Guo Xiaohui, Chief Physician, Professor and Doctoral Tutor of the Endocrinology Department of Peking University First Hospital. Chairman of the Diabetes Education Management Society of Chinese Society for Health Promotion and Education, Chairman of Beijing Diabetes Association. Expert of the National Health Science Expert Database.
Why did “Sweet Sadness” find me
Q1: The blood glucose was measured accidentally and found to exceed the standard value. Is this diabetes coming to the door?
A: Occasionally, the blood glucose test is abnormal. If the fasting blood glucose is tested, there may be a problem. You need to go to the hospital for examination and evaluation as soon as possible. If your blood sugar is high after a meal, it may be that you drank a lot of sugary drinks during the meal or consumed high-sugar foods, which caused abnormal blood sugar fluctuations. But if there are frequent abnormalities in blood glucose after meals, be sure to go to the hospital for a system check in time.
We especially remind everyone not to delay testing and diagnosis because of fear. Because the earlier diagnosis and treatment start, the better the treatment effect.
Q2: Can diabetes be inherited?
A: Diabetes has a genetic “susceptibility”. Parents have diabetes, and children have a greater chance of getting diabetes. We have also seen in the clinic that many people with diabetes have diabetes in their homes for several generations.
But it should be noted that in addition to genetic factors, environmental factors are also very important for diabetes. For those with genetic high-risk factors, timely examination and active treatment through diet, exercise, weight control, etc. can make diabetes come later.
Q3: Why must blood sugar be controlled?
A: Severe hyperglycemia will lead to life-threatening conditions such as ketoacidosis, hyperglycemia and hyperosmolar coma. But the “asymptomatic” damage caused by high blood sugar is actually more dangerous. If long-term blood sugar management is poor, chronic blood sugar rises, which may eventually lead to very serious consequences.
Sugar circulates with the blood to various tissues and organs of the body, and combines with the proteins in them to denature them. The blood vessel wall is the first part to be affected, which can lead to undesirable consequences such as arteriosclerosis, which in turn affects the brain and heart. The capillaries that affect the fundus can cause retinopathy of the fundus, and even blindness; affect the blood vessels of the kidneys, increase urine protein, decrease renal function, and eventually require dialysis or kidney transplantation; affect the blood vessels of the lower extremities and cause neuropathy, and the patients will experience numbness and pain , The wound is not easy to heal, and there is even the possibility of amputation.
I would like to remind everyone to pay special attention to regular physical examinations and to go to the hospital for a comprehensive examination if blood glucose is found to be abnormal. Even if you don’t use medicine, you should start to control your blood sugar by changing your lifestyle.
Is it enough to “control your mouth” and “step open your legs”
Q4: What problems should be paid attention to in the diet of diabetic patients?
A: There are two aspects to the dietary principles of diabetic patients.
The first is to control the total heat. We need to know how many calories we need to consume through food throughout the day. To calculate the required calories, you must first know your ideal weight. Can teach you a rough algorithm, subtract 105 from the number of centimeters in height. For example, for a man with a height of 170 cm, his ideal weight is 170 105, which is 65 kg. Secondly, how many calories you need to take in should be calculated based on your daily activities.
Heavy physical workers need more than 35 kilocalories per kilogram of body weight.
Office workers in the office need 30 kilocalories per kilogram of body weight.
Bedridden patients need about 25 kilocalories per kilogram of body weight.
It should be reminded that this formula cannot be applied mechanically. For example, a patient with type 1 diabetes who is already very thin cannot supply calories according to his current abnormal weight, but needs to calculate his ideal weight. At the same time, adolescents in the growth and development period, pregnant women in pregnancy, and the elderly should also increase or decrease the calorie intake appropriately to meet their special physical needs.
The second is a balanced diet. In order to control blood sugar, do not eat any staple food or carbohydrates. This will cause nutritional imbalance.
Carbohydrates are a very important source of energy for the body, and there is very little waste produced in the process of metabolism, which can be said to be quite “clean” energy. Diabetes patients should not stop eating due to choking and stay away from carbohydrates. The key is to control the amount of intake.
Some patients still have this misunderstanding, thinking that only eating vegetables and fruits is enough. Everyone should know that the energy provided by only consuming vegetables and fruits is far from enough for the body’s daily needs.
In addition to carbohydrates, protein is another important source of energy that cannot be ignored. When the long-term energy intake is insufficient, the body will not only use up the stored sugar, but also consume protein, which will bring greater harm to the body. Staple food contains a lot of trace elements and vitamins, and protein is rich in fat-soluble vitamins, which play their respective purposes when the body maintains daily functions.
balanced! balanced! balanced! The important thing is to say three times. The diet of diabetic patients should be balanced, and the types of food can be diversified. Long-term persistence is more beneficial to the body.
Q5: For diabetics, can sugar-free food be safe to eat?
A: Many people think that there is no sugar in sugar-free food. But these sugar-free foods just don’t use obvious sugar components such as sucrose and glucose, and there are not many “invisible sugars” among them.
The flour, starch, etc. used to make food will be digested and absorbed by the human body and finally converted into sugar. In addition, the cream and fat added in snacks and other foods contain high energy, which will still be broken down into sugar after being absorbed and metabolized by the body. Therefore, sugar-free food is not “invisible grass” and absolutely cannot be “eaten open.”
Q6: How to exercise more appropriately for diabetic patients?
A: Exercise is of course necessary for diabetic patients, but it should be noted that excessive exercise may cause injury. Not to mention the joint damage caused by improper exercise. In the case of poor blood sugar control, the pancreatic islet function is also very poor. After a lot of exercise, there is not enough insulin secretion in the body, and sugar cannot enter the cells, leaving the cells in a “starved” metabolism. The accumulation of lactic acid in the body will not only cause muscle soreness, but also bring more adverse effects. For example, further consumption of fat, production of ketone bodies.
Therefore, it is a very big mistake to rely on exercise alone to lower blood sugar. Exercises for diabetic patients should be carried out under the guidance of professionals, and should not be reckless!
Regular inspections are necessary
Q7: How do diabetic patients conduct daily monitoring of their physical condition?
A: The ultimate goal of treating diabetes is to reduce the occurrence of various chronic complications. In order to reduce complications, it is not only necessary to manage blood sugar, but also to manage blood pressure and blood lipids to control weight.
In the regular follow-up of patients with diabetes, blood pressure is an important part, because complications such as cerebral infarction and cerebral hemorrhage are highly correlated with blood pressure.
In addition, the benefits of blood lipid management may actually be greater than the benefits of managing blood sugar. It can prevent the formation of atherosclerotic plaque and reduce the risk of thrombosis.
Before adjusting the medication, we must also observe the patient’s weight change. Because obesity itself is a high risk factor for cardiovascular and cerebrovascular diseases, weight management is very important.
Q8: What kind of tests do diabetics need to do regularly?
A: In addition to checking blood sugar, blood pressure, and blood lipids regularly, it is also very important for diabetics to have a glycosylated hemoglobin check every three months.
The patient’s usual blood glucose measurement only provides information at a point in time, there is a certain degree of chance, and it cannot reflect the average situation. The glycosylated hemoglobin represents the average blood glucose level of the patient in the past 8 to 12 weeks, and has nothing to do with the time of blood draw, whether the patient is fasting, whether the patient uses insulin, etc., and can more effectively reflect the blood glucose control of diabetic patients.
In addition, the liver and kidney function can be measured once every three months or six months, so that the doctor can adjust the medication.
The related examinations for chronic complications can be checked once a year, such as fundus examination, electrocardiogram examination, lower extremity artery examination, urine protein examination, etc. Monitor every organ of the body in time.