At 5:30 Beijing time, I met with you all on the airwaves, and the frequency you are listening to is FM89.9, the voice of Karachin, and you are listening to 899 Air Clinic, which is brought to you every Monday, Wednesday and Friday. I’m your old friend Xiaomei, and Lou is your guide for today’s show.
For those of you who are familiar with the program, you know that in each episode, we will connect with experts from Chifeng College Hospital to introduce you to health care knowledge, and the experts from the hospital will also give you the most professional answers to your questions about diseases. For cell phone users, edit your question and send it to 1062950099 with the letter A. Liu Yanjie, Department of Endocrinology, Affiliated Hospital of Chifeng College
In today’s program, we are talking to Dr. Yanjie Liu from the Endocrinology Department of the Affiliated Hospital of Chifeng College, but before we talk to Dr. Liu, we would like to tell you about her personal information. Dr. Liu Yanjie, deputy chief physician of endocrinology department of the Affiliated Hospital of Chifeng College of Inner Mongolia, graduated from Inner Mongolia Medical College in 1995 and has been working in the first line of internal medicine. He specializes in the diagnosis and treatment of diabetes mellitus and its acute and chronic complications, thyroid disease, endocrine hypertension, hyperlipidemia, pituitary tumor and adrenal gland disease. In the past three years, he has successfully opened his personal website to help patients.
Host:After knowing Dr. Liu’s personal information, let’s invite Dr. Liu in the airwaves, Dr. Liu, hello, please say hello to the listeners in front of the radio.
Dr. Liu.
Host: With the improvement of people’s living standards, the increase of work pressure, the change of diet structure, physical activity, the incidence of diabetes has increased year by year, has become the third largest chronic disease after cardiovascular disease, cerebrovascular disease, become the world’s fifth leading cause of death, foreign alias to it “silent killer”, the incidence of diabetes in China has been close to 10%, some developed cities reached 12 The prevalence of diabetes in China is close to 10%, and in some developed cities it reaches 12%. Now with the increase in the number of diabetic patients, the level of knowledge, we know more and more about diabetes Although life is getting better and better, but there are many friends do not really understand diabetes, so please first introduce us to the end what is diabetes, okay?
Dr. Liu: In our body there is an endocrine organ – the pancreas, there is a cell in the pancreas called pancreatic B cells, it secretes a hormone is also known as insulin, he controls the level of glucose in our body, is the only hypoglycemic hormone in our body, when it appears to function abnormally, too much glucose can not be eliminated, and finally developed into elevated blood glucose, causing When it functions abnormally, excessive glucose cannot be eliminated, and eventually it develops into elevated blood sugar, causing a series of metabolic disorders, and becomes diabetes.
Moderator: What are the symptoms of diabetes when the body is in discomfort?
Dr. Liu: Most of us know that diabetes has the symptoms of “three more and one less”: thirst, excessive drinking, excessive urination, and lethargy, but in fact, most diabetic patients may not have these symptoms in the early stage, and only when the blood sugar is high to a certain degree do the symptoms of “three more and one less” appear. In fact, most diabetic patients may not have these symptoms in the early stage, but only when the blood sugar is high to a certain level do the symptoms of “three more and one less” appear. So how to detect diabetes early? 1. Family history of diabetes; 2. Repeated pre-meal hypoglycemia: panic, heartbeat, cold sweat, hunger, weakness, dizziness, which can be relieved immediately after eating and the symptoms disappear; 3. There seems to be a secretion, can not be removed; eye fatigue, vision loss; and so on. If you have any of these conditions, you should go to the hospital and get a blood sugar test to find out if you have diabetes.
Moderator: What tests can be done in the hospital to find out if you have diabetes?
Dr. Liu: Nowadays, you can find out if you have diabetes by testing your fasting and 2-hour postprandial blood sugar.
Moderator: What tests can doctors use to determine if a patient has diabetes?
Dr. Liu: If there are two fasting blood glucose tests greater than or equal to 7.0, or two postprandial 2-hour blood glucose tests greater than or equal to 11.1, the diagnosis of “diabetes” can be made; in foreign countries, diabetes is diagnosed based on glycosylated hemoglobin, but it is easy to miss some patients, so we now follow the WHO’s diagnostic criteria.
