Once a person has diabetes, “trouble” will come. First of all, we must strictly control the diet, meal time and the amount of meals are subject to strict restrictions, whether it is windy or rainy, visiting friends and relatives or business trips, travel and play in the mountains to eat on time and quantitatively; secondly, we must buy drugs in a timely manner, take medication, but also can not eat the wrong medicine, you must eat the medicine designated by the doctor; thirdly, we must often and regularly measure blood glucose, urine and other physical and chemical examinations; fourthly, we must suffer from a variety of complications and torment. Troubled by various complications, all day long suspicion, sleep and food insecurity, and finally have to end up in the complications. However, some people “do not believe in evil”, do not believe that eating can also cause or cure disease, as usual, “eating and drinking”, the result is blindness, amputation, kidney failure, cerebral hemorrhage. Therefore, the International Diabetes Federation in 1995 put forward a slogan: “Reduce the cost of ignorance of diabetes”. This paper intends to the causes of diabetes, complications, diet and nutrition, etc. to make some explanations, with a view to attracting everyone’s attention, so as to reduce some of the unnecessary “sacrifice”. First, what is diabetes after people eat food, carbohydrates in the gastrointestinal tract after digestion, decomposition into glucose, glucose is absorbed into the bloodstream known as blood glucose, is the main source of energy. Glucose is as important to the human body as gasoline is to a car. Without gasoline as fuel, the car cannot run. Without blood sugar to provide energy, human life activities, especially brain and heart function, will be impaired. Healthy people in normal circumstances, blood sugar can be maintained in a relatively constant range, this is due to the regulation of the nerves and body fluids, the source and destination of blood sugar are very smooth, in a state of dynamic balance. In this, insulin plays an important role. Insulin is a hormone secreted by the pancreatic beta cells of the pancreas, and its function is to assist the entry of blood sugar into the cells. Let’s draw an analogy: the cell is like a house, insulin is equivalent to the key to open the door, only with the key to open the door, glucose can enter the cell, in which metabolism to produce energy for the body to use. After a meal, carbohydrates in the digestive tract is broken down into glucose, blood glucose rises, then the secretion of insulin also increased accordingly. Insulin promotes the utilization of glucose by the cells on the one hand, and on the other hand, it stores the temporarily unused glucose in the form of hepatic glucose in the liver as a “demand deposit”, and then raises it from the liver when necessary to be utilized by the body as energy. The above blood glucose changes usually return to the original level two hours after a meal. However, when insulin secretion is insufficient or insulin utilization is impaired for a variety of reasons, glucose is blocked from entering the cells and remains in the bloodstream, resulting in elevated blood glucose, and diabetes mellitus occurs when excessive blood glucose is excreted in the urine. Diabetes mellitus is a chronic systemic disease characterized by high blood sugar and urinary glucose. At present, deaths caused by diabetes rank third only to cardiovascular and cerebrovascular diseases and tumors, and it is estimated that there are more than 130 million diabetic patients in the world, of which there are about 40 million in China, and most of them are concentrated in the urban residents, brain workers, and the middle-aged and elderly people who have a rich life. Therefore, for the above people, diabetes has been a common and frequent disease, should cause widespread concern – diabetes is inseparable from you! Second, the causes of diabetes mellitus, types and typical performance 1, the causes of diabetes mellitus (1) genetic factors: about 25% to 50% of patients with diabetes mellitus have a family history of disease. (2) Obesity factors: obesity makes the body insensitive to insulin, is an important cause of diabetes. Data show that more than 10% of normal body weight, the incidence of diabetes for the normal weight of 1.5 ~ 2 times, more than 20% for 3 times, more than 25% for 3.8 times, and obese patients with cardiac, cerebral and renal complications and mortality rate is significantly higher than that of patients with normal weight. (3) Exercise factors: the lack of modern people’s exercise makes the body too much energy can not be consumed, resulting in obesity, but also easy to induce diabetes. (4) other factors: certain viral infections (such as encephalitis, mumps virus, etc.); certain chemical poisons; pregnancy; mental stimulation; trauma and other factors have the potential to induce diabetes. 