Everyone is afraid of diabetes because the incidence of diabetes is around 10%, which means that more than 100 million of us in China will have diabetes, and this is particularly significant in relation to the fact that we are getting richer and richer as a country, and our lifestyles are changing.

My father was diabetic, my grandmother was diabetic, so I could develop diabetes after middle age or old age, and that's at least a lot more likely than most people to get it.

The scary thing about diabetes is that it can cause serious complications. For example, it can cause cardiovascular, cerebrovascular and lower limb vascular occlusion, diabetic nephropathy, blindness, foot necrosis, amputation, and so on.

Vascular surgery is directly related to the diabetic foot, and hemodialysis is very much related to diabetic nephropathy.

Unfortunately, there is no cure for diabetes, but diabetes can be controlled by a variety of treatments, because the complications of syrup mainly come from poor blood sugar control, then how to control the main contains five aspects.

Patient education in diabetes mellitus

II Self-monitoring of blood glucose

Three dietary treatments

IV Exercise therapy

V. Drug therapy

We can also simplify it to the triad of diabetes treatment diet and exercise plus medication.

You can't have one without the other.

Medication also requires the help of a doctor to help make judgments to help choose the right medication to match. Generally include all kinds of oral medicine and insulin, we should not be afraid of insulin. Insulin is a very effective drug, before many patients will mention that after taking insulin will be addicted, after a long time will not work, in fact, there is no such thing. The invention of insulin is a landmark event in the treatment of diabetes and has provided good protection to a large number of diabetics.

Dietary treatment is the basis of treatment for all types of diabetes, and a proportion of sober diabetics can control their condition relatively well with diet alone.

Exercise can increase the body's sensitivity to insulin, lower body weight, reduce body fat content, enhance physical strength and improve work capacity and quality of life, you can choose to walk walking running or swimming and other types of ways.

The diagnosis of diabetes mellitus is mainly based on fasting glucose level (FPG) and 2-hour postprandial glucose tolerance test (OGTT). Below are the World Health Organization's diagnostic criteria for abnormal glucose metabolism and diabetes.

The slightly high blood glucose described by this friend may belong to abnormal glucose metabolism, which has not yet reached the standard of diabetes mellitus. Therefore, you need to pay attention to the following aspects to control your blood sugar and avoid progressing to diabetes.

1 Health education on diabetes

Since diabetes is a lifelong disease, the patient's behavior and self-management skills are also critical to the success of diabetes control. Every patient with diabetes should receive diabetes education as soon as he or she is diagnosed, and the goal of this education is to enable patients to fully understand diabetes and acquire diabetes self-management skills. The goal of this education is to enable patients to fully understand diabetes and acquire self-management skills. The content of this education includes instruction on diet, exercise, blood glucose monitoring and self-management skills.

2 Nutritional therapy

All patients with diabetes and pre-diabetes need to receive individualized medical nutrition therapy, which is done under the guidance of a dietitian familiar with diabetes treatment or an integrated management team (including diabetes educators). The patient's nutritional status should be assessed and reasonable goals should be set to control the total energy intake and to distribute various nutrients in a rational and balanced manner to achieve the patient's metabolic control goals.

(1) Control of fat intake

a Dietary energy provided by fat does not exceed 30% of total dietary energy.

b Saturated fatty acid intake should not exceed 7 per cent of total dietary energy, and trans-fatty acid intake should be minimized (trans-fatty acids may be used in oily foods that have a very tangy, crunchy or smooth texture, such as cookies, chocolate pies, custard pies, pudding cakes, candies, ice cream, etc.).

c Daily dietary intake of cholesterol should not exceed 300 mg.

(2) Carbohydrate intake

Measurement of carbohydrates is a key component of glycemic control. Dietary carbohydrates should provide 50% to 60% of total energy. Sugar alcohols and non-nutritive sweeteners can be consumed in moderation by people with diabetes. Eat regular meals daily and try to keep carbohydrates evenly distributed.

（3) Protein intake

In diabetic individuals with normal renal function, the recommended protein intake is 10% to 15% of the energy supply ratio, and it is advisable to limit protein intake to 0.8g per kg of body weight per day in patients with proteinuria.

