The Hidden "High Blood Sugar Surge": Postprandial Blood Glucose Monitoring and Three Levels of Diabetes Prevention

Understanding Sub-Health Through Postprandial Blood Glucose: Why do I need a postprandial blood glucose test after just having a fasting blood glucose test? What does postprandial blood glucose reflect? Postprandial blood glucose is the blood glucose measurement performed two hours after a meal. To test postprandial blood glucose, the person being tested usually eats the equivalent of 100 grams of glucose in a sugary food, and the blood glucose is measured two hours later. Normally, postprandial blood glucose should be below 7.8 mmol/L. A level >10 mmol/L suggests possible diabetes. Blood glucose at any time should not exceed 11.1 mmol/L. This is because when a normal person is about to develop diabetes, the main symptom is elevated postprandial blood glucose. This means that even if a person's fasting blood glucose is normal, their postprandial blood glucose should still be measured. Only when both fasting and postprandial blood glucose are normal can diabetes be ruled out. This is because some diabetic patients may have normal fasting blood glucose, but their postprandial blood glucose may be high. A prolonged state of high postprandial blood glucose is called a "hyperglycemic episode." This "high blood sugar surge," unlike the turbulent waves of the ocean, damages the endothelium of blood vessels through its gentle flow, especially large vessels, leading to cardiovascular and cerebrovascular diseases and causing a health crisis.

In a sense, for people with a genetic predisposition to diabetes, and for those who are obese or have high blood pressure but no genetic predisposition, regular annual postprandial blood glucose testing is one of the effective measures for early detection of diabetes. Why do blood glucose tests sometimes go wrong? The most common reasons for errors in postprandial blood glucose testing are:

1. The food consumed contains insufficient or excessive glucose.

2. Less than two hours have passed since the meal, or the time has been too long. What to do when the doctor recommends a follow-up test? Whether the error occurs during the testing process or a doctor recommends a follow-up test, you must follow the doctor's instructions. Don't be lazy, as this could lead to misdiagnosis or missed diagnosis. Blood glucose test values ​​sometimes differ from a person's perception; some people may not feel anything abnormal but their test results are abnormal, which is related to individual differences. To prevent sub-health and the occurrence of diabetes, you must never arbitrarily skip testing. Can urine glucose test for high blood sugar? Compared to urine glucose testing, blood glucose testing has more requirements and is more complicated. However, urine glucose sometimes cannot accurately reflect blood sugar levels because blood sugar must exceed a certain threshold (renal threshold) of approximately 10 mmol/L to be detectable in urine. If blood sugar does not exceed this threshold, glucose in the urine will not be detectable. This can easily delay diagnosis. Furthermore, the amount of water consumed and medications taken can affect urine. Therefore, urine glucose testing cannot be used as a diagnostic basis for high blood sugar or diabetes. Based on current experience, preventing high blood sugar (diabetes) can be divided into three levels:

1. Using scientifically feasible methods to prevent diabetes as much as possible.

2. For those who already have high blood sugar (diabetes), minimizing complications, because high blood sugar (diabetes) is destructive to the body. Although "high sugar" is neither acid nor alkali, its corrosiveness is very strong and should not be underestimated.

3. Improving the quality of life and survival of people with high blood sugar (diabetes). We should not only live, but also live happily. A happy life comes from mental health, physical comfort, and good moral and social adaptability. Note: Fasting blood glucose and postprandial blood glucose tests are both diagnostic methods aimed at early detection of high blood sugar and controlling the disease in a sub-healthy state. The progression from high blood sugar to diabetes takes time, varying from person to person. This is related to both genetics and environmental factors. Gene therapy is currently difficult to achieve, but prevention is possible. Specifically, hereditary diseases are congenital diseases caused by mutations (abnormalities) in the genetic basis (chromosomes and genes) of germ cells or fertilized eggs.

Based on the types of hereditary diseases, we classify them into three categories:

1. Single-gene hereditary diseases: These are hereditary diseases controlled by a single pair of alleles, with a wide range of inheritance.

2. Polygenic hereditary diseases: These are hereditary diseases caused by abnormalities in several pairs of genes. The onset of polygenic hereditary diseases is not only due to abnormalities in multiple gene pairs but also significantly related to environmental factors. This is also called multifactorial inheritance. 3. Chromosomal disorders; also called chromosomal abnormality syndromes, are caused by changes in the number, morphology, or structure of chromosomes. Medical research has found that diabetes is a polygenic inherited disease with multiple causes, including both genetic and environmental factors. This is crucial because knowing the cause allows us to control the incidence of diabetes by improving the environment, emphasizing education, adjusting diet, and correcting behavior.

Can women with high blood sugar get pregnant? Before answering whether or not a woman can get pregnant, we must first determine if her blood sugar is truly high. If it is, we need to find out the cause. If the cause is unclear after testing, it's best to wait until it's determined before considering pregnancy. If diabetes has been identified as the cause of the high blood sugar, it's best to avoid pregnancy, treat the diabetes first, control the disease, and then consider pregnancy.

Can couples with high blood sugar get pregnant? If both partners develop diabetes before the age of 40, their children have a 50% chance of developing diabetes sooner or later. Therefore, when trying to have children, both partners must control their blood sugar levels to avoid inheritance. Secondly, high blood sugar in pregnant women can enter the fetal bloodstream, causing pancreatic islet hyperplasia and the production of large amounts of insulin. This promotes fat synthesis and inhibits fat breakdown, leading to macrosomia (large baby) and dystocia (difficult labor). Furthermore, high blood sugar in pregnant women can also cause fetal malformations, especially in early pregnancy. Most dangerously, high blood sugar in pregnant women can be accompanied by severe vascular disease, causing placental insufficiency and potentially leading to fetal death or stillbirth.

These are the adverse effects on the fetus and newborn. There are also adverse effects on the mother: The most common condition, preeclampsia, has a high incidence rate, with pregnant women with high blood sugar being 4 to 8 times more likely to develop it than normal pregnant women. Secondly, during pregnancy, delivery, and the postpartum period, pregnant women and postpartum women with high blood sugar are more prone to infections, even developing sepsis. Furthermore, postpartum women with high blood sugar often experience prolonged labor or uterine bleeding due to incomplete uterine involution. Even greater losses occur when a cesarean section is necessary due to a large fetus, increasing the risk to both the mother and fetus and raising the overall cost of childbirth.