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Glucose Intolerance

Updated : April 30, 2024





Background

Glucose intolerance is a condition in which the body cannot control the blood sugar levels and this led to the high level of blood glucose concentration. This condition is linked to diabetes and other factors. Pancreas produces insulin. It plays an important role in regulating the blood glucose levels. Individuals with glucose intolerance ae not produce enough amount of the insulin or cells do not respond to the insulin sensitivity. This caused the increased level of blood sugar.

Epidemiology

Diabetes increases worldwide. The reasons behind are like people are getting older, moderate lifestyles and obesity. In the Middle East, North America and Asia, glucose intolerance is linked to type 2 diabetes.

Urban development and lifestyle changes increase the risk. Some studies ae gender specific but male and female both affect by this disease. Ethnic groups like African, Hispanic, Native American and Asian have high rate of glucose intolerance and diabetes.

Anatomy

Pathophysiology

People with glucose intolerance decreases the beta cell activity. This may occur when pancreatic beta cells are not produces insulin to control the high level of blood glucose. This can lead to insulin resistance in peripheral tissue like muscle and adipose tissue. This prevents the glucose uptake and increases the blood sugar level. Adipose tissue releases the free fatty acids in the abdominal region. This also causes glucose intolerance. Chronic low-grade inflammation, genetic factors like sedentary lifestyle, obesity and aging can also cause glucose intolerance. Impairs insulin signaling leads to hyperglycemia and type 2 diabetes. The condition represents a complex interplay of genetic predisposition and environmental factors. It is necessary to understand the mechanism to prevent and manage the disease.

Etiology

  • Insulin Resistance: When pancreatic beta cells are not produces enough insulin to control the high level of blood glucose. This can lead to insulin resistance in peripheral tissue. This prevents the glucose uptake and increases the blood sugar level.
  • Genetics: Genetic factors play an important role in the glucose intolerance. People are at high risk who has family history of diabetes or related diseases.
  • Obesity:  Excess body weight mainly abdominal or visceral fat is associated with the glucose intolerance. It can lead to insulin resistance and develop type 2 diabetes.
  • Physical Inactivity:  Lack of regular physical activity can lead to insulin resistance and obesity. This can cause glucose intolerance.
  • Poor Diet: Diets rich in carbohydrates, sugar and saturated fat can lead to insulin resistance and obesity. This can cause glucose intolerance.
  • Age:  Aging is associated with reduction in insulin sensitivity. As people get older, they may at the risk of glucose intolerance and diabetes.
  • Hormonal Changes: Conditions like polycystic ovary syndrome (PCOS) in women and hormonal imbalances can lead to insulin resistance and glucose intolerance.
  • Gestational Diabetes: Women who has gestational diabetes during pregnancy are at an increased risk of glucose intolerance later in life.
  • Certain Medical Conditions: Conditions like hypertension and cardiovascular disease are associated with glucose intolerance.
  • Chronic Inflammation:  Chronic kidney disease or autoimmune diseases is caused by inflammations. This can affect the insulin signaling and lead to glucose intolerance.
  • Medications: Medications like antipsychotics and glucocorticoid can affect the glucose metabolism and lead to insulin resistance and glucose intolerance.

Genetics

Prognostic Factors

The positive prognosis factors are include lifestyle changes and medical treatments. Necessary steps have to be taken to manage the disease.

Clinical History

People with family history of diabetes or glucose intolerance, conditions like obesity, PCOS, cardiovascular disease or gestational diabetes during pregnancy are at the high risk. This disease develops gradually. It appears less or no symptoms at first. As the time increases, it progresses to diabetes. Lifestyle factors, genetics, and early treatment may vary the time.

Signs and Symptoms:

Frequent Urination (Polyuria): The kidney produces more urine as they eliminate the excess glucose.

Excessive Thirst (Polydipsia): Increased urination leads to dehydration. This results in excessive thirst.

Increased Hunger (Polyphagia): because of the low glucose use, body need more nutrient even after eating.

Fatigue: The body is unable to use glucose efficiently. This results in fatigue.

Blurred Vision: Fluid levels may change and that affect the shape of the lens in the eye. This leads to the blurred vision.

Physical Examination

General Examination

  • Obesity: Excessive body weight mainly abdominal obesity is associated to glucose intolerance and type 2 diabetes.
  • Hypertension: Elevated blood pressure is associated with metabolic syndrome. This can lead to insulin resistance and glucose intolerance.