(4) Alcohol intake

Alcohol is not recommended for people with diabetes. If alcohol is consumed the total energy contained in the alcohol should be calculated. Do not drink more than 15g of alcohol per day for women and 25g for men (15g of alcohol is equivalent to 450ml of beer, 150ml of wine or 50ml of low proof liquor). No more than 2 times a week. One should be alert to the possibility of alcohol-induced hypoglycemia and avoid drinking on an empty stomach.

(5) Salt intake

Salt intake is limited to less than 6g per day, and patients with combined hypertension should be even more severely restricted.

3 Exercise therapy

Adults with diabetes should get at least 150 min per week (e.g., 30 min of exercise 5 days per week) of moderate-intensity (50% to 70% of maximum heart rate, exercising a little too hard, with increased but not rapid heart rate and breathing) aerobic exercise.

Moderate intensity sports include brisk walking, tai chi, cycling, table tennis, badminton and golf. More intense sports are dancing, aerobics, jogging, swimming and cycling uphill.

4 Blood glucose monitoring

Blood glucose testing, which should be carried out at home by people with diabetes, is used to understand the level of control and fluctuations in blood glucose. This is an important measure for adjusting blood glucose to meet targets and reducing the risk of hypoglycemia.

5 Drug treatment

Type 2 diabetes is a progressive disease. During the disease progression of type 2 diabetes, pancreatic β-cell function declines progressively with the duration of the disease and the degree of insulin resistance changes little. As a result, reliance on exogenous means of glycemic control gradually increases as the disease course of type 2 diabetes progresses. Clinical treatment with oral medications and a combination of oral and injectable hypoglycemic agents is often required.

In addition, people with diabetes should quit smoking. This is because smoking is associated with an increased risk of tumors, diabetic macrovascular disease, diabetic microangiopathy, and premature death. Studies have shown that smoking cessation in patients with new-onset type 2 diabetes can help improve metabolic markers, lower blood pressure and albuminuria. To avoid complications of diabetes, people with diabetes should quit smoking.

The above 5 areas are the 5 carriages of diabetes prevention and treatment. By starting with these areas and paying attention to them, the progression of diabetes and complications can be controlled, thus improving the quality of life of patients and prolonging their lifespan.

Diabetic patients to control blood sugar, should follow the principle of the five carriages of sugar control, to do from diet, exercise, drugs and other aspects of common control of blood sugar:

1, diet: is the basis for controlling diabetes, because food intake will bring energy intake, sugar lovers can effectively control postprandial blood sugar if they can master the principles of dietary treatment. Dietary principles are: control total energy intake, reduce the intake of high-energy foods, and increase the intake of foods rich in dietary fiber, such as whole grains, vegetables, etc., drink more water, reduce salt intake, daily salt intake should be controlled within 6 grams.

2, exercise: exercise can increase the body's consumption of fat, glucose, which can effectively reduce blood sugar, blood fat, etc., is one of the essential measures for diabetic patients to control blood sugar. When sugar patients should pay attention to the amount of exercise is not too large, if the intensity of exercise is too large, easy to lead to elevated blood glucose; do not exercise on an empty stomach, fasting exercise is easy to lead to hypoglycemia; sugar patients are suitable for moderate-intensity aerobic exercise, weekly exercise time of at least 150 minutes or more, and perseverance.

3、Drugs: If you can't control your blood sugar through diet and exercise, you need to use hypoglycemic drugs under the guidance of your doctor, and sugar lovers should pay attention not to choose their own drugs.

Diabetes is to some extent the result of a poor lifestyle, and diabetes treatment must have a combination of sensible diet, effective exercise and medication. Complete reliance on medication will not bring blood sugar under control, and people who know how to live, that is, who know how to eat, drink, play, and have fun, will be able to control their blood sugar.

