The fasting blood sugar is 6.8. I have done a glucose tolerance test. What do you think of the test report? What to do next?

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People who find that their blood sugar is elevated are usually asked to do a glucose tolerance test to judge the degree of abnormal blood sugar. Many people may have noticed that an insulin release test is also performed at the same time as the glucose tolerance test. These two tests can clearly Diagnosis of diabetes or pre-diabetes, and understanding of the function of self-regulating blood sugar can provide a basis for what intervention and treatment measures should be taken next.

So, what information can glucose tolerance tests and insulin release tests provide?

Let’s first understand how the body regulates blood sugar. Blood sugar mainly comes from the daily diet. As the energy material required for physiological activities, it will be utilized by tissue cells, and the excess blood sugar will be stored for emergency use. In the process of blood sugar utilization and storage, insulin secreted by pancreatic islet cells must be involved. Only through the transport of insulin can blood sugar enter cells and be stored.

When the insulin secreted by pancreatic islet cells is insufficient, blood sugar cannot be fully utilized and cannot be stored, which leads to the occurrence of hyperglycemia. Therefore, under normal circumstances, the amount of insulin secreted by pancreatic islet cells is consistent with the changes in blood sugar. Only in this way can blood sugar remain at a stable level.

Secondly, there are several typical situations that may occur in the glucose tolerance test and insulin release test:

Blood sugar: fasting blood sugar 3.9-6.1mmol/L, 2 hours postprandial blood sugar 4.4-7.8mmol/L

Insulin: 8-20 units of insulin on an empty stomach. Insulin will increase by 5-10 times from half an hour to an hour after a meal, and it will return to the fasting level two to three hours after a meal.

Analysis: Half an hour to an hour after eating is the time when the body absorbs the most nutrients, and the increase in blood sugar will reach the highest peak after a meal. At this time, the islet cells will also secrete the largest amount of insulin to promote the utilization of blood sugar; then Blood sugar gradually decreased, and insulin secretion decreased, and the change curves of the two were synchronized in time and amplitude.

Blood sugar: fasting blood sugar 6.1-7.0mmol/L, 2 hours postprandial blood sugar 4.4-7.8mmol/L

Insulin: the amount of insulin on an empty stomach is less than 10 units, which can be increased by 5-10 times from one hour to one hour after a meal, and it is close to the fasting level two to three hours after a meal.

Analysis: This situation shows that islet cells can respond to postprandial hyperglycemia in a timely manner and rapidly secrete a large amount of insulin to promote the utilization of postprandial blood glucose. Islet cells are damaged to a certain extent, and they are in pre-diabetes and may progress to diabetes.

Blood sugar: fasting blood sugar 3.9-6.1mmol/L, 2 hours postprandial blood sugar 7.8-11.1mmol/L

Insulin: In the fasting state, insulin is 8-20 units or slightly lower, and the increase rate is less than 5 times from half an hour to one hour after a meal, and it is close to or slightly lower than the fasting level two to three hours after a meal.

Analysis: It shows that the ability of pancreatic islet cells to respond to the stimulation of postprandial hyperglycemia is reduced, and sufficient insulin cannot be secreted in time to ensure the utilization of postprandial blood glucose. It indicates that the islet cells are further damaged and the body is in pre-diabetes.

Blood sugar: fasting blood sugar greater than 6.1mmol/L and (or) 2 hours postprandial blood sugar greater than 11.1mmol/L

In terms of insulin: insulin is less than 8 units on an empty stomach, the increase is less than 5 times after half an hour to one hour after a meal, and less than 8 units two to three hours after a meal.

Analysis: It shows that whether in fasting or postprandial state, pancreatic islet cells cannot secrete sufficient insulin, blood sugar can neither be effectively utilized nor stored in time, and the condition of high blood sugar persists, that is, diabetes occurs.

It should be noted that: the above four situations are typical manifestations of blood sugar and pancreatic islet cell secretory function, and the actual population will have different manifestations on this basis, and doctors will make judgments and give corresponding interventions accordingly. treatment measures. for example:

Impaired fasting blood glucose and impaired glucose tolerance can appear independently or simultaneously. Either of these three conditions indicates that the body is in pre-diabetes. If no intervention is given, most of them will progress to diabetes within 1-3 years.

Whether it is fasting blood glucose or 2-hour postprandial blood glucose, as long as one of them meets the above-mentioned diagnostic criteria for diabetes, it can be diagnosed as diabetes, and in clinical practice, the increase of 2-hour postprandial blood glucose often occurs earlier than the increase of fasting blood glucose, so only test Half of the people with fasting blood sugar will miss the chance of early detection of prediabetes and diabetes.

When the insulin secreted by islet cells is higher than the normal level, especially when postprandial hyperglycemia, the insulin secretion is much higher than the 5-10 times increase, but the blood sugar is at an elevated level, indicating that the body has a problem in using insulin , which is commonly referred to as insulin resistance, and most of these people are overweight and obese.

In summary, the glucose tolerance test can clearly understand the degree of blood sugar rise, and the insulin release test can be used to understand the causes of hyperglycemia. The treatment of diseases is about treating the cause of the disease. Only through these two inspections can we more accurately formulate a suitable intervention and treatment plan, and control blood sugar while protecting the function of the pancreatic islets, so as to better prevent and delay the progression of the disease.

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