Dysglycemia

Dysglycemia is a general definition for any abnormalities in blood glucose levels. They include hyperglycemia, hypoglycemia, impaired glucose tolerance test, impaired fasting glucose, among others. ^{[1] [2] [3] [4]}

Hyperglycemia

If blood sugar levels remain too high the body suppresses appetite over the short term. Long-term hyperglycemia causes many health problems including heart disease, cancer, ^[5] eye, kidney, and nerve damage. ^[6]

Blood sugar levels above 300 mg/dL can cause fatal reactions. Ketones will be very high (a magnitude higher than when eating a very low carbohydrate diet) initiating ketoacidosis. The Mayo Clinic recommends emergency room treatment above 300 mg/dL blood glucose.

The most common cause of hyperglycemia is diabetes. When diabetes is the cause, physicians typically recommend an anti-diabetic medication as treatment. From the perspective of the majority of patients, treatment with an old, well-understood diabetes drug such as metformin will be the safest, most effective, least expensive, most comfortable route to managing the condition. ^[7] Diet changes and exercise implementation may also be part of a treatment plan for diabetes.

Hypoglycemia

Hypoglycemia is a fall in blood sugar to levels below normal. ^[8] This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. ^[8] A feeling of hunger, sweating, shakiness and weakness may also be present. ^[8] Symptoms typically come on quickly. ^[8]

The most common cause of hypoglycemia is medications used to treat diabetes mellitus such as insulin and sulfonylureas. ^{[9] [10]} Risk is greater in diabetics who have eaten less than usual, exercised more than usual or have drunk alcohol. ^[8] Other causes of hypoglycemia include kidney failure, certain tumors (such as insulinoma), liver disease, hypothyroidism, starvation, inborn error of metabolism, severe infections, reactive hypoglycemia and a number of drugs including alcohol. ^{[8] [10]} Low blood sugar may occur in otherwise healthy babies who have not eaten for a few hours. ^[11]

References

1. Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, et al. (July 2012). "Basal insulin and cardiovascular and other outcomes in dysglycemia" (PDF). The New England Journal of Medicine. 367 (4): 319–28. doi:10.1056/NEJMoa1203858. PMID   22686416. S2CID   3972959.
2. Park-Wyllie LY, Juurlink DN, Kopp A, Shah BR, Stukel TA, Stumpo C, et al. (March 2006). "Outpatient gatifloxacin therapy and dysglycemia in older adults". The New England Journal of Medicine. 354 (13): 1352–61. doi:10.1056/NEJMoa055191. hdl: 1807/16915 . PMID   16510739.
3. Bosch J, Gerstein HC, Dagenais GR, Díaz R, Dyal L, Jung H, et al. (July 2012). "n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia" (PDF). The New England Journal of Medicine. 367 (4): 309–18. doi:10.1056/NEJMoa1203859. PMID   22686415.
4. Srikanthan P, Hevener AL, Karlamangla AS (May 2010). "Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III". PLOS ONE. 5 (5) e10805. Bibcode:2010PLoSO...510805S. doi: 10.1371/journal.pone.0010805 . PMC   3279294 . PMID   22421977.
5. "Excess sugar linked to cancer". Science Daily.
6. "Diabetic ketoacidosis - Symptoms and causes". Mayo Clinic. Retrieved 2018-01-30.
7. Consumer Reports Health Best Buy Drugs. "The Oral Diabetes Drugs: Treating Type 2 Diabetes" (PDF). Best Buy Drugs: 2. Retrieved 18 September 2012.
8. "Hypoglycemia". National Institute of Diabetes and Digestive and Kidney Diseases. October 2008. Archived from the original on 1 July 2015. Retrieved 28 June 2015.
9. Yanai H, Adachi H, Katsuyama H, Moriyama S, Hamasaki H, Sako A (February 2015). "Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes". World Journal of Diabetes. 6 (1): 30–6. doi: 10.4239/wjd.v6.i1.30 . PMC   4317315 . PMID   25685276.
10. Schrier RW (2007). The internal medicine casebook real patients, real answers (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 119. ISBN   978-0-7817-6529-9.
11. Perkin RM (2008). Pediatric hospital medicine: textbook of inpatient management (2nd ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 105. ISBN   978-0-7817-7032-3.