The Sour Side to Sugar

(Part 2)

By Kimberly Ancira, MS, CPT

What is high blood sugar (Hyperglycemia)?

There is nothing sweet about high blood sugar, and many people who are at risk for diabetes and cardiovascular disease don’t learn about its detrimental effects until it’s too late. High blood sugar, or hyperglycemia, is the body’s response to the chronic intake of simple carbohydrates. Sugars that are particularly worrisome include those that are often eaten alone; for instance sugary drinks and candy. When foods high in sugar are eaten by themselves, or on an empty stomach, they spike blood sugar levels because other nutrients are not present to slow down the rate of absorption (such as fats, proteins and fiber). For example, orange juice consumed alone is going to raise blood sugar levels higher than eating an actual orange because the juice lacks fiber, and fiber helps slow the digestion and absorption of sugar.

Consequences of Hyperglycemia:

1. Diabetes

Chronic hyperglycemia in combination with genetics and lifestyle can increase the risk for Type 2 Diabetes. When beta cells are no longerable to compensate for insulin resistance by adequately increasinginsulin production, impaired glucose tolerance appears, characterizedby excessive postprandial hyperglycemia. Impaired glucose tolerancemay evolve into diabetes. Basically, the body becomes insensitive to insulin resulting in the inability to use circulating blood glucose and becomes less efficient at moving sugar out of the bloodstream. Type 2 Diabetes is referred to as non-insulin dependent diabetes because the disease is not predicated on the absence or shortage of insulin. Type 2 Diabetes makes up about 90% of the cases and an alarming rate of children are now being diagnosed with this disorder than ever before.

Type 1 Diabetes is a much different case, as the body does not produce insulin altogether. This disorder is usually diagnosed early in life, well before age 40. This disorder is treated primarily with insulin support.

Those with Type 1 or Type 2 Diabetes are at a much higher risk for cell damage because they either do not make or do not respond properly to insulin. Glucose levels need to be watched closely to avoid hyperglycemia because having too much sugar in the blood for long periods of time can lead to serious health problems. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart and kidney disease.

2. Cardiovascular Disease

Hyperglycemia starts a complex chain of events that damages blood vessels and can cause cardiovascular disease. The protein osteopontin is known to be elevated in the blood of diabetics and is strongly related to diabetes complications. Inflammation is a basic mechanism underlying atherosclerotic plaque formation, which causes cardiac infraction and stroke. Osteopontin participates in the repair of small injuries in the vessel walls but if the level gets too high for too long, as is the case in hyperglycemia, it will cause development of atherosclerotic plaques instead.

3. Kidney Disease

Long-term hyperglycemia may cause kidney failure or kidney disorders. Kidney functions can diminish when the kidney vessels are affected by hyperglycemia. With loss of kidney function, there is an accumulation of water; waste; and toxic substances, in the body, that are normally excreted by the kidney. Loss of kidney function also causes other problems such as anemia, high blood pressure, acidosis (excessive acidity of body fluids), disorders of cholesterol and fatty acids, and bone disease.

4. Blindness

Over time, hyperglycemia can cause fluid to build up behind the retina. Another complication is called retinopathy. This can damage the blood vessels. The vessels supply the blood to the portion of the eye that can sense light or the retina. Thus, retinopathy can lead to blindness.

5. Amputations

Hyperglycemia can lead to nerve damage. Symptoms of damaged nerves are loss of feeling in the arms, hands, feet, legs and toes. In addition, uncontrolled blood sugar levels can impair immune system function. This impairment can cause minor cuts to become infected. If a person has nerve damage and doesn’t check their extremities daily, amputations may result.

How does high blood sugar affect weight loss?

Generally speaking, foods high in simple sugars are also bad for weight loss. After eating food, our body releases enzymes into the digestive tract to break down the compounds into their individual components (glucose, fructose, galactose, lactose, maltose, or sucrose). All sugars and starches are eventually broken down by the body into the simple sugar glucose for energy. Glucose then circulates the bloodstream supplying cells with fuel on an as needed basis. If the body is not in need of energy, the extra glucose is converted into glycogen, which is stored in the muscles and liver. If the body is already storing enough glycogen the glucose gets converted into fat.

When foods rich in simple sugars are digested, the pancreas creates a high level of insulin. When this excess insulin is created, the body does not know what to do with the excess and ends up storing the excess insulin in fat cells. This process leads to excess body fat.

