Impaired glucose and jess tolerance. Violation of tolerance to carbohydrates and diabetes in the elderly. How often is this violation?

At least once in a lifetime, every person has to take a glucose tolerance test. This is a fairly common analysis that allows you to identify and control impaired glucose tolerance. This condition is suitable for ICD 10 (international classification of diseases of the 10th revision)

What is it, why is it done and when is it really needed? Is diet and treatment necessary if glucose concentration is high?

Violation of tolerance as a concept

With a normal daily routine, a person eats food several times, not counting snacks.

Depending on how often and what kind of food was consumed, whether a diet is followed, blood sugar levels change. This phenomenon is completely normal. But sometimes the concentration of glucose unjustifiably increases or decreases sharply, and such a condition is already fraught with danger according to the ICD 10.

An increase in blood sugar for no apparent reason is a violation of glucose tolerance. The difficulty is that it can be detected only with a clinical study of blood or urine according to the ICD 10.

Often impaired glucose tolerance does not appear. And only in certain cases, including during pregnancy, are there symptoms similar to those of diabetes mellitus:

• Dry skin;
• Drying out of the mucosa;
• Sensitive, bleeding gums;
• Long healing wounds and abrasions.

This is not a disease, but treatment is already required. The body signals that not everything is proceeding normally, and you need to pay attention to your diet and lifestyle. A special diet is usually prescribed, if the violations are serious - drug treatment according to the ICD 10.

Important: impaired glucose tolerance is not always, but often becomes an impetus for the development of diabetes. In this case, one should not panic, but consult a specialist and undergo all necessary examinations.

If the amount of insulin in the body remains normal, the main actions should be aimed at preventing the development of acquired diabetes mellitus.

Treatment with folk remedies gives good results - this is an alternative option during pregnancy, when treatment with medications is undesirable, although ICD 10 does not particularly involve treatment with folk remedies.

How is glucose tolerance analysis performed?

In order to establish whether there is a violation of glucose tolerance, two main methods are used:

1. Capillary blood sampling.
2. Venous blood sampling.

Intravenous glucose is required when the patient suffers from diseases of the digestive system or metabolic disorders. In this case, glucose cannot be absorbed if taken orally.

A glucose tolerance test is prescribed in such cases:

• If there is a hereditary predisposition (close relatives suffer from diabetes mellitus 1 or 2 types);
• If there are symptoms of diabetes during pregnancy.

If, with the strict observance of all the rules of the analysis, the indicators differ from the norm, the patient has a violation of glucose tolerance.

A similar phenomenon can lead to the development of type 2 diabetes mellitus, and with further ignoring of alarm signals, to insulin-dependent diabetes. This is especially dangerous during pregnancy, treatment is necessary, even if clear symptoms are not yet available.

Why glucose tolerance is impaired

The reasons for an unreasonable increase or decrease in blood sugar can be:

1. Recent stresses and nervous shocks.
2. Hereditary predisposition.
3. Overweight and obesity as a diagnosis.
4. Sedentary lifestyle.
5. The abuse of confectionery and sweets.
6. Loss of cell sensitivity to insulin.
7. During pregnancy.
8. Insufficient production of insulin due to disorders of the gastrointestinal tract.
9. Dysfunction of the thyroid gland and other organs of the endocrine system, leading to an increase in blood sugar.

The absence of preventive measures in the presence of these factors inevitably leads to the development of type 2 diabetes mellitus - that is, acquired.

Methods for the treatment of impaired glucose tolerance

Two tactics of therapy are used: drug and alternative. With timely diagnosis, treatment with alternative methods is often sufficient, without taking medication.

Non-drug treatment of impaired glucose tolerance is based on such basic principles:

1. Fractional nutrition in small portions. You need to eat 4-6 times a day, while evening meals should be low-calorie.
2. Minimize the use of flour products, pastries, as well as sweets.
3. Strictly control weight, avoiding fat deposition.
4. To make vegetables and fruits the main food products, excluding only those that contain a large amount of starch and carbohydrates - potatoes, rice, bananas, grapes.
5. Be sure to drink at least 1.5 liters of mineral water per day.
6. If possible, exclude the use of animal fats, preferring vegetable oil.

Usually following these nutritional rules gives a good result. If it is not achieved, special drugs are prescribed that contribute to the normalization of glucose metabolism and. Taking hormone-containing drugs is not necessary in this case.

The most popular and effective drugs prescribed to improve glucose metabolism in the body:

• Glucophage;
• Tonorma;
• Metformin;
• Glucofay;
• Amaril.

All appointments must be made strictly by a doctor. If, for some reason, taking medications is undesirable or impossible, for example, during pregnancy, impaired glucose tolerance is treated with alternative recipes, in particular, a variety of herbal infusions and decoctions.

The following medicinal plants are used: blackcurrant leaves, horsetail, burdock root and inflorescences, blueberries. Steamed buckwheat is very popular in the treatment.

