Sunday, July 18, 2010

Four Mistakes blood glucose control

Recently, the top three hospitals in Guangzhou are held from time to time "to teach diabetic patients Figure Dialogue Project." This is a special instructor with the patient in a "Figure dialogue" is a technique used to help diabetic patients to enhance self-management of a new education model, to easily participate in diabetes Figure as long as the dialogue, we can learn from and diabetes-related knowledge and sufficient communication identify problems, draw conclusions, and ultimately implement the behavior change, effective control of diabetes.

Department of Endocrinology, Peking University Hospital, according to Professor Guo Xiaohui, director introduction, previous diabetes education models are mostly one-way spoon-feeding methods, such as organizing health talks, pamphlets and other grant knowledge. Although the broad audience, but the results are unsatisfactory. The "Figure dialogue" tool appears and allows the staff interact with patients. Chinese Medical Association, diabetes care and diabetes education credits will be deputy director of Building green is "Figure dialogue" one counselor, she's Sir Run Run Shaw Hospital in Hangzhou, "Diabetes Figure words," found that there are so many "I know elements", though that diet therapy is an important means of controlling blood sugar, to know how much smaller meals to reduce the burden of islet, control progression of the disease, but diabetes, hypoglycemic still there are many misunderstandings.

Mistakes 1

There are a lot of people that "can lower blood sugar pumpkin"

"In Figure spoke, I really did not think there are many diabetic patients to eat pumpkin as a good way to lower blood sugar." Building green "This is a great mistake." A few years ago, major media have reported: pumpkin glycemic index of 75, according to the amount of sugar, 55 if the generated index below basic diabetes can eat. 55-75 If, should control the consumption of 75 or more is a high index of food, more food should be minimal. In the clinical part of the patient, she found, as had fresh pumpkin, not only failed to lower blood sugar, but the face and the phenomenon of skin stained yellow, and even blood sugar.

Mistakes 2

Sugar moon cake, sugar-free cookies is not afraid to eat more

Sugar-free foods will mean "help control blood sugar" or "low calorie" it? Not be more wrong. In fact, this sugar-free food moon cake is done, a moon cake may be arrived in a meal of sugar. A food can raise blood sugar quickly, and there is no absolute relationship between them is sugar, the key is its nutrient composition and dietary fiber characteristics. Sugar-free snacks, biscuits, like a starch and fat. These are high-calorie food, eat it still make people gain weight. Therefore, health-conscious consumers still do not overly dependent on sugar-free products, should eat more beans, dairy products, grains, vegetables and their control of blood glucose and body weight best.

Myth # 3

Chi Guazi, peanuts, walnuts, sugar will not rise

The reason why love Chi Guazai diabetes, peanuts, walnuts, green floor to hear the answer is: Let them eat snacks, both to reduce hunger, but also to protect one of the means adequate nutrition. In fact, eating these foods have a lot of requests. Because walnuts contain more oil, it should be a corresponding reduction in the fat meal intake. However, eat peanuts, melon seeds is not allowed? These foods both yangkeng, little sugar, little impact on blood sugar, the fat is contained in saturated fatty acids, should be able to easily eat, right?

Some truth in this view, it is still not fully and correctly. Peanuts and melon seeds does a lot of advantages, but they, after all, is rich in fatty acids of plant seeds, is a high calorie, high fat foods, such as peanuts, seeds and nuts contain more calories than the same weight even higher pork at times, a lot of food is certainly not conducive to maintain body weight and blood lipid control, which indirectly affect blood glucose and blood pressure control. Therefore, the daily consumption of peanuts not more than 10 (8 grams), not more than 50 seeds (20 grams), or else, or will affect the treatment of diabetes.

Myth # 4

If a blood sugar test and found that high blood sugar, many patients certainly the first act to reduce appetite

In fact, this is very bad. "Because doctors Ye Hao, dieticians Ye Hao, you set an appetite, high blood sugar if you should not reduce the appetite, but the drug should be added, see a doctor." Building green said, "Some of the patients a to reduce high blood sugar rice, I encountered three patients clinical situation is such, eat more small meals, while increasing blood sugar, and finally got cancer, I can not say that cancer is caused by eating less, but eat less true Shang Wei. "

■ Links

Control of diabetes, we were "Figure dialogue"

All you want to participate in "Diabetes Figure dialogue" suffering from the medical staff and patient education projects do not need to pay.

It is understood that the project is from the Eli Lilly Company and the International Diabetes Federation (IDF) and the Health Interactive (Healthy Interactions) jointly launched the company, formally launched in April this year after Lilly gradually to 500 hospitals Figure dialogue tool, this diabetes "Figure dialogue" tool contains four maps, respectively, "with diabetes peer", "what is diabetes," "healthy eating and exercise" and "insulin with the" value of 150 euros each.

In China, the project launched by the Chinese Diabetes credits will (CDS) of the strong support of education and nursing science as a CDS leader of the team of Professor Guo Xiaohui, said: "Diabetes Figure Dialogue in March 2008 was launched in the UK Today, more than 40 countries around the world to get a promotion and application, and the tool has been translated into over 25 different languages. now has become a popular education model of diabetes, Lilly will be the new education mode into China, China's diabetes health care training to hospitals Figure dialogue tool that allows more people with diabetes to participate and benefit from. "

Glycemic control and short-term long-term with both hands

Host: users Hello everybody, welcome to the family doctor online, today we are honored Shenzhen Second People's Hospital Endocrine Division Director Professor Luo Guochun to talk to us about the problem of diabetes treatment. The detection of diabetes among the project is to test one of them, "glycosylated hemoglobin", but many people do not know what effect this test items are, in fact, glycosylated hemoglobin in diabetes have been used for the detection of which for many years, has asked Professor Luo with We talk about the role of detection of glycated hemoglobin, glycated hemoglobin Why should pay attention to?

