With the increasing incidence of diabetes, the word “diabetes” has frequently appeared in major online media in recent years, and the public is no stranger to diabetes. However, for the diagnosis of diabetes, many people only remember that fasting blood glucose is greater than 7.0 and postprandial blood glucose is greater than 11.1. Once they find that their blood glucose is higher than the above value, they think they have diabetes and even start to use hypoglycemic drugs. In fact, in addition to diabetes, there are many clinical situations that will lead to increased blood sugar. It is necessary for you to understand the following situations. Several types of hyperglycemia that are easily misdiagnosed as diabetes 1. Acute infection When the body is infected by viruses or bacteria, a series of inflammatory reactions will occur in the body, stimulated by inflammatory factors, the body’s glycemic hormone will also increase secretion In some people, it may cause a temporary increase in blood sugar. When the infection is cured, the blood sugar can return to normal, so if blood glucose is found to be abnormal when measuring blood sugar, you must first see if you have a cold or fever or a bacterial infectious disease. 2. Surgery or trauma In the hospital, many patients who are admitted to the hospital due to trauma or after surgery have elevated blood glucose, and those higher than 11.1 are not uncommon. This is because glucagon and catecholamine are under stress. Or increased secretion of glycemic hormones such as growth hormone. 3. Liver function damage If the patient has liver disease or liver function damage due to toxins, drugs, etc., the ability of liver cells to synthesize hepatic glycogen decreases, and inactivation of glucagon and other glycemic hormones in the liver decreases, and the liver The decrease in the number of insulin receptors on the cell membrane leads to increased insulin resistance. Under the combined effect of these factors, blood sugar will also increase, but patients usually do not have obvious “three more and less” symptoms. 4. Acute pancreatitis Insulin is the only hypoglycemic hormone in the body, and the pancreatic islet cells are the main place for insulin secretion. In the event of acute pancreatitis, the inflammatory response causes transient damage to the islet cells and decreases the amount of insulin secreted, resulting in increased blood glucose. 5. Drugs This is the most easily overlooked factor. Many drugs such as glucocorticoids, diuretics, certain antihypertensive drugs, birth control pills, etc. can cause glucose metabolism disorders, resulting in abnormal blood sugar, so if you find that blood sugar is elevated, you should also see if you are taking these drugs. 6. There are other diseases such as pituitary gland, adrenal gland, thyroid gland and other diseases that can also cause secondary hyperglycemia, which also needs attention. How is diabetes diagnosed? According to the diagnostic criteria for type 2 diabetes in China, the diagnosis of diabetes needs to meet one of the following criteria: 1. There are typical “three more and one less” symptoms and random blood glucose ≥ 11.1 or plus 2. Fasting blood glucose ≥ 7.0 or plus 3 For patients without typical diabetes, blood glucose ≥ 11.1 at 2h after 2 times of glucose load at different times, but it should be noted that when the body has the above stress situation, it should be reviewed after the stress state. Although the incidence of diabetes is getting higher and higher today, you should not worry too much about the increase in blood sugar when you check it. First rule out whether the above condition exists, and if diabetes is diagnosed, you need to actively treat it to avoid heart and eye , Brain, kidney and other important organs and blood vessels cause serious harm. References: “Guidelines for the Prevention and Treatment of Type 2 Diabetes in China” (2017) (Part of the picture source network in the text, the copyright belongs to the original author, thank you for the picture author, if you find any infringement of your copyright, please contact me , I will delete.)
Many diseases may have a certain relationship with heredity! Hereditary disease refers to a disease that is wholly or partly determined by genetic factors. It is usually congenital and can also be acquired. Such as congenital stupid type, multi-finger (toe), congenital deaf-mute, hemophilia, etc. These genetic diseases are completely determined by genetic factors, and only after a certain time of birth, the onset of disease, sometimes after several years, more than ten years or even several Ten years later, obvious symptoms will appear. What we often hear about: Congenital deafness, high myopia, thalassemia, red-green blindness, hemophilia, hirsutism of the external auditory canal, bronchial asthma, type I diabetes, rheumatoid arthritis, schizophrenia, epilepsy, congenital Heart disease, peptic ulcer, varicose veins of lower extremities, glaucoma, kidney stones, spina bifida, anencephaly, cleft lip, cleft palate, deformity, albinism, some tumors, etc. These diseases are all genetic diseases. As a cardiovascular doctor, we still talk about my cardiovascular related diseases. 1. What the hospital sees We can always meet a family in the hospital. When the father or mother has high blood pressure, diabetes, hyperlipidemia, and cardiovascular and cerebrovascular diseases, the possibility of children or siblings having these diseases is very high. . I personally met an uncle who had 6 brothers and sisters, 2 of whom had a heart stent, 1 had a heart bypass, 2 had a cerebral infarction, and 1 had a cerebral hemorrhage. All have cardiovascular and cerebrovascular diseases. Studies have shown that hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases and genetics have a clear relationship. 2. Genetically-related diseases 1. Familial hypercholesterolemia The prevalence of familial hypercholesterolemia is 0.18-0.32%. It is an autosomal dominant genetic disease that leads to abnormal metabolism of low-density lipoprotein cholesterol. It is manifested by high levels of low-density lipoprotein, and early appearance of senile rings or characteristic xanthomas in multiple parts of the body, and early coronary heart disease. These people under the age of 40 years may have an old ring, or flat yellow tumors may form on the eyelids. There are two types: homozygous and heterozygous. Homozygous familial hypercholesterolemia often has the symptoms and signs of coronary heart disease around the age of 10, and the descending aorta, abdominal aorta, thoracic aorta, and pulmonary artery trunk are prone to severe atherosclerosis, heart valves and heart Membrane plaques can also form on the surface of the membrane, and most of them die of cardiovascular disease before the age of 30. Male heterozygotes can suffer from coronary heart disease when they are 30 to 40 years old, and the onset age of female heterozygotes is about 10 years later than that of men. 2. Type 1 diabetes suggests that genetic defects are the basis of type 1 diabetes. This genetic defect is manifested in the abnormality of HLA antigens in the sixth pair of human chromosomes. Research tips: Type 1 diabetes has the characteristics of familial incidence-if your parents have diabetes, then you are more likely to suffer from this disease than people without this family history. Type 1 diabetes often occurs in childhood or adolescence, and the onset is generally more rapid. Symptoms such as thirst, polydipsia, polyuria, polyphagia, fatigue, and weight loss, and rapid weight loss are very obvious. Some patients have ketoacidosis for the first time. . The third characteristic of type 1 diabetes is that it will eventually be treated with insulin without exception, so type 1 diabetes was originally called insulin-dependent diabetes. Three, three high and cardiovascular disease and genetic are related 1. Hypertension and hypertension are polygenic inherited diseases, parents have hypertension, and the probability of their children suffering from hypertension in the future is as high as 45%; one parent suffers from hypertension The probability of children suffering from high blood pressure is 28%, while the probability of children with normal blood pressure of parents is only 3%. 2. People with diabetes and a family history of diabetes have a significantly higher prevalence of diabetes than those with a negative family history. The parents have diabetes, and their children are 15 to 20 times more likely to have diabetes. 3. Hyperlipidemia has found that a considerable number of patients with dyslipidemia have one or more genetic defects. Abnormal blood lipids caused by genetic defects are mostly family-clustered and have a marked genetic tendency. 4. Cardio-cerebrovascular disease The basis of cardio-cerebrovascular disease is atherosclerosis. The latest “Practical Cardiology” writes that atherosclerosis has a family inheritance and is an independent risk factor. Modern medical research proves that, except for injuries, almost all diseases are related to genes. Different human genotypes have different sensitivities to environmental factors. Sensitive genotypes can cause diseases under the influence of environmental factors. 4. Genetic genes cannot be changed, but they must still be prevented. Prevention is effective and it is necessary that some people say that human gene recombination is not over