There are a fairly large number of methods to combat unstable blood sugar. But at the same time, it is important to maintain a healthy lifestyle, especially during pregnancy and breastfeeding.

Quitting smoking and drinking alcohol, walking in the fresh air, playing sports, following a diet - all this significantly affects the glucose tolerance of the body and can help to avoid converting a small disorder into a pathology, especially during pregnancy.

An equally important point is the state of the nervous system. Constant stress and anxiety can be a decisive factor. Therefore, if there is a need, it is worth contacting a psychologist. He will help to pull himself together, stop worrying, and if necessary, prescribe medications that help strengthen the nervous system.

Impaired glucose tolerance, or prediabetes, is a condition that involves elevated blood sugar, but its performance is not as high as in the case of obvious type 2 diabetes. Moreover, this condition is borderline, therefore, without appropriate intervention, both from the specialist and from the patient, it can go directly to diabetes, as well as cause other serious complications. When properly exposed, it can be adjusted.

Medical diagnostic center "Energo" is a clinic where they provide services for the treatment of many diseases, including the endocrine system. A thorough diagnosis allows you to develop an individual treatment regimen and adjust the patient's condition, thereby avoiding the serious consequences of the prediabetic state.

Prediabetic condition: causes

The main causes of impaired glucose tolerance are as follows:

• significant excess weight, in the development of which the main factors are transmission and a sedentary lifestyle;
• genetic predisposition: it was proved that family members where someone was sick or suffering from diabetes are also at risk, which allowed to identify certain genes responsible for the production of full-fledged insulin, the sensitivity of peripheral tissue receptors to insulin, and other factors;
• age and gender: most often prediabetes and diabetes are diagnosed in women over the age of 45 years;
• other diseases: we are talking primarily about diseases of the endocrine system leading to hormonal and metabolic failure, as well as diseases of the gastrointestinal tract (stomach ulcers, due to which glucose absorption can be impaired) and diseases of the cardiovascular system (atherosclerosis, high blood pressure, high cholesterol, etc.). For women, polycystic ovary disease may be a risk factor;
• complicated pregnancy: often prediabetes, turning into type 2 diabetes, also occurs after gestational diabetes, which occurs in women during pregnancy. Usually problems with blood sugar occur in the case of late pregnancy or large fetus.

It should also be remembered that the prediabetic state can be diagnosed not only in adults, but also in children. Prediabetes in a child usually arises as a consequence of an infectious disease, less commonly, surgical intervention, which makes it necessary to pay special attention to the period of rehabilitation of the child after an illness or surgery.

Prediabetic condition: complications

The main complication of this condition is, of course, its possible transition to acquired type 2 diabetes, which is much more difficult to control. In addition, the presence of excess blood sugar, albeit not at a critical level, leads to an increase in blood density, which can cause plaque formation, clogging of blood vessels and, as a result, problems with the cardiovascular system, namely heart attacks and strokes.

In turn, the transition of the prediabetic state to diabetes entails the possible defeat of other body systems, including the kidneys, vision, nervous system, decreased immunity and general body resistance.

Prediabetic condition: symptoms

Since the violation of tolerance is not yet a disease as such, it is most often asymptomatic. The presence of any symptoms most often indicates latent (latent) diabetes mellitus or very close to this condition that requires treatment.

The presence of the following symptoms indicates the need to undergo a glucose tolerance test:

• dry mouth, thirst, especially with emotional and mental stress and, as a result, an increase in daily fluid intake: the body needs more water to dilute thick blood;
• frequent urination, including with an increase in urine volume, single and daily: consumption of more water forces the body to excrete it more often;
• severe hunger, including nighttime, which usually leads to overeating and weight gain: there is an accumulation of insulin, a hormone that lowers blood sugar.
• fast fatiguability;
• fever, dizziness after eating: occur due to a sharp change in blood sugar;
• headaches: can be caused by narrowing of the vessels of the brain due to the formation of plaques in them.

As you can see from the list, the signs of prediabetes are quite blurred (only thirst and frequent urination can be considered a specific symptom), therefore, diagnosis is of particular importance in this case.

Prediabetic condition: treatment

Experts recommend checking your blood sugar level about twice a year, and in case of symptoms of high blood sugar or the presence of risk factors for the development of the disease, you should contact.

Primary reception

The initial appointment with a specialist involves a preliminary history taking based on the patient's complaints, as well as information on the presence or absence of diabetes and other diseases in the family. In addition, the initial examination includes an examination of the patient and, necessarily, the appointment of laboratory tests that can accurately establish a violation of tolerance.

The diagnosis of problems with the breakdown and assimilation of sugar is based on the glucose tolerance test (glucose test), which is a blood sampling for analysis in several stages:

• on an empty stomach: usually not less than 10 hours after the last meal;
• an hour and two hours after a special carbohydrate load: the patient will need to drink a glucose solution containing 75 grams of this carbohydrate;

It should be remembered that the effective glucose tolerance test requires compliance with a number of requirements, which include the absence of physical exertion and stress immediately before and during the test, as well as the absence of viral diseases, recent surgeries, etc. Do not smoke during the test. Failure to comply with these rules will distort the test results in both positive and negative directions. Before the test, you must consult your doctor.

