Sunday, July 18, 2010
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!