Diabetes mellitus around you and me

Diabetes warning signal

How do you know if you have diabetes? How many of the phenomena listed below do you agree with?

1. Dry mouth, excessive drinking, increased urination and other phenomena, but no obvious reason can be found.

2. Eat more, but lose weight and get tired more easily.

3. Reactive hypoglycemia occurs after meals, which is manifested as fatigue, weakness, sweating, trembling and hunger.

4. Obesity.

5. Family history of diabetes.

6. Women have a history of macrosomia ( the weight of the newborn exceeds 4kg ), recurrent miscarriage or intrauterine fetal death, etc.

7. Repeated skin sores, furuncle and carbuncle.

8. Wound healing is very slow or surgical wounds are not easy to heal.

9. Male impotence. Women often have abnormal vaginal dryness or vulvar pruritus.

10. There are no obvious causes for fatigue, weakness, excessive drinking and urination among children and adolescents.

11. Frequent or repeated infections, such as urinary tract infection, furuncle and mold infection.

12 prone to painless myocardial infarction or unexplained arrhythmia, heart failure.

13. Sudden vision loss or rapid cataract development occurs.

14. The occurrence of unexplained urinary retention, urinary incontinence, and the occurrence of multiple bubbles in urine.

15. Hand and foot numbness of unknown cause occurs, and the sensation decreases or disappears. Walking seems to be stepping on a cotton pad.

16. Prolonged shoulder pain, stiffness, difficulty raising hand and turning shoulder appeared.

17. Stubborn or intermittent diarrhea occurs, which is characterized by defecation 2 – 10 times a day, often occurring after meals, at night or in the morning. The stool is pasty or watery, or is characterized by fatty diarrhea. Diarrhea and constipation can also occur alternately.

18. Repeated occurrence of burn-like skin blisters.

With the above symptoms, it is still uncertain whether you really suffer from diabetes. You should go to the hospital to have an intravenous blood test, and the blood sugar concentration extracted shall prevail. According to the latest diagnostic criteria for diabetes by the American Diabetes Association ( ADA ) in 1997, simply speaking, diabetes can be diagnosed if the blood sugar rises to either of the following two criteria.

Fasting blood glucose ≥7.0mmol/L or blood glucose ≥11.1mmol/L 2 hours after meal

Basic knowledge of diabetes

Diabetes is a chronic systemic metabolic disease, which is mainly a clinical syndrome caused by the interaction of genetic and environmental factors. It is characterized by chronic hyperglycemia, accompanied by glucose, fat and protein metabolic disorders caused by insulin secretion and functional defects.

The clinical manifestations of diabetes include two aspects: first, high blood sugar and more urine sugar cause more than three and less than one, such as eating more, drinking more, urinating more and losing weight; The other is the symptoms caused by complications, such as eye, kidney, nerve, blood vessel and heart diseases, which are lifelong diseases.

Typical clinical manifestations of diabetes are as follows:

1. polyuria, polydipsia and polydipsia

Due to the increase of glycosuria and urine osmotic pressure, the reabsorption of water in renal tubules decreases and the urine volume increases. The total volume in a day is usually more than 2 – 3 liters, and occasionally more than 10 liters. The severity of polydipsia, polydipsia and polydipsia is proportional to blood sugar concentration, urine sugar and urine volume.

2. Be good at hunger and eat more

Because a large amount of glycosuria and sugar are not fully utilized, accompanied by high blood sugar, islet secretion is stimulated, appetite is often hyperfunction, and hunger is easy. If the patient’s appetite drops suddenly, even anorexia, one should be alert to complications such as ketosis and acidosis.

3. Fatigue, emaciation and weakness

Due to sugar metabolism disorder, reduction of high energy phosphate bonds, negative nitrogen balance, water loss, severe cases have ketoacidosis and electrolyte imbalance, patients are susceptible to fatigue, weakness, gaunt face, listlessness, weight loss, etc. Long – term sick children are short and thin, with sallow complexion, dry hair, stunted growth and weak physical strength.

4. Skin itching

It is mostly seen in female pudendum and is mostly caused by urine sugar stimulation. Sometimes fungal vaginitis such as candida albicans can be complicated, pruritus is more serious, often accompanied by a large amount of leucorrhea and other secretions.

5. Other symptoms

There are soreness of limbs, numbness, lumbago, hyposexuality, impotence, infertility, menstrual disorder, constipation and vision disorders. Complications such as cardiovascular, kidney, brain, eye, muscle and joint can often occur in patients with long course of disease and serious illness. The liver can also swell and recover after appropriate treatment. A few patients can see yellow skin and carotene blood disease, etc.

