Fasting blood sugar is 12.8, more than 20 hours after a meal, what should I do? Doctor reminds: do it well

Fasting blood sugar 12.8, more than 20 hours after a meal? For this blood sugar level, if it is the first measurement, then there is no doubt that it can be directly diagnosed as diabetes. If it is already a diabetic patient, it can also mean that the blood sugar control is very poor. Because we do not know the age of the patient and the type of diabetes, we will discuss type 2 diabetes, which accounts for more than 95% of diabetes types. However, whether it is type 1 or type 2 diabetes, this blood sugar value will increase the risk of acute complications such as ketoacidosis in patients, so it is necessary to control blood sugar to the normal range as much as possible. 1. Lifestyle intervention diabetes requires comprehensive treatment, lifestyle intervention is the first link. Without strict lifestyle intervention, the use of more hypoglycemic drugs is futile. Therefore, we must first strictly implement the diabetes diet, quantify the timing of eating, and correct bad habits that can increase blood sugar, such as smoking and alcoholism. Why didn’t you mention sports? If you want to correct high blood sugar in the short term, exercise will not have a big impact on blood sugar at this time, but in the long run, you must adhere to regular exercise. 2. Hypoglycemic drug therapy Intensive insulin therapy is the first option. On the one hand, because the action of hypoglycemic drugs is slower, it cannot reduce blood glucose to normal as soon as possible. On the other hand, if this blood glucose level has been around for a while, the islets in the body The cells are overworked and they are very tired, and they may even gradually fail. So at this time, the use of insulin secretagogues and other hypoglycemic drugs is less effective, and it will also accelerate islet cell failure. However, the use of insulin can make fatigued islet cells temporarily rest, protect islet cells from premature failure, and can achieve the purpose of lowering blood sugar as soon as possible. As for the use of insulin, there are no strict rules. Pre-mixed insulin can be used, or you can use the basic long-acting insulin before bedtime plus three meals of short-acting insulin. If the blood sugar level is still high after using insulin, consider combining other hypoglycemic drugs in addition to insulin secretagogues, such as metformin, acarbose, or insulin sensitizer rosiglitazone, and the new hypoglycemic agent dapagliflozin Net, sitagliptin, etc. 3. The goal of glycemic control The setting of glycemic control goals needs to be individually considered based on the patient’s age, course of disease, life expectancy and complications. Generally speaking, the lower the age, the stricter the glycemic control. For most non-pregnant type 2 diabetics, fasting blood glucose is controlled at 4.4-7.0mmol / L, postprandial blood glucose is controlled at <10mmol / L, and glycated hemoglobin should be <7.0%. Because elderly people are prone to hypoglycemia accidents, So it can be relatively relaxed. Finally, you need to remind that the above blood sugar level should also be checked for the impact of combined stress factors, such as infection, surgery, trauma, etc., and if necessary, actively deal with stress factors. References: "Guidelines for the Prevention of Type 2 Diabetes in China" (2017 Edition) (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.)