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.

How to control blood sugar increase

Diabetes has become a hazard to human health is one of the three diseases, extremely harmful to human health. Diabetes is due to inadequate secretion of human insulin or insulin-producing cells caused defects in metabolism of glucose, protein and lipid metabolism in the quality of a syndrome, high blood sugar as the main clinical sign. In people's living standards are improving the occasion, all the food on the table certainly abundant than usual, unconsciously on the carbohydrates (sugars), protein, fat, carbohydrate intake will increase, resulting in blood sugar rise high.

How to avoid blood sugar too high? In addition to develop good habits, proper work and rest, eating sparingly, drink less, smoke less, the modern medical research also found that taking propolis can control blood sugar. Direct effect of propolis on diabetes is mainly:

1, the rich propolis flavonoids, terpenes and other active component (such as catalpol pterostilbene) alone or work together with significant decrease of blood sugar, but has no effect on normal blood sugar.

2 diabetes is most often associated with high blood lipids. Abundant flavonoids in propolis have a good role in regulating blood lipids, improve blood circulation, anti-oxidation, protection of vascular function, and could well prevent the emergence of diabetes syndrome.

3, propolis flavonoids can play a role in activation of cells for tissue regeneration, on the occurrence of pathological cells and tissues to treat and repair, could mutate to repair the insulin cells.

4, diabetics often have a variety of inflammation and complications. Terpenes Propolis ingredients have good antibacterial, anti-inflammatory effect, greatly reduce and avoid complications.

In addition, propolis also enhance immunity and significantly improve the efficacy and restore physical function, diabetes played a very good adjuvant effect. Therefore, propolis is ideal for controlling blood sugar.

Intensive blood glucose control measures

Body is in stress, the body a variety of elevated blood sugar hormones such as adrenaline, glucocorticoid, glucagon, growth hormone significantly increased, leading to stress hyperglycemia, which is especially evident in diabetic patients. Critically ill surgical patients, regardless of history of diabetes, this time there is always insulin resistance and hyperglycemia. In recent years, the hospital is combined with intensive insulin therapy in critically ill patients in clinical trials of glucose control in these patients and treatment goals.

Blood sugar control standard of concern

2001, van den Berghe, Belgium, etc. of Leuven found that strict control of critically ill surgical ICU patients with glucose in the normal range (4.4 ~ 6.1mmol / L) can reduce mortality, the results were published, caused widespread concern. However, van den Berghe, a study such as the subsequent medical ICU outcome in critically ill patients have shown that intensive treatment group the main outcome indicators of hospital mortality (37.3%) and the conventional treatment group (40.0%) was not significantly decreased, but intensive treatment can reduce the incidence of complications, shorter mechanical ventilation time and hospital stay.

Diabetes treatment guidelines in many countries are included in the results of the study. 2009 American Diabetes Association (ADA) guidelines for blood glucose control in critically ill patients required as close as possible 6.1mmol / L. 2007 version of the Chinese type 2 diabetes prevention and treatment guidelines have also pointed out that the need for intensive care after surgery or mechanical ventilation in patients with high blood glucose (> 6.1mmol / L), by continuous infusion of insulin and blood glucose control as much as possible in the 4.5 ~ 6.0mmol / L range can improve the prognosis; but also that the more conservative target blood glucose (6.0 ~ 10.0mmol / L) in some cases more appropriate.

Strict control of blood sugar risk

Similar studies (such as GLUCONTROL, etc.) were found in critically ill patients Intensive Glucose did not benefit, VISEP studies or even because of strengthening the control of blood glucose group, the incidence of low blood sugar is too high and forced an early halt. 2008, published in "JAMA" A meta-analysis has drawn a different conclusion, namely, for critically ill patients, and strengthen control of blood sugar has nothing to do with hospital mortality, and increase the risk of hypoglycaemia, but can reduce sepsis the risk.

March 2009 "New England Journal of Medicine" published in the NICE-SUGAR trial results, the findings Leuven questioned. The pilot selected the 6104 total of comprehensive surgical critical patients were randomly divided into the intensive blood glucose group (n = 3054) and conventional blood glucose group (n = 3050). Intensive Glucose blood glucose control in the 4.5 ~ 6.0mmol / L, conventional blood glucose blood glucose control in ≤ 10.0mmol / L. 90 days showed enhanced mortality was higher than the conventional hypoglycemic hypoglycemic group (P = 0.02), and the incidence of severe hypoglycemia (6.8%) compared with conventional blood glucose group (0.5%) was significantly higher (P <0.001 ). The results of the ICU glucose control in critically ill patients have a significant impact strategy would negate the strict control of blood glucose in critically ill patients in clinical strategy.