Early mild symptoms are usually asymptomatic, and when the condition is severe or out of control, there are typical clinical manifestations such as thirst, polydipsia, polyuria, polyphagia and weight loss. Laboratory examination can find hyperglycemia and diabetes. Some patients have diabetes only when complications occur.

Common typing

Diabetes mellitus can be divided into Type 1 DiabetesMellitus and Type 2 Diabetes Mellitus according to its pathogenesis.

Type I diabetes patients: insulin secretion is insufficient, so excessive glucose in blood cannot be converted into glycogen, resulting in long-term hyperglycemia. Type 1 diabetes mostly destroys insulin-secreting β cells in pancreas due to dysfunction of autoimmune system. The reason is not fully understood, and it may also be related to heredity and virus infection.

Type II diabetes patients: At first, insulin secretion was mostly fine, mainly due to the decrease of insulin sensitivity of target cell and receptors distributed in muscles and fat in the body, forming insulin resistance, which made cells unable to effectively absorb and utilize glucose, resulting in excessive sugar accumulation in blood.

Regarding the etiology and pathogenesis of diabetes mellitus,

For now,

It is mainly related to the following factors:

Factors Causing Diabetes

hereditary factor

At present, most people think that diabetes is a hereditary disease. The incidence rate of diabetes is significantly different between blood relatives and non-blood relatives. The former is 5 times higher than the latter. The importance of genetic factors in the etiology of diabetes type I ( insulin dependent ) is 50%, and the importance of genetic factors in diabetes type II ( non – insulin dependent ) is more than 90%, so the genetic factors causing diabetes type II are significantly higher than diabetes type I.

Mental factor

Mental tension, emotional excitement and various stress states will cause a large amount of secretion of hormones that raise blood sugar, such as growth hormone, norepinephrine, glucagon and adrenocortical hormone.

Obesity Factors and Decreased Physical Activity

At present, obesity is considered to be an important inducing factor of diabetes. About 60 – 80% of adult diabetes patients are obese before onset, and the degree of obesity is proportional to the incidence of diabetes. Some studies believe that the ratio of muscle to fat can affect the incidence of diabetes when physical activity decreases with age. Between 25 and 75 years old, muscle tissue gradually decreases, which is one of the main reasons for the obvious increase of diabetes in obese elderly people.

Long-term malnutrition

Excessive and uncontrolled diet and overnutrition overburden the potentially dysfunctional insulin beta cells and induce diabetes.

Infection

Some studies believe that there is a significant relationship between juvenile diabetes and viral infection. Infection itself does not induce diabetes, but only makes invisible diabetes visible. Other studies suggest that enterovirus, mumps virus, rubella virus, etc. can cause damage to islet β cells and lead to type I diabetes.

Pregnancy

Some experts believe that the number of pregnancies is related to the onset of diabetes, and multiple pregnancies are easy to induce diabetes.

Genetic factor

At present, researches believe that diabetes is caused by several gene damages: type I diabetes is HLA-D gene damage on the short arm of chromosome 6; Type II diabetes is the damage of insulin gene, insulin receptor gene, glucose lyase gene and mitochondrial gene. Diabetes is a genetic disease.

Misunderstanding of diabetes diet Q&A

Q: Is it beneficial and harmless to eat more vegetarian coarse grains?

A: Generally speaking, vegetarian coarse grains ( such as millet, purple rice, sorghum, oats, buckwheat, wheat bran, etc. ) contain more dietary fiber and have the effects of reducing blood sugar, lipid and constipation. However, eating too much coarse grains may increase the burden on the gastrointestinal tract and affect the absorption of nutrients, resulting in malnutrition.

Q: Is it correct to say that it is no harm to eat more sugar-free food?

A: The so-called sugar-free foods generally refer to foods that do not contain sucrose or are replaced by other sweeteners such as xylitol. These sweeteners are low calorie sugars or do not produce calorie sugars. But sugar-free biscuits, sugar-free bread and so on are still made of grain, and these foods will also be converted into glucose in the body and cause blood sugar to rise. Therefore, this kind of food should still be included in the total calorie range and should not be eaten in excess.

Q: Without the symptoms of ” more than three and less than one”, is there no diabetes?

A: The so-called ” more than three and less than one” symptoms refer to: more drinking water, more food intake, more urine and less weight. In fact, many patients with diabetes do not necessarily have typical symptoms of more than three and less than one. Patients with diabetes of different types and different disease stages may have symptoms of different severity, and may also have other clinical manifestations, such as skin pruritus, unknown spots, and persistent difficulty in healing after skin injury, which may all be signs of diabetes. Therefore, whether or not to suffer from diabetes is mainly confirmed by blood tests in addition to symptoms.

