Everyone who is concerned about their health, especially middle-aged and older people over the age of 45, should be aware of the “5 carriages” of diabetes treatment. We know that diabetes is a chronic, long-term disease that, once diagnosed, will stay with you for the rest of your life. The treatment of diabetes is not just about lowering blood sugar. It takes skill and approach to control and navigate the demon of diabetes. To manage your diabetes well, you must drive the 5 carriages, which are: diabetes education, blood glucose monitoring, diet, exercise, and medication. They are: diabetes education, blood glucose monitoring, diet therapy, exercise therapy, and medication. The following is a description of each: 1. Organized and comprehensive diabetes education can help patients gain a comprehensive understanding of diabetes, help them learn how to control their diet, how to exercise, how to use medication, how to deal with hypoglycemic reactions, how to deal with acute complications, how to prevent and deal with chronic complications, etc., and help them learn to properly deal with the adverse effects of the disease on their lives, studies and work. Just like DD Taijiquan, the highest level of Chinese martial arts, no matter how powerful the disease is, I have my own way to dissolve it one by one easily, and it flies away in a flash. Managing and treating diabetes is also an art that needs to be mastered through learning. If you learn it well, you will gain for life. 2, blood glucose monitoring We often compare diabetes to the “sweet honey killer”, which hides in the shadows and is difficult to detect. Without knowing the enemy, how can we defeat them? The best way to expose the enemy to the sun is blood glucose monitoring. If the blood sugar is not high, it means that the enemy has been “temporarily suppressed” by our artillery fire. Multiple high blood glucose checks suggest that our attack plan needs to be further changed. Monitoring blood glucose requires skill. For patients treated with oral hypoglycemic drugs, monitoring fasting (6-7 a.m.) and postprandial (2 hours from the first bite) blood glucose 3-4 times a month can give a general idea of blood glucose fluctuations. In contrast, for a patient receiving insulin therapy, blood glucose needs to be monitored at least five times a day, including fasting, 2 hours after three meals and at bedtime. This all-day blood glucose monitoring is called a “blood glucose profile”. Patients can monitor 2-3 full days per month and adjust their insulin dosage according to the blood glucose profile. Otherwise, adjusting insulin dosage based only on the blood glucose value at one point once in a while will often lead to losing the battle because of incomplete understanding of the enemy. Patients who ask their doctors to adjust the treatment plan based only on 1-2 blood glucose values are likely to mislead their doctors and fail to achieve good treatment results. Generally, during the period of blood glucose stabilization, the number of monitoring can be reduced appropriately. During the period of medication adjustment, the number of blood glucose monitoring is increased, even 8-9 times a day. There is an old Chinese saying “If you know yourself and your enemy, you will never lose a hundred battles”. The importance of blood glucose monitoring is self-evident. In the process of blood glucose monitoring, it is necessary to monitor the changes of blood pressure, weight and lipid every year, and adjust the antihypertensive and lipid-lowering treatment plan according to the monitoring results. 3. Diet therapy Whether for type 1 or type 2 diabetic patients, diet therapy is the most important therapeutic measure, which runs through the whole process of diabetes treatment and is the basis of comprehensive diabetes treatment. Without the correct diet plan, taking more drugs and injecting more insulin, blood sugar control will not be satisfactory. Diet has the following principles: small amount of meals, total control, fixed calories, variety, reasonable mix, vegetable-based, fish and meat appropriate. Keep the weight moderate and avoid over and under nutrition. Patients are advised to buy a book on diabetic diet treatment and learn to cook a few delicious and nutritionally well-matched small dishes to improve blood sugar control and at the same time, have a good meal. The diet should also take into account the prevention and treatment of hypertension, hyperlipidemia and hyperuricemia. A low-salt, low-fat diet is the most appropriate meal plan, and animal offal and seafood are also best eaten sparingly. The formulation of a diet plan is relatively simple, but the implementation is difficult. We should first have a sense of healthy eating, and then gradually penetrate into the three meals a day. A mouth can not eat into a fat, slowly change well. A study was done on a group of people with a long-term salty diet, given a light diet. In the first 2-4 weeks, these people are very uncomfortable with the light diet, appetite decline. But after 1-2 months, they accepted the list diet and rejected the salty food. Therefore, for dietary adjustment, one cannot expect to make complete changes in 1-2 days, but with effort, it is possible to form new healthy eating habits after 1-2 months of adaptation. 4, exercise therapy Among the 5 carriages of diabetes, exercise therapy is a more difficult carriage to navigate. For middle-aged friends, work is intense, life is strenuous, where there is time to exercise 3 times a week, and each exercise time needs to be more than 40 minutes. For older people, running and exercising is far less comfortable than resting at home, not to mention that hugging grandchildren is too busy. But let’s take a look at how those who keep exercising for a long time look at sports. “Every day running, which day not running, all uncomfortable, no energy.” “Exercise used to, which day does not go out, bored.” It can be seen that physical exercise is a habit, once this habit is formed, do not exercise can not. Just like a person who is used to riding a horse, do not let him ride a horse, but not adapt. Therefore, for diabetic patients, it is worth forcing themselves to accept painful exercise, after a period of “adaptation period”, I believe you will also like to skate around the corner of life every day, will also like to walk fast when the feeling of fitness, like the youthful vitality brought about by exercise. For more information on how to choose the intensity of exercise and exercise, you can refer to the chapter on weight loss exercise in this book. 5.Medication There are countless glucose-lowering drugs available in the market, and many of them are advertised as being able to “cure diabetes completely”, so the choice of glucose-lowering drugs must be made carefully. First of all, patients should go to a regular hospital to get a clear diagnosis and ask the doctor to help them choose medication according to the severity of their condition. Adjust the oral medication according to the blood sugar control, sometimes, the earlier choice of insulin therapy is a more brilliant choice. Secondly, learn to recognize the authenticity of advertisements to prevent being cheated and fooled. Every patient wants to be cured of diabetes, and unscrupulous people take advantage of this eagerness and ignorance of diabetes to promote their “ancestral” or “newly developed” miracle drugs with great success. Imagine if there really existed a very effective hypoglycemic drug, in today’s highly developed society of information and technology, the difference between the market in the United States and the market in China would be no more than one year. In other words, if a good drug is available, it should be fully available in regular hospitals. The choice of medication should be based on one’s financial situation. Pursuing the latest, most expensive, and best medication not only causes a heavy financial burden, but also may result in adverse side effects of the new medication. The shorter a drug has been used, the greater the possibility of clinical problems. Therefore, when choosing an oral medication, you should honestly inform your doctor about your financial situation, what you can afford to pay for the medication each month, and after a collaborative discussion, choose the most appropriate, not the most expensive, medication. In conclusion, driving five carriages at the same time requires not only courage and perseverance, but also knowledge and skills, an optimistic and fearless spirit and a broad mind to fight against the disease. I believe that after a period of practice, you will be able to master the driving skills, easily drive the 5 carriages, like Santa Claus, happy to fly into the sky, smoothly run through the road of life.