In the early stage of insulin treatment, many diabetic patients will hold the attitude of talking about insulin, thinking that this is a harbinger of aggravation of the disease. And accept insulin treatment for a long time, a part of the fear of people to remove, will also be eager to try, think you can give yourself a “cure”, since the hospital to see the doctor, the doctor is adjusted each time a few units, why not try to set a program for themselves? The following is a case is a typical error I encountered in clinical work case: for can not “long meat” distressed Li Li suffered from type 1 diabetes for 5 years, from the date of diagnosis, the weight has been down, a total of five years down almost 20 pounds. Li is 5-feet-5-inches tall and now weighs only 64 kilograms. In order to gain weight, Li ate more at every meal, far exceeding the calories prescribed by her doctor. Because of the type 1 diabetes, the body insulin absolute lack, so Xiao Li eat more blood sugar is sure to soar. So he took it upon himself to increase his insulin dose before each meal by 2 to 4 units each. In addition, in order to stabilize blood sugar, but also in order not to grow “fat meat” but “lean meat”, Li will exercise after each meal, sometimes a walk for half a day. A long time, Li is very distressed, one is unstable blood sugar control, high and low; two is the weight is not long, but also a downward spiral; three is walking every day to lower blood sugar, the work and study are delayed. As a last resort, Li came to Beijing for treatment. After entering the ward, we monitored Li’s blood glucose for three days, and found that Li’s blood glucose before three meals was relatively high, at 10.0-16.0 mmol/L. Through continuous diabetes education, and by inviting doctors from the Department of Nutrition to consult with her, we formulated a calorie diet suitable for Li’s height and weight, and persuaded Li to change from walking for three to four hours to brisk walking for about 30 minutes after a meal. By adjusting the diet and exercise program, Xiao Li’s blood glucose magically controlled, hospitalized for half a month, weight gain of 1 kg, do not look at this small 1 kg, stop the pace of the continuous decline in weight, which is Xiao Li’s whole family looked forward to for five years. After returning home, Li strictly implemented the diet and exercise treatment program developed by the hospital, 3 months after the test glycated hemoglobin 7.0%, weight gain of 1 kg. Like Xiao Li, many insulin-injecting patients think that if they increase the amount of insulin, their blood sugar will drop, and if they exercise, they will have little problem eating more and gain some weight. This understanding is not comprehensive enough. First of all, eating more food does not necessarily mean that you can gain weight. The role of insulin is often compared to that of a key that opens the door to the cells in the body, allowing glucose from the blood to enter the cells. Glucose enters the cells and can be turned into energy or utilized by the body or stored (i.e., weight gain), while the clinical manifestation of glucose entering the cells is a decrease in the concentration of glucose in the blood. Diabetic patients usually lack sufficient insulin in the body (that is, we often say that the body of absolute or relative lack of insulin), if you eat too much, blood glucose is certainly high, and certainly can not enter the cells to be used by the body, and ultimately can only be white from the urine out of the body. Over time, not only can not make weight gain, but also may make weight loss (i.e., diabetic patients “three more and one less” symptoms of the reason). A large amount of glucose from the urine, but also increase the burden on the kidneys, promote the occurrence and development of diabetic nephropathy. Secondly, exercise may also raise blood sugar. This idea may sound puzzling. As a matter of fact, proper exercise can indeed burn energy, while increasing the sensitivity of skeletal muscles to insulin and promoting the decline of blood glucose. However, excessive exercise will make the body overexcited, resulting in the secretion of many blood sugar-raising hormones, such as adrenaline, but will make blood sugar rise. Xiao Li walks for half a day, which belongs to over-exercise, so his blood glucose did not drop as he thought, but instead rose before meals. Thirdly, since patients with type 1 diabetes are absolutely lacking in insulin secretion, they have to rely entirely on exogenous insulin to control their blood glucose, and this is where a relatively fixed diet and exercise regimen is very important for coordinated and smooth glucose lowering. Of course, relative fixation does not mean eating the same food every day. Food exchange portions and the glycemic index of food are important references for food selection. Blood glucose testing and record keeping are equally important. When recording blood glucose, don’t forget to keep track of your diet and exercise, and summarize them every once in a while to help you understand your body. If you do it right, you will know better than the glucose meter and your doctor how much food to eat, what kind of food to eat, how to exercise or how much insulin to take, and what level your blood sugar can be roughly at. Of course, if you’re not sure, always consult your doctor. If you want to eat something you haven’t eaten before, try one food at a time and start with a small amount for sure.