A netizen asked such a question, the fasting blood sugar test result was 6.8, the level of glycated hemoglobin reached 8.1%, began to take hypoglycemic drugs, but also strengthened physical exercise, 3 months weight loss of 5 kg, blood sugar and glycated hemoglobin Has all met the standard, can you stop the medicine? Let’s take a concrete analysis based on the actual situation. Is this blood sugar level considered diabetes? The fasting blood glucose is 6.8. This value does not seem to be high. It has not reached the diagnostic criteria for diabetes that exceeds 7.0, but judging from the level of glycated hemoglobin, it has reached 8.1%, which is a bit high. The level of glycated hemoglobin usually reflects the overall blood sugar level of our body in the past two or three months. Under normal circumstances, it should be lower than 6.0%, and now it has reached 8.1%. Although there is no specific value of postprandial blood glucose, but The average blood sugar level of this glycated hemoglobin level is already as high as 11.5mmol/L. Let’s compare the fasting blood glucose level. It is conceivable that our postprandial blood glucose level must be relatively high and definitely exceed the 11.1 diabetes diagnosis level. . Since there is a problem with diabetes, it is of course necessary to actively control diabetes. Whether it is taking hypoglycemic drugs or strengthening physical exercise, it is an important means to strengthen blood sugar control. This friend lost weight through three months of hard work Weighing 5 kg, the blood sugar and saccharification indicators have returned to normal, which is a very gratifying result, indicating that the blood glucose control measures we have taken are effective and have achieved good blood sugar control results. After 3 months of medication + exercise, blood sugar returns to normal, can you stop the medicine? But can this medicine be discontinued? We also need to analyze the specific situation of the individual. First of all, it should be clear that through our own efforts to lower blood sugar, it does not mean that our diabetes problem is “cured”. The reason why diabetic people have high blood sugar problems is because of the body’s ability to regulate blood sugar. The problem is usually unable to be fully repaired and cured. Therefore, for diabetes, we talk more about “regulation” of blood sugar, rather than “cure.” The blood sugar of diabetes is controlled to a completely normal range, which does not mean cure, does it mean that the hypoglycemic drugs you eat must not stop, of course not, the blood sugar control of diabetic patients, especially the blood sugar control of type 2 diabetes patients It is by no means as simple as taking hypoglycemic drugs. Diet and exercise are also important ways to strengthen blood sugar regulation in diabetic patients. For the question of this friend, let’s interpret it with specific circumstances-for new-onset diabetic patients, the current blood sugar is controlled to a completely normal range, the dose of hypoglycemic drugs taken by themselves is lower, and you can try to stop the drug At the same time as continuing to strengthen exercise, attention should also be paid to dietary interventions. For the problem of a large increase in postprandial blood glucose, the intake can be reduced in a targeted manner, and the appropriate glycemic index such as polished rice and white noodles is higher. The intake of carbohydrates, as well as some foods with high sugar and high calories, should also pay attention to eating less, while strengthening exercise and exercise, do dietary conditioning, from the control of input and enhance consumption, actively strengthen blood sugar Conditioning control, if the blood sugar level is regularly reviewed after the drug is stopped, it can be kept within the normal range, at least the level of glycated hemoglobin can be kept below 6.5%, of course, the drug can be stopped. However, the adjustment of diet and exercise and regular blood glucose monitoring are indispensable. It is necessary to regulate and improve blood glucose metabolism through a strict and self-disciplined healthy lifestyle, so as to maintain the stability of blood glucose and meet the standards, so as to reduce the health caused by high blood sugar Risk and probability of diabetes complications. If you control your blood sugar within the normal range through exercise and taking medicine, continue to exercise after stopping the medicine, and pay more attention to your diet, but after stopping the medicine for a period of time, the blood sugar has further increased and still can not meet the needs The level of control achieved, such as the fasting blood sugar exceeding 7, and the basic requirement of postprandial blood sugar less than 10, then it shows that our life conditioning and taking hypoglycemic drugs to control blood sugar, the effect of hypoglycemic drugs on blood sugar control is obvious Once the drug is stopped, blood sugar will be out of control again. In this case, it is necessary to insist on taking hypoglycemic drugs. In short, maintain and be reasonable through your own good habits
There is a close relationship between diabetes and exercise. A friend asked: Can exercise treat diabetes? Such questions may not be accurate enough, but what is certain is that when physical conditions permit, reasonable adherence to exercise is an important aspect of diabetic patients to do good blood sugar regulation and reduce the risk of complications. With the problem of diabetes, blood sugar rises, as the course of the disease develops, there may also be complications of one kind or another. Therefore, for chronic metabolic diseases such as diabetes, do a good job of regulating blood sugar to minimize various concurrency The risk of disease is the top priority for long-term diabetes control. To do well in the treatment and control of diabetes, it is not only as simple as taking medicine for medical treatment. Diet and exercise are as important as reasonable medication, but also have two basic diabetes prevention and control means. For diabetics, good diet, exercise and other life interventions are the basis for regulating good blood sugar and reducing the risk of complications, which is worth our lifelong persistence. Today we don’t talk about diet, just to talk to you about diabetes and exercise. The benefits of exercise for diabetics are reasonable, and the benefits for diabetics are many. Exercise can strengthen the body’s energy consumption and strengthen the body’s blood sugar utilization. One of the important causes of diabetes is the body’s long-term excess energy intake, and if it can be found that blood sugar rises, it can actively regulate life, control intake through diet, and then strengthen the body’s consumption through exercise. Can better correct the body’s excess energy and elevated blood sugar. Exercise can improve the insulin sensitivity of muscle cells in the body. It is very important to adjust the blood sugar level of diabetic people, improve the utilization of insulin in the body, and improve the problem of insulin resistance. Therefore, because exercise can enhance muscle utilization of glucose and improve insulin resistance of muscle cells, this is also exercise. It can strengthen the important benefit of human blood sugar regulation. Exercise helps to regulate and control obesity. Obese people are a high-risk group of diabetes, and many diabetics also have the problem of obesity. It is also very important to control the weight, waist and obesity to strengthen blood sugar regulation and improve the body’s insulin resistance. Exercise can lose weight and reduce fat, not only can reduce the body’s subcutaneous fat, but also help to improve the problem of visceral fat accumulation, especially some friends with mild to moderate fatty liver problems, there are insulin resistance problems of liver cells, through reasonable Exercise can not only help improve obesity and weight loss, but also help improve the liver’s insulin resistance, strengthen the use of blood sugar, and thus achieve the effect of lowering blood sugar. Exercise helps reduce the risk of complications in diabetic patients. The benefits in this regard come from two aspects. One is that exercise can strengthen the regulation of blood sugar. Once the blood sugar is controlled, the risk of diabetes complications is naturally reduced. On the other hand, the benefit is that exercise can enhance cardiopulmonary function. , Improve the body’s blood circulation ability, help regulate blood pressure and blood lipids, help strengthen the body’s immunity, these health benefits can also benefit diabetics, reduce the risk of cardiovascular complications and microvascular complications . It is important for people with diabetes to exercise reasonably. We emphasize that people with diabetes should pay attention to exercise to regulate diabetes. The importance of exercise for diabetes has been discussed earlier, but to achieve a good blood sugar regulation effect, reasonable exercise is still very important. The so-called reasonable exercise is first of all the choice of exercise amount and exercise method, which varies from person to person. If you are young and have good physical conditions for new-onset diabetic patients, you may wish to exercise moderate exercise intensity on a step-by-step basis. Of physical exercise, especially for friends with obesity problems, if you want to do a good job of weight control, you should pay more attention to increase the amount of exercise and strengthen the body’s consumption. Only when the amount of exercise is reached, can you achieve a better weight loss effect. And if it is an older middle-aged and elderly friend, combined with their blood sugar status and diabetes severity, choose the exercise method that is suitable for them and can play the role of exercise, without having to excessively pursue excessive exercise intensity It is generally recommended that moderate-intensity aerobic exercise is the most suitable. If the amount of exercise is too small, the exercise effect will not be achieved, and it will not help to regulate blood sugar. If the amount of exercise is too large, it may cause exercise risks or health hazards.