Critically ill patients with different blood glucose goals and prognosis, further study reveals. In short, the goal blood glucose control in critically ill patients is inconclusive, but should prevent the two extremes, that is, uncontrolled high blood sugar, or too stringent control of blood sugar.

Consensus of foreign blood glucose control

NICE-SUGAR study findings, experts on the glycemic control in critically ill patients is extremely concerned about the consistent view is that blood glucose control can not be too strict. American Medical Association and the American Diabetes Endocrine Society (AACE / ADA) jointly issued a consensus of inpatient glycemic control, indicating that their current views of handling these patients. Points are as follows:

Glycemic control in critically ill patients with blood glucose in critically ill patients 1.ICU continued> 10mmol / L, they should start insulin therapy. 2. If for insulin treatment for most patients blood glucose should be maintained at 7.8 ~ 10.0mmol / L. 3. Insulin infusion to control blood glucose in critically ill patients and to maintain the ideal treatment. 4. Recommend effective and safe use of insulin infusion program to reduce the incidence of low blood sugar. 5. Must closely monitor blood glucose, blood sugar control in order to achieve the best results and to avoid hypoglycemia.

Non-hospital glycemic control in critically ill patients hospitalized at present no information on blood glucose control in patients with non-critical prospective, randomized controlled trials reported. Recommendations are as follows: 1. Recommended for non-critical patients insulin treatment, in compliance under the premise of safe fasting blood glucose should be as much as possible <7.8mmol / L, and random blood glucose <10.0mmol / L. 2. Of the hospital before the strict blood sugar control and blood sugar stable patients, strict glycemic control is appropriate. 3. On dying patients, or those who suffer from a variety of serious diseases, control of blood sugar should not be too strict. 4. Recommended subcutaneous injection of insulin, combined with blood sugar level, eating and other factors, to achieve and maintain blood glucose control targets. 5. Does not encourage use of adjustable amount of insulin infusion devices for the hospital's single insulin therapy. 6. On the need for treatment of high blood sugar most of the hospitalized patients were not suitable for non-insulin antidiabetic therapy.

Treatment of hyperglycemia in critically ill patients should be evaluated and adjusted every day to ensure the smoothness of blood glucose. Blood sugar can be used to predict the volatility of ICU mortality. High blood glucose variability is ICU strong predictor of death in patients with elevated blood sugar mean the combination of forecasting more efficient. Even if the blood glucose concentration is higher, lower blood glucose variability also has a protective effect.

Postprandial blood glucose Gaoyao "cored"

The general blood sugar control mainly depends on fasting and postprandial blood glucose levels, both of compliance, be considered a good control, but all diabetics know, to let the two goals are to meet the requirements, is not an easy thing .

Diabetes in particular the development of type 2 diabetes is a long process, early to go through with impaired glucose tolerance (IGT) stage, two-hour postprandial blood glucose ≥ 7.8 mmol / l and <11.1 mmol / L phase. Postprandial hyperglycemia with the high incidence of impaired glucose tolerance to type 2 diabetes, the percentage of change on high, and the occurrence of major cardiovascular and cerebrovascular disease risk factors. IGT in the population and thus were detected, active control, the reduction of type 2 diabetes and macrovascular complications, with important strategic significance.

Abnormal glucose metabolism in a large number of long-term prospective study of the confirmed diagnosis of postprandial plasma glucose levels were consistent with diabetes-prone diabetes microangiopathy (retinopathy, nephropathy), when postprandial blood glucose> 11.1 mmol / l, if the meal two-hour glucose of 2 mmol / L, total mortality can be reduced by 1 / 3. Which is consistent with IGT, diabetes microangiopathy rare, but large vessel disease and related risk factors had emerged at this stage. When the postprandial blood glucose> 7.8 mmol / l, postprandial blood glucose two hours of 2 mmol / L, total mortality can be reduced about 1 / 4. Present study found that postprandial hyperglycemia is an independent risk factor for cardiovascular death. Postprandial blood glucose levels two hours better than the fasting glucose to predict the incidence of coronary heart disease, and all-cause mortality and cardiovascular disease mortality increased in the.

In the IGT stage, if taken to a number of interventions, can make the IGT to diabetes is not converted, or even a return to normal glucose tolerance. In the IGT population control postprandial hyperglycemia can reduce the incidence of myocardial infarction.

Most common two-hour postprandial blood glucose lowering the simple way is to change the way of life: a reasonable scientific diet, doing exercises, weight reduction diet are light, in particular, to reduce abdominal fat, is a fundamental measure for prevention and treatment IGT. If not controlled by the treatment of postprandial blood glucose, you need to increase use of medication.

