The onset of type 2 diabetes is slow and the symptoms are hidden. The vast majority of patients do not have typical [hyperglycemia] symptoms such as polyuria, excessive drinking, excessive eating and weight loss. Some patients even see a doctor because of [hypoglycemia] before meals, showing recurrent hypoglycemia symptoms such as hunger, palpitation, shaking hands and cold sweat before meals, which can be relieved after eating.
Why do diabetics suffer from preprandial hypoglycemia?
Under normal circumstances, After eating, Blood sugar rises, Stimulate insulin secretion. Elevated insulin will quickly shut down the production of endogenous glucose in the liver. At the same time, it also promotes the intake and utilization of glucose by peripheral tissues, so the postprandial blood sugar will not rise too high. After eating 30 minutes, 60 minutes of insulin secretion reached a peak, generally 5 to 10 times of the basic level, 2 hours after the meal insulin level began to decline, 3 to 4 hours after the meal insulin basically returned to the preprandial level, so hypoglycemia will not occur before the meal.
In the early stage of some patients with type 2 diabetes, the pattern of insulin secretion has changed. Insulin secretion is not high enough 30 and 60 minutes after meal (called islet B cell secretion hypofunction) or although the level is very high, it cannot play a role (called insulin resistance), resulting in an increase in blood sugar 30 and 60 minutes after meal. Accompanied by the delay of the peak time of insulin secretion, the insulin level is still very high 2 hours or even 3 hours after the meal, and the glucose consumption in the body is almost the same at this time. If the meal is not eaten in time, hypoglycemia may occur.
Who is prone to this?
Patients with obesity, fatty liver, dyslipidemia, hypertension and hyperuricemia, Women with previous history of polycystic ovary syndrome and gestational diabetes mellitus are all at high risk of diabetes. If preprandial hypoglycemia symptoms occur, the possibility of early diabetes mellitus should be highly suspected. Prolonged glucose tolerance test plus insulin release test can be clearly diagnosed.
How to prevent and treat hypoglycemia before meals?
Before patients get a correct diagnosis, they often relieve hypoglycemia symptoms by increasing food intake (such as candy, chocolate, dessert and high-fat and high-calorie foods), which will aggravate postprandial hyperglycemia and make diabetes develop into real diabetes quickly in the early stage.
The correct approach is to change the lifestyle, through diet control and proper exercise, lose weight, increase insulin sensitivity, so as to prevent or delay the occurrence of clinical diabetes. If hypoglycemia symptoms still exist, you can take the method of eating less and eating more or taking drugs such as acarbose that can slow down carbohydrate absorption in your meal.