As we all know, diabetes is a very common chronic disease in clinic. Diabetes can cause many complications, including macrovascular complications, such as coronary heart disease, cerebrovascular disease, lower extremity vascular disease, and microvascular complications, such as diabetic nephropathy, diabetic retinopathy. Among them, diabetic nephropathy is one of the most common and difficult complications of diabetes. According to statistics, diabetes is currently the number one cause of chronic kidney disease in my country. Therefore, how to avoid the occurrence of diabetic nephropathy has become the top priority of diabetic patients. Here are four suggestions: 1. Strict control of blood sugar. Hyperglycemia is an important factor that causes kidney damage. Therefore, blood sugar must be controlled at an ideal level for a long time. Fasting blood glucose <6.1 mmol/L, two hours postprandial blood glucose <8.0 mmol/L, glycated hemoglobin <6%. By strictly controlling blood sugar, the chance of kidney disease can be greatly reduced, and at the same time, most early diabetic nephropathy (microalbuminuria) can be reversed or delayed. In the early stage of diabetic nephropathy, hypoglycemic drugs excreted mainly through the biliary tract, such as Nuohelong, Tangshipingping; insulin therapy should be given when renal insufficiency occurs. 2. Strict control of blood pressure and abnormal hemodynamics can lead to glomerular sclerosis. Compared with high blood sugar, hypertension has more damage to the kidneys of diabetic patients. Strict control of blood pressure can significantly reduce protein filtration in patients with diabetic nephropathy and delay the process of renal impairment. 3. Lowering blood lipids and blood viscosity Abnormal blood lipids are also one of the risk factors for kidney damage. Therefore, blood lipids (especially low-density lipoprotein cholesterol) should be controlled within the normal range. 4. Properly restrict protein intake. A high-protein diet can increase the glomerular perfusion pressure and filtration rate, and increase urinary protein excretion. Therefore, to reduce the burden on the kidneys, protein intake should be limited in the early stages of diabetic nephropathy. The intake, protein intake in the diet should be 0.8g/kg body weight per day. Mainly choose high-quality animal protein (such as chicken, fish, lean meat, eggs, milk) to supply more essential amino acids. Vegetable protein (such as tofu, soy milk, etc.) will increase the burden on the kidneys, and at the same time can not be fully utilized by the body, it should be properly restricted. If you have edema, you should also limit salt intake (less than 5g per day). Early diabetic nephropathy (namely the first three stages) after active treatment, especially the combination of traditional Chinese and Western medicine, has obvious effects and can be completely reversed. However, since the onset of diabetic nephropathy is hidden, there are almost no symptoms in the early stage of the disease, so it is easy to be ignored by patients; and once the face and lower extremities are swollen and a lot of proteinuria, kidney disease has often developed to an irreversible stage, and the best treatment is lost opportunity. Therefore, once diagnosed with diabetes, whether or not there is edema, it is recommended to regularly check urine microalbumin and renal function to facilitate early detection and timely treatment of diabetic nephropathy. If you have any related problems such as kidney disease, you can directly [private letter] Professor Yang Yanfang
Find out that there is a problem with type 2 diabetes and feel that the sky is about to collapse? In fact, you don’t have to be so scared. You are scared because you don’t know enough about this disease. Isn’t type 2 diabetes better? It is true that diabetes is a chronic metabolic disease, and most diagnosed type 2 diabetics need to actively control blood sugar and prevent and intervene in the risk of complications during their lifetime, but if they can control blood sugar as soon as possible, Maintain healthy and good living habits, rationally choose medications for hypoglycemic drugs. Diabetes can control blood sugar well. There are also many diabetic patients who strictly manage blood sugar, and no serious diabetes complications have occurred throughout their lives. From this From a perspective, diabetes is actually not terrible. Correct understanding of diabetes Type 2 diabetes is a chronic metabolic disease based on abnormal blood glucose metabolism and elevated blood glucose, which is usually not completely cured. Diabetic people’s elevated blood sugar will produce a variety of discomfort symptoms and complications. With the development of the disease course, the risk of severe fluctuations in blood sugar will further increase, whether it is high or low blood sugar, or severe fluctuations in blood sugar , Are important aspects of endangering the health of the body, therefore, for the diabetic friends, the ability to control blood sugar smoothly is to protect the health of the body and reduce the top priority of reducing the health hazards of diabetes. But if we look at it from another perspective, a chronic metabolic disease problem usually has a slower and relatively controllable effect on the body. It is found that type 2 diabetes is a disease and is also given by our body One of our health warnings is that blood glucose metabolism has started to go wrong. We should pay more attention to our own health problems, try our best to regulate and control blood sugar, and pay attention to monitoring blood pressure, blood lipids, etc. Related indicators to actively regulate good health. “Why don’t people get sick when they eat whole grains?” This is a common saying that we often say, but the truth is obvious. Although chronic diseases such as diabetes can be harmful to health, if they are linked to those sudden Isn’t it better for diseases with a high mortality rate, such as myocardial infarction and cerebral hemorrhage? The problem of diabetes is preventable and controllable. If diabetes is preventable, it means that there is a middle ground between our normal blood sugar level and the diagnosis of diabetes. For example, fasting blood glucose exceeds 6.1, and fasting has not exceeded 7.0. In the case of impaired blood glucose, the blood glucose level exceeds 7.8 within 2 hours after a meal, but the glucose tolerance abnormality has not exceeded 11.1. These glucose metabolism abnormalities are pre-diabetic conditions. If it can be detected early, early intervention and control will be developed. The chance of true diabetes will be greatly reduced. Even if it eventually develops into diabetes, friends who strengthen blood sugar control as soon as possible will have diabetes much later. It is said that diabetes is controllable because even if the type 2 diabetes problem is diagnosed, if active conditioning and control can be carried out, the blood sugar of most diabetic patients can be controlled under the premise of reasonable diet, exercise, and reasonable use of hypoglycemic drugs To a stable range, and if you can actively regulate the blood sugar level and control the blood sugar in a reasonable and stable range for a long time, the risk of diabetes complications will be greatly reduced, and the health impact and health hazards will also be greatly reduced . And because of maintaining a healthy lifestyle, you will also benefit from other aspects of the health of the body. Therefore, sometimes, if you look at the problem from another angle, if you can actively pay attention to diabetes, strict self-discipline in life, and change the life that affects health Bad habits, long-term adherence to a reduced lifestyle, but it is also a kind of “blessing by disaster” for health. Diabetes is preventable and controllable. If we can actively control blood sugar levels as early as possible, the impact of diabetes on health will become smaller, and it will not affect people’s life expectancy. It may even be caused by the long-term maintenance of a healthy lifestyle. Cardiovascular health and other aspects of the further benefit, therefore, found the problem of type 2 diabetes, not to be panic, excessive tension and anxious mood will affect the control of blood sugar and blood pressure and other indicators, but should be positive for this disease, Be active and do your blood sugar conditioning as soon as possible. This is the attitude towards diabetes. Written at the end: Diabetes itself is not terrible, terrible is me
. . . . . . . Diabetics who have a long course of disease and poor blood sugar control generally have different degrees of complications. Such as diabetic macrovascular disease, small blood vessel disease and so on. Skin lesions are also very common, but are not valued by doctors and patients.  . . . . . . . Diabetic skin disease is also called anterior tibial pigmentation spot, which often occurs in the elderly and patients with long course of disease and neuropathy, retina and kidney disease. It is the most common type of diabetes. Skin manifestations and lesions are often limited to the front of the thigh and shin, and the upper limbs and torso are rare. Skin lesions usually consist of small brown, well-defined superficial atrophic depressions. Typical skin lesions are 1 cm or smaller in diameter, round, smooth surface, pigmented, involving both sides, asymmetric, often No conscious symptoms.
