How to intensify the treatment of diabetes

  The concept of intensive diabetes treatment has not yet reached widespread popularity. However, experts in the field have almost reached a consensus: intensive treatment is much better than no intensive. Intensive glycemic control can prevent or delay the onset and progression of diabetic retinopathy, diabetic nephropathy and neuropathy. Based on good glycemic control, intensive therapy can have a more positive impact, reducing the risk of diabetes-related complications by 12%, especially microvascular complications by 25% and myocardial infarction by 16%. The risk of developing late complications of diabetes can be reduced. Intensive treatment can reduce the toxic effects of glucose and improve the effects of insulin resistance due to promoting the relief of hyperglycemic symptoms and improving lipid levels. It can improve and restore the function of damaged pancreatic B cells in some diabetic patients to varying degrees. From the perspective of the pathogenesis of type 2 diabetes, the use of insulin at an early stage allows islet cells to rest, which in turn has the potential to restore islet cell function. In clinical practice, some patients have shown a pleasing recovery of islet function after short-term intensive treatment with insulin pump, and for a long time, they can maintain normal blood glucose without insulin and oral drug hypoglycemic therapy, relying only on basic control such as regulation of diet and exercise.  According to the professor, the degree of reinforcement varies for different groups of people. For elderly patients, patients who have been suffering from diabetes for a long time, and patients who have already had cardiovascular and cerebrovascular events, it is necessary to moderately intensify for such patients, using the right dose and the right combination to control their blood glucose levels not too high, and the main goal is to prevent and control the occurrence of complications. For diabetic patients with a relatively short duration of the disease, early intensive treatment is to be carried out, the goal of which is not only to prevent complications, but also to protect the function of the patient’s secretory organs and to make the best efforts to restore them to normal. This type of diabetic patient has never been treated but has particularly high blood glucose levels. It is possible to intensify treatment with short-term insulin, with a treatment period ranging from two or three weeks to one month.  The HBa1c should be controlled below 6.5 during intensive treatment (the test method varies from place to place and the reference data varies), and the fasting blood glucose should generally be at 6mmol/l and the postprandial blood glucose at 8mmol/l. At the same time of intensive treatment, the diabetic patient’s high blood pressure, high blood lipid, high blood viscosity, high uric acid and high weight should be strictly controlled.