1.Monitor blood glucose on time: fasting and three post-meal blood glucose, and if necessary, need to monitor pre-meal and bedtime and nighttime blood glucose.
2.Actively cooperate with the examination.
(1) Bun meal test and insulin release test: Blood should be drawn on an empty stomach and no water or food should be consumed during the test. The night before the test, prepare a 2 tael white bun and 300-400 ml of plain water, and the next morning when the test is done, the blood collector will explain the time and method of taking it. Note that it takes about 5 minutes to take the bun, and drink water while chewing.
(2) Urine microalbumin: leave the morning urine every morning, if more than one day can be left to take urine samples.
(3) 24-hour urine protein quantification and endogenous creatinine clearance: urinate once at 7:00 a.m., pour out this urine, and start to keep urine samples from after 7:00 a.m. Add preservative to the container after the first urine, and keep each urine in the container for the next 24 hours until the last urine at 7:00 a.m. the next day, record the total amount of urine and record it on the lab sheet, and also record the height and weight on the The total amount of urine was recorded on the lab sheet, and the height and weight were also recorded on the lab sheet. A small amount of mixed urine was left in the corresponding small urine cup for examination.
(4) Fundus examination: Ophthalmology.
(5) Ultrasound examination: fasting and urine holding are required.
(6) Electromyography.
(7) Other routine examinations: fasting blood draw for routine blood, electrolytes, liver and kidney function, lipids, glycosylated hemoglobin, blood coagulation four blood rheology, etc. are required to operate in the department.
3, diabetes is a metabolic disorder caused by a variety of etiologies, characterized by chronic hyperglycemia, accompanied by insufficient insulin secretion and/or impaired action, resulting in disorders of sugar, fat and protein metabolism, causing chronic damage, dysfunction or failure of multiple organs. Typical clinical manifestations are three more and one less, i.e., more drinking, more eating, more urination and weight loss.
4.Benefits of receiving diabetes education: Patients who receive systematic diabetes education and reasonable treatment in the early stage of diabetes, compared with the same period of patients without diabetes knowledge, the average life expectancy is extended by 10-15 years; the required dose of hypoglycemic drugs is reduced by 1/5-1/2; the required time to reach the standard is shortened by 5-10 years; the required medical expenses in the next 10 years are reduced by 1/5-1/3 The occurrence of serious end-stage events (amputation, blindness, kidney failure) is reduced by 1/5-1/2.
5, the characteristics of diabetes.
(1) Epidemic onset: Diabetes is currently the third most prevalent chronic disease.
(2) Complex etiology: genetic and environmental factors co-pathogenesis.
(3) The course of the disease is protracted.
(4) Systemic disease: Diabetes is a chronic systemic disease with the most common sites of damage: eyes, kidneys, nerves, heart, cerebral vessels, feet and lower limb vessels. Comprehensive treatment of hyperglycemia, hypertension, hyperlipidemia and hypercoagulability is the main measure to prevent chronic complications.
(5) Heterogeneity and variability: The causes of diabetes, age of onset, degree of hyperglycemia, clinical manifestations, drug response and prognosis are very different, and individualized treatment must be emphasized, and patients should not compare specific treatment measures with each other.
(6) Interventional: Long-term reasonable control of weight, blood glucose, lipids and blood pressure can significantly reduce or delay the occurrence of diabetic complications and improve the overall prognosis.
(7) Very different prognosis: The prognosis varies greatly. The factors that affect the prognosis are unchangeable factors (such as age, disease duration, genetics, etc.) and changeable factors (lifestyle habits, psychological status, knowledge of diabetes, reasonableness of treatment), which should be actively changed from unfavorable factors to favorable factors in an effort to improve the prognosis.
6, the principles and methods of treatment of diabetes: including diet, exercise, drugs, education and monitoring five major methods.
