没有症状的糖尿病被马意味着什么naged Well?
Blood sugar (glucose) control is crucial when you’re living with type 2 diabetes. Dips and spikes can not only make you feel cranky and sluggish, but they can also wreak havoc on your personal health. (No wonder your primary care doctor was on you about your last A1C checkup.)
这most serious effects of blood sugar swings are a higher risk for糖尿病相关的健康并发症如中风，心脏病和神经损伤(neuropathy)。
For the record, theAmerican Diabetes Association (ADA)notes that you have diabetes if one of the following applies to you:
- Your blood glucose after fasting (and before a meal) is 126 milligrams per deciliter (mg/dl) or higher.
- Your blood glucose two hours after eating a meal is 200 mg/dl or higher.
- Your血红蛋白A1C.(a two- to three-month average measure of how much glucose attaches to the hemoglobin in your red blood cells) is 6.5 or higher.
棘手的部分是你可能不觉得2型糖尿病when blood sugar levels are too high，根据ADA。It feels different for everyone. “Not everyone will have the same symptoms, and some individuals will have no symptoms at all,” says Lori Zanini, RD, CDE, a Los Angeles–based former spokesperson for the Academy of Nutrition and Dietetics.
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因为血糖管理对你的2型糖尿病的整体健康非常重要，因为如果您认为您的水平可能无法控制，您需要采取行动，即使您感觉完全没事。
“Symptoms of uncontrolled diabetes may not appear until prolongedhyperglycemia(high blood sugar) has been present,” saysMary Ann Emanuele, MD, an endocrinologist, professor, and medical director of inpatient diabetes at Loyola University Medical Center in Maywood, Illinois. She adds that if your healthcare team determines your glucose isn’t well controlled, adjusting your medication with their help can make a difference.
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‘Controlled’ Means Different Things to Different People
没有放之四海而皆准的建议提单ood sugar control.
这ADA says that a “reasonable” goal for many nonpregnant adults is to aim for an A1C level of less than 7. Yet some patients may be given a more stringent goal by their healthcare providers, such as 6.5, if that’s reachable without harmful side effects, including低血糖。
On the other hand, if you are elderly, managing other health complications, or reliant on insulin, you may be given less stringent goals. “It really becomes more important to just keep [levels] in the same place,” saysRahil Bandukwala，做，在加利福尼亚拉古纳山的MemorialCare鞍背医疗中心的内分泌学家。“保持A1C在7.5和8.5之间可能对这种患者来说是非常合理的，”Bandukwala博士增加了，回应了ADA的建议。
Because elderly people are more likely to have blood sugar that swings too far downward, with fewer warning signs, managing their glucose too tightly can put them at greater risk for hypoglycemia, says Bandukwala. When you have low blood sugar, you’re at a higher risk for becoming dizzy and falling or passing out, notes theADA。
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How (and When) to Check Your Blood Sugar Levels
As Dr. Emanuele says,glucose monitoring可以是帮助您在控制下获得血糖的重要工具。通常，您可以使用葡萄糖仪或凝血仪来自行，这通过用刺血针粘贴手指并将血液放置在您插入仪表中的一次性测试条上，分析了一滴血液。您的血糖目标由您和您的医生设置，但没有糖尿病的成年人的血糖低于100毫克/ dL，在饭前和禁食。饭后两小时少于140 mg / dl，注意到ADA。
Some people will check their blood sugar daily or multiple times a day, sometimes using a continuous monitor that is worn on the body — particularly those who havetype 1 diabetes或者谁有2型但服用胰岛素。然而，一个人应该监测他们的血糖的频率是基于许多因素，包括但不限于它们是否在胰岛素上，无论是胰岛素吗？oral medication，以及他们的血糖被控制的程度，它们有多大。
“It’s an individual discussion with each patient, but in general I tell my patients with type 2 diabetes whose blood sugar is controlled that they don’t need to check it every day,” says Bandukwala. “If they have a glucometer and they want to check it then I will tell them they can do a paired reading once a week, which means a fasting (before eating) reading and then another reading one to two hours after a meal (postprandial).” Checking too often can lead to unwarranted panic over daily fluctuations, as well as unnecessary pain from too-frequent lancet pricks, he adds. The美国家庭学院is among the organizations advising that daily glucose self-testing has no benefit in patients with type 2 diabetes who are not on insulin or medications associated with hypoglycemia.
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Meanwhile, keep an eye out for these nine key warning signs and symptoms that blood sugar is too high — and talk to your doctor about whether you need to adjust your management plan.