In addition to biochemical blood tests, the diagnosis of a prediabetic state also involves analysis of urine for cholesterol and uric acid, especially if there are suspicions of the presence of concomitant diseases at risk (atherosclerosis, etc.).

Further treatment regimen

If during the tests, suspicions of a diagnosis of prediabetes (impaired glucose tolerance) or latent diabetes are confirmed, the treatment prescribed by a specialist will be complex (diet, physical activity, less often taking drugs) and aimed at eliminating the causes, and at the same time - symptoms and signs of the disease.

Most often, the general condition of the patient can be corrected by a change in lifestyle, primarily a change in eating habits, which aims to normalize metabolic processes in the body, which in turn will help to reduce weight and return blood glucose to acceptable limits.

The basic principles of nutrition in the diagnosed prediabetic state suggest:

• a complete rejection of easily digestible carbohydrates: bakery and flour products, sweets such as desserts and sweets, potatoes;
• reduction in the amount of digestible carbohydrates (rye and gray bread, cereals) and their uniform distribution throughout the day
• reduction in the amount of animal fats consumed, primarily fatty meat, lard, sausage, mayonnaise, butter, fatty meat broths;
• increased consumption of vegetables and fruits with a high fiber content and low sugar content: preference should be given to acidic and sweet and sour fruits, as well as beans, beans, etc., since they contribute to the rapid saturation of the body;
• reduction in the amount of alcohol consumed, if possible - refusal from it, during rehabilitation;
• an increase in the number of meals up to 5-6 per day in small portions: a similar diet allows you to lessen the load on the digestive organs, including the pancreas, and avoid overeating.

In addition to diet, to correct the prediabetic state, it is also necessary to change the lifestyle, which involves:

• daily physical activity (starting from 10-15 minutes a day with a gradual increase in the duration of classes);
• more active lifestyle;
• smoking cessation: nicotine negatively affects not only the lungs, but also the pancreatic cells responsible for the production of insulin;
• control of blood sugar: control tests are performed a month or a half after the start of treatment. Control tests allow us to establish whether the blood sugar level returned to normal and whether it can be said that impaired glucose tolerance was cured.

In some cases, with a low diet and active physical activity, a specialist can also prescribe medications that help lower blood sugar and cholesterol, especially if controlling the prediabetic state also involves the treatment of concomitant diseases (usually the cardiovascular system).

Usually, with the timely diagnosis of tolerance disorders, as well as with the patient observing all the doctor's prescriptions regarding diet and exercise, the blood sugar level can be stabilized, thereby avoiding the transition of the prediabetic state to type 2 diabetes.
   Prediabetic state: prevention

Due to the fact that most often the prediabetic state is caused by external factors, it can usually be avoided or diagnosed in the early stages, if you follow the following preventive measures:

• control weight: if you are overweight, you must discard it under the supervision of a doctor so as not to deplete the body;
• balance nutrition
• to refuse from bad habits;
• lead an active lifestyle, engage in fitness, avoid stressful situations;
• women with gestational diabetes or polycystic ovary regularly check their blood sugar levels by taking a glucose test;
• take a glucose test as a preventive measure at least 1-2 times a year, especially in the presence of heart disease, gastrointestinal tract, endocrine system, as well as in the presence of diabetes in the family;
• at the first signs of impaired tolerance, make an appointment with a specialist and undergo a diagnosis and possible subsequent treatment of prediabetes.

You can make an appointment with a specialist at the Energo Clinic either by phone or using the special form for patients, which can be completed on the clinic website.

Greetings to regular readers of the blog and casual passers-by! Do you know what is the first bell in the violation of carbohydrate metabolism long before the development of diabetes?

Impaired glucose tolerance (NTG) and fasting glucose are prediabetes, and now you will learn about the causes, symptoms, treatment and prognosis, and whether it can be cured.

Having studied the material of the article, you will understand a lot, and most importantly, there will be a goal to which you need to strive.

What is prediabetes and how to treat it

Any disease has the very beginning, when there are no visible signs, but pathological changes are already underway. So in diabetes there is a condition when it is just outlined and when you can do something. This condition is called impaired glucose tolerance or in common people with prediabetes.

The cause of prediabetes

Let's first decide who this condition occurs in: adults (women or men) or children. What does prediabetes lead to more often? With type 1 or type 2 diabetes?

This term is used to denote a violation of carbohydrate metabolism in adult applicants for type 2 diabetes, as well as in children with obesity who are at risk for type 2 diabetes. And all because this type of diabetes develops rather slowly and it is still possible to suspect something was wrong and prevent the disease, and there is also a connection between the onset of prediabetes and the insulin resistance of these patients.

