Pre-diabetes, also known as impaired glucose regulation, is an abnormality of glucose metabolism between normal blood glucose and diabetes, and is a pre-diabetic stage in the natural course of diabetes, including impaired fasting glucose (IFG) and abnormal glucose tolerance (IGT), both of which can occur separately or in combination.
Epidemiological studies have shown that the prevalence of diabetes in adults over 20 years of age in China is 9.7% and the prevalence of pre-diabetes is 15.5%. Diabetes is a lifelong disease that can lead to cardiovascular, renal, ophthalmic, and neurological lesions. In severe cases or when exposed to stress factors such as trauma and infection, serious acute complications such as ketoacidosis and hyperosmolar coma can occur, which can be life-threatening if not diagnosed and treated early.
Pre-diabetes is a process that almost all patients with type 2 diabetes must go through, and its incidence is significantly higher than that of diabetes, and if its development is not effectively curbed, the incidence of diabetes will further increase. Pre-diabetes is not only a high-risk group for diabetes, but various chronic complications of diabetes already appear at this stage, such as microangiopathy – lesions of the kidney and retina, neuropathy and macrovascular lesions such as cardiovascular and cerebrovascular.
Therefore, early detection of pre-diabetic patients and effective treatment to reverse and not transform into diabetes is an important means to prevent the occurrence of diabetes, which is also the embodiment of the idea of “treating the disease before it occurs” in Chinese medicine.
The occurrence of pre-diabetes, in addition to certain genetic factors, is mainly related to poor lifestyle.
1, the diet is not reasonable. Excessive consumption of fatty, sweet and oily products, long-term excess nutrition, resulting in the body’s metabolic dysfunction and induce pre-diabetes.
2, excessive smoking and alcohol. Nicotine in cigarettes can promote the secretion of adrenaline in the body, so that blood glucose increases, long-term alcohol consumption can cause increased blood lipids and liver glycogen isogenesis disorders, are the causative factors of pre-diabetes.
3, living irregularly. Irregularity in living, staying up late, sleeping these bad habits affect the metabolic function of the human organism, triggering the production of pre-diabetes.
4, lack of exercise. With the improvement of living standards, people rely on cars and other means of transport, and do not pay attention to physical exercise, research shows that exercise can suppress appetite, reduce weight, improve insulin resistance, promote the use of glucose and increase energy consumption, has an important role in reducing blood sugar.
5, emotional and mental disorders. Modern people’s fast-paced life, high pressure, excessive tension and anxiety can cause endocrine dysfunction and induce pre-diabetes. Therefore, lifestyle interventions for pre-diabetic patients help patients return to normal blood sugar, reduce the incidence of diabetes and diabetic complications, and improve the quality of life. Life intervention is mainly carried out from three aspects: diet, exercise and psychological adjustment.
I. Dietary guidance
The main sources of human glucose are carbohydrates, fats, proteins and other substances in food. After eating, food decomposes a large amount of glucose into the blood under the action of human enzymes, causing the rise of blood sugar. The secretion of insulin in normal people also increases accordingly to keep blood sugar within the normal range. However, the presence of insufficient insulin level and insulin resistance in diabetic patients cannot effectively suppress the rise of blood glucose, and the state of hyperglycemia will occur.
The carbohydrates, fats and proteins in food are the main source of energy for the human body and are the main substances to maintain the life activities of the human body. Excessive control of diet can cause nutritional deficiency, make the body thin and weak, and reduce the resistance. Therefore, pre-diabetic patients must properly control their diet, both to eat enough and nutritious. Diet therapy is the basic treatment for diabetic patients and should be adhered to for a long time.
The diet of pre-diabetic patients should pay attention to the following points.
1, try to reach and maintain the standard weight. (Standard weight = height cm – 105)
2, balanced diet. Adhere to the traditional diet concept, “five grains for nourishment, five vegetables for enrichment, five fruits for help, five animals for benefit”, the daily diet can intake enough protein, carbohydrates, fat, vitamins, inorganic salts, trace elements and dietary fiber, not partial food.
3.Strictly control total calories.
(1) 4-6 taels of staple food per day, and it is advisable to mix refined and coarse grains. Avoid foods with high monosaccharide content, such as sugar, jam, pastry, red dates, honey, etc.
(2) Daily fat intake should be less than 50 grams, with less than 20 grams of cooking oil. It is recommended to consume vegetable oils containing polyunsaturated fatty acids such as peanut oil, sesame oil, and even olive oil as cooking oil. Avoid foods rich in poly-saturated fatty acids, such as fatty beef, lamb, pork and cream. Cooking should be done more often by steaming, boiling, stewing, mixing and brining. Avoid methods such as frying and deep-frying.
