’s enough insulin in the system to keep diabetes at bay even when blood glucose levels run high. But when the blood contains elevated levels of sugar, plus all of that unutilized insulin, other life-threatening conditions can develop from the clogging and damaging of blood vessels. READ MORE

The CDC estimates that some 70 million Americans are at risk of metabolic syndrome, which substantially steps up the risk for coronary artery disease and stroke in addition to diabetes. Metabolic syndrome is not so much a disease as a collection of worrisome risk factors. The combination of high blood pressure, raised triglyceride (fat) levels, low HDL or “good” cholesterol, and extra weight around the waist comprise metabolic syndrome. It’s also sometimes known as insulin-resistance syndrome or, distressingly, Syndrome X. LESS


Diabetes Risks

Linking Obesity to Diabetes

The association between obesity and diabetes is well established. For years it has been observed that trends in the two conditions run parallel, and the current epidemic levels of both conditions bear this out. However, an association does not establish a causal scientific link. It’s circumstantial evidence. READ MORE

What we can say concretely is that obesity is a major risk factor for diabetes. According to the CDC, about 55% of all diagnosed diabetics are obese. Even more convincingly, 90% of type 2 diabetes cases could be prevented through a combination of a healthy diet and an active lifestyle, according to the Harvard School of Public Health. LESS


Identifying and Managing Diabetes Complications

Losing eyesight, losing a limb, and losing kidney function are among the more frightening complications of diabetes. The root cause behind all three of these risks is the effect of excess blood sugar on circulation and the nervous system. READ MORE

When blood sugar rises too high, red blood cells get drenched in glucose. Like a candied apple, a coated cell becomes stiff. “Sticky cells” cannot be transported easily through the small vessels. The blood vessels most vulnerable to circulatory problems are those that are the most fragile, including not only the vessels of the nerves but those of the eyes, feet, and kidneys.

Small blood vessels carry blood to nerves, and about half of all diabetics have nerve damage causing numbness, discomfort, and ulcers in the feet, which when infected can lead to amputation.

Managing Insulin Issues

Thanks to advances in treatment, many people lead complete and comfortable lives with diabetes. If you have been diagnosed with diabetes type 1 or 2, there are a number of options for maintaining healthy blood sugar levels.

The touchstones for diabetes treatment include:

  • Glucose monitoring

  • Blood pressure monitoring and management

  • Regular eye and skin examinations

  • Diet management, including the counting of carbohydrates

  • Physical activity according to a doctor’s recommendations

  • Special attention around complicating factors such as pregnancy, stress, and aging

  • Lifestyle modifications, including concerns about driving and operating machinery

Anyone with type 1 diabetes will require lifelong insulin therapy. The available types of insulin — rapid-acting, long-acting, intermediate — vary in how quickly and for how long they can control blood sugar. Your physician will help you figure out what type of insulin is appropriate based on several factors. Three delivery mechanisms — needle, pen, and pump — are available to inject the hormone. Insulin can’t be administered orally, though other oral meds may be prescribed to someone with type 1 diabetes to manage related issues such as blood pressure and cholesterol levels.

Some people with type 2 diabetes require insulin and medication, while others can keep blood sugar levels in check with diet and exercise. Physicians routinely recommend losing weight and staying active. Medications given orally or by injection can be taken to lower glucose production in the liver, and may be prescribed in conjunction with insulin treatments. LESS


The material on this site is for informational purposes only and is not intended as medical advice. It should not be used to diagnose or treat any medical condition. Consult a licensed medical professional for the diagnosis and treatment of all medical conditions and before starting a new diet or exercise program. If you have a medical emergency, call 911 immediately.