Moderator: Why do people develop diabetes?
Dr. Liu: This involves the pathogenesis of diabetes, which is a very complex issue, so far, scientists have not completely cracked its code, now mainly considered and these aspects related to: At present are also after a large number of studies related to the following factors: 1. The role of mental factors in the occurrence and development of diabetes has been confirmed by Chinese and foreign scholars in the last decade, and it is believed that along with mental tension, emotional excitement and various stress states, it will cause the secretion of a large amount of hormones that raise blood sugar, such as growth hormone, norepinephrine, glucagon and adrenocorticotropic hormone, etc.; 3. Obesity factors: At present, it is believed that obesity is an important cause of diabetes. About 60%-80% of adult diabetic patients are obese before the onset of the disease, and the degree of obesity is directly proportional to the incidence of diabetes, and some basic research materials show that: as age increases, physical activity gradually decreases, the ratio of human muscle to fat is also changing. From the age of 25 to 75, muscle tissue gradually decreases, from 47% to 36% of body weight, while fat increases from 20% to 36%, which is one of the main reasons for the increase of diabetes among the elderly, especially the obese and fat elderly; 4. diabetes. Nowadays, the concept of “the richer the life, the fuller the body, the more diabetes” has been formed at home and abroad; 5. Genes: At present, science believes that diabetes is caused by several types of genetic damage: no matter what type of diabetes, whether it is caused by genetic susceptibility, environmental factors or viral infection, it is ultimately caused by genetic damage. The genes are damaged. In other words, diabetes is a genetic disease.
Moderator: In addition to hyperglycemia, do diabetic patients have symptoms of hypoglycemia?
Dr. Liu: Yes, every diabetic patient has more or less hypoglycemic reactions in the course of diabetes treatment, mainly manifested as panic, heartbeat, shivering, weakness, cold sweat, dizziness, hunger, and some patients have blurred consciousness, babbling, convulsions and even coma, which can be relieved immediately after eating sweet food.
Moderator: Why do diabetic patients have hypoglycemia?
Dr. Liu: Hypoglycemia can occur when diabetic patients do not eat on time or eat less during medication, or when they take too much medication or take too much insulin during treatment.
Moderator: What are the consequences of not treating diabetes if it is diagnosed through medical means?
Dr. Liu: If a diabetic patient does not receive regular treatment, the incidence of various complications after 10 years is more than 78%, and these complications seriously threaten the life of the patient, causing disability or premature death, which brings great pain to the patient and family, and also causes huge economic losses to the country. A large number of medical studies have shown that the mortality rate of diabetic patients is twice that of normal people, and the incidence of cardiovascular disease, blindness, uremia and amputation in diabetic patients is 4 times, 25 times, 18 times and 7 times that of normal people. At present, 60% of diagnosed diabetic patients in China have poor blood sugar control, which is enough to cause a variety of serious chronic complications, such a worrying consequence and facts, should cause us enough attention and vigilance.
Moderator: What is the best way to treat diabetes as far as the current medical level is concerned?
Dr. Liu: Now we should pay attention to one thing, so far the treatment for diabetes is only control, there is no complete cure, and there is no best way, the treatment plan that suits you is the best treatment.
Host: We all know that insulin is a good drug to treat diabetes, but are all diabetic patients suitable for insulin?
Dr. Liu: Insulin is the only hormone that lowers blood sugar in the body, and it is also the only hormone that promotes the synthesis of glycogen, fat and protein at the same time. However, not every diabetic patient is suitable for insulin treatment.
Moderator: What kind of patients need insulin therapy?