The general blood sugar control mainly depends on fasting and postprandial blood glucose levels, both of compliance, be considered a good control, but all diabetics know, to let the two goals are to meet the requirements, is not an easy thing .

Most people with diabetes, and even doctors, are often only concerned with fasting blood glucose at the expense of postprandial blood glucose control. Recognizing the importance of postprandial blood glucose control on the overall blood sugar control is very helpful.

Tears can also be detected with blood sugar?

According to the latest research shows that the United States, tears which also contains sugar, sugar in the detection of tears can also accurately reflect blood glucose levels.

The latest research shows that the tears of diabetic patients also contain sugar and can be very accurately reflects the blood sugar level.

According to Reuters, the United States Institute of Ophthalmology, Indiana, Dr. Chatterjee 200 patients studied, hoping to find the tears and blood that may exist between the various connections. The results, Dr. Chatterjee found that tears in the sugar content and sugar content is very close. Not only that, when the body's blood sugar levels change, the tears in the sugar content will also change accordingly.

For diabetic patients, this is good news, because the cost of tears sugar testing should be far lower than blood tests, and does not hurt. Dr. Chatterjee hoped that continuously improve the technology to be extended to a wider range.

Glycemic control do not fall into 4 major errors

Recently, in the hospital 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

Understanding and knowledge of diabetes, and found in the full exchange of questions and draw conclusions, and ultimately implement the behavioral change, effective control of diabetes.

According to Professor Guo Xiaohui, director of the Hospital of Endocrinology 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. 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 " know the elements ", though that diet therapy is an important means of controlling blood sugar, insulin that need smaller meals to reduce the burden of control of the disease development, but lowering blood sugar in diabetic there are still a lot of misunderstanding.

Myth # 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. If 55-75, should control the consumption, a high index of 75 or more 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, the concern over the health of consumers or not to rely 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 not only yangkeng, little sugar, little impact on blood sugar, contain fat is 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 large number 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 first affirmative 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 the cause of gastric cancer is to eat less, but eat less true Shang Wei. "

Blood sugar control can stop medicine?

The answer to this question is not.

Many people with diabetes to make this mistake, but don't forget your blood sugar is normal in the drug help normally, so you a withdrawal glucose immediately to rebound, and this is the first rally more difficult time adjusting treatment. And everyday life situation of stress, such as blood will increase mood swings, insomnia, fever, overworked, etc can affect blood glucose, so must note glucose normal don't stop. Before we can to diagnose diabetes patients said, you can not take medicine, reasonable diet, exercise, blood sugar to normal can not take medicine. Now some overseas study proves that is in reasonable diet, exercise, under the premise of maintaining good blood glucose after a long time, so that islet function. So now, the view of newly diagnosed type 2 diabetes will in reasonable diet, exercise and medication, as soon as possible. Because of the medicine after eating choice space with bigger, can improve the quality of life of patients with diabetes, so early, medicine, insulin early may delay the occurrence and development of the complication.

At present, no cure diabetes. Using diet therapy, exercise therapy, oral medication, insulin and TCM therapy, can effectively control condition, but also cannot effect a radical cure diabetes. Those so-called can cure diabetes is not the panacea. Even some patients after proper treatment, clinical symptoms disappeared, sugar, NiaoTang normal, as normal person to work and Labour, if do not pay attention to take food does not control or not according to the requirement, physicians, still can appear hyperglycemia and NiaoTang. Therefore say, diabetes is permanent illness, treatment, even to insist for a long time to get ideal condition, we must adhere to control diet and exercise therapy, medicine, and regularly check to the hospital.

If blood glucose control, no long-term chronic high condition can lead to chronic complications, such as diabetes, heart disease, cardiovascular disease, kidney disease, eye lower lesions, etc. Additionally, if in the short-term fluctuations in bad also rising. For example, a dramatic increase in blood sugar in the short term can lead to coma, is a potentially lethal. If blood sugar in a short time, low seere hypoglycemia, also can cause patients to occur, it is fatal hypoglycemic coma.

Diabetes is a touchstone diabetes treatment, or the mirror. Because we have diet, exercise therapy, and drugs to doctors and patients between closely, all these achievements are needed by long-term glucose self-monitoring to test. So, we hope all the patients with diabetes, and good blood glucose control keep proper treatment, don't think glucose down, disease is not.

To keep the awareness of diabetes, it is a may impair the health of the "tiger", a cage will have the opportunity to cut out to shut the cage does not relax.