First of all, eat, three meals regular diet is the prerequisite for sugar control, and irregular diet or overeating, can lead to high and low blood sugar, can not meet the standard. Ingredients, you should choose low sugar content, rich in fiber vegetables, as well as the role of blood sugar regulation of bitter melon, fungus, carrots and onions, etc., cooking methods, you should use steaming, cold and other methods with less salt and oil. Food is not unable to eat, but to control from the amount, which is really will eat.

Besides drinking, mainly drinking water, green tea, pu-erh can also be, green tea contains vitamin C and vitamin E, etc., often drink is conducive to the prevention of cardiovascular disease. As long as the tea is not too strong, diabetics can drink it. Coffee contains a variety of nutrients, but its calories are higher than tea, black coffee without sugar is drinkable. Milk and soy milk contain a lot of protein and other nutrients, milk can also supplement calcium, the elderly, especially for women is very favorable. If the blood sugar reaches the standard, women can drink no more than 15 grams of alcohol per day and men no more than 25 grams. Sugar-sweetened beverages are a good thing to have on hand to prevent hypoglycemia.

The so-called play refers to exercise, and first of all, we should choose suitable and favorite exercise methods, such as walking, jogging, Tai Chi, dancing, swimming and other moderate-intensity exercise, about 30 minutes each time, no less than five times a week, and long-term persistence. Some patients can get good control of their blood glucose through reasonable diet and effective exercise, and even reduce the amount of medication. Therefore, exercise is conducive to the treatment of diabetes.

About joy, is to have an optimistic and positive mindset, since you have diabetes, a comprehensive understanding of diabetes knowledge, treatment and medication precautions, take the initiative to closely cooperate with the doctor to monitor blood glucose laboratory indicators. Let yourself live a normal life, relax yourself in regular exercise every day, do not stay up late, regular sleep, regular life and routine, can control blood sugar stable.

There is a saying "Diabetes is not a disease, it's just a reminder to change your lifestyle from now on. "

If you find this article useful, you are welcome to follow and re-post it, ask questions and add to it, and talk to each other to improve.

References:

[1] Liu, Chunrong. Learning to Eat, Drink and Have Fun Controlling Blood Sugar. Medication and Health (South Central Pharmacy). 2017.08.

By Cui Xifeng Clinical Pharmacy, Fengtai Hospital, Beijing 8.30.2018

Drugs.com authoritative interpretation, unauthorized reproduction, plagiarism will be prosecuted

After diet and exercise, we also have very effective medications to control high blood sugar, called oral hypoglycemic agents, or injectable medications, including the classic injectable medications such as insulin, or the current GLP-1 agonists. These medications, used singly or in combination, can be very effective in controlling high blood sugar, and they can also help to control blood sugar.

In type 1 diabetes, we have no choice but to use insulin, and in type 2 diabetes, we start with oral medication, and then we add insulin if the oral medication doesn't work.

Type 2 diabetes is a progressive disease, and at a certain point in the disease, even in the early stages of the disease, when the blood sugar is very high, we tend to put the patient on insulin, and after the insulin treatment has relieved the blood sugar, we can switch to oral medication, and then we can switch to oral medication, and we can switch to oral medication.

But for most patients, we can start with oral medication because diabetes is a progressive disease and as the disease progresses, the body produces less and less insulin, and insulin resistance may become more and more severe, and at that point, the body's ability to control blood glucose will decline, and we'll have to use medication to help the body further control blood glucose.

So at a certain stage, when the oral medication fails, we have to add insulin to the oral medication, and many people are afraid to inject insulin, and think that insulin means that the disease is more serious. It's true that often when a patient uses insulin, it's when the oral medication doesn't work, but it doesn't mean that the disease is more serious, because if you've always had good glycemic control, and you add insulin to it, you can still get better insulin control, and you can reduce complications, and if you don't have complications, it means that the disease is not serious. If the patient has good blood sugar control, the addition of insulin will still allow for better insulin control and reduce complications, and if there are no complications, then the diabetes is not that serious.

Nowadays, more and more people are plagued by high blood sugar, this blood sugar in the end how to rise? How to control blood sugar, the following, "ask the doctor" focus on diet for everyone to talk about.

Why does blood sugar rise?