For friends with diabetes, high blood sugar itself is actually nothing, but the complications of diabetes caused by long-term uncontrolled high blood sugar is the real point of harm to the body. What are the complications of diabetes, and what are the complications of diabetes? Today I will give you a brief introduction. Acute Complications of Diabetes Complications of diabetes do not necessarily appear gradually in the course of the development of long-term diabetes. There are also some complications of diabetes. The risk of acute attacks due to severe disturbance of glucose metabolism. Such complications The risks also deserve our attention. Common acute complications of diabetes include ketoacidosis and osmotic coma caused by severely elevated blood sugar. It usually occurs when the blood glucose level is severely exceeded, which is caused by the body’s blood glucose metabolism and severe metabolic disturbances such as fat, protein, and electrolyte metabolism. Ketoacidosis is an acute complication of diabetes caused by the abnormal secretion of various hormones in the body, which disrupts the balance of hormone levels in the body, resulting in an imbalance in the metabolism of various substances in the body. It is usually characterized by high blood sugar, high blood ketones, and metabolic acidosis. Mild acidosis may cause polyuria, increased symptoms of polydipsia, and dehydration of the body, accompanied by nausea, vomiting, low appetite, etc. In severe cases, there will be mental depression, drowsiness, and coma Symptoms such as severe ketoacidosis can cause problems such as hypotension, cerebral edema, shock, kidney failure, and even life-threatening events. Hyperosmolar coma is another acute complication of diabetic patients. This situation is the same as ketoacidosis, and there are problems such as dehydration and electrolyte loss. The symptoms are similar, but the symptoms of dehydration, neurological disorders, and coma are more typical symptoms. In addition to the above two kinds of acute complications, people with diabetes should also pay attention to the risk of acute complications such as lactic acidosis and hypoglycemia coma. To reduce the risk of acute complications, it is necessary to actively strengthen the regulation and control of blood sugar. Reduce the possibility of a sharp rise in blood sugar and sharp fluctuations, control the blood sugar to reach the standard, and the risk of acute complications of diabetes will be greatly reduced. Compared with acute complications, chronic complications of diabetes tend to develop slowly, but the health risks to the body are not small. There are many types of chronic complications of diabetes, which are mainly divided into two categories: macrovascular complications and microvascular complications. The major vascular complications of diabetes mainly refer to the risk of cardiovascular and cerebrovascular diseases caused by high blood sugar causing atherosclerosis. Hyperglycemia cannot be effectively controlled. Long-term hypertension can cause an inflammatory reaction of the endothelial cells of the blood vessel wall, leading to accelerated development of atherosclerosis. Therefore, most people with diabetes are at high risk of cardiovascular disease. . Therefore, for diabetics, actively controlling blood sugar is an important aspect of reducing the risk of cardiovascular disease. While actively controlling blood sugar, we must also pay attention to the active regulation of high blood pressure and hyperlipidemia, as well as some bad habits in life The impact should also be removed and improved as much as possible. Only in this way can the risk of cardiovascular complications of diabetes be better reduced. The types of microvascular complications of diabetes are more diverse, mainly including diabetic nephropathy complications of diabetic kidney function changes, diabetic complications of neuropathy, ocular complications of ocular fundus lesions caused by diabetes, and changes in the feet and legs caused by diabetes Many diabetic foot complications and so on, these complications gradually occur, but if you do not pay attention to control, it will gradually increase, which may lead to kidney failure, blindness, amputation and other risks, is also a very serious problem. If you have chest tightness and chest pain during diabetes control, you may wish to quickly check the cardiovascular health problems to see if there is a cardiovascular complication of diabetes; if you have a trace of physical examination during diabetes control The problem of proteinuria, even the problem of elevated creatinine, may be that diabetes has gradually affected your kidney health (diabetic nephropathy); if during the period of diabetes control, there are neurological symptoms such as limb numbness, pain, and abnormal sensation, Complications of diabetic neuropathy may have begun to occur. During the period of diabetes control, blurred vision, eye fatigue, blurred vision, bleeding of the fundus, etc. may occur
Diabetic kidney complications are one of the most common complications in the long-term course of diabetes. Whether it is type 1 diabetes or type 2 diabetes, if there is no active blood sugar control, the chance of diabetic kidney complications is very high. What are the symptoms of diabetes affecting kidney function? How to prevent the occurrence of diabetic nephropathy? Today we will briefly introduce this knowledge. First of all, it is important to emphasize that for diabetics, it must be recognized that the harm of high blood sugar to kidney health is huge, and it is also slow and gradual. Once you understand this, you should actively control blood sugar and regularly It is not scientific to check the kidney function without waiting for the symptoms to suspect that high blood sugar hurts the kidney or even when the kidney function is abnormal. Although it is not too late to make up for it, it is better if we can plan ahead. The pathogenesis of diabetic nephropathy is diversified and more complicated, which is related to genetic factors of personal constitution and hemodynamic changes of high blood glucose on the formation of small arterial arteries of the kidneys, resulting in the sclerosis of small arteries of the kidneys. At the same time, abnormal glucose metabolism , It also causes abnormal metabolism of various substances in the kidney area, which also affects the health of the kidney. In addition, diabetes combined with high blood pressure is also an important risk factor for kidney disease. Under the function of these factors, our kidneys Health is gradually affected until renal function is impaired, and eventually it will eventually develop into renal failure. Diabetes-related clinical manifestations of kidney damage. Diabetic hyperglycemia can damage kidney health and cause gradual changes in kidney function. The most common sign of diabetes affecting kidney health is the appearance of trace proteinuria. However, it should be understood that the occurrence of trace proteinuria is not the initial stage of diabetes damage to the kidneys, but that diabetes has a clear sign of damage to the kidneys. From the occurrence of diabetes, it is pointed out that high blood sugar has begun to affect kidney health The health of the ball is affected, and it is not that the symptoms of proteinuria will occur at once, and under the long-term influence of high blood sugar, when trace proteinuria occurs, usually from the stage, diabetic nephropathy has reached the level of stage 3. Another manifestation of diabetic kidney damage is the emergence of high blood pressure. Almost all the complications of diabetic nephropathy will eventually cause high blood pressure. High blood pressure itself is also a chronic disease that damages kidney health. If the diabetic person’s blood pressure is not high, but the blood pressure gradually begins to rise or even diagnosed as high blood pressure, it is necessary to actively investigate the changes in kidney function. Usually, high blood pressure in type 1 diabetic patients is often accompanied by trace proteinuria There are many types of diabetes in people with type 2 diabetes, and many high blood pressures appear before the abnormal kidney function. However, no matter whether it is the increase in blood pressure caused by diabetic nephropathy or primary hypertension combined with diabetes affecting kidney health, it is worth noting that it should be As early as possible, actively regulate the problem of hypertension. If there are problems such as trace proteinuria and elevated blood pressure, you still do not pay attention to actively control blood sugar and protect kidney function. The kidney damage caused by diabetes will increase further. At this time, it will show continuous proteinuria and glomerular filtration The rate also began to decline, kidney function began to decline, and most patients will show symptoms of edema, and about 20% of patients will have problems with nephrotic syndrome. The most serious complication of diabetic nephropathy is renal failure, manifested by the loss of function of most nephrons, uremia symptoms, glomerular filtration rate of less than 10, and accompanied by increased blood creatinine, such a situation belongs to Diabetes end-stage renal disease, kidney failure, is generally maintained by dialysis or organ transplantation. How to reduce the risk of diabetic kidney complications If you want to reduce the health hazards of diabetes to the kidneys and reduce the risk of kidney complications caused by diabetes, the first thing to do is, of course, to be active and control your blood sugar levels as early as possible. Again, it is too late to control blood sugar when there are symptoms of kidney damage or a decline in kidney indicators. You should be aware of the rise in blood sugar and actively control blood sugar when new diabetes develops. If you can control the blood sugar as early as possible, you can greatly reduce the occurrence of diabetic nephropathy complications
Is diabetes scary? Diabetes is terrible and terrible, not terrible or terrible! Why do you say this? Because diabetes is terrible depends on how much you value diabetes and your health. Diabetes is really terrible. Diabetes is a basic metabolic chronic disease characterized by abnormal blood glucose metabolism. Generally speaking, no matter whether it is type 1 or type 2 diabetes, diabetes problems cannot be completely cured, but through a variety of Comprehensive conditioning of the method also actively controls blood sugar. The scary part of diabetes is not just that the disease is usually incurable, but that if diabetes is not controlled for a long time, it may cause serious complications. Some people with diabetes have long-term uncontrolled blood sugar, and high blood sugar affects arterial and vascular health for a long time, causing and accelerating the hardening and stenosis of the coronary arteries of the heart. Under the influence of high blood sugar, the arteries continue to unstable plaque, plaque rupture, and finally lead to Coronary artery occlusion, acute myocardial infarction, myocardial infarction if not rescued in time, damage myocardium, cause damage to heart function, serious life-threatening, causing death, you say terrible is not terrible? Some diabetic people, because they do not control blood sugar for a long time, high blood sugar affects the health of the cerebral arteries for a long time, causing the degeneration of the cerebral arteries and becoming inelastic. At the same time, under the influence of hypertension, the cerebral arteries rupture and hemorrhagic stroke problems occur. The mortality rate of acute cerebral hemorrhage is as high as 35% or more. Are you terrible? In some diabetic patients, due to long-term uncontrolled blood sugar, high blood sugar affects the renal arteries and kidney health for a long time, leading to a gradual decline in kidney function, from trace proteinuria to creatinine, glomerular filtration rate gradually decreases until the kidney Functional failure requires regular hemodialysis, and various complications and infection risks also follow. Are you terrible? Some diabetics do not control blood sugar for a long time, and high blood sugar affects the health of the arteries of the fundus for a long time, which eventually leads to retinal lesions. The initial stage may be vision loss and blurred vision. However, if you still do not pay attention in the later stage, you may Causes vision loss until it is completely blind. Diabetes complications are the primary cause of blindness in adults. Are you terrible? Some diabetic patients, because they do not control blood sugar for a long time, high blood sugar affects the arteries of lower extremity arteries and veins for a long time, causing pain and ulcers in the feet, and diabetic foot problems. It will continue to develop, and the problem of gangrene of the feet will require amputation to solve it. You say it is terrible or not. The points mentioned above are due to the serious complications that eventually develop in the long-term course of diabetes due to the lack of blood glucose control and attention to disease control and conditioning. These problems can either cause disability or lead to death if In this way, is diabetes really terrible? Diabetes is not terrible. The scary part of the diabetes problem is that in the long-term development of diabetes, the blood sugar is not actively controlled, and the complication problems that occur gradually, become more and more serious, and have higher and higher risks. Actively control the blood sugar and actively control the blood sugar. The risk of diabetes complications will be greatly reduced, and the risk of serious complications will be lower. From this perspective, diabetes is not so terrible. To control the blood sugar as soon as possible, when should it be early? Generally speaking, when our blood sugar is beyond the normal range and has not been diagnosed with diabetes, we should actively attract attention, strengthen life conditioning and exercise to strengthen blood sugar control. The study found that if the fasting blood glucose exceeds 6.1 and the postprandial blood glucose exceeds 7.8, such as impaired fasting blood glucose or impaired glucose tolerance, it will actively strengthen life conditioning interventions and actively regulate the problem of hyperglycemia, not only can reduce the development of The probability of diagnosis of diabetes has a clear benefit for the subsequent control of the course of diabetes and the reduced risk of complications. For friends who have been diagnosed with diabetes, don’t worry too much, strengthen blood sugar control, and actively control blood sugar levels. We should not compare with others, and more with ourselves. I didn’t know that I had diabetes, or I had diabetes but didn’t feel it. There is no active blood sugar control, but the sooner you realize the risks, the sooner you can strengthen your blood sugar conditioning control, the sooner the body will benefit. If you start today, it is also the earliest in your life course
1. . Childhood obesity has a 2-4 times higher risk of cardiovascular disease. Childhood obesity, 75% probability of still being overweight after adulthood, the probability of developing hypertension, heart disease, cardiovascular and cerebrovascular diseases is 2 to 4 for adults Times.  .2. . Childhood obesity and diabetes risk is three times higher. Now some parents will let them eat a lot of meat, drink carbonated drinks, etc. according to their children’s preferences, which will make the child overweight. Children with obesity are three times more likely to develop diabetes than those who are not overweight. 3. The psychological problems of obese children are more prominent. Obese children have poorer social adaptability than normal children, and psychological phenomena such as depression, social withdrawal and splitting behavior are also significantly higher than normal children. Welcome to Dr. Yang Mingbo, Doctor of Liver, and learn more by private letter.
