With the improvement of living standard in China, the incidence of diabetes is also increasing year by year, but in clinical diagnosis and treatment and health education for patients, it is found that many patients and even primary medical staff still have some misconceptions in diabetes treatment, which affect the correct treatment of diabetes.
Misconception 1: Medication is used when diabetes is detected Generally, newly diagnosed diabetic patients should first carry out diet control, adhere to appropriate physical activities, live a regular life, maintain emotional stability, lose weight in obese people, and observe for about 1~2 months.
If the blood glucose control is satisfactory after these measures, you can adhere to non-drug treatment. Only those whose blood glucose control is unsatisfactory after the above treatment will be treated with appropriate hypoglycemic drugs.
Misconception 2: Combination of similar drugs
There are many kinds of oral hypoglycemic drugs, such as insulin-producing drugs, biguanides, α-glucosidase inhibitors, insulin sensitizers, etc. The mechanism of action of each class of drugs is different, but the mechanism of action of the same class of drugs is basically similar, so the combination of the same class of drugs is generally not advocated. The combination of drugs of the same class can sometimes lead to severe hypoglycemia.
Misconception 3: Improper drug selection
If obese patients apply insulin-producing agents, pediatric patients apply sulfonylurea oral hypoglycemic drugs, lean patients or those with abnormal heart, lung, liver and kidney functions apply biguanides, and patients with acute complications such as ketoacidosis or serious chronic complications such as diabetic nephropathy use oral hypoglycemic drugs, they are not suitable choices and should be avoided as much as possible.
Myth 4: Taking medication based on feelings
Some diabetic patients are accustomed to judge the good or bad blood sugar control according to their self-perceived symptoms. Many type 2 diabetic patients have less obvious symptoms and do not feel much difference between taking medication and not taking medication, so they think it is not important to use medication or not. In fact, it is not accurate to estimate the condition based on symptoms alone. In clinical practice, only a small number of patients with mild type 2 diabetes have good control of their blood glucose through diet and exercise alone, and the vast majority of patients with type 2 diabetes require medication at the time of diagnosis.
Myth 5: Take medication only, no review
Blood glucose tests can be used to understand the control of the disease and the effect of clinical treatment, and can also be used as an important basis for selecting drugs and adjusting their dosage. With the prolongation of the disease, the effect of many sulfonylurea hypoglycemic drugs gradually decreases, which is called “secondary failure of hypoglycemic drugs” in medicine. Some patients do not pay attention to regular review, they feel psychologically secure because they have not stopped treatment, but if secondary failure of drugs occurs, it is actually the same as no treatment. Some patients have been taking the medicine, but the result is still complications, the reason is this.
Myth 6: Chinese medicine is a cure for diabetes
Neither Western medicine nor Chinese medicine has yet solved the problem of the root cause of diabetes. Objectively speaking, Chinese medicine has a certain role in the prevention and treatment of chronic complications of diabetes, but in terms of lowering sugar, Chinese medicine is far less effective than Western medicine.
Myth 7: Excessive sugar reduction
Many diabetic patients often take a variety of drugs in combination and in excessive doses in order to bring their blood sugar under control quickly, which not only increases the side effects of the drugs, but also makes it easy to overdo it, triggering hypoglycemia and even hypoglycemic coma, which is very dangerous.
Myth 8: Stopping medication without permission
At present, diabetes cannot be completely cured and needs long-term treatment. After taking medication, the patient’s blood sugar returns to normal and the symptoms disappear, but this does not mean that the diabetes has been cured, so the patient should continue to use medication to maintain, and at the same time should not relax the diet control and physical exercise, and should not stop the medication without permission, otherwise it will cause the high blood sugar to return and the condition will deteriorate.
Myth 9: Frequent medication changes
The effect of medicine has a gradual process, with the prolongation of the medication time, the effect of medicine will gradually appear. Many patients do not understand this point, and within a few days of taking the medication, they are not satisfied with the degree of decrease in blood sugar and urine sugar, that is, they think that the medication taken is not effective and are eager to change the medication. In fact, some glucose-lowering drugs (such as insulin sensitizers) can only achieve maximum glucose-lowering effect after taking them for half a month to a month. Therefore, do not easily think that a certain drug is not effective. A more reasonable method is to gradually adjust the dose of the drug according to the blood sugar level, and if the blood sugar still does not drop or is not well controlled when the maximum effective amount of the drug is taken, then change to other drugs or combine with other drugs.
Myth 10: Ignore individualized medication
Diabetes medication emphasizes individualization and should be selected according to each person’s specific situation (such as fat and thin, liver and kidney function status, age, etc.). The so-called “good medicine” is the medicine suitable for the patient’s own condition, not new drugs, expensive drugs are good drugs, other patients with good drugs may not be applicable to another patient. For example, a diabetic patient who had been ill for many years was getting worse and worse with the effect of hypoglycemia, and his blood sugar was not well controlled for a long time, so that he developed diabetic nephropathy and renal insufficiency. Later, he heard from others that metformin was good, and soon after he bought it, it led to the aggravation of kidney damage and “lactic acidosis coma”.