If we compare our body to a power plant, glucose is the coal used to generate electricity, the cells of the body that consume glucose are like a boiler room, and the liver, muscles, fat, etc. that temporarily store glucose are like a warehouse.

Like a real power plant, we need to purchase coal on a regular basis. Every meal is also the day when our purchases are completed, and a group of "coal distributors" called insulin will move the coal (blood sugar) from the logistics line (blood system) to the boiler room (cells), and all the excess will be stored in warehouses (liver gluconeogenesis, muscle gluconeogenesis, adipocytes) to be used in case of emergencies.

If too much coal is purchased (too much glucose is supplemented) or if there is a shortage of coal distributors (insufficient insulin production) this can result in a backlog of excess coal on the logistics line (increased blood glucose levels).

Diet control can lower blood sugar

If high blood sugar is caused by excessive glucose production, cultivating healthy eating habits is the most economical and safest way to lower blood sugar. Today, based on the latest version of the Chinese Diabetes Dietary Guidelines, Ask a Doctor offers a few suggestions for your daily diet.

(1) Coarse and fine combinations of staple foods, with one-third each of whole grains and mixed legumes

Coarse that we often say coarse food, "fine" refers to the refined food, such as rice, noodles, this kind of food into the body will generate a large number of glucose, not only fast glycemic, and nutritional single, so you have to eat with. Moreover, the coarse and fine with eating not only to ensure the digestion and utilization of food, but also to the body to supplement more vitamins, minerals, dietary fiber and protein.

(2) Eat more vegetables, fruits in moderation, with a variety of types and colors

It is recommended that the daily intake of fresh vegetables 300 to 500 grams, dark vegetables account for one-half (dark vegetables contain flavonoids that can delay the rise of blood sugar after meals), green leafy vegetables not less than 70 grams; between meals choose to eat a small amount of low glycemic index of the fruit, about 150 to 200 grams.

(3) Eat fish and poultry, eggs and livestock should be eaten sparingly, and processed meat should not be eaten as much as possible.

Meat is a high quality source of protein, and those with high blood sugar should take care to supplement it. However, there are rules for eating meat, simply put: four-legged (livestock) is better than two-legged (poultry), and two-legged is better than no legs (fish).

Livestock meat (muscle and offal of pigs, cows, sheep, donkeys, etc.) is high in fat and should be eaten sparingly. Moreover, high-fat and high-cholesterol foods such as animal offal, fish roe, fatty meat and squid should be strictly controlled. In addition, do not eat processed meat products such as cured, baked, smoked, sauced and marinated.

(4) Milk and beans are available in every meal, and snacks and additional meals are chosen reasonably.

Those with high blood sugar should ensure 300 grams of liquid milk or an equivalent amount of other dairy products daily. No more than 4 eggs per week, without discarding the yolk. You can eat some nuts as a snack when you are hungry, but not more than 25 grams per day.

(5) Eat a light diet, drink plenty of fluids, and limit alcohol consumption.

Cooking is based on steaming, less salt (about 6 grams per day), no sweets, no frying, deep-frying and other foods high in fat.

Friends with high blood sugar must drink more water. If you don't drink enough water, it will aggravate the disorder of blood sugar metabolism and lead to higher blood sugar concentration, which can be serious and lead to coma or even life-threatening due to hyperglycemia. Therefore, as long as there is no cardiac or renal disease, do not blindly restrict water intake.

Alcohol is a substance that is preferentially metabolized by the liver, and further alcohol consumption by friends with high blood sugar will lead to more cholesterol being deposited in the blood vessels, accelerating the formation of blood clots. Therefore, friends with high blood sugar must limit their diet, do not drink if you can, and should not drink more than 25 grams, equivalent to a small glass of red wine. However, for the sake of health, it is advisable to replace alcohol with tea.

If blood sugar reaches dangerous levels it is still necessary to use hypoglycemic medication.

"Ask the Doctor" - a team of doctors from the ancient city of Xi'an, sharing scientific and practical health knowledge for you.

In diabetes, the main focus is to prevent and delay the onset and progression of chronic complications, and blood glucose, blood pressure, and lipids are equally important in such an accompanying lifelong prevention and control effort.