Skin Changes

  • Acanthosis Nigricans: Dark, velvety patches of skin on the neck, armpits or groin indicate insulin resistance.

Neurologic Examination

  • Peripheral Neuropathy: Numbness, tingling or pain in the extremities is associated with long-term uncontrolled level of glucose.

Ophthalmic Examination

  • Diabetic Retinopathy: Changes in the blood vessels of the retina in the extreme cases of diabetes is lead to glucose intolerance.

Abdominal Examination

Hepatomegaly is also associated with non-alcoholic fatty liver disease (NAFLD).

Musculoskeletal Examination

  • Limited Joint Mobility: Joint mobility is a common issue in diabetic patients. It causes restricted joint movement.
  • Oral Examination
  • Periodontal Disease: Gum disease and oral infections are more common in with diabetes disease.

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

  • Type 1 Diabetes Mellitus
  • Type 2 Diabetes Mellitus
  • Gestational Diabetes
  • Polycystic Ovary Syndrome
  • Acromegaly

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

Glucose tolerance treatment involves the lifestyle changes and medication. A healthy diet with balanced carbohydrates, fiber and lean proteins is necessary. Physical exercise is necessary as it improve the insulin sensitivity and glucose metabolism. Medications like metformin is used to regulate the blood glucose level. Close monitoring, regular follow up and self-management is important in order to improve the result and treatment.

Lifestyle Modifications

Lifestyle changes is necessary to manage the glucose intolerance. It reduces the risk of the type 2 diabetes. The main goal it to reduce the body weight by 7%. Moderately intense exercise like brisk walking is necessary. Reduce the calory intake. Consume food with quality like monounsaturated fats and nuts, berries, yogurt, high-fiber foods and tea. It reduces the risk of diabetes. Red meats and sugar-sweetened beverages increases the risk. Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet is sued to manage the glucose intolerance.

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Role of Metformin

Metformin is classified as a biguanide. It inhibits the hepatic production of glucose and increases the sensitivity of insulin. It benefits for patients whose age are under 60, obesity and females with gestational diabetes mellitus. Patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) also get the positive result. Medical organizations have different opinion on whether alternative pharmacotherapies can be used to manage the glucose intolerance. Metformin is often used because it target the hepatic production of glucose and the sensitivity of insulin.

Medication

Media Gallary

Glucose Intolerance

Updated : April 30, 2024




Glucose intolerance is a condition in which the body cannot control the blood sugar levels and this led to the high level of blood glucose concentration. This condition is linked to diabetes and other factors. Pancreas produces insulin. It plays an important role in regulating the blood glucose levels. Individuals with glucose intolerance ae not produce enough amount of the insulin or cells do not respond to the insulin sensitivity. This caused the increased level of blood sugar.

Diabetes increases worldwide. The reasons behind are like people are getting older, moderate lifestyles and obesity. In the Middle East, North America and Asia, glucose intolerance is linked to type 2 diabetes.

Urban development and lifestyle changes increase the risk. Some studies ae gender specific but male and female both affect by this disease. Ethnic groups like African, Hispanic, Native American and Asian have high rate of glucose intolerance and diabetes.

People with glucose intolerance decreases the beta cell activity. This may occur when pancreatic beta cells are not produces insulin to control the high level of blood glucose. This can lead to insulin resistance in peripheral tissue like muscle and adipose tissue. This prevents the glucose uptake and increases the blood sugar level. Adipose tissue releases the free fatty acids in the abdominal region. This also causes glucose intolerance. Chronic low-grade inflammation, genetic factors like sedentary lifestyle, obesity and aging can also cause glucose intolerance. Impairs insulin signaling leads to hyperglycemia and type 2 diabetes. The condition represents a complex interplay of genetic predisposition and environmental factors. It is necessary to understand the mechanism to prevent and manage the disease.