2, diabetes is divided into which types According to the World Health Organization (WHO) and the American Diabetes Association in 1997, the new diabetes typing, usually diabetes is divided into four types: (1) Type 1 diabetes: previously often called insulin-dependent diabetes, accounting for about 10% of the total number of diabetes mellitus, which can occur at any age, but more common in children and adolescents. It is now believed to be caused by a viral infection that damages the cells of the pancreatic islets, and effective treatment depends on insulin injections. (2) Type 2 diabetes: Usually called non-insulin-dependent diabetes in the past, it accounts for about 90% of the total number of cases, mostly occurring in adults over 40 years of age or the elderly, with obvious family heredity, and the onset of the disease is relatively insidious. Mostly due to various reasons, the body’s sensitivity to insulin is reduced, that is to say, the peripheral tissues of the human body need more insulin than normal in order to effectively utilize blood glucose, and at this time, although the pancreas still secretes a certain amount of insulin, the amount of secretion is relatively insufficient. (3) Gestational diabetes mellitus: refers to the discovery of diabetes mellitus in women without diabetes mellitus during pregnancy, usually in the middle or second trimester. The incidence rate accounts for 1% to 3% of pregnant women. The reason is that during pregnancy, especially after the mid-pregnancy, the placenta secretes a variety of hormones against insulin, coupled with the reduced sensitivity of the body’s tissues to insulin during pregnancy, which makes insulin appear to be relatively insufficient. Hyperglycemia can adversely affect the fetus, so it should be actively dealt with. (4) Other special types of diabetes. Typical performance of diabetes mellitus Typical diabetes mellitus patients often show “three more and one less”. (1) polyuria: increased urine output, increased urination, especially at night. (2) drinking: due to excessive urination, excessive water loss, resulting in intracellular dehydration, stimulating the thirst center, drinking water naturally increased. (3) Polyphagia: due to the loss of sugar from urine, coupled with the impaired utilization of sugar, the body is short of energy, stimulating the appetite, so that the amount of food increases. (4) Lethargy and fatigue: due to sugar utilization disorder, the body’s “energy” supply is reduced, in order to meet the needs of the activity, the body constantly breaks down fat and protein, so that the weight loss, wasting; due to metabolic disorders, water-electrolyte imbalance, the energy can not be released normally, so the patient is fatigued and lack of mental energy. Third, the complications of diabetes mellitus 1, why diabetes mellitus complications Long-term sugar, fat and protein metabolism disorders will gradually cause biochemical, physiological and morphological changes in various tissues and organs. At present, the chronic complications of diabetes have become the main cause of diabetes disability and death. The following is a brief introduction to the causes of chronic complications of diabetes mellitus. (1) Prolonged hyperglycemia puts the body’s tissues and organs in a high-glucose environment, causing abnormalities in tissue and organ morphology and function. Hyperglycemia can cause extensive microvascular basement membrane thickening, lumen thinning, or even blockage, making it difficult for oxygen and other nutrients to reach the needy parts, thickening of glomerular peritoneal membrane, and decrease in nerve conduction function. (2) High blood pressure and high blood fat further aggravate the damage to blood vessels caused by high blood sugar. (3) Changes in the activity of enzyme systems related to sugar, fat and sorbitol metabolism, resulting in abnormal intracellular metabolism. (4) Hyperinsulinemia has a non-negligible role in chronic complications of diabetes mellitus (e.g. promoting atherosclerosis). 