Dr. Liu: Nowadays, with the improvement of people’s knowledge and the promotion of the Internet, people’s awareness of insulin has changed from the beginning of fear to the present active request for insulin, which is a welcome progress. However, there are still some patients who need to apply insulin or refuse to use insulin, mainly because of the misunderstanding of insulin. First of all, we should understand that insulin is a drug to cure disease and save lives, not an addictive drug, so insulin injection will not become addictive and dependent, it is a need of the condition. Indications: ①Patients with type 1 diabetes, due to the impaired function of their own pancreatic β-cells and absolute insufficiency of insulin secretion, need insulin treatment at the onset and need lifelong insulin replacement therapy to maintain life and living. It accounts for about 5% of the total number of people with diabetes. ②Patients with type 2 diabetes can start the combination therapy of oral medication and insulin if their blood glucose still does not reach the control goal based on the combination therapy of lifestyle and oral hypoglycemic drugs. Generally, if HbA1c is still greater than 7.0% after a larger dose of multiple oral medication combination therapy, insulin therapy can be considered to be initiated. (iii) Patients with wasting diabetes mellitus. ④In the course of diabetes (including patients with newly diagnosed type 2 diabetes), insulin therapy should be used as early as possible when weight loss without obvious cause occurs. ⑤ For patients with initial type 2 diabetes mellitus with high blood glucose, since it is difficult to achieve satisfactory control of blood glucose with oral medication, and the rapid remission of hyperglycemic toxicity can partially reduce insulin resistance and reverse β-cell function, intensive insulin therapy can be used in newly diagnosed type 2 diabetes mellitus with significant hyperglycemia, which can protect the function of residual islet B cells and restore some of the dormant islet B cells, and The rate of remission of diabetes can be improved. (6) There are also some special cases that require insulin therapy: perioperative period; temporary use of insulin to overcome the risk period in case of serious acute complications or stress, such as diabetic ketoacidosis, hyperosmolar hyperglycemia, lactic acidosis, infection, etc.; serious chronic complications, such as diabetic foot, severe diabetic nephropathy, etc.; combined with some serious diseases, such as coronary heart disease, cerebrovascular disease, hematological disease, liver disease, etc. Gestational diabetes mellitus and women with diabetes mellitus combined with pregnancy, during pregnancy, before and after delivery, and during lactation, if blood glucose cannot be controlled by diet alone to reach the required target value, insulin treatment is required and oral hypoglycemic drugs are prohibited. (7) Patients with secondary diabetes and idiopathic diabetes.
Moderator: Are there any problems that need special attention when using insulin?
Dr. Liu.
Moderator: Can you completely control your blood sugar as long as you use insulin?
Dr. Liu: No, the premise of all hypoglycemic drugs is to control diet, and insulin is no exception.
Moderator: What do diabetic patients need to pay attention to in order to be able to better control their blood sugar?
Dr. Liu: Diabetes treatment involves education, diet, exercise, drugs and monitoring of these five aspects, which is often referred to as the five carriages, emphasizing integrated treatment, a variety of treatment with each other, one cannot be missing, so that 50% of the treatment of diabetes in your own hands, and we can only play a 50% role in medical workers. To this end, diabetic patients must: 1. receive self-care education; 2. adjust their diet and lifestyle, choose the appropriate exercise and exercise amount; 3. monitor blood glucose and urine sugar; 4. use medication accurately as required by doctors; 5. receive annual screening for chronic complications of diabetes for early detection and timely treatment.
Moderator: What should we do in our life to prevent the occurrence of diabetes properly?
Dr. Liu: Many diabetic patients have delayed diagnosis and treatment because of atypical symptoms in the early stage, so it is recommended that middle-aged and elderly friends take the initiative to go to the hospital for regular check-ups, early detection and early treatment to control the development of the disease, especially it should be noted that the earliest clinical abnormality in most type 2 diabetic patients is: elevated postprandial glucose, so during the check-ups, you cannot monitor fasting glucose alone, and never forget to monitor postprandial glucose. Therefore, we cannot monitor fasting blood glucose alone, but never forget to monitor postprandial blood glucose. Diabetes is a chronic disease, as modern medicine has not yet fully elucidated the pathogenesis of diabetes, there is a lack of effective cure, but adhering to scientific and reasonable comprehensive treatment can make the disease well controlled. Good control of blood glucose can prevent or reduce and delay the occurrence and development of chronic complications of diabetes, reduce the mortality rate associated with diabetes, prolong the life span of diabetic patients, and improve the quality of life. Therefore, every diabetic patient should understand that diabetes is a lifelong disease that cannot be cured at this time, but can be controlled. If you want to know more about endocrinology, you can visit my website, or you can ask for my website by SMS, my phone number is 15804767677