With type 1, everything happens almost instantly, in a few days or weeks a person develops a total lack of the hormone insulin, which leads to ketoacidosis, which is very difficult to miss. With type 1, there is never true insulin resistance in the opening.

I think it became clear to you that the concept of prediabetes refers to the formation of type 2 diabetes mellitus, which in turn is associated with an increased content of insulin in the blood and tissue sensitivity to it, i.e., tolerance to absorbed glucose develops.

Symptoms of prediabetes in women and men

Violation of glucose tolerance (NTG) does not manifest itself clinically, which is fraught with some danger. What threatens and how to determine impaired glucose tolerance?

Impaired glucose tolerance is a complex and not very clear term for a simple layman. In this article I will try to tell in a simple and accessible language about this condition and the main risks in identifying it.

The term impaired glucose tolerance (NTG), in simple terms, means a decrease in the absorption of blood sugar by body tissues for certain reasons, but diabetes does not yet develop.

This condition was previously considered one of the stages of diabetes. Today, prediabetes is isolated in a separate disease and put in the appropriate diagnosis, which is encoded according to ICD 10 as R 73.0. This disease is one of the components of such a serious enough disease as metabolic syndrome. Somehow I will write a separate article on this syndrome, therefore, so as not to miss.

Many doctors and patients underestimate the impaired glucose tolerance and do not observe patients in dynamics, while changes in carbohydrate metabolism have already begun, which can lead, and then to complications. And you can avoid this by knowing how.

Impaired glucose tolerance is a frequent companion of a disease such as obesity, since it is present, which also leads to impaired glucose uptake by the body.

Prediabetes treatment

For the most impatient, I decided to disrupt the logical train of thought and first write about the treatment of impaired tolerance, and then you will find out who we should examine for carbohydrate disorders and what are the diagnostic criteria for prediabetes in terms of blood sugar.

So, treatment consists of three components:

• nutrition adjustment
• increased physical activity
• hypoglycemic therapy (optional)

Nutrition and diet for prediabetes

In the framework of this article, I can’t give you a detailed menu for a week, but I’m ready to give you general recommendations on nutrition, using which you will create an individual diet for yourself.

A more proper diet for type 2 diabetes I described in the article. Follow the link to learn more about how to eat with this disease.

We recall that the cause of all problems is a high level of insulin and tissue insensitivity. To solve the problem, we need to remove the cause, i.e., a high level of insulin. And what stimulates the pancreas to produce a lot of this hormone? Of course, carbohydrate food!

Here's the basic recipe for you: we remove all products with a high and medium glycemic index from our old diet. What does the glycemic index mean in the article? Avoid very strong carbohydrates in some foods - maltodextrin. It raises blood sugar stronger and faster than glucose.

But that's not all. Along with the glycemic index, there is also an insulin index. It shows how much a particular product raises insulin levels. For example, a product may be with a low glycemic index, but high insulin. These products include all dairy products. I recommend removing them from the diet.

What then remains? The following product groups are at your disposal:

• meat, poultry, fish
• almost all vegetables
• some fruits and berries
• nuts and seeds
• greenery
• low-carb pastries and desserts

I hasten to reassure you, you will not adhere to such nutrition all your life. As soon as your weight, insulin and blood sugar returns to normal, you can carefully expand your diet. But if, the product causes you to increase blood glucose levels, then it should be abandoned for good.

Some ask me: “Why can’t you eat spicy dishes with prediabetes?” This prohibition has no basis, unless this spicy dish contains carbohydrates. Eat to health!

Physical activity in prediabetes

The second most important treatment is physical activity. This does not mean that now you need to plow like horses in the gym, especially since you never did it. You need to increase the intensity and speed gradually, adjusting to your sensations.

As soon as you feel that the previous load has become small for you, you can increase the pace. For the first time, to speed up the metabolism, brisk walking in a forest or park, simple exercises with your own weight (squats, push-ups, press exercises, a “bar”, etc.) are enough to do. At first it’s enough to do no more than 1 hour, but not less than 30 minutes. Classes should be every weekday, but it can be done without days off.

Then you can go to a sports club and practice more professionally with weighting materials. I recommend that you first hire a coach so that he draws up an individual training program for you.

Antidiabetic drugs for prediabetes

In some cases, doctors add sugar-lowering drugs to the overall treatment regimen. For this category of patients, the most suitable are the preparations of the metformin group (siofor, glucophage, etc.)

However, I do not like to prescribe medications ahead of time, and all because with their prescription, a person's motivation to work on his own diet and fi decreases. loads. The subconscious mind thinks that the medicine will do everything for himself. That is why such people often disappear from the view of the doctor.

NTG treatment folk remedies

Here is where there is a popular fantasy to roam! You can try any methods, the main thing is not to harm your health, but do not forget that the main treatment for you is the correction of nutrition and increased physical activity. Folk remedies have no relation to medicine, and therefore I will leave the question of choosing a treatment method to more competent citizens.

NTG risk groups

Diagnosis of impaired glucose tolerance is carried out not for all, but for certain categories of people who are prone to the development of this disease.

