In October we learned how insulin is connected to American’s expanding girth. Blood sugar plays a large role, followed by increased secreted insulin, which allows for blood sugar to be stored as fat. But what if insulin isn’t produced and therefore doesn’t control blood sugar, then what?
As one of my undergraduate professors would say, “we live in a Goldilocks world,” having some blood glucose is vital, but too much is detrimental. Too much blood sugar is called hyperglycemia and often occurs in Diabetes type 1 (autoimmune condition) or Diabetes type 2 (insulin resistant, linked to extra weight). Classic signs of diabetes are: frequent urination, intense thirst, and ravenous hunger. High blood glucose, when filtered through the kidney allows for glucose to spill over from the blood into the urine, pulling water along with it. This causes frequent urination and dehydration, which accounts for increased thirst.
Insulin is important because it allows glucose in the blood to enter cells, cells need glucose for energy. Most cells in the human body require insulin before glucose can enter. Insulin effectively removes excess glucose from the blood. Excess blood glucose (especially greater than 400 mg/dL) is dangerous. Conversely, blood sugar too low (less than 40 mg/dL) is dangerous and can render a person comatose, cause brain damage, and result in death.
Uncontrolled high blood sugar leads to degenerative cardiovascular and neurological diseases. It damages small to medium blood vessels and peripheral nerves. Nerve damage (neuropathies) are the most common complication of diabetes leading to impotence, incontinence, and loss of sensation. Neuropathies can be severe, resulting in gangrene and need for amputation. Hyperglycemia decreases immunity, slows wound healing, increases likelihood of infections. There is evidence that diabetes (elevated blood sugar) increases dementia risks by 2 times. High blood glucose promotes high triglycerides, high LDL cholesterol, atherosclerosis (thus cardiovascular disease), and poor circulation. Degenerative changes may occur within the small vessels in the eye and in the kidney (renal damage).
What is your fasting blood sugar? Fasting blood sugar, ideally is between 80-90 mg/dL (the conventional normals are between 65-110 mg/dL). It is often a good idea to screen for pre-diabetes or diabetic changes by testing fasting blood glucose annually. I believe it is a good idea to order a fasting insulin test; this is a sensitive test which indicates future insulin resistance, allowing us to make proactive life and treatment changes preventing insulin resistance and diabetes (type 2) in the future.