Being Extra Thirsty and Having to Urinate More Than Usual
This is a common but not-so-obvious sign of blood sugar that is too high: feeling really thirsty and needing to drink more than usual. “过分过分据Zanini说，被称为聚氨酯，当葡萄糖积聚在血液中，并且你的肾脏开始努力摆脱额外的葡萄糖时，“Zanini说。如果你的肾脏不能跟上和调整血糖，以便恢复正常水平，她补充说，过量的糖通过尿液冲出你的身体。你可能会成为dehydrated并晕眩。
You’re Hungrier Than Usual but Losing Weight
Many people with uncontrolled high blood sugar find that they’re hungrier than usual, which signals a symptom called polyphagia,MedlinePlus笔记。据您所介绍梅奥诊所。
“Since your body is not getting energy from the preferred source, glucose, it has to turn to muscle and fat,” Zanini explains. “When your body starts breaking down muscle and fat for energy, you experience unintentional and unhealthy weight loss.” In addition to these changes in weight and appetite, you may notice weakness in your muscles and experience more frequent falls, Emanuele adds.
RELATED:它有什么不受控制的2型糖尿病
You Feel Tiredness and Fatigue Constantly
Fatigue andextreme tirednessare symptoms of uncontrolledblood sugarada说。“简单地说，当你的身体不适合加工胰岛素或没有足够量的胰岛素时，糖留在我们的血液中，而不是进入我们的细胞用于能量，”Zanini说。还，frequent urinationcan lead todehydration, which Bandukwala identifies as another contributing factor to fatigue.
You Have Noticeably Blurry Vision and Frequent Headaches
您可能会注意到您的愿景并不像往常一样清晰，而且事情可能会出现一点模糊。根据Joslin Diabetes Center在波士顿。这改变了镜头的形状，这使得它无法正确焦点，导致视力模糊。您也可能发现自己在工作中挣扎，难以驾驶，遭受频繁的头痛，Emanuele笔记。
You Develop Sores That Tend to Heal More Slowly Than Usual
根据National Institute of Diabetes and Digestive and Kidney Diseases。糖尿病原因神经损伤and affects circulation, especially in the lower legs and feet, which can delay healing because there isn’t enough blood flow to the area. Even minor wounds are more prone to infections, which can become very serious and even result in amputations of the foot. You may notice drainage seeping onto your socks or an unpleasant smell if you develop a foot ulcer, notes the美国百科医学协会。
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You Notice Tingling and Numbness in Your Hands or Feet
As mentioned, uncontrolled blood sugar can cause nerve damage, also known asdiabetic neuropathy。What you may notice is a tingling sensation or even numbness in your hands and feet. Some people experience pain in their hands and feet as well. Thoughneuropathy最常见的是长期患有糖尿病的人，它可以发生在糖尿病患者患者患者患者患者患者患者患有症恶劣的任何人身上。
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You’re Developing Blisters, Dryness, or Other Skin Changes
Small pieces of extra skin, called皮肤标签，可以在皮肤的折痕中形成，特别是如果你有糖尿病，你试图找到管理你的体重的方法，请注意ADA。Dark, thick areas of soft skin (called acanthosis nigricans) may form on the back of the neck or hands, armpits, face, or other areas. These can be a sign of胰岛素抵抗, Zanini says. Blisters, infections, dryness, itchiness, discolorations, and abnormalities of the skin can all be warning signs of high blood sugar. Check with your doctor if these skin changes develop.
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You’re Getting Yeast Infections More Often Than Usual
高血糖可能导致您获得更频繁的生殖器yeast infections。罪魁祸首通常是一种酵母（真菌），称为Candida albicans, per theADA。根据这一点Centers for Disease Control and Prevention，在女性中，症状可以包括：vaginal itching, redness or soreness; pain duringsexual intercourse; pain or discomfort during urination; and thick,abnormal vaginal discharge。While yeast infections are common in people who don’t have diabetes, having more glucose in your blood puts you at higher risk of getting them. “The yeast feeds off the glucose, and if your blood sugar is high there’s more glucose in the urinary tract,” explains Bandukwala. Uncircumcised men with hyperglycemia are also at risk, he says.
“我们也看到它现在与服用SGLT-2抑制剂的患者发生了一点，这迫使身体通过尿液排出更多葡萄糖，”内分泌学家增加。这FDA has added a warning对于SGLT-2抑制剂的处方信息，关于更罕见的罕见和可能致命的 - 生殖器状况，称为necrotizing fasciitisPerineum，或Fournier的坏疽（俗称肉类饮食疾病）。
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Swollen or Bleeding Gums, Which Increase Your Infection Risk
Gum disease is acomplication of diabetes指出,National Institute of Diabetes and Digestive and Kidney Disease。It can also make diabetes harder to control, because the body’s response to infection is to release more glucose into the bloodstream, according to theADA。
Your saliva contains glucose; and the more it contains, the more there is to feed the bacteria that combine with food in your mouth to form plaque and cause gum disease. Symptoms can include red or inflamed gums at first. If they are unaddressed, they can progress toperiodontitis, which can cause your gums to pull away from your teeth, the appearance of pus or溃疡, or even tooth loss, notes the梅奥诊所。Get your blood sugar under control and see a dental professional to prevent damage to your gums and teeth.
Additional reporting byDiana RodriguezandAndrea Peirce。