When you mention diabetes, you will immediately think of middle-aged and elderly people, but what many people don’t know is that children also suffer from diabetes, and the world’s children with diabetes are increasing rapidly, and my country is no exception. According to statistics, the incidence of diabetes in children and adolescents currently accounts for about 5% of the total number of patients with diabetes in my country, and it is growing at a rate of 10% per year. Why do children get diabetes? Diabetes that occurs in children before the age of 15 is called childhood diabetes. The vast majority of childhood diabetes is type 1 diabetes, which is manifested in the absolute lack of insulin secretion. The main causes of type 1 diabetes include: 1. Genetic genetic parents have diabetes, and children’s risk of diabetes increases. If one of the parents has type 1 diabetes, the risk of children’s disease is about 2% to 5%. The incidence of diabetes in children born to mothers with gestational diabetes is four times that of children born in normal pregnant women. The consistency of identical twins suffering from type 1 diabetes can reach 50%. Current research suggests that genetic defects are the basis of type 1 diabetes. This genetic defect is manifested in the abnormality of HLA antigens in the sixth pair of human chromosomes. 2. Autoimmune deficiency type 1 diabetes patients can detect a variety of autoimmune antibodies in the blood, such as glutamate decarboxylase antibody (GAD antibody), islet cell antibody (ICA antibody) and so on. These abnormal autoantibodies can damage the beta cells of human islets that secrete insulin, making it unable to secrete insulin normally. 3. Viral infections Viral infections can cause diabetes, and many people may be surprised. Type 1 diabetes patients often have viral infections for a period of time before the onset of the disease. The more common viruses, such as those that cause mumps and rubella, and The Coxsackie virus family, which can cause polio, can play a role in type 1 diabetes. In general, children suffering from type 1 diabetes are mainly autoimmune diseases based on genetic genes, which may be related to viral infections and the external environment. In fact, so far, the specific causes of diabetes have not been fully studied. It is worth mentioning that with the improvement of living standards, high-calorie, high-sugar, high-fat diets have made many children chubby, and obesity is very common among children. Not only do these children eat too much, they have too much energy, but they also exercise very little. This phenomenon also causes a problem. Obesity will cause insulin resistance, insulin sensitivity will decrease, and glucose tolerance will be abnormal, and then develop into type 2 diabetes. Do not think that only the elderly will get type 2 diabetes, the incidence of type 2 diabetes in children gradually increases. The incidence of diabetes in children has increased. As parents of “sugar kids”, they feel anxious. Although diabetes will not be immediately fatal, they are prone to various acute and chronic complications and damage other organ functions. Children with type 1 diabetes need insulin replacement therapy for life due to the absolute lack of insulin. Type 1 diabetes cannot be completely cured. For children with type 2 diabetes, insulin is insensitive due to obesity. During active drug treatment (including oral medication and appropriate insulin use), lifestyle habits change, control of high-fat and high-calorie diets, and exercise, if weight After being controlled and the insulin sensitivity gradually increased, both insulin and oral metformin can be discontinued. Therefore, type 2 diabetes can be cured in childhood, but it requires a lot of perseverance and long-term adjustment of living habits.
Hello everyone, I am a nephrologist. As everyone knows, the incidence of diabetes in my country has been increasing in recent years. This has a lot to do with economic development, Westernization of lifestyle, aging population, and obesity rate. Relevant data show that the number of adult diabetes patients in my country reached 109.6 million in 2015, ranking first in the world. An epidemiological investigation and analysis pointed out that about 60% of the diabetic patients in my country are not diagnosed. Although many people have heard of the term “diabetes”, the science about diabetes and other chronic diseases is far behind. Therefore, the National Health and Health Commission has also been advocating the theme of “Healthy China Trip”, which aims to enable diabetes patients to receive disease treatment better, earlier and more regularly. Today I’m going to chat with you about diabetes medication. Dispelling rumors ● Although the author is engaged in nephrology, but I tell you that the nephrologist is half an endocrinologist, don’t believe it, because diabetes has a major complication of diabetic nephropathy, so many kidney functions appear due to diabetes After the problem will be followed up and treated in our department. After contacting these patients with diabetes, I found that some patients and their families are still affected by some rumors of diabetes. ●Two days ago, our department admitted an old lady with diabetic nephropathy. She had had creatinine and proteinuria for 2 years. The reason for coming to hospital this time is that creatinine is more than 100 higher than last year’s review, and blood sugar control is also very poor. I wonder if the old lady and his wife didn’t take it seriously. They often disappeared after checking the room, and the blood sugar could not be measured for several days. According to her specific disease and blood sugar level, she decided to use home insulin therapy. This said, the old lady and her wife were very excited, saying: Insulin is harmful and can not be beaten. Once beaten in this life, it will not be able to escape, and the body will become worse after being beaten. This is useless. My neighbor is…………, so it is better to take medicine. A brief introduction to diabetes ●In fact, diabetes is not unique to these decades. In ancient times, our traditional medicine classified it as the category of “diabetes”. This has been discussed in the Yellow Emperor’s Internal Classic in the second century BC. In the view of modern medicine, it is considered to be a group of metabolic diseases characterized by chronic hyperglycemia caused by multiple causes, rooted in defects in insulin secretion and/or utilization. Diabetes can be divided into type 1 diabetes and type 2 diabetes, of which type 1 diabetes is relatively rare in Asia. Therefore, most of the diabetic patients in my country are mainly “type 2 diabetes”, which can account for 95% or more. ●Combined with the case I talked about above, if you are in pre-diabetes (impaired fasting blood glucose, impaired glucose tolerance), you can adjust it by diet and exercise therapy. If the blood sugar is still not well controlled, it is necessary to add suitable hypoglycemic drugs according to insulin secretion, utilization and blood sugar level. However, please note that although oral medicine is the preferred choice for diabetes, the disease after diabetes has been still progressing, and it will have various complications, so the treatment methods and treatment drugs must follow the disease course and complications The situation is dynamically adjusted. What are the characteristics of insulin secretion in diabetic patients? ●Insulin secretion in patients with type 1 diabetes is actually a complete lack or severe deficiency. Their pancreatic islet function is very poor, so the insulin secreted is very little or no. Type 2 diabetes is slightly different. It is a progressive disease. It can be manifested as delayed β-cell response to glucose in the early stage, and it is prone to increased blood glucose after meals and hypoglycemia before the next meal. ●As the disease progresses, the function of β cells will further deteriorate, and the number of functional β cells in diabetic patients will also decrease. It can be manifested as a serious lack of insulin secretion, fasting and postprandial blood sugar are increased, and we are eating three meals a day, it is certainly not possible to control blood sugar without insulin, so at this time the patient needs to resort to exogenous Insulin supplement or replacement therapy. When do people with diabetes need to start insulin therapy? ● Here I tell you that if it is type 1 diabetes, then insulin should be used at the beginning of the disease (decided by its disease characteristics, if you don’t understand, you can look at my introduction to the principle of type 1 diabetes above), and need to Lifelong insulin replacement
