Using Viscoplastic Energy Model of GH-Method: Math-Physical Medicine to Investigate Relationships Between Diabetes Retinopathy and Hypoglycemia via TBR, Hyperglycemia via TAR (No. 1046, VMT #444)

Abstract

Gerald C. Hsu

Diabetes mellitus is a metabolic disorder characterized by abnormal glucose metabolism, leading to conditions of hyperglycemia (high blood sugar) and, under certain conditions, hypoglycemia (low blood sugar). This relationship between diabetes and blood sugar level fluctuations is rooted in the disease's pathophysiology.

Hyperglycemia and Diabetes: In Type 2 diabetes, resistance to insulin—a hormone that regulates sugar movement into cells—or insufficient insulin production can lead to chronic hyperglycemia. Initially, the pancreas might produce extra insulin, but over time, it may not sustain the necessary levels. Untreated hyperglycemia can result in complications like cardiovascular disease, kidney damage (nephropathy), nerve damage (neuropathy), and retinal damage which leads into blindness (retinopathy).

Hypoglycemia and Diabetes: Despite hyperglycemia being a key characteristic of diabetes, those with the condition, particularly those undergoing insulin therapy or using certain glucose-lowering medications, risk developing hypoglycemia. This risk stems from imbalances among insulin levels, food intake, and physical activity. In Type 2 diabetes, hypoglycemia can occur when using insulin or certain medications that enhance insulin production, making the balance among medication, diet, and physical activity critical. Hypoglycemia can lead to confusion, seizures, and loss of consciousness, posing significant danger, such as sudden death.

The Balance: The pathophysiological link among diabetes, hyperglycemia, and hypoglycemia underscores the need for meticulous management, involving a mix of medication, diet, and physical activity to keep blood glucose levels within a target range and prevent both hyperglycemia and hypoglycemia. Continuous glucose monitoring (CGM) is vital for diet and exercise adjustments to avoid glucose level extremes.

The American Diabetes Association has announced guidelines for three metrics: time-in-range (TIR, between 70 mg/dL and 180 mg/dL), time-below-range (TBR, less than 70 mg/dL, indicating hypoglycemia), and time-above-range (TAR, higher than 180 mg/dL, indicating hyperglycemia).

This article draws on the author’s data collected from May 1, 2018, through March 19, 2024, and uses the Viscoplastic energy model (SD-VMT) to explore the relationship between diabetic retinopathy (DR) and glucose fluctuations, particularly hypoglycemia (TBR) and hyperglycemia (TAR).

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