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High blood sugar

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High blood sugar

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High blood sugar is an alarming topic worldwide. World Health Organization (WHO) has recorded that 422millions of people having diabetes mellitus. High blood sugar is also known as prediabetes, which consisting of impaired fasting glucose and impaired glucose tolerance. It occurs when the sugar level is higher than normal but not yet enough to develop diabetes.

According to Malaysia National Health and Morbidity survey (NHMS) 2019, the prevalence of the population having high blood sugar is 23.6%. This is around 5million adult individuals in Malaysia are prediabetic. They have a higher risk of getting diabetes in the future. Besides, NHMS also showed that among 1 in 5 adults in Malaysia (3.9million) is having Diabetes mellitus.

Source: Malaysia National Health and Morbidity survey 2019

Why do we have high blood sugar?

Our body required sugar as an energy source to work. Every time when we eat the foods, the foods will turn out to glucose in blood vessels. The blood sugar needs to enter our body cells to use. Insulin hormone acts as a key to open the lock of our body cells which then allows sugar goes into the cell. In normal conditions, the liver and pancreas maintain our blood sugar in a balanced state.

Things get haywire when our insulin cannot function properly either due to low insulin or insulin become non-sensitive. In these conditions, we will get high blood sugar in the blood vessels. Sugar cannot go into the cell which resulted in prediabetic or diabetes mellitus.

The following risk factors that could lead to high blood sugar are:

  • Family history of diabetes mellitus
  • Overweight or obese (BMI ≥ 23kg/m2)
  • Sedentary lifestyles
  • Hypertension, High cholesterol
  • History of Gestational Diabetes Mellitus
  • Polycystic Ovarian syndrome
  • Hormonal problem such as crushing disease

The table below depicts the classification of venous blood glucose levels. All the blood glucose level finding is based on venous blood glucose level and not capillary blood glucose (glucometer). Always consult your doctor if you have any problems.

ClassificationFasting blood
glucose level
(mmol/L)
Random blood
glucose level
(mmol/L)
Normal<6.1<7.8
Impaired fasting
glucose (Prediabetic)
6.1-6.9<7.8
Impaired glucose
tolerance (Prediabetic)
<7.07.8-11.0
Diabetic Mellitus≥7.0≥11.1
Table 1: Classification of venous blood glucose level

what are the symptoms with high blood sugar?

The symptoms of high blood sugar range from asymptomatic to symptomatic. Someone will not know he or she is in a high blood sugar state unless they get tested.

However, we still can look for some symptoms of high blood sugar which are:

  • Easily tired
  • Easily thirsty
  • Frequent urination
  • Easily hungry and increase appetite
  • Weight loss
  • frequent infection such as urinary tract infection or skin infection

What’s the complication of high blood sugar?

we have often heard about diabetes can lead to amputation of the legs. Besides diabetic foot, what are the other complications of high blood sugar? Below are the complications of long term high blood sugar:

  • cardiovascular disease
  • Diabetic emergency such as diabetic ketoacidosis
  • Low blood sugar (hypoglycemia)
  • Diabetic Kidney disease
  • Visual problem
  • Diabetic foot
  • Sexual dysfunction
  • Oral health problem

Are there any lifestyle modifications for high blood sugar?

Weight Reduction. Weight reduction is important for those who are overweight or obese. According to American Diabetes Association (ADA), sustained weight loss of ≥7%-10% within 6 months has been proven to effectively revert or delay the progression of prediabetes to diabetes.

Exercise. Physical activity has been proven to be effective in reducing weight and blood sugar. It is recommended to do exercise for at least 150minutes per week and with no more than 2-3 days rest. For example, 30minutes of brisk walking, jogging, cycling, gardening, badminton and etc for 5 days or more per week.

Stop Smoking. Smoking tobacco including cigarettes, electronic cigarettes, cigars, vapes, shisa, and pipes can lead to many complications. Research has shown that smoker has poorer blood sugar control.

Always check your cholesterol and blood pressure. People with high blood sugar should check their blood cholesterol levels annually and blood pressure regularly. All these risk factors have been associated with an increased mortality rate.

What could we eat in high blood sugar?

Mediterranean diet. According to National Institute for Health Care Excellence (NICE), a Mediterranean diet that focuses on low calorie, low fat, high fiber diet, whole grains, fruits, vegetables, and minimal refined sugar has shown to beneficial in revert or delay the progression of high blood sugar.

High fiber diet. People with high blood sugar should take at least 20-30g of fiber per day. Examples of fiber foods include fruits, vegetables, legumes, and whole-grain cereals.

Whole grains. Research has shown that replacing white rice with brown rice will delay the progress of prediabetes to diabetes. Malaysian Dietary Guidelines have recommended Malaysian use whole grains as 50% of the total grains intake.

Avoid sugar-sweetened beverages and choose food that is low or medium in glycemic index. Try to avoid sugar-sweetened beverages. Replace them with plain water as this will reduce the risk of developing diabetes mellitus. Besides, choose food that is low or medium in glycemic index. Foods that are high in glycemic index tend to raise the glucose level higher. Examples of low or medium glycemic index foods are all-bran breakfast, barley, brown rice, basmati rice, cereals, wholemeal and etc.

Follow the Healthy eating plate. A healthy eating plate showed the portion of foods that a person should take. It consists of 1/2 plate of fruits and vegetables, 1/4 plate of noodles, rice, and other carbohydrate sources, and 1/4 plate of protein sources.

Picture 2: Healthy Eating Plate

Last but not least, always check your sugar level if you are in the high-risk group as high blood sugar will go into diabetes if early intervention is not taken. Always consult your doctor and dietician if you are in high blood sugar or diabetes. They will provide a suitable medical or diet plan for you in treating high blood sugar.

References

Ali MK, Bullard KM, Saydah S, Imperatore G, Gregg EW. Cardiovascular and renal burdens of prediabetes in the USA: analysis of data from serial cross-sectional surveys, 1988-2014. Lancet Diabetes Endocrinol. 2018;6(5):392-403.

American Diabetes Association. (2019). 5. Lifestyle management: standards of medical care in diabetes—2019. Diabetes care42(Supplement 1), S46-S60.

Bajaj, S. (2018). RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017. International journal of diabetes in developing countries38(1), 1-115.

Ministry of Health Malaysia (2015). Malaysian Dietary Guidelines.

Ministry of Health Malaysia (2020). National Health and Morbidity Survey 2019: Non-communicable diseases, healthcare demand, and health literacy. Retrived from http://iptk.moh.gov.my/images/technical_report/2020/4_Infographic_Booklet_NHMS_2019_-_English.pdf

Ministry of Health Malaysia (2021). Clinical Practice Guidelines on Management of Type 2 Diabetes Mellitus (6th ed.).

Mudaliar U, Zabetian A, Goodman M, et al. (2016). Cardiometabolic risk factor changes observed in diabetes prevention programs in US settings: a systematic review and meta-analysis. PLoS Med 2016;13:e1002095

National Institute for Health and Care Excellence (NICE). (2017). Type 2 diabetes: prevention in people
at high risk.
Available at https://www.nice.org.uk/guidance/ph38.

Seah JYH, Koh W-P, Yuan J-M, van Dam RM. (2019). Rice intake and risk of type 2 diabetes: the Singapore Chinese Health Study. European Journal of Nutrition. 2019;58(8):3349-3360.

World Health Organization (WHO). (2020). Disbetes. Retrived from https://www.who.int/news-room/fact-sheets/detail/diabetes.

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