  • Insulin Resistance: When pancreatic beta cells are not produces enough insulin to control the high level of blood glucose. This can lead to insulin resistance in peripheral tissue. This prevents the glucose uptake and increases the blood sugar level.
  • Genetics: Genetic factors play an important role in the glucose intolerance. People are at high risk who has family history of diabetes or related diseases.
  • Obesity:  Excess body weight mainly abdominal or visceral fat is associated with the glucose intolerance. It can lead to insulin resistance and develop type 2 diabetes.
  • Physical Inactivity:  Lack of regular physical activity can lead to insulin resistance and obesity. This can cause glucose intolerance.
  • Poor Diet: Diets rich in carbohydrates, sugar and saturated fat can lead to insulin resistance and obesity. This can cause glucose intolerance.
  • Age:  Aging is associated with reduction in insulin sensitivity. As people get older, they may at the risk of glucose intolerance and diabetes.
  • Hormonal Changes: Conditions like polycystic ovary syndrome (PCOS) in women and hormonal imbalances can lead to insulin resistance and glucose intolerance.
  • Gestational Diabetes: Women who has gestational diabetes during pregnancy are at an increased risk of glucose intolerance later in life.
  • Certain Medical Conditions: Conditions like hypertension and cardiovascular disease are associated with glucose intolerance.
  • Chronic Inflammation:  Chronic kidney disease or autoimmune diseases is caused by inflammations. This can affect the insulin signaling and lead to glucose intolerance.
  • Medications: Medications like antipsychotics and glucocorticoid can affect the glucose metabolism and lead to insulin resistance and glucose intolerance.

The positive prognosis factors are include lifestyle changes and medical treatments. Necessary steps have to be taken to manage the disease.

People with family history of diabetes or glucose intolerance, conditions like obesity, PCOS, cardiovascular disease or gestational diabetes during pregnancy are at the high risk. This disease develops gradually. It appears less or no symptoms at first. As the time increases, it progresses to diabetes. Lifestyle factors, genetics, and early treatment may vary the time.

Signs and Symptoms:

Frequent Urination (Polyuria): The kidney produces more urine as they eliminate the excess glucose.

Excessive Thirst (Polydipsia): Increased urination leads to dehydration. This results in excessive thirst.

Increased Hunger (Polyphagia): because of the low glucose use, body need more nutrient even after eating.

Fatigue: The body is unable to use glucose efficiently. This results in fatigue.

Blurred Vision: Fluid levels may change and that affect the shape of the lens in the eye. This leads to the blurred vision.

General Examination

  • Obesity: Excessive body weight mainly abdominal obesity is associated to glucose intolerance and type 2 diabetes.
  • Hypertension: Elevated blood pressure is associated with metabolic syndrome. This can lead to insulin resistance and glucose intolerance.

Skin Changes

  • Acanthosis Nigricans: Dark, velvety patches of skin on the neck, armpits or groin indicate insulin resistance.

Neurologic Examination

  • Peripheral Neuropathy: Numbness, tingling or pain in the extremities is associated with long-term uncontrolled level of glucose.

Ophthalmic Examination

  • Diabetic Retinopathy: Changes in the blood vessels of the retina in the extreme cases of diabetes is lead to glucose intolerance.

Abdominal Examination

Hepatomegaly is also associated with non-alcoholic fatty liver disease (NAFLD).

Musculoskeletal Examination

  • Limited Joint Mobility: Joint mobility is a common issue in diabetic patients. It causes restricted joint movement.
  • Oral Examination
  • Periodontal Disease: Gum disease and oral infections are more common in with diabetes disease.
  • Type 1 Diabetes Mellitus
  • Type 2 Diabetes Mellitus
  • Gestational Diabetes
  • Polycystic Ovary Syndrome
  • Acromegaly

Glucose tolerance treatment involves the lifestyle changes and medication. A healthy diet with balanced carbohydrates, fiber and lean proteins is necessary. Physical exercise is necessary as it improve the insulin sensitivity and glucose metabolism. Medications like metformin is used to regulate the blood glucose level. Close monitoring, regular follow up and self-management is important in order to improve the result and treatment.

Lifestyle Modifications

Lifestyle changes is necessary to manage the glucose intolerance. It reduces the risk of the type 2 diabetes. The main goal it to reduce the body weight by 7%. Moderately intense exercise like brisk walking is necessary. Reduce the calory intake. Consume food with quality like monounsaturated fats and nuts, berries, yogurt, high-fiber foods and tea. It reduces the risk of diabetes. Red meats and sugar-sweetened beverages increases the risk. Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet is sued to manage the glucose intolerance.

Metformin is classified as a biguanide. It inhibits the hepatic production of glucose and increases the sensitivity of insulin. It benefits for patients whose age are under 60, obesity and females with gestational diabetes mellitus. Patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) also get the positive result. Medical organizations have different opinion on whether alternative pharmacotherapies can be used to manage the glucose intolerance. Metformin is often used because it target the hepatic production of glucose and the sensitivity of insulin.