Due to the aging of the human body, the function of pancreatic islets will inevitably deteriorate with the progress of the disease and age, and therefore blood glucose control will become more and more difficult. As for blood pressure and blood lipids, there are a lot of clinical research data suggesting that blood pressure and blood lipids basically won't deteriorate much if one can manage one's lifestyle well and take medication regularly.

Therefore it will also require more effort on our part when it comes to blood sugar management. Although it is difficult to say, if people with diabetes can melt lifestyle management into a daily habit, then it is actually not that difficult to manage blood sugar.

From a lifestyle perspective, managing blood sugar is mastered in several key ways:

1. Eat and move in a balanced way to achieve or maintain a healthy weight: Diet control should be combined with exercise so that the body's energy balance can be achieved, which is also helpful for weight control.

2. Staple food in quantities and with a combination of coarse and fine food: It is recommended to use whole grains and beans as staple food, which can ensure sufficient intake of dietary fiber and at the same time take care of vitamin B supply.

3. Eat more vegetables, fruits in moderation: recommended to eat a variety of colorful vegetables, because of the combination of various vitamins in such a diet is comprehensive, daily vegetable intake is recommended for 500g.

4. Eat fish and poultry, eggs and livestock in moderation: in terms of eating meat, mastering the 4-legged is not as good as 2-legged, 2-legged is not as good as no legs, so that the fat content of the diet will be effectively controlled, an egg a day to ensure that the protein intake, cholesterol is not too much, it is worth recommending.

5. Milk and beans every day, snacks and meals reasonable choice: as far as possible to ensure that the diet of three meals a day, to avoid snacks or meals, even if it is difficult to avoid snacks or meals are also recommended to refer to the nutritional labeling on the food package to choose a lower salt content, less energy.

6. Eat a light diet, drink plenty of water, and try to quit drinking: drinking plenty of water can promote the glucose in the blood to be eliminated from the body through urine, and alcohol (be it white wine, red wine, or yellow wine) will adversely affect blood glucose control, so it is recommended to quit as much as possible.

7. Timing and rationing, chewing and swallowing slowly, and paying attention to the order of meals: slowing down the speed of eating can fully digest and absorb the nutrients in the food, and also improve the postprandial blood glucose, and it is recommended to have soup first, then vegetables, then meat, and finally the main course of the meal.

8. Drug selection is based on guideline recommendations, and multiple combinations work together: there are now relatively complete guidelines for diabetes control, and it is economical and practical to select drugs according to the treatment pathway recommended by the guidelines, as many patients require multiple drug combinations to achieve comprehensive, long-term glycemic control that takes into account the multiple pathophysiologic changes in diabetes.

First, how is type 1 diabetes treated?

(1) Dietary control

The basic dietary principles are: control the total number of calories in a day, eat small and frequent meals, diversify the types of food as much as possible, and try to avoid fried foods, fatty meats, candies, sweet drinks, and all kinds of processed foods.

(2) Exercise therapy

For people with type 1 diabetes, exercise has both advantages and disadvantages. Pros include: lowering blood glucose, controlling weight, preventing cardiovascular disease, and increasing insulin sensitivity. The disadvantages are: induced hypoglycemia, ketoacidosis.

Therefore, people with type 1 diabetes must take into account their physical condition when exercising.

(3) Insulin therapy

Insulin is the most essential measure to maintain the survival of patients with type 1 diabetes.

There are many ways to apply insulin, patients with poor glycemic control need to be continuously infused with insulin through a vein or use an insulin pump, and after basic glycemic control they can be changed to four subcutaneous injections a day, and some patients with good glycemic control can have insulin injections only twice a day.

(4) Blood glucose monitoring

At home, you can use a blood glucose meter to measure your fingertip blood glucose and record the trend of blood glucose changes. In addition, it is necessary to go to the hospital regularly for follow-up, take your recorded blood glucose to the doctor for reference, as well as draw blood to check venous blood glucose and glycated hemoglobin, etc., so as to facilitate the doctor's medication adjustment.