Below are the factors for which diagnosis is necessary:

1. the presence of relatives with diabetes mellitus of the first line of relationship
2. overweight (BMI\u003e 27 kg / m2)
3. a history of gestational diabetes (diabetes during pregnancy)
4. giving birth to a large fetus (more than 4.5 kg) or stillbirth
5. the presence of hypertension (with blood pressure\u003e 140/90 mm Hg)
6. high blood triglycerides (\u003e 2.8 mmol / l)
7. a high density lipoprotein level of less than 35 mg / dl
8. chronic periodontal disease and furunculosis
9. taking diabetogenic drugs (diuretics, estrogens, glucocorticoids)
10. over 45 years old

Criteria for impaired glucose tolerance

In my previous article, I wrote about normal blood sugar levels. Here is this article. Now I want to point out the criteria for the level of sugar with impaired glucose tolerance.

In order to make this diagnosis, you need to prove it, and this is done using the so-called glucose tolerance test. This test is done at a clinic or any paid lab. For the test you will need a pure glucose powder in a volume of 75 grams and a slice of lemon if desired, in order to seize the unpleasant sugary taste of glucose.

Before the study, for 3 days you need to eat normally with a sufficient content of carbohydrates, and also adhere to the usual rate of physical activity. It is advisable to avoid stressful situations before the study and not to smoke, this can distort the results. You need to get a good night's sleep and give up analysis if you just came from a night shift.

You come to the laboratory on an empty stomach (at least 10 hours of hunger) and donate blood for sugar, after which you are given glucose powder diluted in warm (otherwise it will not dissolve) water and time is spotted. Then you need to sit quietly for 2 hours in the corridor (if you go for a walk along the corridors, to the stairs or the street, the result will be incorrect).

Most importantly, the test should take place in a calm environment and without physical activity. During these two hours, they will take your blood twice for analysis (1 and 2 hours after drinking glucose). According to the latest recommendations, 1 fence after 2 hours is enough.

That's all. This simple procedure was successfully completed, and now it remains only to wait for the results. The results are usually ready on the same day after lunch or immediately the next.

Prediabetes rates

Below you see a table where the diagnostic criteria for prediabetes are indicated (the picture is clickable).

Prediction of prediabetes or what to do next

Are your parameters correct?

I congratulate you, now you can be free for a year, but do not forget to work on the risk factors that you definitely have, since you were sent for this analysis. But after a year, if the risk factors are not eliminated, you will need to pass this test again.

Your parameters correspond to the diagnosis of “impaired glucose tolerance”

Then it’s time to take decisive measures, and even so, diabetes is not far away. Firstly, you need to remove all risk factors that contribute to this disease, secondly, begin to monitor your diet (reduce or abandon light carbohydrates, excessively fatty foods, alcohol), and thirdly, start regular exercises in recreational sports.

In some cases, medications that relieve insulin resistance, for example, may be needed to reduce body weight. How long to take metformin with prediabetes is decided only by the doctor at the reception.

Is there a connection between prediabetes and cancer

There is a hypothesis about the connection between cancer and prediabetes on the Internet. How true is that? In truth, rationalization is present in this statement. Since impaired glucose tolerance occurs in people with overweight, and the fact that obese people are more often susceptible to cancer is an undeniable and proven fact.

So you need to fight initially with excess weight, and there prediabetes will disappear, and a high risk of cancer.

Prediabetes and pregnancy

During pregnancy, especially in the second trimester, glucose tolerance normally increases. This process proceeds physiologically and gently, if the woman was completely healthy before conception and did not have excess weight. But if a woman was initially complete and had a heredity in type 2 diabetes mellitus, then with a greater degree of probability a pathological impairment of glucose tolerance may develop, which can easily turn into gestational diabetes.

Diagnosis of carbohydrate disorders in pregnant women is carried out in the same way as in non-pregnant women, but the evaluation criteria will be different. Since the topic of diabetes and prediabetes in pregnant women is very large and will not fit in this article, I decided that I would devote a separate time to it. and don’t miss a lot of other useful information about diabetes.

And finally, I want to say that the future of a patient in whom impaired glucose tolerance was detected is completely in his hands. This condition is successfully cured by changing the normal lifestyle to a healthy one. In the article I already wrote about this. By eliminating this problem, you will avoid the appearance of a more serious disease - diabetes, and it's worth it. Is not it?

In the next article I want to talk about the main ones. Knowing these reasons, you can influence fate and prevent the disease.

On this I say goodbye to you. Subscribe and press the buttons of social networks right under the article.

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

Impaired glucose tolerance is a fairly common problem. That is why many people are interested in additional information about what constitutes such a condition. What are the causes of violations? What symptoms are accompanied by pathology? What treatments does modern medicine offer?

What is a similar violation?

What is impaired glucose tolerance? In such a condition, a person has an increase in the amount of sugar - higher than normal, but at the same time lower than that in which patients are diagnosed with type 2 diabetes mellitus.