To make matters worse, after a meal is completely digested excess insulin will continue to find sugar to be stored elsewhere. To do this, the insulin will have to take sugar out of the blood stream, which results in low blood sugar (hypoglycemia) after about 30 to 45 minutes. Since your blood sugar level is now low, you will have the natural craving to consumer more sugar to replace it. This often leads to over eating which causes more fat gain and drastically alters your blood sugar levels.

Risk factors for Type 2 Diabetes include:

age (diabetes risk increases with age, especially after the age of 45)
history of physical inactivity

family history of diabetes
ethnicity/race (e.g., African Americans, Hispanic/Latino Americans, American Indians, some Asian Americans and some Native Hawaiians and other Pacific Islanders)
diagnosis of gestational diabetes or delivery of a baby weighing more than 9 pounds
high blood pressure (> 140/90 mm Hg)
HDL level < 35mg/dl and/or a triglyceride level > 250 mg/dl
diagnosis of pre-diabetes
polycystic ovarian syndrome
history of vascular disease, such as heart disease

Signs and Symptoms:

Call your doctor if you have the following symptoms:

Increased urinary frequency, painful urination, weight loss
Shakiness, sweating, and tiredness
Confusion
Shortness of breath, chest pain or discomfort, swelling of lips or throat
Rapid heartbeat or heart palpitations
Nausea that interferes with your ability to eat
Diarrhea (4-6 episodes in a 24 hour period), unrelieved by diet or medication

The most serious side effect and symptom of diabetes and long term high blood sugar levels is kidney damage. If there is damage to kidneys, there will be protein in the urine, called proteinuria. Urine levels need to be checked periodically in those with hyperglycemia or diabetes. Diet, exercise and medication use will need to be discussed with your health care provider to prevent further kidney damage. Strict blood sugar control will help prevent proteinuria.

Preventing Hyperglycemia and Diabetes

Diet, exercise, and maintaining a healthy body weight are the main proponents for preventing and treating hyperglycemia and diabetes. The good news is that people can take control of their symptoms by eating right, exercising, and testing blood sugar regularly.

It is important to reduce the intake of refined carbohydrates and sugars in the diet to maintain a healthy weight and keep stable blood glucose levels. The best way to do this is to eat complex carbohydrates, such as whole grains, whole fruit, vegetables, and legumes with each meal. Meals should have complex carbohydrates in addition to quality protein sources and healthy fats.

Regular exercise helps control blood glucose levels in the following ways:
• It increases glucose uptake by the cells.
• It improves insulin sensitivity by improving glucose metabolism.
• It also reduces the risk of CVD.

Measuring Blood Glucose Levels

Regular blood work is recommended, which will test various markers such as HbA1c, or hemoglobin A1c. Hemoglobin are red blood cells that carry oxygen from the lungs to the rest of the body. Hemoglobin also carries sugar, because sugars can stick to all kinds of proteins in the body. Once sugar sticks to hemoglobin it is stuck there for the life of the red blood cell, about 3-4 months. The more sugar there is in the blood, the more will end up stuck to the hemoglobin, which increases the A1c level.

A1c is therefore a measure of how much sugar is stuck to the hemoglobin and can indicate what the average blood sugar level has been for the past 2 to 3 months. This test allows you to see overall how good one’s blood sugar control has been. If the hemoglobin carries a lot of glucose, then there’s a good chance that proteins in blood vessels have suffered some damage as well.

Measuring fasting plasma glucose (FPG) levels is the preferred way to test for Type 2 Diabetes, with a score of 126 or higher leading to a positive diagnosis. If the FPG score is 100 mg/dl to 125 mg/dl, the person is diagnosed as having impaired fasting glucose (IFG) levels, which is officially known as pre-diabetes, according to the American Diabetes Association. If you have a blood sugar of greater than 126 mg/dl, while fasting, you may be diagnosed with diabetes, or if you have any two blood sugar readings over 200mg/dl.

Another important test is the glucose tolerance test, which most doctors do not offer so you must specifically ask for it. A glucose tolerance reading above 140 mg/dl indicates high blood sugar levels (hyperglycemia) and can lead to toxic effects, such as blindness, cell, nerve and organ damage. It is therefore crucial to keep blood sugar levels below 140 mg/dl.

The Sour Side to Sugar (Part 2)