Diabetes Mellitus

• Chronic hyperglycemia is the hallmark of type 1 or type 2 diabetes.

Stress or Infection

• Acute illnesses, infections, or prolonged stress may transiently raise blood sugar levels (stress hyperglycemia).

Endocrine Disorders

• Conditions such as Cushing’s syndrome, or iatrogenic causes like steroid therapy, can cause elevated blood sugar levels.

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Hypoglycemia

• Causes
  Excess insulin from treatment, insulinoma, or reactive hypoglycemia
  Impaired gluconeogenesis due to liver failure
  Overuse of glucose by peripheral tissues in sepsis
• Severe Liver Disease
• Glucose Production
  The liver's inability to produce enough glucose, especially during fasting states, contributes significantly to hypoglycemia.

Children

• In children, type 1 diabetes may present with acute hyperglycemia.

Older Adults

• In older adults, diabetes is often type 2 and may be complicated by comorbidities.
• Elderly patients are particularly vulnerable to both hyperglycemia and hypoglycemia due to altered metabolism and polypharmacy.

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Glucose Metabolic Markers and Regulators

• Blood Sugar & Glucose in Plasma:
  Both reflect the current level of sugar circulating in the bloodstream. These are the central metrics for assessing glycemic status and are directly influenced by various hormonal signals.
  
  
• Insulin:
  This hormone, secreted by pancreatic beta cells, lowers Blood Sugar and Glucose in Plasma by facilitating the uptake of glucose into cells. It is key in maintaining normal glycemic levels.
  
  
• Glucagon:
  Secreted by pancreatic alpha cells, Glucagon acts in opposition to Insulin by stimulating the liver to release stored glucose, thereby increasing Blood Sugar during fasting or low-glucose conditions.
  
  
• Glycosylated Hemoglobin (HbA1c):
  This marker measures the non-enzymatic attachment of glucose to hemoglobin over approximately two to three months, providing a long-term view of Blood Sugar control.
  
  
• Somatotropic Hormone (Growth Hormone, GH):
  This hormone influences metabolism by reducing the sensitivity of tissues to Insulin, indirectly contributing to higher Blood Sugar levels. It also plays a role in growth and overall energy balance.
  
  
• Serotonin:
  Although primarily known as a neurotransmitter, Serotonin also modulates Insulin secretion and energy balance, indirectly affecting Blood Sugar regulation.
  
  

These markers are interrelated elements of the body’s glucose metabolic and endocrine network. Blood Sugar and Glucose in Plasma provide the primary measure of glycemic status, controlled by the opposing actions of Insulin and Glucagon. Glycosylated Hemoglobin (HbA1c) offers insight into long-term glucose management, while Somatotropic Hormone (Growth Hormone, GH) and Serotonin modulate metabolic processes that influence overall blood sugar levels.

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