2, what are the chronic complications of diabetes (1) eye complications. Mainly include: diabetic retinopathy, cataract, temporary refractive changes, hemorrhagic glaucoma, optic neuropathy and eye infections. (2) Kidney disease. It can occur in about 40% of diabetic patients and is characterized by proteinuria. If it is not detected and treated in time, renal decompensation will occur, and if it develops further, uremia can occur, which requires long-term dialysis or kidney transplantation treatment to maintain life. (3) Neuropathy, including peripheral neuropathy and vegetative neuropathy, can cause abnormal sensation of limbs, gastrointestinal dysfunction (such as bloating, constipation, etc.), and reproductive system disorders. Prolonged hyperglycemia plays a direct destructive role on nerve cells, and also damages the blood vessels supplying nerve cells, which is the main cause of peripheral neuropathy. (4) Cerebrovascular lesions. Most of them are ischemic stroke, accounting for 88.8%, mainly multiple lacunar cerebral infarction. The main symptoms include: headache, dizziness, numbness of limbs, and in severe cases, hemiplegia can occur, which is life-threatening. (5) Heart disease. It is not easy to be detected, with rapid progression of onset and high mortality rate. (5) Lower limb vasculopathy, including ischemic pain caused by atherosclerosis of the lower limbs and diabetic gangrene. Diabetic patients suffer from insufficient blood supply due to vascular lesions, lack of sensation due to neuropathy and accompanied by infection, which often cause serious injury, ulcer, gangrene, and finally some patients need to amputate their limbs, which is the serious harm caused by diabetic foot. (7) Skin lesions. It mainly includes: pruritus, fungal skin infection (tinea cruris, tinea pedis, tinea cruris, tinea cruris, tinea corporis, etc.), bacterial skin infection (gangrene, carbuncle, folliculitis, etc.). Types of oral hypoglycemic drugs and their side effects 1. Types of oral hypoglycemic drugs At present, oral hypoglycemic drugs for the treatment of diabetes mellitus (western medicine) have the following three categories: (1) Drugs that can increase or stimulate the number of insulin secretion, secretion rate, including sulfonylurea hypoglycemic drugs (D860, euglycemic, Ketoglycolide, Damacang, Mepyridamole, Lidumet, Disha, Gedi, Glycosyntropic, Glycosyntropic, Yaleli) and phenylalanine derivatives hypoglycemic drugs (Phenylalanine), which can be used for the treatment of diabetes mellitus. class derivatives of hypoglycemic drugs (Novaluron). (2) Drugs that reduce the absorption of nutrients in the intestinal tract, including biguanide hypoglycemic drugs (hypoglycemic, hypoglycemic tablets, Geritol, Medicom, Dixa, Lixin) and alpha-glucosidase inhibitors (Pegaptan, Bexin, Miglitol). (3) Insulin sensitizers, currently known as Vindia in China, are chemically composed of rosiglitazone maleate, which reduces blood glucose by increasing insulin sensitivity. It is used with caution in patients with abnormal liver function and heart failure. 2, oral hypoglycemic side effects (1) sulfonylurea oral hypoglycemic side effects ① sulfonylurea easy to cause hypoglycemic reaction, mostly occurring in the elderly, the symptoms are often more serious, rapidly into a coma, the blood glucose drops extremely, and hypoglycemia lasts for a long time, and it is difficult to correct. The reason for its occurrence and the method of taking drugs, inappropriate time, too much exercise, too little food and the elderly drug metabolism is slow. ② Gastrointestinal discomfort is a more common side effect of sulfonylureas. ③As its main mechanism of action is to stimulate insulin secretion, it can cause hyperinsulinemia. A very small number of patients have allergic reactions such as skin rash, generalized itching, or abnormal changes in blood counts after taking the drug. If the above situations occur, the drug should be stopped promptly. ⑤ Ubiquinone and D860 may occasionally cause liver function impairment, so liver function should be checked regularly when taking them. (2) Side effects of metformin oral hypoglycemic drugs ① 65% of patients taking glucagon will experience gastrointestinal side effects, about 20% of patients taking metformin will experience gastrointestinal discomfort such as nausea and vomiting, loss of appetite, diarrhea, etc. In addition, some patients will have dry mouth or metallic taste in the mouth. ② Lactic acidosis, a serious side effect of bimatoprost hypoglycemic drugs, especially glucagon. Therefore, elderly patients suffering from serious heart, liver, lung and kidney diseases and alcoholics should avoid taking it. (③) Hypoglycemic reaction, alone application will not cause hypoglycemic reaction, but when bisacodyl glucose-lowering drugs are combined with sulfonylurea glucose-lowering drugs and insulin, hypoglycemic reaction will occur. (3) Side effects of α-glucosidase inhibitors The occurrence of side effects is related to the size of the dosage used, and the most important side effects are gastrointestinal reactions, such as bloating, diarrhea, gastric distension, constipation, abdominal pain and so on are common. Other