Luo Guochun: "glycosylated hemoglobin" is the hemoglobin inside red blood cells, and some combination of glucose, it is called "glycated hemoglobin." Glycosylated part of the rise represents the increase in blood glucose, glycosylated hemoglobin has been determined for the detection of diabetes for many years, but there are many diabetic patients do not understand about this test.

Glycated hemoglobin is characterized by relatively long time to reflect blood glucose, and relatively stable, but merely reflects the determination of blood glucose blood glucose level at that time, other times not reflect blood glucose levels. Therefore, the significance of blood glucose has some limitations, it is best fasting blood glucose (including postprandial blood glucose), while detection of glycated hemoglobin, a shorter length can be a good expression in patients with immediate and recent (2-3 months) the blood glucose level.

Moderator: normal glycated hemoglobin range?

Luo Guochun: Determination of different laboratories may have some differences, the normal value is typically 4 to 6% level. For diabetic patients, there is a glycated hemoglobin control standards, a slightly different control standards at home and abroad, according to Diabetes Branch of Chinese Medical Association to develop standards to control below 6.5%, that is glycosylated hemoglobin over 6.5% on behalf of glycemic control bad.

Moderator: postprandial blood glucose and fasting blood glucose, glycosylated hemoglobin which had great influence?

Luo Guochun: high levels of glycated hemoglobin, the representative of the overall glucose level, is already reflected in the postprandial blood glucose, also reflects the fasting blood glucose, postprandial blood glucose and fasting blood glucose, but the proportion of time is not the same. Comparison of fasting blood glucose levels, "good" when the time is not too high level, so postprandial blood glucose on glycosylated hemoglobin will be larger. Sometimes normal fasting glucose, glycosylated hemoglobin, postprandial blood glucose may also be higher there.

Moderator: glycated hemoglobin is too low to say it?

Luo Guochun: Low blood sugar is not generally long, that diabetes does not appear to reduce the level of glycated hemoglobin, so the lower the level of glycated hemoglobin is not important whether the increase is critical.

Moderator: Some users asked for breakfast blood glucose levels are normal, but doctors have told him that glycated hemoglobin is too high, they did not understand why you say it?

Luo Guochun: If the fasting blood glucose and / or postprandial blood glucose level to a certain extent when the glycosylated hemoglobin will increase performance. If found glycosylated hemoglobin increased, while fasting glucose normal, only to illustrate the level of blood glucose was normal, but the total period of time after it is elevated blood sugar. Therefore, patients thought that a good glycemic control, in fact, higher glycosylated hemoglobin that does not control blood sugar Recently good. Therefore, more reliable determination of glycated hemoglobin and important because it reflects a period of time the level of overall glycemic control.

Moderator: glycated hemoglobin measured how much time before a more appropriate

Luo Guochun: red blood cell metabolism, a process that is generally 60-90 days, can see its metabolic rather long time, so glycated hemoglobin in the blood can stay a long time, which is well reflected in blood glucose over time, clinical generally measured 3 months time, if too long an effect measured not so good, because there is no continuity. If the year closed beta four times, once every 3 months test, which can reflect the year four times the blood sugar control.

Moderator: For children and the elderly, the metabolic rate of glycated hemoglobin different?

Luo Guochun: glycated hemoglobin level is increased, the differences between different age groups may be, but the difference is not obvious.

Moderator: If the patient measured high levels of glycated hemoglobin, then in the next few months in the diet or the treatment of what can be adjusted?

Luo Guochun: We usually daily fasting blood glucose and postprandial blood glucose test, blood glucose levels are reflected in the day, discovered in time to adjust after the treatment. However, glycosylated hemoglobin increased, suggesting that not nearly good blood glucose control for a long time, then the (previous phase) treatment on the need to adjust. To know whether the actual blood glucose level increased, not simply a fasting plasma glucose or postprandial blood glucose results. Can not say that today's high or low blood sugar, and to explain all the problems. In general, we must look glycated hemoglobin, also at the same day of blood glucose levels, both of which can see better understand the overall blood sugar levels.

Moderator: patients have different agents, some with insulin therapy, some with oral hypoglycemic agents, the two treatment on glycosylated hemoglobin have different?

Luo Guochun: If hypoglycemic effect of oral hypoglycemic agents is not good, can be reflected through the detection of glycated hemoglobin oral not good, to make a quick switch to the better treatment modalities, such as insulin. Treatment failure with oral drugs, use of insulin therapy or can get a good effect.

Moderator: That is glycated hemoglobin test can be used as the basis to judge the efficacy of treatment?

Luo Guochun: Clinically, diabetes, glycated hemoglobin generally not as a diagnostic tool, but as a treatment monitoring tool, glycated hemoglobin level of treatment measures to change the judge as the basis of this indicator is very useful.

Oral combination therapy is a necessary means to h blood glucose control

2010 year 1 month 10th (Sunday) 9 am to 11:30, 2009 "Great Chinese Medical Association Health Forum," The Fourth Lecture Hall at the Beijing Great Hall of the small, the theme "Prevention of chronic diseases, management of health" . Invited Chinese Medical Association, former chairman of Credit diabetes, Endocrinology, China-Japan Friendship Hospital Director Professor Yang Wenying on "Diabetes Prevention and Self Management" seminar topics, and a healthy lifestyle for people on-site Q & A activity hot spots. Sina Health Channel as Exclusive Video: Asymptomatic hyperglycemia is a silent killer of diabetic complications

Portal network partners to provide media support. Following is the text Professor Yang Wenying Record live lectures:

Dear Moderator Huangyuan Chang (Editor's note: Huang began, the Chinese Academy of Medical Sciences Assistant Dean, Beijing Union Medical College Principal Assistant to the Dean of Public Health), distinguished guests, ladies and gentlemen, Good morning everyone!

