Hidden Sugar: What It Is, Symptoms, Diagnosis, and Treatment

Hidden sugar is a condition that closely affects the circulation, nerves, and immune system. This is because, if left untreated, it can manifest as Type 2 diabetes. It is often overlooked, especially in children and adults, since it doesn't present symptoms in the early stages. However, with regular doctor check-ups, it can be diagnosed and treated before it turns into Type 2 diabetes. Additionally, people with a family history of diabetes should take preventive steps to manage hidden sugar, as it is important for their health.

What Is Hidden Sugar?

Hidden sugar refers to a situation where blood sugar levels are higher than they should be but not high enough to be diagnosed as diabetes. This condition can also be referred to as impaired fasting glucose and impaired glucose tolerance. Hidden sugar is a sign that the body is beginning to lose its ability to use insulin effectively. Insulin is a hormone produced by the pancreas that helps the body convert glucose into fuel. After food intake, the carbohydrates are converted into glucose, which is known as blood sugar. When the body becomes resistant to insulin, glucose levels in the blood rise, and hidden sugar occurs. If not controlled, hidden sugar can lead to Type 2 diabetes.

What Are the Symptoms of Hidden Sugar?

Typically, glucose in the bloodstream is reabsorbed by the kidneys. However, at high glucose levels, proteins in the kidneys that bind to glucose and reabsorb it become saturated. As a result, glucose is not reabsorbed and is excreted in the urine, pulling water with it. When blood sugar rises, large amounts of water are excreted through the urine. This water loss in urine can lead to tissue dehydration and symptoms such as nausea, dizziness, headaches, constipation, and fainting. Additionally, when glucose leaves the body through the urine, the thirst response in the brain is triggered to replenish the lost water. Furthermore, the blood vessels in the retina may be damaged due to high blood sugar levels. This can result in vision problems. Although hidden sugar does not exhibit as pronounced symptoms as diabetes, it can cause the following:

• Darkening of the skin around the knees, elbows, neck, and armpits
• Increased thirst
• Increased urination
• Fatigue
• Blurred vision
• Slow wound healing

What Causes Hidden Sugar?

Insulin is released to help lower blood sugar levels, thus keeping blood sugar under control. The causes of hidden sugar are similar to those of diabetes. The normal fasting blood sugar level is 99 mg/dL or lower, while hypoglycemia (low blood sugar) is below 70 mg/dL. If hidden sugar is present, the fasting blood sugar level rises to 100-125 mg/dL. A diagnosis of diabetes is made when the blood sugar level exceeds 125 mg/dL. Hidden sugar can occur in anyone, but certain factors increase the risk. Lifestyle and genetics are particularly influential factors on hidden sugar. Regular consumption of red meat, processed meat, and sugar-sweetened beverages can increase this risk. However, regular exercise not only helps maintain weight but also reduces the risk of hidden sugar. Risk factors for hidden sugar include:

• Increased age
• Excess body weight
• Increased waist circumference
• Ethnic background
• Dietary habits
• Insufficient physical activity
• Smoking
• Family history of hidden sugar or diabetes
• High blood pressure
• Polycystic ovary syndrome (PCOS)

Diagnosis of Hidden Diabetes

Typically, there are no symptoms for hidden diabetes. The symptoms are similar to those of regular diabetes and do not help distinguish hidden diabetes. Therefore, if the doctor notices that a person's blood sugar level is elevated, they may request additional tests to diagnose hidden diabetes. In the blood samples taken, the person's blood sugar level is higher than normal but not high enough to be classified as diabetes, and fasting glucose is impaired. This condition is sufficient for a hidden diabetes diagnosis. After this, it is confirmed with an oral glucose tolerance test (OGTT) after the fasting blood sugar level is elevated. For the glucose tolerance test, the person needs to drink a sugary beverage after 8 hours of fasting before the test. This allows observation of how the person’s glucose intake reacts after fasting. The laboratory results indicating hidden diabetes are as follows:

• Fasting blood sugar: 100-125 mg/dL
• OGTT result: 2-hour sugar level of 140-199 mg/dL However, if fasting sugar exceeds 125 mg/dL and postprandial sugar exceeds 199 mg/dL, this condition is called diabetes. It should be noted that if the levels of hidden diabetes are not reduced, the person will eventually develop diabetes.

Treatment of Hidden Diabetes

Lifestyle factors are the primary cause of prediabetes, and making changes in certain aspects of life can significantly reduce the risk and help prevent hidden diabetes from progressing to diabetes.

Regular physical activity can help slow the progression of hidden diabetes to diabetes. Adults should aim for at least 150-300 minutes of moderate-intensity aerobic activity each week, provided there are no other health issues. Additionally, strength-training exercises, such as weight lifting or push-ups, should be done at least twice a week. Regular exercise and a nutritious diet not only reduce the risk of developing diabetes but also protect the heart from future diseases. Along with regular exercise, a balanced, nutritious diet that reduces sugar intake helps improve hidden diabetes levels. Some effective nutritional recommendations for managing hidden diabetes include increasing intake of unprocessed, high-fiber carbohydrates, fruits, and vegetables, while reducing saturated fat and processed meat consumption.

The management of hidden diabetes also involves continuous monitoring of risk factors and regular testing of blood sugar levels. In addition to lifestyle changes, doctors may suggest other methods to minimize the risk of developing diabetes.

Ways to Prevent Hidden Diabetes

Preventing hidden diabetes is also effective in preventing the development of diabetes in the future. Here are some preventive measures:

• Maintain a healthy weight: If a person is overweight, especially due to fat accumulation in the abdominal area, the risk of developing hidden diabetes increases. For this, it is important to avoid simple sugars, saturated fats, and processed protein products.
• Stay physically active: Being active is important for both weight maintenance and overall health. Exercise increases muscle mass, which helps lower blood sugar levels and allows the body to respond better to insulin.
• Quit smoking: Smoking is strongly linked to diabetes. People with diabetes who continue to smoke are more likely to develop complications such as heart disease and blindness.
• Regular doctor visits: Regular check-ups are essential to intervene in case of slight increases in blood sugar levels. This helps prevent the development of hidden diabetes or diabetes.
• Treat existing conditions: Conditions like high cholesterol and high blood pressure can lead to diabetes in the future. Therefore, treating these conditions is important. If you notice any signs or symptoms of hidden diabetes, such as increased thirst, hunger, or fatigue, more frequent urination, or blurred vision, you should consult a healthcare provider to clarify any concerns.