Blood sugar, also called blood glucose level, indicates the concentration of glucose in the blood. Glucose is one of the most important energy sources for the human body and is obtained through food in the form of carbohydrates (i.e., sugar). Glucose is distributed throughout the body via the bloodstream, reaching all body cells that require energy. The hormone insulin is needed for these cells to break down the glucose; it is responsible for the first step in this process.
Insulin is normally produced by the body itself in the pancreas. Together with the hormones glucagon and adrenaline, insulin is responsible for regulating the amount of carbohydrates in the body.
Blood glucose levels can be measured using special devices, which can help identify blood glucose imbalances. Normal fasting blood glucose levels are roughly 60-100 mg/dl. Up to two hours after eating a main meal, blood glucose levels can rise to 120-140 mg/dl because new glucose has just been ingested and must first be broken down by the released insulin.
The HbA1c value provides information about blood sugar levels over the past 8-12 weeks by measuring the proportion of hemoglobin (the red blood cell) to which glucose in the blood is bound for transport. This value should normally be between 5.9% and 6.1%.
Blood sugar imbalance – What happens?
A blood sugar imbalance occurs when blood sugar levels are either too high or too low, meaning the measured blood sugar values deviate significantly from normal. Excessively high blood sugar is called hyperglycemia. This is characterized by symptoms such as fatigue, excessive thirst, nausea, and vomiting. In most cases, the elevated blood sugar concentration must be corrected through insulin administration and/or fluid intake.
If blood sugar levels are too low, this indicates hypoglycemia. Symptoms include sweating, rapid heartbeat, trembling, headache, and fatigue. In this case, carbohydrates should be consumed as quickly as possible to raise blood sugar levels and provide the body with renewed energy. People often reach for dextrose, juice, or other sugary drinks because these quickly release sugar into the bloodstream and are relatively easy to process.
diabetes
Diabetes is a disease that currently affects 537 million people worldwide. Type 2 diabetes, in particular, is becoming a prominent modern phenomenon in our society. But what exactly is diabetes, and why are there two different types?
Type 1 diabetes
This type of diabetes is an autoimmune disease that usually first appears in young people during puberty (10-15 years of age). In this case, the misguided immune system destroys all insulin-producing cells. These are located in the pancreas and are part of the islets of Langerhans, known as beta cells.
As a result of this autoimmune disease, the body is unable to produce any or only insufficient amounts of insulin and therefore cannot break down blood sugar. This leads to a corresponding increase in blood sugar levels. To date, there is no definitive cure for type 1 diabetes, but more and more products are appearing on the pharmaceutical market that make living with diabetes easier.
Type 2 diabetes
This type of diabetes develops over the course of a person's life and is usually self-inflicted. Because many different processes in blood sugar metabolism are disrupted, blood sugar levels remain chronically elevated. This means that the body's cells no longer respond as sensitively to insulin and thus develop a kind of insulin resistance. In addition, there is often a reduced secretion of insulin by the beta cells. Unlike type 1 diabetes, the causes of this type of diabetes can be identified relatively easily. Type 2 diabetes frequently occurs in older people. Overweight individuals are also frequently affected.
Type 2 diabetes is more common in people who already have high blood pressure and elevated blood lipids. An unhealthy lifestyle, such as smoking, lack of exercise, and a diet low in fiber and/or high in fat, can contribute to an increased risk of developing diabetes. In addition, type 2 diabetes is sometimes caused by certain medications and other hormonal disorders (e.g., polycystic ovary syndrome).
Type 2 diabetes also presents a problem with its potential complications. These can include nerve damage and changes to the large blood vessels, which in the worst case can lead to heart attacks, strokes, and similar events. Disorders of the small blood vessels are also possible, which can cause damage to the eyes, kidneys, and heart.
Hyperglycemia and hypoglycemia - what is the difference?
Both hyperglycemia and hypoglycemia occur in people with diabetes. This section briefly explains what these conditions are and what to do in case of an emergency. Hyperglycemia is the medical term for high blood sugar. When blood sugar levels rise above 250 mg/dl, it can lead to a diabetic coma and is therefore an acute emergency. If symptoms include deep breathing and sweet-smelling breath, it may be diabetic ketoacidosis.
