Q: What are the causes of diabetes? How many types are there?
A: There are two main causes of the onset of diabetes, one is hypo-insulinism and the other is insulin resistance. There are two main types of diabetes mellitus, type 1 diabetes and type 2 diabetes. Type 1 diabetes is an autoimmune disease, the so-called autoimmunity is “self-family fighting self-family”, that is, the body sees the islets as foreign substances, to destroy them. At present, type 1 diabetes is treated with replacement therapy, which replaces the damage to the pancreas by replenishing insulin outside the body to achieve the purpose of blood glucose control; type 2 diabetes is a problem with the role of insulin, the amount of regular insulin can not play a corresponding effect, more insulin is needed, just like “inflation”, originally one The effect that one insulin can play is now required to be completed by two or even more insulins, and the long-term overload of secretion work eventually leads to the failure of the islet function.
Q: What are the main hazards of diabetes?
A: Many diabetic patients often do not feel uncomfortable in the early stage, much less affect work and life, but the harm of high blood sugar to health is slowly proceeding, which is a development process from quantitative to qualitative change. The high blood sugar will damage the blood vessel wall and cause the lesion of large blood vessels and microvessels. The lesion of large blood vessels will affect blood transport, leading to ischemia of important organs and various diseases such as cerebral infarction, myocardial infarction and necrosis of lower limbs; microvessels are the place for nutrient exchange between blood and tissues, and if the lesion of microvessels occurs, it will lead to tissue ischemia and hypoxia, causing eye blindness, uremia, diabetic foot and other diseases.
Q: Are people who are overweight more likely to get diabetes? What do normal people need to pay attention to?
A: There is a link between diabetes and fatness. Obese people are prone to insulin resistance. Obesity is a major trigger for the development of diabetes, but it does not follow from this that people of normal weight should not have diabetes. In clinical practice, we often see that normal or even thin people have type 2 diabetes, and they often have severe disease. In addition to routine blood tests and urine tests, the most important thing is to measure blood glucose. If you have a family history of diabetes, or if you have a huge baby over 8 pounds, you are at high risk for diabetes, and it is recommended that you have a “glucose tolerance test” in addition to your regular checkups to determine if your blood sugar is normal.
Q: Should diabetics avoid sweets in their diet?
A: Diabetes is a disease caused by a combination of genetic factors and acquired environmental factors. Acquired environmental factors are dominant. Irregular diet, lack of exercise and excessive obesity are all causes of this disease. The preference for sugar may lead to obesity, but not directly to diabetes. People who are obese are at high risk for diabetes, and it is best to reduce the risk of the disease by consuming fewer sweets. A diabetic diet should be less “sugary”. Sugar is not judged by its sweetness. The sugars that our tastebuds can perceive are “monosaccharides”, but the “polysaccharides” found in carbohydrates are not perceived by the tastebuds. Therefore, some foods that are not too sweet but contain a lot of carbohydrates should also be classified as sparingly eaten. For example, snacks made from flour, soda crackers, sesame seeds, salted bread, rice vermicelli, rice noodles, root vegetables such as potatoes, lilies, sweet potatoes and taro, and nuts such as sunflower seeds, hazelnuts and peanuts.
Q: Can children also get diabetes?
A: Nowadays, the incidence of type 2 diabetes in children is increasing year by year. Children with a family history of diabetes, acquired over-nutrition, low activity level and obesity are the high incidence group. Diabetes has a great impact on the growth and development of children; however, none of the current glucose-lowering medications are suitable for children, so prevention is key. It is recommended that after birth, children should have a balanced diet, eat less or no high-calorie foods like “fast food”, and develop good exercise habits to avoid obesity as the key to preventing type 2 diabetes in children.
Q: Which diabetic patients need to be treated with “insulin”?
A: In the treatment of type 2 diabetes, there are three conditions that need to be treated with insulin.
1.Long-term therapy: Older diabetic patients who have been suffering from the disease for more than 10 years, whose pancreatic function has deteriorated and insulin secretion is very poor, and who cannot control their blood sugar well with more than 2 kinds of oral medications, or who have developed more serious complications, need long-term treatment with insulin.
2.Short-term therapy: Acute conditions such as infection, fever, trauma, surgery, major organ damage, etc. occur during the course of the disease and require insulin therapy in the short term.
3.Rest therapy: If the disease starts aggressively, the blood sugar is very high and the patient is thin, and there are serious symptoms such as diabetic ketosis, it is necessary to use insulin to repair the function of the pancreas in a short period of time.
Q: What are the new breakthroughs and therapies in diabetes treatment?
A: The number of people with diabetes has increased dramatically in recent years, and China is the second largest country after India. At present, there are some new breakthroughs in the treatment of diabetes.
In 2009, gastric diversion, a bariatric surgery, was officially approved for the treatment of type 2 diabetes. After the surgery, only through diet control and exercise, the blood sugar can be controlled satisfactorily and diabetes remission can be achieved.
In the field of medical treatment, a gastrointestinal hormone called “enteroglucagon” was discovered, which is a hormone secreted by intestinal mucosal cells after food enters the intestine, and this hormone can promote the secretion of insulin and inhibit the release of glucagon to lower blood sugar. Based on this discovery, “enteroglucagon” glucose-lowering drugs were produced. At present, there are oral preparations and injections. Oral preparations include sitagliptin, saxagliptin, vigliptin, ligliptin, etc.; injections include exenatide and liraglutide, etc.
3.Cell therapy of diabetes. As a new method, it is still under clinical observation.