Many friends know that diabetes will have more than three symptoms, and true diabetics will also often lose weight. Some friends asked why my blood sugar is well controlled, and my weight has not increased, and I am still losing weight. What? Regarding this issue, let’s analyze it concretely. Why does diabetes cause weight loss? The reason why the blood sugar is increased and diagnosed as diabetes is because our body has abnormal metabolism of blood sugar. The sugar in the body cannot be fully metabolized and is accumulated in the blood, which makes the glucose in the blood The concentration is further increased, although the blood sugar is increased, blood sugar is the main component that supplies energy to the body. When the blood sugar is not fully utilized, the function of the body will also be insufficient. Therefore, many friends because of the insufficient energy supply of the body, also Symptoms of hunger are more likely to occur, and we often eat and drink more, and our own body, in order to ensure the energy supply of the body, will further decompose fat and protein in the body under the premise that the blood sugar is not fully utilized. Waiting for the body to supply energy, therefore, body fat, etc. are consumed, so some people with diabetes will also have the typical characteristics of body weight loss. After the blood sugar is controlled, why does the body continue to lose weight? We said that if we want to control the problem of diabetic weight loss, the main thing is to control the blood sugar. If the blood sugar is controlled well, the blood sugar remains within a stable and reasonable range. If the body’s use of blood sugar returns to normal, the possibility of weight loss in diabetes patients continues Generally not large, but due to various factors, it may happen that the blood sugar has been controlled, but the weight continues to lose weight. There are many reasons for this situation, in simple terms, several common. First, dietary control is too strict. Many friends know that controlling blood sugar is not only about taking medicine, but also paying attention to diet to control exercise and exercise. This is a very good way to regulate blood sugar. However, if diet control is too strict, the body’s nutrition is insufficient due to too little intake. In this case, the blood sugar is controlled in time, and the body may continue to lose weight because of too little nutritional intake. The problem. Second, drug-induced weight loss. Most diabetics need to use drugs to enhance blood sugar control in addition to diet and exercise. There are many kinds of drugs to lower blood sugar. Some drugs have a certain weight loss effect on body weight, such as metformin, such as dapagliflozin, etc. Drugs, while lowering blood sugar, also have a certain weight loss effect. At the same time, sometimes taking other drugs while taking hypoglycemic drugs, especially some drugs that enhance body metabolism, such as thyroxine, also have the effect of causing body weight loss. Therefore, if the blood sugar is well controlled and the body continues to lose weight, the cause of the medication should also be evaluated. Third, the impact of other diseases. Obviously the blood sugar control is quite good, but the body still has further weight loss problems. Don’t just consider the cause from diabetes blood sugar control. Many diseases may lead to weight loss, such as gastrointestinal absorption problems. For example, hyperthyroidism or hypothyroidism, such as adrenal insufficiency, may cause body weight loss. While checking blood sugar control, it is also very important to actively investigate other causes. How to deal with the continuous weight loss of the body? For the problem of diabetes and blood sugar control, the body is still further thinning, we must first assess the actual situation, whether this thinning is beneficial to health or harmful. If you are a diabetic and your weight is severely overweight, if you can strictly control your intake, actively control the post-blood glucose level, and maintain a good and healthy lifestyle, your body will continue to lose weight, which is completely normal, but also It is beneficial to body weight loss. If you can control your weight to a healthy and reasonable range, you don’t have to worry too much about this weight loss. This is a normal process after the body metabolism is corrected and the body shape returns to normal. Why not be afraid Worried? And if it is a friend who was originally within the healthy range, weight loss occurred during the course of diabetes, and after the blood sugar is controlled, the weight still continues to decline, even lower than the normal healthy level. Pay attention to it. On the one hand, we should pay attention to the comprehensive supplementation of nutrition. Without excessively increasing the sugar intake, the product
Diabetes and hyperuric acid are associated with each other. “In recent years, the prevalence of hyperuricemia in China has continued to rise. Among metabolic diseases, more patients have hyperuricemia. The survey shows that 25% of diabetic patients Complicated with hyperuricemia, this is due to the “blood connection” of glucose metabolism and uric acid metabolism. When urate is deposited on the pancreatic islets, it can lead to impairment of β-cell function, induce and aggravate insulin resistance, trigger disorder of glucose metabolism, and eventually lead to diabetes. Studies have shown that the risk of type 2 diabetes increases with the increase of blood uric acid levels. Diabetes can lead to hyperuricemia. It can be said that diabetes and high uric acid are accompanying “difficult brothers and brothers”. For hyperuricemia and diabetes, both have a common risk factor: obesity. Insulin resistance and dyslipidemia are more pronounced in patients with diabetes and hyperuricemia, glomerular filtration rate (e-GFR) is lower, and the harm is greater. Sugar friends encountered hyperuricemia, how to choose hypoglycemic drugs? In the selection of hypoglycemic programs for patients with diabetes and high uric acid, in addition to the hypoglycemic effect, blood uric acid levels must also be taken into account. The principle of multidisciplinary combined treatment should be followed, and drugs with uric acid lowering effects should be selected in a targeted manner. Achieve the effect of two birds with one stone. 1. Insulin Insulin is a common drug for patients with diabetes, but insulin can promote the synthesis of liver uric acid and the reabsorption of uric acid by the kidneys, inhibit the excretion of renal uric acid, and increase the blood uric acid level. Therefore, patients with diabetes and high uric acid should use insulin with caution. If diabetes requires long-term use of insulin therapy, it is recommended to use insulin sensitizers, biguanides, and alpha-glucosidase inhibitors in combination with blood uric acid levels, and uric acid-lowering drugs if necessary. 2. Insulin sensitizers such as pioglitazone and rosiglitazone both have the effect of reducing uric acid and protecting the kidneys, so it is recommended for patients with diabetes and hyperuric acid. 3. Biguanide antihyperglycemic drugs The classic antihyperglycemic drug metformin, which has both hypoglycemic and weight-reducing effects, has long-term use and has a uric acid-lowering effect, so patients with diabetes and high uric acid are recommended. 4α-glycosidase inhibitors such as acarbose (abasin) can reduce the increase in blood uric acid levels caused by the breakdown of sucrose, and can be used by patients with diabetes and high uric acid. 5 Insulin secretagogues sulfonylureas (such as glibenclamide, glimepiride) and mealtime blood glucose regulators can increase serum insulin concentration, affect the metabolism and excretion of uric acid, and raise blood uric acid levels, so it is not recommended in the clinic use. 6. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors such as dapagliflozin, englitazone, and caglitazone can both reduce blood uric acid and control blood sugar to varying degrees. SGLT-2 inhibitors have a moderate reduction in serum uric acid levels and are used as a potential supplement for lowering uric acid. The benefit of SGLT-2 inhibitors in gout disease is more worth looking forward to. Patients with mild liver and kidney dysfunction do not need to adjust the drug dose of SGLT-2 inhibitors, and are contraindicated in patients with severe renal impairment [e-GFR<.30mL/(min•1.73m2)] or dialysis patients. SGLT-2 inhibitors are all oral drugs, administered once a day, morning, fasting or after eating. A few days ago, the blood sugar-reducing drug Daglijean of the “soul bargaining” of the National Medical Insurance Bureau was one such kind of medicine. A 10mg tablet was 4.36 yuan. Dagresi has a very strong hypoglycemic effect and is fasting for patients with type 2 diabetes Both blood sugar and glycated hemoglobin have a significant lowering effect. The mechanism of reabsorption of glucose and uric acid in the renal tubules is very similar to that of the site. Daggliflozin inhibits the reabsorption of urinary sugar while also inhibiting the reabsorption of uric acid. Studies have confirmed that dagligliflozin can reduce blood by 10%-15% Uric acid levels. Because there are no data on the use of SGLT-2 inhibitors among minors, pregnant women and lactating women, it is not recommended for use in such populations. The main adverse reactions of SGLT-2 inhibitors are genitourinary tract infections, mostly mild to moderate bacterial or fungal infections, and conventional anti-infective treatments are effective. It is recommended that patients pay attention to personal genital hygiene, drink water in an appropriate amount, and keep the urine clear, which can reduce the incidence of infection. 7. Other drugs Glucagon-like polypeptide-1 (GLP-1) receptor agonist (liraglutide, exenatide), dipeptidyl peptidase 4 inhibitor (DPP-4) Ting, vildagliptin): can improve islet function, reduce insulin resistance, will not cause blood uric acid to rise, and can even pass