7.Scientific and reasonable dietary treatment should be adhered to throughout the course of the disease, and every diabetic patient should pay attention to the diet structure, quantity and time at any time. It is important to emphasize regular, quantitative and fixed meals, remembering that more and less is not always the case, and to pay attention to variety, reasonable matching and balanced nutrition. The calorie distribution of each meal should be relatively constant, and the imbalance of calories between meals should be avoided. Do not add meals under non-hypoglycemic condition, do not eat sweet food with high content of monosaccharide or monosaccharide (such as pastries, drinks and preserves), and avoid frequent intake of high-calorie snacks (such as melon seeds, peanuts and pine nuts). Avoid frequent consumption of fried and deep-fried foods. Grain corn food to coarse, fine with, protein food to meat, eggs, milk with, avoid long-term food type single. All kinds of alcohol should be moderated, the maximum allowable amount of liquor 50ml/day, avoid addiction to smoking and alcohol. Eat more 1 or 2 types of vegetables.
8, exercise therapy can: 30-6 – minutes after meals suitable for exercise, do not advocate early morning fasting large amount of exercise. Exercise before meals is likely to lead to hypoglycemia, and exercise immediately after meals affects the digestion and absorption of food. Determine the intensity of exercise according to personal circumstances. Exercise for the purpose of weight loss, in addition to a certain duration (but there should be intervals in between), should also have a certain exercise intensity. Exercise for the purpose of lowering blood sugar should last for about 30-40 minutes starting after 30 minutes after each meal.
9. Medication: sulfonylureas should be taken before meals, biguanides can be taken before, during and after meals, glycosidase inhibitors should be chewed when eating the first bite of main food, glinides should be taken 3-5 minutes before meals, and insulin sensitizers can be taken in the morning. Premixed insulin should be injected 20-30 minutes before meal, and Novalis 30 Special Charge should be injected 10-15 minutes before meal. Long-acting insulin and intermediate-acting insulin are injected at 10:00 p.m. without further meals.
10, complication treatment: the most serious complications of diabetes patients, to be treated with a combination of Chinese and Western medicine, especially Chinese medicine has a unique advantage in the treatment of complications of diabetes.
11.Only food with low rise rate, but no “sugar-lowering” food, avoid taking “sugar-lowering” health food and not counted in the dietary intake.
12.Conventional food can be consumed, avoid blind unscientific prescriptions and test prescriptions for “food therapy”.
13, prevention of hypoglycemia: after hospitalization, you should notify the doctor in charge when you feel hungry and help him/her analyze the reason, do not add meals without authorization. If you have abnormal sweating, weakness, trembling hands, panic, chest tightness, dizziness and other symptoms at any time, you should immediately inform the doctor or the nurse on duty to check your blood sugar in time. Please bring your own soda crackers or candies during hospitalization in case of hypoglycemia. It is strictly forbidden to go home to eat or go out to eat after insulin injection to avoid hypoglycemic attack on the way. Avoid strenuous exercise before meals.
14. Adjustment care: You should keep calm and cheerful mood, avoid tension and impatience. Avoid exertion. Adopt a healthy lifestyle, participate in activities with little exercise appropriately, and avoid smoking and alcohol.
15, adhere to the principle of treatment under the guidance of a diabetes specialist, do not rush to the doctor, do not blindly believe in exaggerated advertising.
16.People who have a family history of diabetes should have their fasting and postprandial glucose checked regularly after the age of 35 to know whether they have diabetes.
17.Learn how to use insulin pen before discharge.
18.A blood glucose detector should be prepared before discharge.
19.Follow up after discharge: keep in touch with the professional doctor frequently in order to adjust the treatment plan in time and correctly.
(1) Adherence to treatment: After discharge from the hospital, adhere to the formulated diet, exercise and medication treatment plan. For light patients, diet and medication should be adjusted appropriately due to increased exercise. At the same time should continue to adhere to the treatment of related diseases.
(2) Follow-up plan: At the early stage of discharge, it is required to measure blood glucose one day a week (including fasting and 2 hours after three meals), and if blood glucose is still under ideal control for 4 consecutive weeks, blood glucose can be measured one day (before and after meals) about 2 weeks. If the blood glucose is elevated, you should first find out the cause and correct it by yourself, otherwise you need to go to the hospital for follow-up. A follow-up visit to the hospital is required every 1-3 months for specific guidance on changes in blood glucose, blood pressure, lipids, weight and complications.