Thus, impaired tolerance is one of the risk factors. The results of recent scientific studies have shown that approximately one third of patients eventually develop, subject to certain rules and correctly selected drug treatment, metabolism normalizes.

The main reasons for the development of glucose tolerance

Not in all cases, doctors can determine why the patient has developed such a disease. Nevertheless, it was possible to find out the main causes of impaired glucose tolerance:

• First of all, it is worth mentioning the genetic predisposition, which takes place in many cases. If one of your close relatives has diabetes, the likelihood of developing such a condition increases significantly.
• In some patients, the so-called insulin resistance is detected during the diagnosis process, in which the sensitivity of cells to insulin is impaired.
• In some cases, impaired glucose tolerance develops as a result of pancreatic diseases in which its secretory activity is impaired. For example, problems with carbohydrate metabolism can appear against the background of pancreatitis.
• The causes can also include some diseases of the endocrine system, which are accompanied by metabolic disorders and an increase in blood sugar (for example,
• One of the risk factors is obesity.
• A sedentary lifestyle also negatively affects the body.
• Sometimes a change in the amount of sugar in the blood is associated with taking medications, in particular hormones (in most cases, glucocorticoids become the “culprits”).

Glucose tolerance disorder: symptoms

Unfortunately, such a pathology in most cases is asymptomatic. Patients rarely complain of deterioration of health or simply do not notice it. By the way, for the most part, people with a similar diagnosis are overweight, which is associated with a violation of normal metabolic processes.

As aggravation of carbohydrate metabolism disorders, characteristic signs begin to appear, which are accompanied by impaired glucose tolerance. Symptoms in this case are thirst, a feeling of dry mouth and increased fluid intake. Accordingly, in patients, there is also a significant decrease in immune defense against the background of hormonal and metabolic disorders - people become extremely susceptible to inflammatory and fungal diseases.

Why is this disorder dangerous?

Of course, many patients with this diagnosis are interested in questions about the danger of impaired glucose tolerance. First of all, this condition is considered dangerous because, if untreated, the risk of developing a well-known insidious disease, namely type 2 diabetes, is very high. On the other hand, such a disorder increases the likelihood of developing diseases of the cardiovascular system.

Basic diagnostic methods

The diagnosis of glucose tolerance disorder can only be made by a doctor. To begin with, a specialist will conduct an examination and collect an anamnesis (the presence of certain complaints from the patient, information about previously transmitted diseases, the presence of people with diabetes in the family, etc.).

In the future, a standard blood test for sugar level is performed. Samples are taken in the morning, on an empty stomach. A similar procedure is carried out in any clinic. As a rule, the glucose level in such patients exceeds 5.5 mmol / L. However, to establish an accurate diagnosis, a special glucose tolerance test is needed.

Test and indications for its conduct

Such a study is by far one of the most accessible and effective methods for diagnosing a condition called "impaired glucose tolerance." But although testing is fairly simple, proper preparation is crucial here.

For several days before taking the blood, the patient is advised to avoid stress and increased physical activity. The procedure is carried out in the morning and on an empty stomach (not earlier than 10 hours after the last meal). First, a portion of blood is taken from the patient, after which they offer to drink glucose powder dissolved in warm water. After 2 hours, a repeated blood sampling is performed. In laboratory conditions, the sugar level in the samples is determined and the results are compared.

If before glucose intake the blood sugar level was 6.1-5.5 mmol, and after two hours it jumped sharply to 7.8-11.0 mmol / l, then we can already talk about a violation of tolerance.

In fact, experts recommend that everyone undergo such testing at least once every two years - this is a very effective preventive precaution that will help to identify the disease at an early stage. However, there are some risk groups for which analysis is mandatory. For example, people with a genetic predisposition to diabetes, as well as patients suffering from obesity, arterial hypertension, high cholesterol, atherosclerosis, neuropathy of unknown origin, are often sent for testing.

Glucose tolerance disorder: treatment

If the tolerance test gives a positive result, then you should immediately contact an endocrinologist. Only a specialist knows which therapy requires impaired glucose tolerance. Treatment at this stage, as a rule, is not medical. However, the patient needs to change his usual lifestyle as soon as possible.

It is imperative to ensure that body weight is within normal limits. Naturally, sitting on strict diets or draining the body with intense physical activity is not worth it. You need to fight extra pounds, gradually changing the diet and increasing physical activity. By the way, training should be regular - at least three times a week. It is worth giving up smoking, as this bad habit leads to narrowing of blood vessels and damage to pancreatic cells.

Of course, you need to carefully monitor the blood sugar level, regularly undergo examinations by the endocrinologist and take the necessary tests - this will make it possible to determine the presence of complications in time.

If this treatment is ineffective, your doctor may prescribe some medications that lower your blood sugar. But it is worthwhile to understand that a universal panacea for such a disease does not exist.

