As an endocrinologist, I have to treat diabetic patients every day, but yesterday I heard that a 30-year-old female colleague had diabetes, and I couldn’t help but feel a little sad that there are more and more diabetics! Maybe it’s partly because we see each other all the time but don’t know about it.
Diabetes was rare a few decades ago, but why is it now an epidemic? The main reason is that the evolution of genes has not kept up with the sudden changes in people’s lifestyles. The genes of modern humans are the result of billions of years of evolution. During the evolutionary process of hundreds of millions of years, our ancestors ran around, hunted and foraged for food, and the food they got was barely enough to keep them alive. The food eaten, fully transformed into energy for ancestors to run around. Food in the body into energy needs insulin as a catalyst, because less food, more activity, insulin utilization efficiency is also high, the need for insulin is relatively small. The genes that have evolved down through so many billions of years do not need to direct the body to produce much insulin, but are sufficient to meet the needs of our ancestors for healthy survival.
In recent decades, people don’t need to run around, they just need to swipe their credit cards or take money out of their wallets, and they have as much delicious food as they want, and their insulin needs have increased greatly. At the same time, people no longer need to run around, often sitting in the office, energy consumption more intake but less consumption, converted into fat stored in the body, hindering the role of insulin, further reducing the efficiency of insulin utilization, insulin is even more inadequate. The genes evolved over billions of years have determined the limited production of insulin, which is completely unable to keep up with the sudden changes in lifestyle. As a result, the blood sugar after food digestion and absorption accumulates in the bloodstream and cannot be further converted, and diabetes is thus created.
So, when it comes to diabetes, almost everyone knows that either dad or mom has it, or relatives, friends or leaders have it. However, even so, certain misconceptions about diabetes medication are still widely circulated, especially the following ones are the most typical.
First, the misconception is that insulin is addictive.
Addiction is often associated with drugs, so it is best to start with the comparison between insulin and drugs.
Insulin is a protein hormone secreted by pancreatic B cells, a substance originally found in the human body, a protein, consisting of 51 amino acids, and in general terms a protein like egg whites, pork, beef, etc. But it is a miraculous and different kind of protein, and four Nobel Prizes have been awarded to it in history. Addictive drugs are alkaloids, a class of nitrogenous alkaline substances that are found mainly in plants and have strong physiological effects on humans and animals. As you can see, insulin is fundamentally different from drugs, not to mention addictive.
What is the role of insulin as the only known hypoglycemic hormone in the body? Insulin is the essential catalyst in the process of burning glucose and is the link that keeps life together. Without it, life would not have the energy to maintain vitality and the chain of life would have to be interrupted. This is the role of insulin. In contrast, drug addiction is the result of external intake and abuse by the person himself, which can produce euphoria accompanied by crazy hallucinations, endangering health and society.
Does a healthy life require fresh air? Does a healthy life need clean drinking water? If there is no air or water, can people still live?
The answer is yes, insulin is the guardian of health, just like fresh air and clean water. Healthy people produce their own insulin in their bodies, and diabetic patients need a little bit of external supplementation because of problems with the insulin production system in their bodies, that’s all. What is the addiction? The diseased organism needs the right and effective treatment to maintain its health.
The reasoning is clear. But this fallacy is widely spread and has a deep legacy of poison. I often see diabetic patients who need insulin asking their endocrinologists worriedly, “Doctor, I heard people around me say that insulin is addictive and that I can’t stop taking it after I take it. I’d better not take it!” In fact, these diabetic patients only need to sit down and think carefully: are the people around them experts, or is the endocrinologist an expert? Are the people around them trustworthy, or is the endocrinologist trustworthy? Is the so-called “addiction” important, or is “health and life” important?
Second, metformin hurts the kidneys.
Metformin, the chemical name is 1,1-dimethylbiguanide hydrochloride, after more than 50 years of clinical application of the test, the safety and effectiveness of the majority of endocrinologists recognized and affirmed, has been more and more widely used clinically, is one of the important means of diabetes patients to fight the disease.
However, there are often patients who need to take metformin full of doubts and anxiety ask: I heard that metformin hurts the kidneys badly, is it? Why don’t we change the drug?
Does metformin hurt the kidneys?
No, it doesn’t. Practice is the only standard to test the truth, 50 years of application history has long proved this, how can it hurt the kidneys? This is a misinformation. The real situation is not that metformin hurts the kidneys, the second is that patients with renal insufficiency should not take metformin. Because renal insufficiency affects the excretion of metformin, so the use of metformin when the kidney function is reduced can accumulate in the body in large quantities, causing hyperlactatemia or lactic acidosis. Specifically, metformin is contraindicated in diabetic patients with serum creatinine levels exceeding 1.5 mg/dL in men and 1.4 mg/dL in women, or with abnormal creatinine clearance.
Metformin hurts the kidneys and can not use metformin when renal insufficiency is a completely different concept, although at a glance they look a little similar, but metformin hurts the kidneys is essentially a misinformation reversing the cause and effect relationship, is wrong not enough to believe.
I may be asked: how can I say that metformin does not harm the kidneys when it is a medicine with three toxins?
It is common to almost all drugs, too much salt can cause death, let alone drugs. From this perspective, metformin has its indications, precautions and contraindications, just like Damacell, Mepida, and Tang Siping, but it is not more “kidney damaging” than Damacell, Mepida, and Sugar Siping.
The old Jia is a retired cadre, suffering from diabetes for many years, insisted on not using oral hypoglycemic drugs, not insulin. The company’s main goal is to provide a comprehensive range of products and services to the public. No, it is not. Then how does he control his blood sugar? By taking Chinese medicine. He spends 2-3 thousand dollars a month on mail-order Chinese medicine from a city in the northwest and claims that his blood sugar is under control.
Can Chinese medicine lower sugar?
According to endocrinologists: it seems to be able to lower a little bit, but it is not reliable to rely on it to treat diabetes. Animal tests have shown that some herbal medicines do have some hypoglycemic effect.
When diabetes is mild, simply controlling the diet can lower blood sugar and receive good results without any drugs. When it comes to learning how to take insulin orally, the limited hypoglycemic effect of some herbs is not enough. So why do a lot of diabetic patients still take Chinese medicine and their blood sugar is still controlled? According to endocrinologists, it’s likely that these Chinese medicines have western drugs in them and are sold at high prices under the guise of Chinese medicine.
The situation is similar to the Chinese medicine to lower sugar is that many advertisements promote “partial cure for diabetes”. The company has been in business for more than 20 years and has been trying out various prescriptions that claim to cure diabetes for more than 20 years. The company’s daughter, who is in college, has repeatedly told her mother that she needs to go to a major hospital to cure her diabetes, and that she cannot believe in small advertisements. Perhaps it is because of the stubbornness of thought at an older age, Liu Da Ma could not listen to her daughter’s advice, but still believed in those small advertisements and went behind her family’s back to the small hutongs to “cure” diabetes. What is the result? The last time she was never discharged from the hospital, she was often rushed to the hospital because of diabetic ketoacidosis. If she hadn’t listened to the advertisements, she could have lived happily for many more decades, hugging her grandchildren and being happy. Unfortunately, it was too late.
This is also the case in the search for medical treatment, medical advertisements are flying around, there are many different opinions in the neighborhood, and even patients and their families are difficult to unify their opinions, it is necessary to remove the falsehoods and distinguish the right from the wrong, so as not to delay the valuable time to treat the disease.