(3) Daily protein 1.0 g/kg body weight. Adequate amount of high-quality protein is beneficial for repairing the function of pancreatic islets. A minimum of one bottle of milk and one egg per day should be ensured. In addition, one or two soybean products, 2-3 pairs of poultry meat, 2-3 pairs of fish and shrimp per day to ensure the daily protein requirements.
4, to ensure that more than 500 grams of fresh seasonal vegetables every day. B vitamins can prevent and control diabetes complications and are abundant in dried beans and coarse grains. Vegetables contain sufficient dietary fiber, which can adsorb many harmful substances in the body, including sugar, slowing down the absorption of sugar, thus lowering blood sugar, lowering blood fat, preventing constipation and preventing cancer.
Vegetables that can be consumed freely (containing sugar 1%-3%): soybean sprouts, mung bean sprouts, bok choy, leek, bitter melon, coronary, cabbage, cabbage, cucumber, tomato, celery, green pepper, lettuce, winter melon, loofah, etc.
Excessive consumption of vegetables that require a reduction in staple foods: potatoes, kidney beans, bean curd, lotus root, eggplant, pumpkin, string beans, etc.
5, reduce salt intake, less than 6 grams per day.
7, paste-like food, such as thin rice, porridge and other high glycemic index, is not conducive to blood sugar control, can damage the function of the islet, try not to eat.
8, diet during exercise: do not exercise immediately after eating, and should exercise 1-2 hours after meals. If the exercise time is long, you can eat properly before and after exercise or halfway through exercise to prevent hypoglycemia during exercise.
II. Exercise instruction
Exercise therapy is an important measure in the treatment of diabetes. Moderate and regular exercise can enhance physical fitness and improve resistance to disease, which can increase the sensitivity of muscle tissue and other tissues to insulin, reduce the resistance to insulin in the body of pre-diabetic patients, increase the utilization of sugar, consume energy and make blood sugar fall. Exercise should pay attention to the following points.
1, exercise should choose relatively soft and light shoes, comfortable dress code.
2, choose the amount and frequency of exercise suitable for you. Choose aerobic exercise of low to medium intensity. Patients who are younger and in better physical condition can choose exercise of medium intensity; elderly people or patients with poor physical condition such as cardiovascular complications can choose exercise of lower intensity.
Exercises of different intensities (each of the following exercises, on average, consumes about 80 kcal in the corresponding time. The amount of calories consumed will gradually increase as the duration of exercise increases)
Minimum intensity exercise (about 30 minutes of exercise)
Low-intensity exercise (about 20 minutes of exercise)
Medium-intensity exercise (about 10 minutes of exercise)
High-intensity exercise (about 5 minutes)
Walking, doing housework, playing tai chi, shopping
Ballroom dancing, going down stairs, cycling
Jogging, going up the stairs, doing radio exercises
Jumping rope, swimming, playing basketball
Exercise to maintain the pulse rate (times / minute) = 170 – age, but also according to your own feeling to master, that is, the perimeter of the body is hot, sweating, but not dripping sweat or panting, can talk can not sing.
3, choose the right time to exercise.
Should be counted from the first bite of food, in about an hour after the meal to start exercise, because at this time higher blood sugar, exercise is not easy to occur hypoglycemia, each exercise lasts 20-30 minutes is appropriate. Never exercise on an empty stomach.
4. Exercise needs to be adhered to for a long time, regular and quantitative, and cooperate with diet and medication. If you eat more, you can exercise more for a while and have a good effect of lowering sugar.
Three, psychotherapy
The occurrence and development of pre-diabetes is related to excessive mental tension, poor interpersonal relationships, sudden life misfortune and other social and psychological adverse stimuli, so in the treatment of pre-diabetes, psychological and emotional regulation and diet, exercise, drugs have an equally important role.
1, overcome the psychological tension and anxiety. Neither disregard the disease, nor too nervous and anxious, worry, but aggravate the disease, should be treated correctly, active treatment, perseverance, maintain an optimistic and positive attitude, has an important role in controlling the disease.
2, “tranquility and emptiness, the spirit is the cure”. Should be broad-minded, contented and happy, do not give yourself too much pressure. Combination of work and rest, a good state of mind can effectively control the disease.
3.Empathy and sex. Can cultivate their hobbies, transfer excessive anxiety about the disease, but also to make life full and colorful, adjust the emotional stability.
4, learn to self-adjustment. The seven emotions of happiness, anger, sadness, pity, fear and fright can hurt people, in life should learn to self-adjustment, do not have too much emotion, emotion and harmony, qi and blood running smoothly, can improve the pre-diabetes, prevent its further aggravation and transformation into diabetes.