Proper nutrition is an integral part of therapy

Of course, in the treatment of such a pathology, nutrition plays an extremely important role. Impaired glucose tolerance requires a special diet. First of all, it is worth changing the eating regimen. Patients are advised to eat 5-7 times a day, but the portions should be small - this will help relieve the burden on the digestive system.

What other changes does impaired glucose tolerance require? The diet in this case must necessarily exclude sweets - sugar, sweets, sweet pastries are prohibited. In addition, it is worth limiting the amount of products containing easily digestible carbohydrates - these are bread and bakery products, pasta, potatoes, etc. Experts also recommend reducing the amount of fat - do not abuse fatty meats, butter, lard. At the time of rehabilitation, it is also worth giving up coffee and even tea, because these drinks (even without sugar) tend to increase blood glucose levels.

What should the patient's diet consist of? First of all, these are vegetables and fruits. They can be consumed raw, boiled, baked. The required amount of protein can be obtained by entering in the menu low-fat varieties of meat and fish, nuts, legumes, milk and dairy products.

Basic preventive measures

Impaired glucose tolerance can be extremely dangerous. And in this case, it is much easier to avoid such a disorder than to face the risk of developing diabetes. To maintain the normal functioning of the body, you need to follow only some simple rules.

For starters, you should adjust the diet. Specialists recommend fractional nutrition - eat 5-7 times a day, but always in small portions. The daily menu should limit the amount of sweets, pastries and excessively fatty foods, replacing it with fresh fruits, vegetables and other healthy foods.

It is important to monitor body weight and provide the body with the necessary physical activity. Of course, excessive physical activity can also be dangerous - loads need to be increased gradually. Of course, physical education should be regular.

Problems with carbohydrate metabolism precede the development of diabetes. Having noticed abnormalities, you should immediately begin therapy. Patients should know: impaired glucose tolerance - what it is and how to cope with this condition. First of all, you should find out how this disease manifests itself.

Characteristic

Violation of tolerance (NTG) is a condition in which the concentration of sugar in the blood is not significantly increased. With this pathology, there is no reason to diagnose diabetes in patients yet, but there is a high risk of developing problems.

Specialists should know the code for ICD 10 for NTG. According to the international classification, the code R73.0 is assigned.

Previously, such disorders were considered diabetes (its initial stage), but now doctors separate them separately. This is a component of the metabolic syndrome, it is observed simultaneously with an increase in the amount of visceral fat, hyperinsulinemia and increased pressure.

Annually, in 5-10% of patients with impaired carbohydrate tolerance, diabetes is diagnosed. Usually this transition (disease progression) is observed in people suffering from obesity.

Usually, problems arise when the process of insulin production is disrupted and the sensitivity of tissues to this hormone decreases. When eating, pancreatic cells begin the process of insulin production, but it is released provided that the concentration of sugar in the bloodstream increases.

In the absence of disturbances, any increase in glucose levels provokes tyrosine kinase activity. But if the patient has prediabetes, then the process of breaking the binding of cell receptors and insulin begins. Because of this, the process of transporting glucose into cells is disrupted. Sugar does not provide energy to tissues in the required volume, it remains in the bloodstream and accumulates.

Signs of pathology

In the initial stages, the disease does not manifest itself. You can identify it during the passage of the next physical examination. But often it is diagnosed in patients suffering from obesity or overweight.

Symptoms include:

• the appearance of dry skin;
• development of genital and skin itching;
• periodontal disease and bleeding gums;
• furunculosis;
• problems with wound healing;
• menstrual irregularities in women (up to amenorrhea);
• decreased libido.

In addition, angioneuropathy can begin: small joints are affected, the process is accompanied by impaired blood flow and nerve damage, a disruption in the process of conducting impulses.

When these signs appear in patients suffering from obesity, it should be examined. As a result of the diagnosis, it can be established that:

• on an empty stomach in humans, normoglycemia or indicators are slightly increased;
• sugar is absent in urine.

When the condition worsens, signs of diabetes develop:

• intense obsessive thirst;
• dry mouth
• increased urination;
• deterioration of the immune system, manifested by fungal and inflammatory diseases.

Almost every patient is able to prevent the transition of increased glucose tolerance to diabetes. But for this you need to know about methods of preventing disorders of carbohydrate metabolism.

It should be remembered that even in the absence of signs of pathology, it is necessary to periodically check the effectiveness of metabolic metabolism for people with a predisposition to the development of diabetes. In the second half of pregnancy (between 24 and 28 weeks), a tolerance test is recommended for all women over 25 years of age.

Reasons for the development of problems

Deterioration in the process of carbohydrate absorption may occur in everyone with a genetic predisposition and provoking factors. The reasons for NTG include:

• severe stress;
• obesity, overweight;
• significant intake of carbohydrates in the patient's body;
• low physical activity;
• deterioration of the process of insulin production in case of gastrointestinal disorders;
• endocrine diseases accompanied by the production of contra-hormonal hormones, including thyroid dysfunction, Itsenko-Cushing's syndrome.