Thanks so cold in the winter, we have such a high interest to be here to participate in health activities in a large lecture hall. Has just introduced a host, my name is Yang Wenying, the Sino-Japanese Friendship Hospital Endocrinology Division. Here I will talk to you about the first part of today is mainly the management of diabetes is divided into four parts: 1, diabetes hazards; 2 diabetes mellitus; 3, diabetes; 4 diabetes prevention.

I believe we have heard of diabetes, perhaps a few years ago we think that diabetes is a rich man's disease, only the rich have. Because then we can vaguely aware that Europe and the United States, developed diabetes has become epidemic. But today, ask friends, family, meals, ask each person can find diabetes. Today, China's economic development, people's living standards improve, diabetes in our country are being rapidly developed. Diabetes has become epidemic, a not uncommon disease.

What is Diabetes? Complex causes of diabetes, classification is also very high. Many types of diabetes Type 2 diabetes is the main body, which accounts for 90% of the total number of diabetic patients -95%. So today I introduce to you the concept of type 2 diabetes and diagnostic criteria.

What is Diabetes? Diabetes is a defect of insulin secretion and decreased secretion or insulin action caused by high blood sugar good condition. Referred to as insulin secretion and / or insulin barriers. These two factors are leading to insulin's role in the process of lowering blood glucose difference. As the secretion of the role of small or poor, leading to a group characterized by chronic high glucose metabolic diseases. We will always ask, high blood sugar on high blood sugar, why is it called metabolic disease? Because the role of insulin is less or worse, the symptoms are elevated blood sugar, but much is not merely to the role of insulin metabolism of glucose and insulin on lipid metabolism, protein metabolism role is multifaceted. High blood sugar 除了 already know a little more than three symptoms of Di, the fact will also look at the body of Ge Zhong organizations particularly the eyes, kidneys, nervous system, vascular system, causing long-term Sun Hai, this is what we call Diabetes Manxing complications.

Clinical manifestations of diabetes, the most typical is a little more than three, the first is a multi-drinking, like drinking, eating, like to eat rare; the second largest food, enough to eat, easy to hunger; third polyuria. If more than 3 line, the first should be more of urine, because a high blood sugar, kidney is the permeability of the diuretic, so the first symptoms of high blood sugar is polyuria, polydipsia, polyuria increased blood osmotic pressure, leading to more drinking, eating.

Although some people with diabetes but no obvious symptoms, mainly of high blood sugar have more than 3 to a certain extent. But not to be easy for more than three of the complications of high blood sugar, blood spots in fact lead to complications, that is, the diagnosis of diabetes point, but the point of blood sugar can be no symptoms of high blood sugar symptoms after a certain degree. Thus the typical symptoms more than 3 more than in moderate diabetic patients there. Is a small weight loss. High blood sugar after the sugar can not enter the cell, the energy consumption as an organization, but with the massive loss of urine. High blood sugar must be a high urine sugar, a lot of sugar lost weight will reduce. Therefore not difficult to understand a little more than three diabetes are: polyuria, polydipsia, polyphagia and weight loss. If your friends have more than three a little time, diabetes has not light up. There are other symptoms of diabetes, although not typical, diabetes-specific symptoms, but often accompanied by symptoms such as easy to skin itching, dry skin, hunger, blurred vision, are easily tired, often feel weak. If you have these symptoms, whether your friends and family, or diabetes at high risk, should be early to the hospital to be checked.

Diabetes harm discounted, because diabetes is more than a "rich man's disease", as long as sufficient food and clothing, and fed high-calorie, and less activity, can be. So far, the prevalence of diabetes in developing countries grow much faster than in developed countries is even higher. Because such a rapid economic development and higher living standards in the process of very rapid growth of diabetes prevalence. Over time we do not attach importance to the early complications did not know the impact of hazards will be very large.

This is a map of the world, China's leading position in the international arena, not that we developed the lead, not lead our country out of poverty, but the number of our diabetic population has a leading position in the world. This is not a good thing. 2007 data, we and the number of diabetes in India is almost, ranking first in the world. And by number for diabetic patients in China and India together have occupied one third of diabetic patients worldwide. This led to our own national burden, the burden on society, family burden, in the global prevention and treatment of diabetes, is also a very heavy burden. If the pace of development in accordance with this pre-promotion in 2025, China and India continue to lead in this regard, China may over India as the world's largest national diabetes. So that we may face the task of prevention and treatment of diabetes is very important the.

What are the complications of diabetes? From acute and chronic is divided into two categories, one category of acute complications and chronic complications of a large class. Acute complications were defined as blood glucose is higher, the acute syndrome associated with the processes. Not widely used in the previous insulin, the diabetic patients particularly prone to ketoacidosis. Insulin use is very standard, our doctors are better, more timely patient visits, so ketoacidosis due to diabetes mortality declined significantly. Type 2 diabetes during acute infection, or suddenly determined to cerebrovascular disease, blood sugar will rise sharply, causing a sharp decline in insulin action, may also cause ketoacidosis. Type 2 diabetes or an acute complication of diabetes, high blood sugar condition, if not properly handled, easy to infection. Second, if they have a slight infection, normal healing is easy, but not work with diabetes, even a cold, handled properly, will cause the common cold increased, secondary serious bacterial infection. In the course of drug therapy will hypoglycemia, and this is a course of treatment of acute diabetic complications. Complications of diabetes, including hyperosmolar syndrome model. Mainly elderly people, or do not know they have diabetes, under acute stress, high blood sugar, urine volume a lot, but poor awareness of drinking water initiative will lead to hyperosmolar syndrome, severe cases can lead to coma. Acute complications, the more rare is lactic acidosis. Chronic complications of diabetes, mainly due to the long-term high blood sugar can lead to chronic tissue damage. Chronic complications, divided into two categories, is microvascular complications, the main part is the eyes and kidneys violations. There is a large class of macrovascular complications, mainly heart, brain and lower limbs of the great vessels. There are peripheral neuropathy and autonomic neuropathy, etc.. Patients with these chronic complications have given tremendous pain.