Many friends want to know, how will it feel at the beginning of diabetes? However, for the early stage of diabetes, due to different individuals, some friends may have typical symptoms of diabetes, and some friends may also have some atypical symptoms, and some friends may not have special symptoms. . What are the typical symptoms of early diabetes? Let me talk about the “three more and one less” symptoms that many friends know. This is indeed a typical symptom of diabetes. Three more refers to drinking more food and more urine, and less refers to weight loss. Why these symptoms occur is of course closely related to the disorder of blood glucose metabolism. The reason why we have increased blood sugar and even diagnosed as diabetes. The reason why the glucose in the blood will rise is because our body has problems with the use of blood sugar. Insufficient use of blood sugar will make the blood sugar rise. High, and insufficient utilization of blood sugar will also lead to inadequate function of the body. The body’s function is insufficient, and people will feel hungry. At this time, there will be symptoms of overeating, and high blood sugar will also affect the filtration and reabsorption function of the kidney. Causes osmotic diuresis, therefore, it will appear as an increase in urine output, which is the symptom of polyuria, and polyuria will cause the body to lose water, and will naturally produce symptoms of polydipsia. As for weight loss, it is also because the body’s blood glucose is not fully utilized, and the body does not get sufficient energy supply. In such cases, the body will further break down fat, protein and other nutrients to provide energy for the body. In this case, fat, protein The consumption will cause body weight loss and weight loss. Through the above introduction, you can see that three more and one less are closely related to high blood sugar, and if the symptoms of three more and one less appear, it is usually the case that the body’s glucose metabolism disorder is more serious. Symptoms, although typical, but when there are more than three and one less, the body’s high blood sugar state has often continued to develop for some time. In addition to the symptoms of three more and one less, other symptoms may appear in the early stage of diabetes, such as insufficient energy supply to the body, frequent fatigue, weakness and other symptoms, such as high blood sugar may affect the health of the retina and optic nerve, causing vision Symptoms such as blurry vision and decreased vision, and high blood sugar can also affect the health of the skin. Patients with diabetes may also have symptoms such as itching, dryness, and susceptibility to infection. If the nervous system is affected by high blood sugar, it may also occur. Abnormal skin sensation, limb numbness, pain and other symptoms. These symptoms may appear during the course of diabetes, or they may appear in the early stage of diabetes. Compared with the symptoms of three more and one less, these Symptoms may not be so typical, but they also deserve attention and attention. If there are other obvious causes of the above symptoms, you should also check the blood sugar level in time. It is more important to point out and point out: for most of the friends with diabetes in the early stage, because the blood sugar rise is not obvious, there may not be too obvious related symptoms in the body, there will be no more than three symptoms, and there will be no symptoms. Skin symptoms, unclear vision and other symptoms, but check blood sugar, blood sugar has risen, and even some friends can already combine fasting blood glucose and postprandial blood glucose values to judge diabetes. For such cases, thousands Don’t think that diabetes has no harm to the body because there are no obvious symptoms or feelings. At the beginning of the discovery of high blood sugar, it is the best diabetes control strategy to control the blood sugar level as soon as possible. In the early stages of diabetes, why do you have no symptoms and feelings and actively control blood sugar? High blood sugar is often slow and gradual to the health of the body. If the blood sugar is not controlled at this time, the problem of glucose metabolism disorder cannot be controlled and corrected, and the blood sugar level will gradually increase, which will gradually damage our major Healthy blood vessels and microvessels, leading to complications such as atherosclerotic cardiovascular disease, such as impaired kidney function, such as complications of the peripheral nervous system, etc., if waiting for obvious symptoms, or concurrent When the disease is in progress, control blood sugar again, often the blood sugar has already risen more seriously, and it is more difficult to control. And if it can be found in the early stage of elevated blood sugar, even when there is abnormal glucose tolerance or impaired fasting blood glucose, then open
The normal fasting blood glucose value of healthy people should be between 3.9 and 6.1, and if the fasting blood glucose reaches such a level of 13, it has exceeded the standard by more than 2 times, can it be said that it is not serious? First of all, fasting blood sugar has reached the level of 13, generally it is definitely a problem of diabetes. If the blood sugar value reaches such a high level, the blood sugar after the meal should be higher, and this value has exceeded the kidney sugar threshold, and urine sugar has begun to appear. Although, from various test indicators, this blood glucose index is already very high, but if it is said to be diabetic, it may not necessarily have a clear feeling, but for such a blood glucose value, because of the abnormal utilization of blood glucose metabolism , It is more prone to hunger, eat more and drink more. Due to high blood sugar leading to osmotic diuresis, the general urine output will also increase, but other aspects may not have obvious symptoms, but whether or not there is Other symptoms, such a blood sugar level, need to be actively paid attention to and regulated as soon as possible. If it is a newly discovered diabetic patient, blood sugar reaches this level as soon as it is discovered. At this time, it is not enough to emphasize that diet and exercise to strengthen blood sugar control. If it is confirmed that fasting blood sugar has reached the level of 13.0, for Such new-onset diabetic patients have already reached the standard of using insulin to control blood sugar. Many friends worry that once insulin is used, it will become dependent and cannot be stopped. In fact, this is a misunderstanding of insulin application. Exogenous supplementation of insulin is used to strengthen blood sugar control. There are usually two applications: the first is to quickly strengthen blood sugar control and reduce blood sugar as soon as possible for the situation where blood sugar rises more seriously. The next short-term medication; the other is to use insulin for a long time to strengthen blood sugar control when the oral administration of 2 or more hypoglycemic drugs is still not enough. We are talking about new-onset diabetic patients. The fasting blood glucose exceeds 13.0, and the glycated hemoglobin level is usually not lower than 9.0%. Under such circumstances, using insulin to control the excessively high blood sugar as soon as possible is a better way. After the blood sugar drops, should insulin still be used? It is necessary to combine with the actual situation. If the blood sugar is controlled, through reasonable diet, strengthening and insisting on exercise, and through reasonable oral hypoglycemic drugs, the blood sugar can be controlled to a reasonable range, of course, insulin is not necessarily necessary. You must insist on using it, but if you have strictly implemented life interventions and combined use of oral hypoglycemic drugs, your blood sugar still cannot be effectively controlled. If you cannot control the target range, you may still have to continue to use insulin to strengthen blood sugar control. It should be pointed out that different situations have different goals for blood sugar control. Therefore, in terms of blood sugar control goals, we must combine our own actual situation and formulate suitable blood sugar control goals. For example, for patients with new-onset diabetes, if the age is not more than 65 years old and there are no complications of diabetes and other serious concomitant diseases, it is generally recommended to control the level of glycated hemoglobin to at least 6.5%, and for some young people, the physical condition is relatively Yes, it is better if it can be strictly controlled to below 6.0%. Only by establishing your own goals for blood sugar control can you develop a reasonable blood sugar control plan in conjunction with your goals. In real life, this kind of control goal is difficult to achieve for many diabetic friends. Either they are too lazy to control their diet and exercise too much in life, or they cannot strictly follow the doctor’s instructions and cannot reasonably adhere to the medication. For diabetes, if we can control the blood sugar level reasonably as early as possible, and control the blood sugar smoothly to meet the standard, we can better protect the body from the harm of high blood sugar, and can better reduce the risk of diabetes complications. And the probability of occurrence, therefore, whether you find that the fasting blood sugar value is high or low when the blood sugar rises, it is very necessary to control blood sugar as soon as possible and strictly control blood sugar. If you are a friend who has diabetes problems, this blood sugar level also deserves active attention. If you are a friend who already knows that you have diabetes, let your blood sugar develop to this value, then it is very possible, and such complications have begun to occur gradually. At this time, whether it is serious or not is not serious. The value of this fasting blood glucose level depends on the comprehensive evaluation of the occurrence and development of related complications.