Read on to see how type 2 diabetes is treated.

(1) Dietary control

The basic dietary principle is to control the total calories in a day and to eat balanced meals.

Obese people need to lose weight by reducing the amount of food they eat, at a rate of 0.5 to 1 kg per week. Consult a dietitian for a specific diet plan.

(2) Exercise therapy

For diabetics, exercise has both advantages and disadvantages. The pros are: lowering blood glucose, lowering blood lipids, reducing weight, preventing cardiovascular disease, and increasing insulin sensitivity. The disadvantages are: induced hypoglycemia, ketoacidosis, aggravate some existing chronic complications.

Overall, long-term, regular aerobic exercise is better for people with type 2 diabetes.

It is recommended that you consult your doctor or diabetes education nurse to develop an exercise program that is right for you.

(3) Oral hypoglycemic drugs

Common oral hypoglycemic agents are:

Insulinotropic agents: The name of the drug is usually "Glaxo XX" or "X Glargine".

Metformin: Commonly used is metformin.

Alpha-glucosidase inhibitors: e.g., acarbose, voglibose.

Thiazolidinediones: e.g. pioglitazone.

DPP-4 Inhibitors: The drug name is usually "Xagliptin".

The choice of drugs is mainly based on blood glucose level, duration of diabetes, patient's body shape, liver and kidney function, pancreatic islet function and other factors. It is necessary to choose the appropriate medication under the guidance of a specialized doctor.

(4) Injectable hypoglycemic drugs

Injectable hypoglycemic drugs include insulin and GLP-1 receptor agonists/analogs.

① Insulin:

Of course not all type 2 diabetes requires insulin therapy.

In recent years, insulin pumps have begun to be used more and more often in patients with type 2 diabetes for more effective and refined glycemic control.

② GLP-1 receptor agonists/analogs:

This is a new class of hypoglycemic drugs that need to be injected subcutaneously like insulin, commonly known as exenatide and liraglutide.

These drugs not only lower blood sugar, but also reduce weight and repair pancreatic islet function. It is suitable for new-onset type 2 diabetes with obesity.

However, these drugs are more expensive and can be used under the supervision of a doctor if available.

(5) Blood glucose monitoring

At home, you can use a blood glucose meter to measure your fingertip blood glucose and record the trend of blood glucose changes. In addition, regular follow-up visits to the hospital are required.

(6) Antihypertensive, lipid-lowering and antiplatelet therapy

High blood sugar is not the worst thing, the worst thing about diabetes is the serious complications that come with it, such as heart attacks and strokes that can be life-threatening.

In addition, some diabetic patients need to be treated with antiplatelet drugs (e.g., aspirin) in order to prevent the development of cardiovascular diseases.

Scientific grasp of the daily food ingredients on the real impact of blood sugar, blood sugar is less likely to be up and down their own can become half of the diabetes experts.

The 4 "secrets" of blood sugar control

1、Eat more coarse grains, coarse and fine combination

Some of the food on the market nowadays is finely processed to satisfy the diversity of people's tastes, but at the same time it also means that it is not good for the health of the body.

Roughage can not only give us intestinal cleansing to promote the body's metabolism, but also can take away the body's excess fat, which are irreplaceable by refined food.

2、Eat less food with high fat content

Fats are necessary for the body's energy, but excessive fat intake can be a burden for people with diabetes.

The survey shows that the population of diabetic patients are mostly middle-aged and elderly people, their body metabolism has been gradually reduced, and too much fat can not be metabolized, the accumulation of the body is prone to cause diabetes.

3. Stop smoking and drinking

Most middle-aged men have the habit of smoking and drinking, smoking for the body's damage can be said that three-year-old children know, and drinking to hurt the stomach, these for the health of the people have some damage, not to mention some damage for diabetics.

4. Nutritional balance and rational mix

Different types of food contain different nutrients. If you want to have a balanced nutrition, you should diversify your diet as much as possible to meet your body's energy supply and demand. So for diabetic patients, food to ensure nutritional balance, eat at least six kinds of vegetables and fruits every day, at the same time to more coarse grains, less refined food.