In the course of treatment of diabetic patients, in addition to simply use some of the drugs do not cause low blood sugar, the long-term use of combination therapy and even later may be hypoglycemic insulin. Our point of view from diabetes, low blood sugar diabetes diagnostic value is less than 3.9 mmol / liter, or 70 mg / 100 ml (conversion method is by 18 mmol), if the blood sugar in diabetic patients than 3.9 mm mole / liter, more serious may occur, low blood sugar reaction, I hope not to blood glucose control in less than 4 mmol / liter.

What is the performance of low blood sugar? Some people ask, I do not have blood glucose meter? Lower blood sugar how do you know? We have low blood sugar triad of determining standards. There are two sets of low blood sugar syndrome, syndrome is a group of lower blood glucose when glucagon glycogen mobilization reflected in the performance, such as palpitation, hunger, cold sweats, trembling body. A serious disturbance of consciousness and even coma may occur, because the blood sugar is very low, causing brain symptoms. If you check blood sugar, whether it is monitoring or intravenous fingertips, you will find blood glucose levels much lower than 3.9 mmol / liter. Others may have symptoms, but not so low value, it means the blood sugar drop too fast. If the blood glucose level decreased, and we certainly have something to eat self-consciousness, this time you may eat some sugary things, or food or drink fruit juice, eat some sugar if the symptoms disappeared after the measures, we Such a process known as the triad of low blood sugar, the first symptoms, the second a low blood sugar, carbohydrate food can ease into the third.

The performance of low blood sugar, these performance values will decrease as the blood sugar more and more serious, if it is 70 mg / 100 ml of blood sugar levels, certainly dizziness, uncomfortable, but at 50 mg / 100 ml when possible no effort, and computing power will be weakened. Shows the comparison of brain cells glucose significantly. To 40 mg / 100 ml, often a cold sweat, palpitation, tremor, pale, and some even appear flush. To 30 mg / 100 ml will lose consciousness, abnormal behavior. To 20 mg / 100 ml can be unconscious person. The performance of low blood sugar with the severity of hypoglycemia.

In the chronic complications, there is microvascular disease. This chart tells you how to check whether there are complications. With diabetes, the regular eye fundus examination, fundus checked, the ophthalmologist will help you judge whether the normal retinal diseases. Tell principles. Foot and skin lesions and the possible future "Diabetes foot" situation.

If we only diagnosed with diabetes, high blood sugar, and high blood sugar when there is no early symptoms, like high blood sugar though no symptoms, but is the silent killer caused by chronic complications. This high blood sugar caused by damage to the organization, not to the dysfunction, these organizations have no symptoms of damage. For example, high blood sugar combined coronary heart disease, coronary heart disease without angina, myocardial infarction does not occur, you do not know the risk factors associated with high blood sugar, when do not know a vascular disease has occurred. Diabetic and non diabetic than how much damage? People with diabetes cardiovascular disease than non-diabetic patients 2-4 times, if accompanied by diabetes, hypertension, mortality rates than non-diabetic patients with high 7 times. End-stage renal failure in diabetic patients with 40%. Amputation in patients with diabetes accounted for 40%. Therefore, early control of blood sugar diabetes must be and all of the risk factors and non-diabetic patients to ensure the same longevity. The cost of diabetes complications, prevention of complications than four times the cost of flowers. Overall treatment costs of diabetes, the complications of treatment costs 80% of the total cost of treatment. Therefore, we hope we have not formed in the early complications of the former, a good control. Control of chronic diseases in drug costs than the cost of treatment after complications is much lower. This is the organization we are here today, we carry out the treatment of diabetes and diabetes prevention reasons.

Thank the Chinese Medical Association, thanked the community concerned about the diabetes groups, and to give you for diabetes prevention and treatment of propaganda, to arouse our attention. In the end of high blood sugar can damage the body which organs have? We drew a graph, the people fat, indicating fat people prone to diabetes. Him from head to toe, almost no one organization is not soaked by high blood sugar will be high blood sugar damages. Although diabetes diagnosis is high blood sugar as an indicator, but it is a systemic metabolic disease.

Diabetic eye disease is one of the most common complications, such as cataract, diabetes will not get cataracts, but cataracts with diabetes much earlier. Blindness caused by cataracts can see again, but accompanied by retinopathy not work. Diabetic retinopathy is the prevention of microvascular retinopathy window. We can not understand stage patients, but to know which of the treatment reversible, which is not reversible on treatment. If the fundus lesions in the early stages of new blood vessels do not have a good control of blood pressure, blood lipids, blood glucose and retinopathy, the development will be very slow. But if to neovascularization of long to cause the vitreous in vitreous hemorrhage, macular hemorrhage cover, angiogenesis does not handle, is the culprit leading to blindness. If to the neovascularization period, ophthalmologists recommend that you do when the laser treatment we must not refuse. One can slow the progress of retinopathy, the second effective in preventing blindness. So as diabetes sufferers, or care about a patient's family members should know each of type 2 diabetes should check eyes. If to the neovascularization period, the doctor will be asked to review every three months, if the laser treatment period, the doctor will recommend laser treatment.