On June 22nd, Cangzhou Chishumin Anorectal Hospital hurriedly came to a patient with perianal swelling and pain, and restlessness.  . The patient is 72 years old and has had perianal swelling and pain for 3 days at the time of treatment. The clinic at home has been treated with antibiotics for three days but the symptoms have not gradually eased. The symptoms of perianal swelling are obvious, which seriously affects sleep. This increasing pain made Li no longer able to bear it, so he had to come to the hospital for consultation. After careful examination, the doctor found that there was a 3cm × 4cm mass in the anus of the patient. It was considered to be “perianal abscess” and surgical treatment was recommended. Although the patient complained of no previous history of diabetes, hypertension, etc., the anorectal clinic doctor in our hospital still measured the blood glucose of the patient urgently under his clinical experience. Unexpectedly, the test results of the blood glucose meter shocked the medical staff. “HI” is displayed on the blood glucose meter, indicating that the patient’s blood glucose value has exceeded the blood glucose meter’s detection range. Why is diabetes related to perianal abscess? The protein synthesis function of diabetic patients is weakened. In the past, malnutrition and low anti-infective ability have been increased. In addition, the patient’s blood sugar has increased, and the skin tissue glycogen content has also increased. Abscesses, boils, etc. The perianal abscess can increase the blood sugar stress to a certain extent, which slows down the healing speed of the perianal abscess. In addition, diabetic patients recover more slowly than healthy people after surgery. Diabetic patients must complete standard hypoglycemic treatment after perianal abscess surgery to control blood sugar and provide protection for wounds. If the blood sugar is not well controlled, it is easy to cause inflammation to spread. In addition, protein should be properly supplemented, such as eggs and lean meat. As the wound continues to heal and blood glucose levels change, the hypoglycemic regimen can be adjusted gradually. How do diabetic patients prevent perianal abscess? First, diabetic patients should usually standardize treatment and control blood sugar, which is the top priority. Second, maintain good hygiene habits, change underwear frequently, clean the anus after defecation, and keep the anus clean, which has a positive effect on preventing infection. Third, control the diet, avoid eating the fat and rich taste (meat, animal liver, etc.) that are likely to cause the disease, hair (beef, lamb, shrimp, crab, scaleless fish and other meat foods, and vegetables Leek, parsley, fennel, green onion, ginger and other spicy spicy things), spicy spicy food. Fourth, prevent diarrhea and constipation, maintain normal bowel movements, and reduce disease factors. Fifth, timely diagnosis and treatment of anal diseases to prevent the spread of inflammation. Sixth, actively exercise the body, enhance physical fitness, strengthen local disease resistance, and prevent infection.
Atorvastatin and other statin lipid-lowering drugs have good lipid-lowering effect and can stabilize plaque to prevent vascular blockage. A large number of studies have shown that statin lipid-lowering drugs can significantly reduce diabetes patients and diabetes with coronary heart disease The risk of patients’ cardiovascular events, so these drugs are widely used in clinical practice, in addition to cardiovascular, neurology, endocrinology will often prescribe such drugs. However, some people say that eating atorvastatin may cause diabetes. is this real? What is the basis? Why may long-term atorvastatin cause new diabetes? Several studies have shown that statin and other statins such as atorvastatin can increase the risk of diabetes. The possible mechanisms are as follows: (1) Statins can affect insulin sensitivity and the process of cellular uptake of blood glucose: studies have shown that statins Lipid-lowering drugs can reduce insulin sensitivity, thereby affecting blood sugar control, leading to increased incidence of type 2 diabetes. Statin lipid-lowering drugs, in addition to affecting insulin sensitivity, can also directly affect the cellular uptake of blood glucose. (2) Statin lipid-lowering drugs affect insulin secretion through β-cells: statin lipid-lowering drugs can not only inhibit the direct action of HMG-COA (hydroxymethylglutaryl coenzyme A reductase) reductase, but also reduce the body Cholesterol reduces insulin secretion, which leads to new diabetes. (3) The role of genetic mutations to promote blood sugar increase: A medical team has deeply studied the mechanism of statin to increase blood sugar, and evaluated whether it is related to the direct inhibition of HMG-COA reductase by statins. The results of the study showed that when the mutation of the gene encoding HMG-COA caused the structure or function of HMG-CoA reductase to be inhibited, the blood glucose in the patient’s body increased. As a HMG-CoA reductase inhibitor, the statin tuned bamboo drug, which inhibits the function of HMG-CoA reductase, is likely to be one of the mechanisms leading to new-onset diabetes. Statin lipid-lowering drugs can cause abnormal blood sugar, should we stop statin lipid-lowering drugs? In most cases, it is not necessary. The reason is simple: weigh the pros and cons. The use of statins can avoid acute cardiovascular and cerebrovascular events. Compared with abnormal blood glucose or diabetes, the advantages are obviously greater than the disadvantages. In one study, after observing 225 patients taking statin lipid-lowering drugs for four years, it was found that for every 5.4 deaths or myocardial infarctions prevented and reduced by statin lipid-lowering drugs, only 1 case had new-onset diabetes. If the effect of statin lipid-lowering drugs on the prevention of stroke and coronary revascularization is considered, the benefit of statin lipid-lowering drugs in preventing cardiovascular events is significantly higher than the risk of statins leading to new diabetes. Therefore, it is still necessary to continue to use statin lipid-lowering drugs in people who are suitable for statin treatment. Especially for people with moderate to high cardiovascular risk and those with definite atherosclerotic cardiovascular disease, compared with cardiovascular benefit, statin lipid-lowering drugs cause little risk of new diabetes. Therefore, even if there is a clear blood sugar abnormality caused by a statin lipid-lowering drug, the statin lipid-lowering drug should still be used consistently. In conclusion, statins such as atorvastatin can significantly reduce the risk of cardiovascular events in diabetic patients. Although it may indeed increase blood sugar or cause new diabetes, this adverse effect is far lower than that of statins. Clinical benefit. But it also reminds us that it is best to monitor blood sugar levels before and during statin administration. At the same time, pay attention to the dosage when taking the medicine. Do not increase the dosage of the medicine by yourself in order to quickly reach the blood lipid standard. References Su Xin, Zhao Shuan. Research progress on the risk of statin-induced new-onset diabetes[J]. Chinese Journal of Cardiovascular Diseases, 2016, 44(5): 456-457. , Thank you for the picture author, if you find any violation of your copyright, please contact me, I will delete it.)
I have written a lot of science about the diet of gestational diabetes, but “sugar moms” still have many questions: fruits are so sweet, can I really eat them? Can sweet corn be eaten? Sweet potatoes are also very sweet, can they really be eaten? Therefore, it is necessary to specifically popularize this question: whether food is sweet or not is not a criterion for judging whether a diabetic person can eat it. Have diabetes, quit all sweet food? With diabetes, many people consciously quit sweet foods, such as cakes, snacks, drinks, fruits, sweet corn, sweet potatoes, do not put sugar in cooking, and even dare not take sugary medicines. Of course, we encourage this kind of behavior, indicating that patients are beginning to attach importance to diabetes. But in fact, in addition to cakes, snacks and other foods made of artificially added sugar, natural sweet foods such as fruits, corn, and sweet potatoes do not need to be quit. First: Sweetness does not mean that the effect on blood sugar is greater. Many diabetics will think that sweet food will have a greater impact on blood sugar, so they will not eat any sweet food. But in fact, the effect of food on blood sugar is not measured by sweetness or not. Sweetness does not necessarily have a big effect on blood sugar, and unsweetened food may not have a small effect on blood sugar. For example, rice is not sweet, but its effect on blood sugar is greater than that of fruit. To measure the effect of food on blood sugar, it is medically described by the glycemic index (abbreviated as glycemic index). The larger the value, the greater the effect on blood glucose. Usually, the glycemic index of glucose is set to 100, the glycemic index >. 70 is a high glycemic index food, and the glycemic index <. 55 is a low glycemic index food. A word I often say to people with diabetes is: You dare to eat rice, why not dare to eat fruit? The essence behind this is: the glycemic index of fruits is much lower than rice. Although the fruit is sweet, the glycemic index of most common fresh fruits is not high, such as 22 for cherries, 36 for apples, and 43 for grapes. The glycemic index of watermelon, cantaloupe, and pineapple is relatively high, above 55, but also lower than the staple food made of rice or flour (see table below). Sweet corn is also very sweet, but the glycemic index is 55, which is also significantly lower than the staple food made of rice noodles; and the glycemic index of boiled sweet potatoes is 77, although it is also high but lower than rice and buns. If you eat it cool, then blood sugar The index will be lower. Comparison of the glycemic index of fruits and common staple foods. In addition, fruits, potatoes and grains are important components of the diet. There are nearly 50 kinds of essential nutrients in the human body, which are indispensable. No natural food can meet all the nutrients required by the human body. Therefore, the diet must be composed of multiple foods. In the case of fruits, fruits contain minerals essential for the body but not self-synthesized, vitamins that have strong antioxidant effects to prevent cell aging, and soluble fiber pectin that can significantly reduce the concentration of cholesterol in the blood. Potatoes and cereals including corn are even more important. This is the basis of our diet, mainly providing carbohydrates, protein and B vitamins. In summary, if you have diabetes, sweet fruits, corn and potatoes can still be eaten: fruits are not too much at a time (about 150g), and corn and potatoes are used as staple foods. You can enjoy delicious food and increase nutrient intake without raising blood sugar. There are no bad foods, only bad collocations~ Welcome to leave a message in the comment area, I will also check back in time! Author| . Ding Bingjie Weibo丨Ding Ding Nutrition Class