side effects include headache, dizziness, fatigue, rash, and itchy skin. Use with caution when liver function is not normal. Fifth, the nutritional treatment of diabetic patients Diabetes is a lifelong disease, once the disease is usually difficult to cure completely throughout life. However, if it can be detected in time, it can be completely controlled. Because diabetes itself is a metabolic disease, so nutritional therapy is the basic treatment measures. For some patients with type 2 diabetes, diet alone can achieve the goal of controlling blood glucose, but even patients who inject insulin or oral hypoglycemic agents, without exception, must also adhere to nutritional therapy. The purpose of nutritional therapy is to provide suitable nutrition to ensure physiological needs, and to prevent or delay the occurrence and development of complications, such as blindness, gangrene of the lower limbs, uremia, cardio-cerebral and cerebral vascular diseases, and so on. 1.Control energy to achieve or maintain ideal body weight Being thin or obese is not good for diabetes, especially the latter. Obese diabetic patients, although they can secrete a certain amount of insulin, but due to the insensitivity of human tissues to insulin, can not give full play to its role, so there is a relative shortage. At this time, simply increase the amount of insulin injection, often can not achieve satisfactory therapeutic effect, only to take measures to gradually reduce the weight to be effective. Therefore, reasonable intake of energy, so that people reach or maintain within the range of ideal body weight, in the treatment of diabetes, has a primary position. 2, lipids The saturated fatty acids in animal fats are detrimental to the prevention and treatment of cardiovascular and cerebrovascular diseases, so they should not be used or used sparingly. Most vegetable oils and deep-sea fish oils are rich in fat-soluble vitamins and polyunsaturated fatty acids, the latter of which can lower blood cholesterol, but excessive consumption of fats can easily lead to obesity, so it should also be in moderation. 3, carbohydrates Appropriate increase in the intake of polysaccharide (starch) can improve the sensitivity of the body’s peripheral tissues to insulin. If the control of staple food is too strict, so that the patient is in a semi-starvation state, the energy required by the body will inevitably rely on the decomposition of fat and protein to obtain, thus easily leading to ketosis. Therefore, carbohydrate restriction should be moderate, with a daily intake of 5 to 6 two rice, noodles is appropriate. 4, minerals and vitamins Due to irrational dietary structure, dieting, taking medication and other reasons, will make the intake of minerals and vitamins is insufficient, which will further induce other diseases and aggravate complications, so pay attention to supplementation. Some of these nutrients should be paid special attention to, for example, B vitamins are effective in the prevention and treatment of neurological complications; calcium is effective in diabetic patients prone to secondary osteoporosis; zinc has an impact on the production, secretion, storage and role of insulin; chromium is a component of glucose tolerance factor. 5, dietary fiber Dietary fiber is polysaccharide, but its structure is different from starch. They can not be decomposed by digestive enzymes in the gastrointestinal tract, in the colon can be microbial decomposition and utilization. Dietary fiber is divided into two categories: soluble and insoluble. Soluble fibers include pectin in fruits, alginate in seaweed, konjac glucan in konjac, mucilage, soybean gum, etc., which can improve the body’s sensitivity to insulin, while soluble fibers in the gastrointestinal tract and starch and other intertwined, delaying its absorption, so it can reduce blood glucose, especially postprandial blood glucose. Insoluble fiber can promote gastrointestinal peristalsis, accelerate the food through the gastrointestinal tract, reduce absorption, so it can reduce blood sugar, and can prevent colorectal cancer, but also can make the stool due to the increase in water and soften so as to prevent and control constipation. The skin of grains, the skin and core of fruits and the stems and leaves of vegetables contain a large amount of insoluble fiber. Another advantage of eating high-fiber foods is that they are good for weight loss. High-fiber food can make the volume of food increase, produce a sense of fullness, do not feel hungry, but at the same time do not produce energy, and in the cereals and high protein foods such as soybean bran contains a large number of vitamins and minerals, but also the human body is essential nutrients.