The second is diabetic microangiopathy diabetic nephropathy. Because renal vascular structure with similar eyes, so the two lesions were classified as chronic diabetic microangiopathy. Kidney is a very important body organs, with the extension of the course, blood sugar, blood pressure and other metabolic disorder, kidney disease will never to sick to dysfunction. Diagnosis of early renal damage is increased urinary protein excretion. Microalbuminuria testing, hospital out-patient determination is very simple and can detect microalbuminuria excretion rate, thus determine whether early damage. If early damage, to further strict glycemic control, blood pressure to reduce the leakage of trace proteins. The second phase, with trace protein leakage, no pay attention to this warning, kidney damage will increase, a large number of protein leakage, clinical nephropathy started. If you have absolutely nothing to the gradual damage to the function of, damage from proteinuria to function, if not treated, seven to ten years dysfunction may be the end stage phase. Therefore, microalbuminuria kidney damage hope of a positive control, slow to clinical proteinuria, because the clinical proteinuria if not dispose of, will gradually lose function.

In the elderly population is at high risk for diabetes, even without diabetes, heart disease change with age, growth will occur. In addition to other high blood sugar, hypertension, smoking, genetic background and so can cause damage to the heart. However, diabetes is the first killer. Because not only have high blood sugar diabetes, hypertension 60% to 60% can be combined lipid disorders. Therefore, the individual must not only diabetes, a risk factor for high blood sugar, so diabetic patients suffering from coronary heart disease than the general population the risk is much higher. So even without diabetes have to take heart, regular inspections.

Diabetes patients often combined nerve damage, and after the nerve damage, is not sensitive to the pain. Therefore, even with coronary heart disease with diabetes, but can no obvious angina, which is painless myocardial ischemia symptoms, so regular inspection is very important.

In addition to cardiovascular disease have cerebrovascular disease, in addition to dizziness, numbness, serious cause paraplegia.

Treatment of diabetic neuropathy is difficult, from the early to hyperalgesia numb extremities or loss, limited mobility, muscle weakness muscle atrophy, diarrhea, constipation, etc., are all neuropathy syndrome.

Neuropathy and diabetic foot is one of the performance of blood vessels. Changes in diabetic foot is a gradual increase, and finally can go to the amputation process. If the year-round in the hospital, you will suffer from poor conservative treatment of diabetic foot must be amputated, and even some with no amputations when conditions are very painful, we can do is prevention, early prevention of vascular disease.

What is a high risk of diabetes? How to alert? First of all, the family history of diabetes should pay attention to during pregnancy had a great child birth, women have high blood sugar during pregnancy were recorded in the future likely to have diabetes. There usually eat too much fat people, there is a lack of physical activity. Now more cars, computers sitting next to a lot more, never a good thing, people who have central obesity. Now we are really good living conditions, here are younger than me, and also older than me, we all had history of difficult times. Why is diabetes less difficult times? As it can eat too little. Can now eat can be wasted, certainly with chronic obesity. Also the elderly can easily get diabetes.

How to check diabetes? If you suspect diabetes, glucose tolerance test to use, if the random blood glucose diagnostic criteria for mood arrive, you can not do the. What is OGTT? Also known as the oral glucose tolerance test, drink 75g of sugar, sugar kimono with fasting plasma glucose 2 hours after the blood glucose values to judge.

Diagnosis of diabetes has not changed is the value of fasting blood glucose greater or equal to 7.0mmol / l, and / or after a meal is greater than equal to 11.1mmol / l. Random blood sugar diabetes symptoms can be confirmed get this data. No early symptoms of most patients, but blood glucose values have reached the diagnostic criteria for diabetes. 60% of the newly diagnosed with diabetes in the past do not know is sick, so diabetes is an early symptom. In particular, fasting blood glucose in 10mmol / l or less, symptoms are often small, but in fact have high blood sugar endangered.

Now I will introduce the treatment of diabetes.

Diabetes was not to simply control the symptoms. Because some symptoms of disease often say no if you can not take the medication? Not! We are to control high blood sugar, high blood pressure, blood lipid disorders in chronic complications of damage. I have repeatedly stressed that these chronic complication caused by blood sugar, can no symptoms. So pay attention to our aim of treatment of chronic complications. International large sample studies have told us that lower blood sugar in diabetic patients long-term measures that can reduce complications. Medicine now to the era of evidence-based medicine, which means there must be evidence conclusion, evidence from large-scale study. Representative of glycosylated hemoglobin in the blood every three months on average, on behalf of long-term blood glucose and chronic complications, glycosylated hemoglobin decreased by one percentage point each, can decrease the risk of amputation 43%, decreased the risk of renal disease 37% , microvascular disease will reach 21% in the next, and coronary heart disease and other diabetes-related endpoints were reduced by 14%, 12%.

Glycemic control to compliance, first of all glycosylated hemoglobin control to 7%, 6.5% or less if the best. At the same time, if diabetic patients with hypertension, dyslipidemia also compliance. We want patients to reach target blood sugar, etc. Collectively, this can lead to complications in the whole control of risk factors to a reasonable range. In blood glucose, the general hope that the glycosylated hemoglobin test at least 3-6 months once the first three months if the conditions which do not have at least half a year. However, we conducted a survey, a patient has never been unexpected, did not even know there is such a sugar project.

Also point blood glucose, many of us have blood glucose meter, can be determined. Only the point of good blood glucose control, your glycosylated hemoglobin to compliance.

Blood pressure, diabetes and reasonable value should be less than 130/80mmHg. There are two values of lipids is particularly noteworthy, first, the bad cholesterol (low density lipoprotein cholesterol) is less than 2.6mmol / l, if you have diabetes, heart disease, or those who change combined with cerebrovascular disease, low-density lipoprotein cholesterol should be less than 1.8mmol / l. Diabetes patients, to blood sugar, blood pressure, blood lipids with one hand. In the treatment of the first to maintain a healthy, happy psychological, reasonable and scientific way of life. Prevention of mental illness is a social issue to be concerned about diabetes, which currently is not done. Many foreign psychologists, social attention, is also high. We should all hope that the psychological status of diabetic patients were treated for comfort. Because we have quite a diabetic patient with mental illness, or even very clear symptoms of depression. Here is a depression score, often foreign to the patient to rate from time to time. If the psychological barriers are found to answer. Please comfortable with diabetes, "they come, then the security of." Diabetes Although there are so many hazards, but as long as you attach importance to, as long as you have the face of this disease, long-term treatment adherence, we still can control these chronic complications, very good level. They come, the safety of each patient must have the mentality, the mentality of the only way we can live as happy as healthy people. Fortunately, this society has been of concern about diabetes greatly improved, to tell you good news, the Ministry of Health has to be the diabetes prevention, chronic disease management into the agenda of great concern.