This requires immediate action and can have various causes. Hyperglycemia most commonly occurs in people who have not yet been diagnosed with diabetes but already suffer from the disease. Forgetting to inject insulin or injecting it at the wrong site (lipohypertrophy) can also cause hyperglycemia. External factors such as stress, infection, or medications that reduce insulin sensitivity (e.g., glucocorticoids) or cause a significant rise in blood sugar levels can further increase the risk of hyperglycemia. Finally, a malfunction of the insulin pen, pen needle, insulin pump, or infusion set (depending on the therapy) can also lead to excessively high blood sugar levels because the insulin cannot be delivered properly.
Hypoglycemia, on the other hand, describes low blood sugar and refers to a blood sugar level below 70 mg/dl. In extreme cases, this can lead to unconsciousness and is therefore life-threatening. In the event of hypoglycemia, it is important to replenish the body's carbohydrate stores as quickly as possible.
Administer glucose. If the person is unconscious, this must never be done by mouth, as this poses a risk of choking. Instead, wait for emergency medical services, who can administer glucose intravenously to stabilize blood sugar levels. Alternatively, a glucagon injection or nasal spray may be used.
Glucagon triggers the release of glucose from the liver, thus enabling a renewed rise in blood sugar levels. Possible causes of hypoglycemia include insufficient carbohydrate intake or an overestimation of carbohydrate intake, which in turn can lead to miscalculations when injecting insulin (accidentally injecting too much or into the muscle instead of the bloodstream). Exercise and physical activity also lead to increased carbohydrate breakdown until energy demands can no longer be met. Alcohol consumption can also cause hypoglycemia, as it causes blood sugar levels to drop rapidly. Increased insulin uptake, for example due to heat, or improved insulin sensitivity during early pregnancy or after weight loss, can also lead to hypoglycemia.
ATTENTION! People without diabetes can also experience hypoglycemia, so the symptoms mentioned above should always be kept in mind.
As a diabetic, you can take steps to prevent medical emergencies related to hyperglycemia and hypoglycemia. First and foremost, it's important to inform those around you about your condition, explain the symptoms, and clearly demonstrate first aid measures. This way, family members can not only provide direct assistance if something happens, but also create an environment that makes daily life easier for the person with diabetes.
It is always advisable to carry an "emergency kit" containing glucose tablets or juice for quick glucose absorption, as well as insulin vials, an insulin pen, batteries for the insulin pump, and a blood glucose meter. A separate slip of paper with the phone numbers of family members, the diabetes clinic, and, if applicable, the insulin pump manufacturer should also always be carried. A diabetes emergency card can also be helpful, as it provides information about the condition and details which medications are currently being taken. This can be particularly useful in the event of unconsciousness and the need for emergency services. These diabetes emergency cards can be applied for online. (Download Diabetes Emergency Card)
If a potential episode of high or low blood sugar is noticed early on, you should seek help immediately, whether by asking for something sugary or by calling emergency services. Because when in doubt, it's always better to be safe than sorry!
Blood glucose measurement
Regular blood glucose monitoring is recommended for all diabetics treated with insulin to allow for greater flexibility in managing their daily lives. Furthermore, regular blood glucose monitoring can facilitate the adjustment of insulin regimens and the injection-meal interval during conventional insulin therapy.
To measure blood glucose levels, a special lancet or an automatic lancing device is usually used to prick the fingertip and take a capillary blood sample. The non-dominant hand is typically used for this, as this avoids inconveniencing the patient in their daily life. The drop of blood is then applied to the test strip in the blood glucose meter, which displays the result after a few seconds. Both the lancet and the test strip are discarded after each measurement and replaced for the next one.
Following the measurement, the patient can react to the blood glucose level and correct it by administering insulin or consuming carbohydrates. Currently, there are generally three different models of blood glucose meters.
The measurement described above is performed by invasive devices that require blood sampling using a lancing device, lancet, and test strips. This method is currently the most accurate, but also the most time-consuming for the user. Non-invasive or minimally invasive blood glucose meters determine blood glucose levels through contact with measuring areas on the body via their physicochemical sensors. While the results are displayed immediately, they can unfortunately become inaccurate quickly.
Permanent blood glucose monitoring devices include all those equipped with an implantable sensor and remote transmission system, usually attached to the arm, which automatically and regularly measures blood glucose levels. This measurement method makes it possible to track changes in blood glucose levels over an extended period and thus analyze the patient's condition more precisely.