This disease also appears during pregnancy. After all, the placenta begins to produce hormones, because of which the susceptibility of tissues to the action of insulin decreases.

Provocative factors

In addition to the reasons for the development of carbohydrate metabolism disorders, patients should know who is more at risk of reducing tolerance. Patients with a genetic predisposition should be most careful. But the list of provoking factors also includes:

• atherosclerosis and increased blood lipids;
• problems with the liver, kidneys, blood vessels and heart;
• hypothyroidism;
• gout
• inflammatory diseases of the pancreas, due to which insulin production is reduced;
• increase in cholesterol concentration;
• the appearance of insulin resistance;
• taking certain medications (hormonal contraceptives, glucocorticoids, etc.);
• age after 50 years.

Particular attention is paid to pregnant women. Indeed, in almost 3% of expectant mothers, gestational diabetes is detected. Provoking factors are:

• overweight (especially if it appeared after 18 years);
• age over 25-30 years;
• genetic predisposition;
• PCOS;
• development of diabetes in previous pregnancies;
• the birth of children weighing more than 4 kg;
• increased pressure.

Patients at risk should periodically check their sugar levels.

Pathology Diagnostics

It is possible to determine the disease only with the help of laboratory diagnostics. Capillary or venous blood can be taken for research. Observe the basic rules for collecting material.

3 days before the planned study, patients should follow a familiar lifestyle: it is not worth changing a diet to a low-carb one. This can lead to a distortion of the actual results. You should also avoid stress before taking blood and do not smoke half an hour before the test. After a night shift, donating blood for glucose is impossible.

To establish a diagnosis of NTG should:

• donate blood on an empty stomach;
• take a glucose solution (300 ml of pure liquid is mixed with 75 glucose);
• 1-2 hours after taking the solution, repeat the analysis.

The data obtained makes it possible to determine whether there are problems. Sometimes it is required to conduct a blood sampling every half an hour to understand how glucose levels in the body change.

To determine impaired tolerance in children, they are also tested with a load: for each kilogram of their weight 1.75 g of glucose is taken, but not more than 75 g.

Fasting sugar counts should be no more than 5.5 mmol / L if capillary blood is tested, and 6.1 if venous.

2 hours after drinking glucose in the absence of problems, sugar should not be more than 7.8, regardless of the place of blood sampling.

In cases of tolerance disorders, the indices in an empty stomach study will be up to 6.1 for capillary and up to 7.0 for venous blood. After taking a glucose solution, they will rise to 7.8 - 11.1 mmol / L.

There are 2 main research methods: the patient can be given a drink or injected intravenously. With oral fluid intake, the stomach should first go through, and only then the process of enriching blood with glucose will begin. When administered intravenously, it immediately enters the bloodstream.

Selection of treatment tactics

Having established that there are problems, you should contact the endocrinologist. This doctor specializes in this kind of disorder. He can tell what to do if glucose tolerance is impaired. Many refuse to consult a doctor, fearing that he will prescribe insulin injections. But it is too early to talk about the need for such treatment. With NTG, another therapy is practiced: lifestyle changes, dietary changes.

Only in extreme cases, drug therapy is required. In most patients, improvements occur if:

• switch to fractional nutrition (food is taken 4-6 times a day, the calorie content of the last meals should be low);
• minimize the amount of simple carbohydrates (remove cakes, pastries, buns, sweets);
• achieve weight loss of at least 7%;
• drink at least 1.5 liters of clean water daily;
• minimize the amount of animal fats, vegetable fats should come in a normal amount;
• include in your daily diet a significant amount of fruits and vegetables, with the exception of grapes, bananas.

Particular attention is paid to physical activity.

Compliance with these principles of nutrition in combination with adequate physical activity is the best way.

They talk about drug therapy if such therapy fails. To evaluate the effectiveness of the treatment, not only a glucose tolerance test is done, but also the level of glycated hemoglobin is checked. This study allows you to estimate the sugar content over the past 3 months. If a downward trend is visible, then diet therapy is continued.

If concomitant problems or diseases are found that provoke a deterioration in the absorption of insulin by the tissues, adequate treatment of these diseases is necessary.

If the patient follows a diet and complies with all the instructions of the endocrinologist, but there is no result, then drugs that are used in the treatment of diabetes can be prescribed. It can be:

• thiazolidinediones;
• α-glucosiad inhibitors;
• sulfonylurea derivatives.

The most popular drugs for treating carbohydrate metabolism disorders are metformin derivatives: Metformin, Siofor, Glucofage, Formetin. If the desired result is not achieved, then in combination with these drugs, other drugs are prescribed that are intended for the treatment of diabetes.

Subject to recommendations, restoration of normal blood sugar levels is observed in 30% of patients with an established diagnosis of NTG. But at the same time, a high risk of developing diabetes in the future remains. Therefore, even with the removal of the diagnosis, it is impossible to completely relax. The patient should monitor his diet, although periodic relief is allowed.