Diabetes control needs to be “person-centered”

  Therefore, the prevention and treatment of type 2 diabetes needs to be “people-oriented” 1. One of the comprehensive considerations of “people-oriented”: the risk of hypoglycemia For older people and diabetics who already have cardiovascular disease, hypoglycemia is a more serious risk than hyperglycemia. The recurrence of hypoglycemia increases the risk of diabetic complications, especially heart disease, and increases diabetic deaths.  2, “people-oriented” comprehensive consideration of the second: the risk of heart disease research shows that diabetes about 60% to 80% of deaths from heart disease, lowering sugar at the same time should reduce the risk of heart disease is an important goal of the current diabetes treatment, to consider improving the endothelial function of blood vessels, lowering blood pressure, anti-inflammatory, lipid regulation, blood circulation and other aspects.  3, “people-oriented” comprehensive consideration of the third: the ideal weight diabetes overweight or obese patients have a great risk of complications, I often say “the longer the waistband, the shorter the life expectancy” is to emphasize the vigilance of diabetes abdominal obesity. Insulin, sulfonylureas, glinides, thiazolidinediones can increase weight!  4, “people-oriented” comprehensive consideration of the fourth: liver and kidney function Diabetic patients with liver disease than non-diabetic patients more than 70%, more than 60% of China’s type 2 diabetes combined with kidney disease, a study report shows that within 5 years a quarter of diabetic patients will progress to kidney disease, at least 48% of kidney disease patients each year is caused by Diabetes is the cause of at least 48% of kidney disease each year. If not taken seriously, once the kidney damage occurs, it is difficult to reverse the disease and become uremic. Most glucose-lowering drugs are generally metabolized by the liver and excreted by the kidneys, so when a large number of glucose-lowering drugs are taken, although blood sugar is being reduced, liver and kidney function is also damaged.  5, “people-oriented” comprehensive consideration of the fifth: economic costs In November 2010, the “China Diabetes Socioeconomic Impact Study” reported that the annual cost of diabetes treatment in China amounted to 173.4 billion RMB; the direct medical expenditure of diabetes accounted for 13% of the total national medical expenditure. The direct medical expenditure of diabetes accounts for 13% of the total national medical expenditure, the use of medical services by diabetic patients is 3-4 times higher than that of non-diabetic patients, and the medical expenditure of patients with the disease for more than 10 years is 460% higher than that of patients with the disease for 1-2 years. 89% of patients in 5 cities have medical insurance, and 11% of patients spend all their household income on disease treatment. The medical expenses of diabetic patients were 9 times higher than those of the same age and sex without diabetes. Those with more than 10 years of disease spent 22% of their household income on diabetes treatment.  Given the significant financial burden of diabetes, it is important to consider both treatment options that control blood glucose and reduce diabetes-related complications, as well as cost-utility analyses using pharmacoeconomics to select less costly treatments. As far as the physician is concerned, the author emphasizes that “one must see the doctor, the other must eat”, so choosing the best treatment option that is financially acceptable to the patient and reducing costs will undoubtedly improve the patient’s ultimate prognosis.