Case sharing 58-year-old Auntie Chen is a “old sugar lover” with a 10-year history of diabetes, and her blood sugar has been under good control. But recently, she had symptoms such as excessive sweating, increased appetite, panic attacks and hand tremors. At first, she thought her blood glucose was not well controlled, but her blood glucose was not significantly high even after repeated measurements at home, so she let her guard down. The symptoms of “three more and one less” became more and more serious, so Chen went to the hospital for examination and was finally diagnosed with diabetes combined with hyperthyroidism. Diabetes and hyperthyroidism have a lot of similar symptoms in the early stages, which often confuse patients and delay treatment. If the two diseases are “combined”, treatment and diet should be adjusted, and early detection is the key. The first thing you need to do is to check for hyperthyroidism when you’re on the alert. It is understood that some diabetic patients, like Auntie Chen, are suffering from hyperthyroidism without knowing it. So, what is the reason why patients are kept in the dark? Since diabetes and hyperthyroidism are both endocrine system diseases, they mostly occur due to autoimmune abnormalities, combined with the influence of environmental, emotional and dietary factors. It is not uncommon for clinical cases of hyperthyroidism and diabetes to coexist. In the early stage of hyperthyroidism, there are often symptoms similar to the “three more and one less” of diabetes (eating more, drinking more, urinating more and losing weight), so it is easy to ignore the disease. In fact, it is not difficult to detect hyperthyroidism in time. When you find that the symptoms of “three more and one less” are aggravated, such as good blood sugar control, but accompanied by panic, sweating, hand trembling, emotional instability, irritability and other symptoms, you should be alert and seek timely medical attention. When the two diseases are “concurrent”, the diet should be reasonably matched. When a diabetic patient suffers from hyperthyroidism, the diet needs to be scientifically matched. Due to the high metabolism of hyperthyroidism, food with high calories, high protein and low fiber should be eaten, while the diet of diabetes requires control of total calories, protein, fat and carbohydrates, etc. The two are contradictory from the perspective of dietary therapy. Professor Li suggests that diabetic patients with hyperthyroidism should limit sugar and iodine, but should also eat foods rich in protein, vitamins and calcium in appropriate amounts. Avoid foods seafood such as kelp, seaweed, shrimp, crab and seafood; hot and spicy foods such as chili, cinnamon, ginger, rooster, duck, mutton and dog meat; stimulating beverages such as strong tea and coffee; and abstain from smoking and alcohol. In addition, exercise should be moderate. When hyperthyroidism is not effectively controlled, strenuous exercise can easily cause arrhythmia, heart failure and hyperthyroid crisis.