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Blood Sugar

The mean normal blood glucose level in humans is about 5.5 mmol/L (100 mg/dL); however, this level fluctuates throughout the day. Blood sugar levels for those without diabetes and who are not fasting should be below 6.9 mmol/L (125 mg/dL).

The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. The body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis.

With some exceptions glucose is the primary source of energy for the body's cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. Glucose is transported from the intestines or liver to body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas.

Glucose levels are usually lowest in the morning, before the first meal of the day (termed "the fasting level"), and rise after meals for an hour or two by a few millimolar. Blood sugar levels outside the normal range may be an indicator of a medical condition. A persistently high level is referred to as hyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. Intake of alcohol causes an initial surge in blood sugar, and later tends to cause levels to fall. Also, certain drugs can increase or decrease glucose levels.

Abnormality in blood sugar levels

High blood sugar
If blood sugar levels remain too high the body suppresses appetite over the short term. Long-term hyperglycemia causes many of the long-term health problems including heart disease, eye, kidney, and nerve damage.
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 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. Diet changes and exercise implementation may also be part of a treatment plan for diabetes.
Fasting blood glucose levels may be higher than the post meal blood glucose in many of the healthy subjects. Such individuals may be said to have physiological insulin resistance and may develop diabetes mellitus as long term complication. In clinical and laboratory practices, many of the time a healthy normal subject will present a fasting blood glucose value higher than the post meal blood glucose value. This creates confusion since there is a common perception that in blood, postprandial (PP) glucose level should be higher than fasting (F) glucose level. The repeated investigation subsequently yields somewhat similar type of result.

Low blood sugar
If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia develops. Symptoms may include lethargy, impaired mental functioning; irritability; shaking, twitching, weakness in arm and leg muscles; pale complexion; sweating; loss of consciousness.
Mechanisms that restore satisfactory blood glucose levels after extreme hypoglycemia (below 40 mg/dl) must be quick and effective to prevent extremely serious consequences of insufficient glucose: confusion or unsteadiness and, in the extreme (below 15 mg/dl) loss of consciousness and seizures. Without discounting the potentially quite serious conditions and risks due to or oftentimes accompanying hyperglycemia, especially in the long-term (diabetes or pre-diabetes, obesity or overweight, hyperlipidemia, hypertension, etc.), it is still generally more dangerous to have too little glucose- especially if levels are very low- in the blood than too much, at least temporarily, because glucose is so important for metabolism and nutrition and the proper functioning of the body's organs. This is especially the case for those organs that are metabolically active or that require a constant, regulated supply of blood sugar (the liver and brain are examples). In healthy individuals, blood glucose-regulating mechanisms are generally quite effective, and symptomatic hypoglycemia is generally found only in diabetics using insulin or other pharmacological treatment, and in starvation or severe malnutrition or malabsorption (of various causes), and conditions such as anorexia. Hypoglycemic episodes can vary greatly between persons and from time to time, both in severity and swiftness of onset. For severe cases, prompt medical assistance is essential, as damage to brain and other tissues and even death will result from sufficiently low blood-glucose levels.

Causes of abnormal glucose levels

Persistent hyperglycemia Transient hyperglycemia Persistent hypoglycemia Transient hypoglycemia
Reference range, FBG: 70–110 mg/dL
Diabetes mellitus Pheochromocytoma Insulinoma Acute alcohol ingestion
Adrenal cortical hyperactivity Cushing's syndrome Severe liver disease Adrenal cortical insufficiency Addison's disease Drugs: salicylates, antituberculosis agents
Hyperthyroidism Acute stress reaction Hypopituitarism Severe liver disease
Acromegaly Shock Galactosemia Several glycogen storage diseases
Obesity Convulsions Ectopic insulin production from tumors Hereditary fructose intolerance

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