The fasting blood sugar was 6.8, and I had a glucose tolerance test. What do you think of the test report? What should we 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 while doing a glucose tolerance test. These two tests can clearly The diagnosis of diabetes or pre-diabetes can also help understand the function of self-regulation of blood sugar, and provide a basis for what kind of intervention measures should be taken next.

So what information do glucose tolerance tests and insulin release tests provide?

First, let's understand how the body regulates blood sugar. Blood sugar mainly comes from daily diet. As energy substance required for physiological activities, it will be used by tissue cells, and excess blood sugar will be stored for emergency use. Insulin secreted by pancreatic islet cells must be involved in the process of blood sugar utilization and storage, and blood sugar can only enter cells and be stored by transporting insulin.

When the insulin secreted by the islet cells is insufficient, the blood sugar is not 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 high and low changes in blood sugar. Only in this way can blood sugar be kept at a stable level.

Secondly, let’s look at several typical situations that may occur in glucose tolerance test and insulin release test:

In terms of blood sugar: fasting blood sugar 3.9-6.1mmol/L, 2-hour postprandial blood sugar 4.4-7.8mmol/L

Insulin: 8-20 units of insulin on an empty stomach, 5-10 times higher in half an hour to one hour after a meal, and return to the level of fasting two to three hours after a meal.

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

In terms of blood sugar: fasting blood sugar 6.1-7.0mmol/L, 2-hour postprandial blood sugar 4.4-7.8mmol/L

Insulin: Insulin is less than 10 units on an empty stomach, can increase 5-10 times from one hour to one hour after a meal, and is close to the level on an empty stomach 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. There is a certain degree of damage to the islet cells, which is pre-diabetic and may progress to diabetes.

In terms of blood sugar: fasting blood sugar 3.9-6.1mmol/L, 2-hour postprandial blood sugar 7.8-11.1mmol/L

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

Analysis: It shows that the ability of pancreatic islet cells to stimulate postprandial hyperglycemia declines, and they cannot secrete enough insulin in time to ensure the utilization of postprandial blood glucose. The level of fasting blood glucose and insulin will also be slightly lower, and fasting blood glucose is often higher than 5.6mmol/L. It shows that the islet cells are further damaged, and the body is in pre-diabetes.

In terms of blood sugar: fasting blood sugar greater than 6.1mmol/L and (or) 2-hour postprandial blood sugar greater than 11.1mmol/L

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

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

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

Impaired fasting blood glucose and abnormal glucose tolerance can occur alone or at the same time. Either of these three conditions indicates that the body is in pre-diabetes, and most of them will progress to diabetes within 1-3 years without intervention.

Whether it is fasting blood glucose or 2-hour postprandial blood glucose, as long as one of them meets the above diagnostic criteria for diabetes, it can be diagnosed as diabetes, and in clinical practice, the rise of blood glucose 2 hours after a meal often occurs earlier than the rise of fasting blood glucose, so only Fasting blood sugar will have half the people miss the opportunity to detect prediabetes and diabetes early.

When the insulin secreted by islet cells is higher than the normal level, especially when the postprandial hyperglycemia is high, 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 , That is, what is commonly called insulin resistance occurs, and most of these people are overweight and obese.

To sum up, glucose tolerance test can clearly understand the degree of blood sugar rise, and insulin release test can understand the cause of hyperglycemia. The treatment of diseases pays attention to the treatment of the causes. Only by passing these two inspections can we formulate an intervention treatment plan that suits us more accurately, and control blood sugar while protecting islet function, so as to better prevent and delay the progression of the disease.

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