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Abstract: The patient presented to the clinic with generalized weakness and mental incompetence, and after examination, was finally diagnosed with type 2 diabetes mellitus. Intensive treatment with detergent insulin injection as well as menthol insulin injection restored the damaged pancreatic islet function, and the disease has been controlled, with all indicators improving, thus eventually getting off insulin therapy, and even finally being able to maintain normal blood glucose through healthy diet and exercise without hypoglycemic drugs.
Basic information】Male, 40 years old
Disease Type】Type 2 diabetes mellitus
Hospital】Shanxi Provincial Hospital of Integrative Medicine
Date of Consultation】May 2022
Treatment plan】Subcutaneous injection drug therapy (Dietary insulin injection, Menthol insulin injection) + oral drug therapy (Metformin hydrochloride tablets, Acarbose tablets) + diabetes health education
Treatment period】10 days of inpatient treatment, 1 month of outpatient follow-up
Treatment effect】The disease has been controlled, and all indicators are improving
I. Initial Consultation
The patient had a lot of socializing, irregular life, smoking and drinking, obesity, body mass index of 29.367kg/m², general weakness and mental inactivity with drowsiness, dry mouth, bitter mouth, excessive drinking and polyuria one week before admission, and sought systematic treatment. We performed random blood glucose tests and the results showed that the patient had 13.99 mmol/L, glycosylated hemoglobin was 9.0%, urine glucose (++++), ketone bodies (-), urine protein (-), and was admitted with “type 2 diabetes”.
II. Treatment history
The patient had a short medical history, but her blood glucose was very high and the effect of oral hypoglycemic drugs was poor, so she was given intensive insulin treatment. So we repeatedly communicated with the patient, analyzed the pros and cons and the results after treatment, and finally allayed the patient’s worries. The patient and his family agreed to try daily subcutaneous insulin injection for intensive treatment after consultation.
At the same time, we monitored blood glucose six times a day (before and after three meals) and adjusted the insulin dose according to the blood glucose situation, and also gave diabetic diet and exercise education, and instructed the patient to eat scientifically and exercise regularly.
On the 9th day of admission, the patient’s symptoms disappeared and his blood glucose gradually decreased to normal, so he was given medication adjustment and adjusted to oral metformin hydrochloride tablets and acarbose tablets to control blood glucose, and was discharged after 10 days of hospitalization. At the time of discharge, the patient was instructed to follow up with the outpatient clinic in 1 month.
III. Treatment effect
The patient’s general malaise, mental weakness, lethargy, dry mouth, bitter mouth, excessive drinking and polyuria symptoms disappeared, and the blood glucose control reached the standard. The treatment plan was adjusted from daily subcutaneous insulin injection to oral medication. 1 week after discharge, the patient was followed up by telephone and indicated no discomfort and good recovery.
IV. Notes
We are glad that after treatment, the patient’s condition has been controlled and all indexes are improving. The patient is advised to continue to adhere to diabetic diet and exercise after discharge, ensuring daily staple food intake of 300g, protein intake of eggs, milk and meat, low salt, low fat and diabetic diet, ensuring daily intake of 1000g of fresh vegetables, and ensuring at least 30 minutes of aerobic exercise daily.
Meanwhile, patients need to continue to take oral metformin hydrochloride tablets and acarbose tablets after discharge to control blood glucose and monitor blood glucose regularly, perfecting blood glucose six times a day (before and after three meals) every 2 weeks, with outpatient follow-up according to the blood glucose situation. According to the results of the outpatient follow-up, the dosage of oral medication was gradually reduced until it was discontinued. In addition, the patient will have outpatient recheck of glycosylated hemoglobin, fasting blood sugar, liver function and kidney function every 3 months, and seek medical consultation if there is any discomfort.
V. Personal insight
Patients with new-onset diabetes mellitus have a short history of disease and their own islet function is damaged, so they can be treated with intensive insulin therapy to restore their islet function and thus normalize their blood glucose. However, many patients in the clinic worry that once insulin is used, lifelong dependence will be formed, and this treatment method breaks the misconception of patients. And the patient in this article, it is the application of this method of treatment, not only left insulin, and finally even expected to stop taking oral drugs, so we are treating patients with new-onset diabetes, to dispel the patient’s concerns and try to use the new method, for patients, is a thing with higher benefits.