Second develop a healthy lifestyle. We have done research in Daqing, as long as a reasonable lifestyle education for all, prevention of diabetes on long-term effects. Lifestyle changes, such as smoking, diet, physical activity, moderate alcohol consumption, we must make the physical and mental health are well guaranteed. Sometimes I am very pleased to see that the streets in the elderly population in walking, dancing, for exercise, which is very good and we hope that we adhere to.

Smoking can damage your body, avoid smoking, we do not explained in detail. Here to give you a balanced diet types, following cereals in the diet can be a little more than vegetables and fruits can be a little more meat, eggs should be fixed, including dairy products, fats should have a reasonable arrangement, each patient should be individualized to your doctor and let them teach you a reasonable diet table. This will enable us at a reasonable diet, to ensure both a good nutritional balance they control blood sugar.

1 bag of milk a day, two (200-250G) carbohydrates. 3 copies of high quality protein per day, a unit of pork quality protein = 1 2 = 2 2 = eggs a fish. Fourth of the crude and refined, not sweet but not salty, frequent meals, seven full. 500G vegetables every day.

Hope that a reasonable exercise, walking, aerobics, exercise is not suitable for everyone, type 1 diabetes and severe chronic complications, we do not want to maintain blood glucose with excessive movement. Campaign is aimed at more moderate obesity, and most people can be mild, half an hour walk a day is enough.

The development of diabetes, an abnormal change is when many people have insulin resistance in diabetes. As a result of this problem, early pancreas to secrete enough insulin also can be compensated, but time Changle on decompensation, and decreased insulin secretion, the glucose output irrepressible, blood sugar, reach the diabetic state. Bad insulin, insulin secretion decreased, leading to high blood sugar, while the large vessels, microvascular complications begins. Therefore, the guidelines in the treatment process will be in accordance with the obese and non-obese type of medication recommended for everyone. However, the insistence is the basis for a healthy lifestyle. Every patient he can do is have a healthy lifestyle, doctors recommend a targeted individual, two, or combined therapy, including insulin therapy, we must find a specialist guide.

Type 2 diabetes at an early stage of course, especially the first 10 years of course, the oral medication is the main therapy, lifestyle control, while the use of oral hypoglycemic agents should be. There are several medicines, a sulfonylurea to promote insulin secretion, nateglinide class, inhibit intestinal absorption of glucose glucosidase inhibitor, increased insulin sensitivity in metformin and thiazolidinediones, tunnel type.

Promote insulin secretion two drugs commonly used sulfonylurea drugs, including D860, glibenclamide, glipizide than the hydrochloride, Gliclazide, Gelie Kui ketone and glimepiride, etc.. In the choice of sulfonylurea drug should pay attention to three issues, if the elderly patients, postprandial blood glucose-based, short-acting drug should be chosen. Renal failure patients can choose gliquidone. Type 1 diabetes, pregnancy, severe liver or kidney dysfunction without use sulfonylureas. Side effects of sulfonylureas is hypoglycemia after overdose. Nateglinide class is short-acting drug, reduced postprandial blood glucose is very effective. Side effects of these drugs, severe side effects of mild hypoglycemia, but does not mean no, so we should pay attention.

The drugs promote insulin secretion is a characteristic effect of these drugs depends on the individual to the endogenous insulin secretion. If the long course of disease, and insulin secretion capacity is very low, the role of these drugs on the very bad. Because drugs can only promote the secretion of insulin, insulin does not promote the synthesis. Glucosidase inhibitors, as well as metformin, especially for overweight patients with diabetes. Can be combined sulfonylurea or insulin. Who can not? There are renal dysfunction, systemic disease, hypoxia can not be used, poor liver function can not be used.

Insulin sensitizers, these drugs especially for poor insulin action in obese type 2 diabetes. Sensitizer in diabetic patients with heart failure can not be used, mainly long-term use, particularly with insulin and may have water and sodium retention, so that worsening heart failure.

On combination therapy, regardless of which type 2 diabetes drug can not be a one pole in the end, the general effect of a single agent in three to five years can be maintained, then long course combination therapy is necessary, more than 10 years of course, half of them should be combined with insulin, which is the progress of the disease, not the drugs themselves, hope that we can understand the problem. Conservative treatment is the traditional ladder therapy, glycosylated hemoglobin control it very well in the higher range are after further treatment, hope to change the concept of early and long-term control of the glycosylated hemoglobin in the 7% .

Therefore, the treatment of oral blood glucose control is a necessary means. We have seen too many lessons, many people repeatedly dressing, did not put sugar in the ideal range, mainly do not know what is the treatment, do not know which drugs have long-term use. And finally to insulin combination therapy phase, please understand that all sufferers. Combined with insulin therapy is mainly self-deterioration of β cell function, oral medication can not always effective, course of disease to a certain extent, there is no condition beyond the control of insulin added. The time required insulin, insulin can control your blood sugar again in a reasonable range. Many people think that playing the insulin, the condition to serious, there is marked insulin dependent, in fact, these are errors. After insulin market for 90 years now, has never been overcome insulin damage after intestinal problems, if one day we can become insulin when oral preparations, we will certainly embrace. I hope that time the inventor can get the Nobel Prize. And final control of blood glucose insulin drug, so I hope we do not because the injection of refusal, it and other drugs is the same.

