Hyperglycemia, a term derived from Greek, refers to high levels of sugar in the blood. Specifically, it is defined as blood glucose levels above 125 mg/dL when fasting and above 180 mg/dL two hours after a meal. Pre-diabetes, with impaired glucose tolerance, is indicated by fasting blood sugar levels between 100-125 mg/dL. (1)
Major Reasons for Hyperglycemia:
Following are the two major reasons for hyperglycemia
- Increased glucose production in the body
- Impaired glucose utilization by the peripheral tissues
Now, let's discuss one by one.
1. Increased Glucose Production in the Body:
A) Increased Gluconeogenesis:
It is represented by an inappropriate increase in hepatic glucose production. Insufficient insulin production or insulin resistance exacerbates hyperglycemia in diabetes patients by increasing gluconeogenesis. (2)
B) Accelerated Glycogenolysis:
The balance of glucose metabolism is maintained by the interplay of insulin and counter-regulatory hormones such as glucagon, cortisol, catecholamines, and growth hormone. Any such imbalance in insulin and counter regulatory hormones lead to glycogenolysis, and in turn leads to hyperglycemia.
2. Impaired Glucose Utilization by the Peripheral Tissues:
Elevated levels of TNF-α due to inflammation can cause insulin resistance by impacting the insulin receptor and disrupting the regulation of the insulin signaling pathway. There is growing evidence that during acute stress, high concentrations of inflammatory cytokines such as TNF-α can cause insulin resistance, which leads to impaired glucose utilization by muscles and organs, further causing hyperglycemia.
Consequences of Hyperglycemia:
- Vascular damage
- Immune dysfunction
- Risk of infections
- Increased risk of death in hospitalised patients (3)
Read the article - Top 10 Main Causes of High Glucose Levels in Blood for more details.
How to Reduce Blood Sugar Levels Immediately and Quickly?
Following 3 are the best ways to reduce blood glucose levels quickly as compared to the other methods:
1. Insulin Therapy:
The Endocrine Society and the American diabetic association (ADA) Practice Guidelines recommend pre-meal glucose levels of <140 mg/dl (<7.8 mmol/l) and random glucose levels of <180 mg/dl (<10.0 mmol/l) for patients treated with insulin in the non-ICU setting. Recently, the ADA suggests that target glucose for patients in non-ICU settings should be between 140 – 180 mg/dl (7.8 – 10.0 mmol/l) to avoid hypoglycemia. (4)
2. Aerobic Exercises:
Physical activity, including structured exercise, improves insulin sensitivity, cardiovascular fitness, blood sugar control, reduces the risk of heart-related death, and enhances mental well-being for most people with diabetes, particularly those with type 2 diabetes. (5)
3. Lowering Stress Hormone Levels:
Stress response is one of the major contributors for hyperglycemia. Stress may result in the release of stress hormones such as cortisol and epinephrine, which are related with insulin resistance, by activating the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis.
Mindfulness and meditation can lower cortisol and stress hormone levels, thereby helping maintain healthy blood glucose levels.
How to Do Meditation?
- Sit in a comfortable posture with a straight spine and closed eyes
- Take six deep breaths
- Take six slow breaths, inhaling for 6 counts, holding for 6 counts, exhaling for 6 counts
- Visualize thoughts without engaging with them for 2 minutes
- Visualize breathing in peace and feeling it increase with each breath for 3 minutes
- Visualize feeling happiness with each breath and feeling both peace and happiness for 2 minutes
- Sit in the same state and posture for 10 minutes. (6)
4. Choice of diet and types of food clinically proven to regulate high blood glucose levels.
- Mediterranean Diet: A study that lasted four years found that when adults with Type 2 Diabetes followed a Mediterranean diet, their HbA1c levels went down significantly. The daily intake was 1,500 kcal/d for women and 1,800 kcal/d for men.
- Low Glycemic index (GI) Diet: Eating a diet that has a low impact on blood sugar (called a "low glycemic index" or "low GI" diet) has been shown to help lower blood sugar levels for both people with diabetes and healthy people.
- Okinawan-based Nordic Diet: Culturally modified diet, such as the Okinawan-based Nordic diet, have exhibited potential for reducing fasting blood glucose and HbA1c levels in diabetic adults.
Calorie restriction and macronutrient ratio changes, such as low carbohydrate diets, have been demonstrated to be effective in diabetes patients for lowering fasting glucose and HbA1c levels. (7)
In summary, Hyperglycemia, or high blood sugar, is defined as blood glucose levels above 125 mg/dL when fasting and above 180 mg/dL two hours after a meal. It is caused by increased glucose production in the body and impaired glucose utilization by peripheral tissues. Consequences of hyperglycemia include vascular damage, immune dysfunction, risk of infections, and increased risk of death in hospitalized patients. Ways to reduce blood glucose levels quickly include insulin therapy, aerobic exercise, lowering stress hormone levels through mindfulness and meditation, and choosing a Mediterranean, low glycemic index (GI), or Okinawan-based Nordic diet.
References:
1. Mouri MI, Badireddy M. Hyperglycemia. [Updated 2022 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430900/
2. Melkonian EA, Asuka E, Schury MP. Physiology, Gluconeogenesis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541119/
3. Dhatariya K, Corsino L, Umpierrez GE. Management of Diabetes and Hyperglycemia in Hospitalized Patients. [Updated 2020 Dec 30]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279093/
4. Dhatariya K, Corsino L, Umpierrez GE. Management of Diabetes and Hyperglycemia in Hospitalized Patients. [Updated 2020 Dec 30]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279093/
5. Riddell M, Perkins BA. Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring. J Diabetes Sci Technol. 2009 Jul 1;3(4):914-23. doi: 10.1177/193229680900300439. PMID: 20144341; PMCID: PMC2769951.
6. Shukla R, Gupta M, Agarwal N, Bajpai A. Mindfulness Meditation as Adjunctive Therapy to Improve the Glycemic Care and Quality of Life in Patients with Type 1 Diabetes. Med Sci (Basel). 2021 May 21;9(2):33. doi: 10.3390/medsci9020033. PMID: 34064218; PMCID: PMC8162570.
7. Jeong Y, Lee E, Park YJ, Kim Y, Kwon O, Kim Y. A Review of Recent Evidence from Meal-Based Diet Interventions and Clinical Biomarkers for Improvement of Glucose Regulation. Prev Nutr Food Sci. 2020 Mar 31;25(1):9-24. doi: 10.3746/pnf.2020.25.1.9. PMID: 32292751; PMCID: PMC7143015.