Blood sugar fluctuations refer to the unstable state in which blood sugar levels change between their peaks and troughs. They not only include short-term blood sugar fluctuations, namely day-to-day blood sugar fluctuations and intraday blood sugar fluctuations, but also include long-term blood sugar fluctuations, that is, high variability of glycated hemoglobin. Blood sugar fluctuations are very harmful to chronic complications of diabetes, even more harmful than the persistence of hyperglycemia . Therefore, maintaining blood sugar stability among diabetics is of great significance to the prevention of diabetes complications.
What causes blood sugar fluctuations in patients with diabetes ?
There are many factors that affect blood sugar fluctuations in diabetic patients, including pancreatic beta cell function, diet, drugs, exercise, etc. Diabetic patients have a loss of their own β-cell function, resulting in insufficient ability to regulate in blood sugar, which is the main reason for blood sugar fluctuations. Patients' intake of high-glycemic foods and excessive food intake will also lead to an increase in postprandial blood sugar, increasing the fluctuation of blood sugar. The use of hypoglycemia drugs will increase the risk of hypoglycemia and increase blood sugar fluctuations. In addition, irregular exercise, emotional stress, sleep disorders, , alcoholism, infection, etc. can also increase blood sugar fluctuations.
Hazards of blood sugar fluctuations
The harm of blood sugar fluctuations to diabetes complications is even more serious than persistent hyperglycemia. Blood sugar fluctuations will cause vascular damage by activating the oxidative stress pathway, damaging the endothelial cell function, aggravate the chronic inflammatory state, etc., and increase the risk of diabetes complications. Studies have shown that blood sugar fluctuations are an independent risk factor for cardiovascular disease, retinopathy, diabetes nephropathy, and diabetic neuropathy in diabetic patients.
How to reduce blood sugar fluctuations and maintain blood sugar stability
1. Control diet
High blood sugar after meals is the main cause of blood sugar fluctuations, so diabetics should control their diet well. While ensuring sufficient energy intake, diabetics can try to choose some foods with lower glycemic index when eating. For example, the staple food can be matched with thickness, and the fruits can be replaced by cucumbers, tomatoes, etc. It should be noted that excessive control of diet among diabetics can cause hypoglycemia, so diabetics should control their diet while meeting their own energy needs.
2. Regular exercise
Regular exercise can increase insulin sensitivity and help control blood sugar. The "Guidelines for the Prevention and Control of Type 2 Diabetes in China (2022)" recommends: Adult html type 12 diabetes patients with at least 150 minutes per week (such as exercise for 5 days a week, 30 minutes each time) moderate intensity (a little effort when exercising, a heartbeat and breathing accelerate but not rush, and you can still talk). Medium-intensity sports include walking , Tai Chi , cycling, table tennis, badminton, etc. If there are no contraindications, it is best to perform 2 to 3 resistance exercises per week (the interval between two exercises is ≥48 hours) to exercise muscle strength and endurance. The exercise area should include the main muscle groups such as the upper limbs, lower limbs, and the training intensity should be moderate. Even if you perform a short period of physical exercise (such as 10 minutes), it is beneficial to accumulate 30 minutes per day. However, diabetics' exercise prescription cannot be copied according to the guidelines. You also need to find a sports prescription that suits you based on your age, condition, preferences and physical ability.
3. Timely adjust the dosage of drugs
Hypoglycemia is a common adverse reaction in the treatment of hypoglycemia-lowering drugs, especially insulin. Irregular diet, pregnancy, alcoholism, etc. may also lead to hypoglycemia. Therefore, diabetics should adjust the dosage of drugs in a timely manner according to their own situation and under the guidance of a doctor.
4. Conduct blood sugar monitoring
blood sugar monitoring cannot only measure fasting blood sugar . It should also include monitoring 2 hours after meals. If necessary, blood sugar should also be measured before going to bed and at 3 a.m. The specific time and how many times are measured, based on the doctor's advice, as well as based on blood sugar fluctuations, diet, exercise and medication.
In fact, the goal of blood sugar management is not only to reduce hyperglycemia, but also to prevent hypoglycemia, reduce blood sugar fluctuations, and control sugar within a narrow range, which is what we often call stable blood sugar meeting standards.