Extension of type 2 diabetes as the disease, its number of cells secreting insulin decreased, that is why the latter should be combined with insulin in the ground. Because of their poor insulin secretion, the doctor will check patients with β-cell function, will tell you how much secretion, it must be combined with insulin, we have to this point please follow the doctor's treatment. Insulin treatment is to supplement the patient's own insulin deficiency. Extra insulin is not playing, this would particularly like you to understand clearly.

Insulin types is very large, because of the time, I can not tell us a lot of insulin. But to tell you that, through scientific development, through the development of teeth in patients with insulin-company development process of becoming more simple insulin injections. Tips are getting smaller. Each has a special insulin insulin pen is very convenient. Insulin in continuous improvement, also invented the insulin analogues. This is to better control blood sugar in patients, and better acceptance of insulin, creating better conditions.

Finally it should be simple to tell you to conduct self-monitoring of blood glucose. Many patients do not check blood glucose, blood glucose monitoring is very important, if dry mouth symptoms, always get up in the night to urinate at night it is very high blood glucose, so blood glucose monitoring is essential, of course, what kind of person, how to monitor different . Generally moderate blood sugar under no symptoms, so we must monitor, monitoring, provided that you have to know the target. Fasting plasma glucose in the 4-6.1mmol / l among the best, but the elderly can also 7.0mmol / l or so, mainly to prevent low blood sugar. Non-fasting blood glucose control in young patients 8.0mmol / l the following, the elderly can go to 10.0mmol / l or so.

This red graph, fasting glucose, fasting glucose, postprandial blood glucose, blood sugar each point represents the spectrum necessary to control blood sugar all day within a certain range. Of course, we will not ask you more every day so check if you have good blood glucose control, fasting blood glucose do not check every day, two to three weeks time you can check, because changes in range of fasting blood sugar is not so great. If not controlled well, it should be every week, fasting blood glucose records. Postprandial blood glucose depends on the condition, very light type 2 diabetes month investigation two or three times you can, if the disease re, then every 3 days should check blood glucose after meals.

Away from the blind eyes to check, from renal failure to investigate urinary protein, from myocardial infarction, to check ECG, away from the amputation to care for feet, away from the stroke must be good management of hypertension, and smoking. To early detection of diabetes, the skeptics can OGTT, no doubt can be random blood sugar. We can not cure diabetes, but I can tell you that we can control diabetes, help prevent the complications of diabetes patients, it must know. Diabetes really is not terrible, the key is to have a good mentality, seriously.

This is a panoramic view of the Sino-Japanese Friendship Hospital, a very nice hospital. Endocrinology and Metabolism Center staff skill levels high, the attitude of doctors and nurses well. Our diagnosis and treatment of diabetes and endocrine diseases have very high capacity of the technical conditions. If we are willing to go where we are very welcome. We have a variety of clinical and basic diabetes, the characteristics of out-patient treatment, it is also dedicated their services to patients.

Finally, I wish tomorrow will be better!

Breakfast is not conducive to a simple blood glucose control

Health care

Is generally believed that patients with diabetes mellitus, and fasting blood sugar compared to postprandial hyperglycemia larger harm. This is because the human body within 24 hours most of the time in the postprandial state, the real fasting state (after dinner a few hours to early morning before breakfast) shorter. It is not hard to understand, postprandial blood glucose is the key to diagnosis and treatment of diabetes, postprandial blood glucose monitoring and control is even more significant. Many patients found that compared with lunch or dinner meal, blood glucose levels after breakfast, higher, more difficult to control some. Why is this? In addition to blood glucose fluctuations in insulin disorder per se, but also to breakfast with a variety of food to poor.

Traditionally, people eat breakfast are relatively simple, the main food mostly bread, biscuits, bread, steamed rolls, rice, noodles, etc., plus milk, eggs, milk and other simple combinations. The staple food of the common feature is easy to digest and absorb, is the glycemic index (GI) of food higher, so the increase in blood sugar faster and higher level. Healthy people, the use of limited appetite for consumption of these can quickly raise blood sugar, in a timely manner to provide energy for the brain food is a good thing, but glycemic control in diabetic patients is harmful. In addition, compared with the other two meals, most people have a lack of vegetables for breakfast. Vegetables are a major source of dietary fiber, dietary fiber not only in the small intestine can not absorb its own, and interfere with digestion and absorption of carbohydrates. So when mixed vegetables and other food consumption, you can reduce the speed of blood sugar, so that mixed food glycemic index (GI) decreased, thus facilitating the postprandial blood glucose control. Cooking oil used in cooking almost 100% pure fat. With different carbohydrates, fat in the stomach to stay for a long time into the small intestine (empty) slower. Because intestinal absorption of carbohydrates is the main place, so the "water" (high fat) foods, such as cooking, meat, eggs or sugar slower on the glycemic index (GI) lower. Of course, excessive intake of fat should be noted that diabetes is also unfavorable. In addition, the total amount of carbohydrates contained in food is high or low blood sugar level after meal a decisive factor, so the total control of breakfast food, but many are also key.

Based on the above analysis, the control level of blood glucose after breakfast, the measures are:

1. Breakfast food variety not to be too simple to mix a variety of food to eat, especially to with more vegetables, especially the fried vegetables. Note, however, to control the total amount of variety in the diabetic diet plan, no more.

2. Staple food categories to choose glycemic index (GI) lower species, such as coarse grains, mixed beans, whole grains, etc., and is best not to porridge.

3. Konjac, edible fungus, mushrooms and other foods rich in dietary fiber and cereals with food, they help to reduce the mixed diet of postprandial blood glucose levels.

Other measures to reduce energy breakfast accounting for the proportion of days of food; adjust the dosage before breakfast and so on.

Ten Mistakes To Friends of blood glucose control is not satisfactory sugar

Although a considerable number of diabetic patients taking hypoglycemic drugs, but blood glucose control is not ideal, why not?