Q: Is it true that young people will not suffer from diabetes?

A: Urban life rhythm is tense, work pressure is great, diet habits often contain high fat, high protein, high calorie food, plus more sitting, less exercise, irregular diet, often see more than 40 years old was diagnosed with diabetes, so young people may not be without diabetes.

Q: The less rice you eat, the better for controlling diabetes?

A: Some people believe that the less rice you eat, the more effective the disease control will be. In fact, insufficient intake of staple foods ( rice, noodles, etc. ) will lead to other complications of diabetes and may aggravate the disease. This is because the reduction of excessive staple food can lead to total calories unable to meet the metabolic needs of the body, resulting in excessive decomposition of body fat and protein, emaciation, malnutrition, low disease resistance, easy secondary infection, hypoglycemia, and even starvation ketosis, endangering life.

Therefore, the staple food should not be excessive, nor should the less the better. It varies from person to person and should be taken appropriately. The average daily carbohydrate intake is 200 – 250g for women and 300 – 350g for men.

Q: Do you have any hypoglycemic drugs in your hand and don’t be afraid to eat more?

A: Some patients think that their appetite has increased, and they can offset it by taking more hypoglycemic drugs. This is a wrong idea. Because, overeating, can increase the burden of the pancreas, and drug overdose will increase drug toxicity and side effects; The treatment of diabetes is a comprehensive treatment, which cannot be solved by drugs alone. Attention must also be paid to diet control, diet therapy, moderate exercise, emotional stability, etc. in order to achieve the effect of controlling blood sugar and stabilizing the disease.

Q: Should diabetics eat less food and more meat?

A: Some patients think that diabetic patients should eat less rice flour and other foods, and eat more meat, eggs, tofu and other high protein foods, which will not cause blood sugar rise, but also can nourish the body.

In fact, although the sugar content of meat, eggs, fish and tofu is not high, they are rich in protein and fat and can still be converted into glucose in the body, so eating more will also raise blood sugar, only slower than staple food. If diabetic patients take a high protein diet for a long time, the pressure in glomerular capillaries will increase, causing glomerular hyperfiltration, aggravating glomerular work burden, causing glomerular filtration membrane damage and glomerular sclerosis. Excessive protein metabolites ( toxic and waste ) urea nitrogen will need to be filtered out through glomerulus, thus increasing renal burden and possibly damaging renal function.

Generally speaking, the daily protein intake of diabetic patients should account for 10 – 15% of the total calories, i.e. equivalent to 0.8 – 1.2g per kilogram of standard body weight per day, so as to reduce the kidney burden and protect the kidney.

Q: Is it correct to say that eating animal oil should be strictly controlled while oil is harmless?

A: Some people think that eating more animal oil such as lard and tallow is harmful to health. Oil is a healthy food, so eating more is no harm. In fact, neither animal oil nor oil is fat, and fat is a high-calorie food. Eating too much is easy to exceed the daily total calories and affect the control of blood sugar. In addition, long-term excessive intake of fat will also increase body weight, resulting in decreased insulin sensitivity in the body.

Q: Sweet fruits contain too much sugar and are not suitable for eating?

A: Generally speaking, fruits are mostly sweet and contain a lot of sugar. They have long been excluded from diabetes foods. In fact, eating various fruits properly is very beneficial to diabetic patients. Fruits are rich in vitamins, minerals and other nutrients and cellulose, which are essential nutrients for human health. Therefore, when blood sugar is under control, fruits should be eaten appropriately.

The carbohydrate content of various fruits is about 6 – 20%. Fruit with relatively low sugar content and relatively slow blood sugar raising speed should be selected. Generally speaking, watermelon, apple, Sydney, kiwi and other fruits have low sugar content and are suitable for diabetic patients. However, bananas, red dates, litchi, pineapple ( pineapple ), grapes and other high sugar content, should not be eaten more. In general, even if you eat fruits with relatively low sugar content, you should reduce the staple food to keep the total daily calorie intake unchanged.

Q: Can you eat more food marked ” sugar – free” on food packaging?

A: There are many ” sugar – free foods” in the market, such as sugar-free cakes, sugar-free chocolate, etc. In fact, sugar-free food refers to sweet food that does not contain sugar, i.e. sucrose and starch sugar ( glucose, maltose, fructose ), and it contains sugar substitutes such as sugar alcohol, including xylitol, sorbitol, maltitol, mannitol, etc. Although these sugar-free foods do not contain sucrose, the foods themselves contain starch and still have calories. Therefore, some people will still have blood sugar increase after eating. Therefore, when eating sugar-free food, it is necessary to calculate its calories into the total calories of staple food so that blood sugar can be stable.

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