Control your blood sugar or Blood sugar controls you

GUEST COLUMN: Dr N Prabhudev

Bengaluru Express
Bengaluru, April 3:

Low blood sugars – below 55mg/dl – presentation is dramatic and is an emergency! High blood sugars are a slow poison but often ends up as an emergency!
Is there a cure for diabetes? There isn’t a cure for diabetes right now. But we are pushing boundaries and taking steps to build a future where diabetes can do no harm. Diabetes is one of the fastest-growing illnesses globally affects about 830 million people worldwide.

Towards a cure!
• In 2015, the drug Harmine belonging to DYRK1A inhibitors – capable of activating insulin-producing human beta cell regeneration!
• In 2019 and 2020, Harmine could work in synergy with GLP-1 receptor agonists such as semaglutide and exenatide to boost beta cell regeneration.
July 2024, groundbreaking results: Harmine-family drugs may be able to induce lineage conversion of islet cell growth
• Harmine alone increased human beta cell mass by 300%
• When paired with a GLP-1 receptor agonist like Ozempic, Beta cell growth skyrocketed to an impressive 700%.
Exercising regularly, managing stress, and eating more foods high in fiber and probiotics may help lower blood sugar levels. However, these lifestyle adjustments do not replace medical treatment for diabetes or other metabolic conditions! Regular exercise and physical activity can help you manage your weight and increase insulin sensitivity. Increased insulin sensitivity means your cells can use the glucose in your bloodstream more effectively. High blood sugar levels and diabetes have been linked to micronutrient deficiencies, including chromium and magnesium.
Blood glucose or sugar levels are a critical part of your overall health and your body’s ability to function properly. Striving to achieve “normal” blood sugar levels is a constant, hour-by-hour pursuit. And it isn’t easy.

Normal blood sugar levels for people without diabetes- fasting – 70 to 99 mg/dL.
When it is 100 to 125 mg/dl life style changes and glycemic monitoring is advised and 2 hrs after meal levels – 140 mg/dL! 2 to 3 Hours after a Meal, Less than 100 mg/dL – 5.6 mmol/L)
Pre-diabetes indicated by an A1c of 5.7 to 6.4 percent
Diabetes by an A1C of 6.5 percent or higher.
Recommended blood sugar ranges in people with diabetes
• Fasting Blood Sugar – In the Morning Before Eating – 80 to 130 mg/dL (4.4 to 7.2 mmol/L)
• 2 Hours After a Meal Less than 180 mg/dL (10.0 mmol/L)
Unless it’s fairly high or low, you generally can’t feel what your blood sugar level is. And in fact, you may not even be able to tell from physical symptoms when it is high! Yes, you will immediately know when your blood sugar levels are low- say around 60 to 65 mg/dl!- extreme weakness and tiredness, blurring, shakiness, sweating are all unmistakable signs of low sugar!
Level 2 hypoglycemia is defined as a blood glucose concentration less than 54 mg/dL (3.0 mmol/L). This level is considered the threshold at which there is a shortage of glucose or sugar in the brain, resulting in neuro-glycopenic symptoms.
Important – Low blood sugar is more dangerous than high blood sugar! Below 55mg/dl is dangerous! Brain needs a continuous supply of glucose! Blurred vision, slurred speech, in coordination, disorientation, seizures, and coma! Medical intervention is necessary!
The 15-10-15 rule
Take without any delay 15 grams of sugar sublingually! Not honey or diet soda! Try glucose tabs
Wait for 10 minutes and check your blood sugar. Repeat 15 gms of sublingual sugar or tablet if the blood sugars are the same!
The glycosylated hemoglobin or A1C test- A1C test – This blood test reflects your average glucose levels over the previous 2 to 3 months. You can eat and drink prior to having an A1C test.
A1C
Pre- diabetes 5.7 to 6.4 percent
Diabetes 6.5 percent or higher
Measures your average blood sugar over the last 2 to 3 months! Although the test reflects the glucose attached to hemoglobin over the past 2 to 3 months, the blood sugar levels in the 2 weeks leading up to your A1C test influence the results the most. Essentially, higher blood sugar levels during this period result in more glucose binding to hemoglobin and consequently a higher A1C readings!
You can translate your most recent A1C result to an “eAG,” or “estimated average glucose level.”
6 percent 126 mg/dL
7 percent 154 mg/dL
8 percent 183 mg/dL
9 percent 212 mg/dL
10 percent 240 mg/dL
11 percent 269 mg/dL
12 percent 298 mg/dL
Your A1C is one of the clearest indicators of your risk for developing diabetes complications like neuropathy (nerve damage), retinopathy – a type of eye disease, nephropathy – kidney disease, cardiovascular disease, and severe infection in any part of your body!
The general guidelines from the American Diabetes Association recommend an A1C level of less than 7.0 percent to help prevent diabetes-related complications. Lowering your A1C closer to 6.0 percent may further reduce the risk of micro-vascular complications (those impacting the small blood vessels), such as those affecting the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy).
Achieving extremely tight blood sugar management also generally requires a strict nutrition plan, very frequent blood sugar monitoring, precise medication management, and, often, years of experience studying your blood sugar levels.
CAUTION- Hypoglycemia unawareness, a condition in which a person with diabetes no longer feels the typical warning signs of low blood sugar. Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively.
“And certainly, someone who has been running A1Cs in double digits – like 10 percent or higher for quite some time should not be targeting an A1C of 6 percent … better to set modest, realistic, achievable goals.”