(1) diet therapy is the basis of diabetes treatment, not for the initial issuance of high blood sugar (such as fasting blood glucose in 8mmol / L below) and type 2 diabetic patients without acute life-threatening complications, first of all be a diet about a month. Such as the control diet, no other special reason, decline or decrease blood sugar is still not satisfied, then considering the selection of antidiabetic drugs.

(2) Some patients do not control the food and service effects to drugs, or would like to serve and not hypoglycemic diet, this is very wrong, even dangerous. Because regardless of whether there are some islet cell function, for newly diagnosed type 2 diabetes, high blood sugar reflects their lack of islet cell secretion of insulin function, restricted diet is aimed at alleviating the burden of pancreatic islet B cells, these cells have a good rest to facilitate their functional recovery. This as suffering from acute hepatitis, gastroenteritis patients need rest and diet (including fasting) has done. Does not control the abuse of oral hypoglycemic diet, just as a sick horse is not moving car, was a set of weight gain (more consumption), and whipping (taking hypoglycemic agents), the result is not only not sick horse pull a cart, but to make a more serious illness or even completely buggered (pancreatic islet B cell dysfunction). Clinical practice has fully proved, not to a good diet this off, oral hypoglycaemic agents often fail.

(3) not to regulate blood sugar levels according to dose. Medication to control high blood sugar. As the patient's blood sugar to rise to a certain extent, there will be more drinking, polyuria, polyphagia and weight loss and other so-called classic symptoms of diabetes, blood sugar is not too high. Such as fasting blood glucose below 13 mmol / L, the majority of there is no feeling of discomfort in patients with (asymptomatic). However, in this state, the development of diabetic disease, can cause a variety of diabetic complications. Although many patients are not satisfied with blood sugar control, but no particular or obvious discomfort, and therefore not under the blood glucose level to regulate the dosage of hypoglycemic agents. From the psychological point of view, patients feel that they have to take drugs, have a sense of security, but in terms of the effect of medication, the patient's medication is void of effectiveness is the more unhappy. Some patients develop serious complications of diabetes due to hospitalization, but also wonder, why not serve a useful drug.

(4) neglect referral or check, do not value the effect of medication. Referral of patients to the hospital or check the few, very few indeed never observed the effect of their medication, do not regularly check your blood glucose, blood lipid and blood pressure, not pay attention to observe the factors that affect their blood glucose. Not pay attention to sum up their own medication rules, but others, and listen to a patient a drug that good and services a medicine, listen to B that B drug in patients with good and switched to drug B is not carefully observed, reviewed less frequently, irregular treatment, it is My diabetic patients with diabetes compared with some developed countries, patients with severe complications and a major cause serious.

(5) that all drugs are effective on their own. In fact, not all patients with diabetes taking oral hypoglycemic agents are effective, easy to understand this in theory, but in practical work is often difficult for patients to accept. China even though a considerable number of diabetic patients taking oral hypoglycemic drugs ineffective or invalid, it is difficult to accept insulin therapy.

(6) frequent replacement drugs. In the body of some sulfonylurea drugs with time prolonged the process of gradually increased. Some patients do not understand this, often taking days or 10 days, see the blood sugar, urine sugar down satisfied, that is eager to change dressings, or that the medication ineffective. In fact, some hypoglycemic agents services to half a month or even a month when the maximum hypoglycemic effect.

(7) on the combination. Each has a maximum effective dose of hypoglycemic agents. The most effective dose is not used (except with drug reaction), do not easily believe that a drug is invalid.

Taking a more rational method: According to blood glucose gradually adjust the dose of hypoglycemic agent services, services to the maximum effective dose of the drug, blood glucose control are not satisfied to be combined with other drugs in a timely manner. But not by applying two similar drugs, such as gliclazide glipizide combined. Almost all drugs have the trade name and chemical name, such as glibenclamide, also known as glibenclamide, gliclazide also called Gliclazide. Many patients not clear, with the right. Proposed to adjust the treatment of patients to consult a doctor, not given a free hand.

(8) antidiabetic drugs more expensive the better. Drug prices is not proportional to its efficacy. Should not be considered hypoglycemic effect of low prices sent forth, the price is high, good medicine. We should not say that this drug must be better than what kind of drug is good, but should be scientific to say which is more suitable for what kind of hypoglycemic agents in diabetic patients. A patient on effective drug is also effective in patients not on B, sometimes B were ineffective or even harmful. Specificity for each patient and choose the most suitable for his drugs, which is a basic principle of rational use of drugs.

(9) one-sided pursuit of specific drugs. Blind pursuit of a considerable number of patients to "go to the root cause of diabetes," the so-called cure for some even in the treatment of certain measures taken for good control of blood glucose has been the case, would rather stop at this stage and effective treatment measures, try to find the so-called energy package cure all diseases, or to the root cause of the "panacea." Some believe that western medicine can only be symptomatic, while the Chinese can go to the root. Some of the side letter qigong remedies. As everyone knows, is now used, including diet, exercise and drug combination therapy of diabetes and diabetic human beings to fight the practice of summary and wisdom, is the result proved the world is indeed effective.

(10) refuse drug treatment. Some were one-sided view that all drugs have side effects, refused necessary medication. Some believe that the medication over time, it will bring damage to the liver and renal function. In fact, the clinical use of hypoglycemic agents, as required in the Pharmacopoeia of the dose range, safety, side effects found only in individual patients. In general, such side effects disappear after stopping the drug will not result in serious consequences to the human body. We can not because the percentage of patients may have side effects and suffer in silence. High blood sugar is not under control and possible side effects of taking drugs compared to the consequences of the former is much more serious. High blood sugar can cause certain complications, particularly high blood sugar can be directly deadly. Very low incidence of side effects, and can be avoided, disappeared after drug withdrawal.