Diabetes mellitus is a chronic metabolic disease. China’s diabetic patients are increasing day by day, has become the world’s largest number of people suffering from the disease. We all know that diabetes is not terrible, the terrible thing is the complications, so timely and relevant examination, the prevention of complications can play a very good preventive role. However, there are many misconceptions in the daily checkups, which are listed below one by one!
Myth 1: Blood sugar check
Monitoring blood sugar for diabetics is a key part of treatment. Some sugar lovers have the following misconceptions when checking blood sugar.
1, stop using hypoglycemic drugs before measuring postprandial blood sugar
The purpose of checking postprandial blood glucose is to check the control of diabetes by drugs. If the blood glucose is measured after stopping the medication, the test result cannot accurately reflect the condition, and will cause blood glucose fluctuation or even aggravate the condition.
Therefore, in order to reflect the real situation of glycemic control of sugar lovers and to avoid blood sugar fluctuation caused by stopping medication, sugar lovers should use their medication normally on the day of blood sugar check.
2. Excessive control of diet before the examination
In order to get the ideal blood glucose monitoring value, some patients excessively control their diet before the examination, and the blood glucose result measured at this time may be normal or low, but it cannot represent the real situation of the usual blood glucose control.
To ensure the authenticity of the test results, medication and meals before the test should be the same as usual. Also ensure good sleep and don’t have mental burden!
3.Only do fasting blood glucose check, less or no postprandial blood glucose check
In fact, postprandial blood sugar is also one of the indicators of blood sugar monitoring. In the early stage of diabetes, often manifested as postprandial blood glucose is elevated and fasting blood glucose is normal, if only check fasting blood glucose, some early diabetic patients may be missed.
Compared with fasting blood glucose, postprandial blood glucose is more closely related to diabetic macrovascular complications, strict control of postprandial blood glucose can help prevent diabetic macrovascular complications; in the treatment, early diabetic blood glucose only in the postprandial rise, should be selected for postprandial blood glucose short-acting hypoglycemic drugs more appropriate, and for fasting and postprandial blood glucose are high patients, the combined application of long and short-acting hypoglycemic drugs is more effective.
Misconception two: urine sugar as a treatment indicator
Diabetes is defined as a positive urine sugar qualitative test. The excretion of sugar in the blood in the kidney depends on three factors: the concentration of blood sugar, the filtering ability of the kidney for blood sugar, and the reabsorption ability of the kidney for blood sugar. So kidney disease and some other diseases can also cause positive urine sugar.
In diabetes, the amount of urine sugar is controlled by the renal sugar threshold, and sometimes urine sugar is often not proportional to blood glucose. Some diabetic patients have a higher renal threshold when their disease worsens, and can have a negative urine sugar, when in fact the blood sugar is already high.
Therefore, positive urine sugar is not necessarily diabetes, and negative urine sugar in diabetic patients does not mean that the blood sugar control is better. Some patients with negative urine glucose tests think that blood sugar is normal, or according to the number of urine glucose “+” as the basis for adjusting the use of hypoglycemic drugs, insulin dose, which is wrong.
Misconception 3: Rarely do glycemic examination
Fasting blood glucose and postprandial blood glucose reflect instantaneous changes in blood glucose levels, and the measured values at each time point are not exactly the same.
The main reason for elevated glycation is the elevated blood glucose level and the long duration of the elevation, which is structurally stable until the end of the 120-day life cycle of red blood cells, when glycation is degraded and disappears.
Blood glucose level fluctuates at any time during the day, while the fluctuation range of glycation level in healthy people is very small (0.1%~0.2%), which objectively reflects the average level of blood glucose in 2~3 months, and can accurately reflect the efficacy of blood glucose control in 2~3 months, and is internationally recognized as the “gold standard” of blood glucose monitoring.
At the same time, sugar is an important indicator for monitoring the complications of diabetes. Long-term maintenance of glycemia at a stable level can help reduce the risk of complications in diabetic patients.
Myth 4: No insulin function test
This test can understand the quality and quantity of insulin secretion, make a preliminary determination of insulin resistance, and clarify the basic condition of diabetes, which is a fundamental test to guide diabetes treatment and prevention. Only after a comprehensive understanding of the patient’s insulin function can effective glucose-lowering drugs be selected for treatment.
Myth 5: Rarely do complication-related tests
Diabetes is often accompanied by structural and functional changes in multiple tissues and organs. To further understand whether the patient has complications, various laboratory tests should be done.
1, lipid examination (mainly including total cholesterol, triglycerides, low-density lipoprotein cholesterol, etc.): diabetic patients are often accompanied by dyslipidemia, which can easily cause atherosclerosis and various cardiovascular diseases.
2.Ophthalmology examination: check visual acuity, lens, fundus to understand whether there are diabetic eye lesions and whether they need active treatment.
3, pulmonary examination: the incidence of tuberculosis in diabetes is 3 to 4 times higher than in non-diabetes.
4, heart and blood vessel examination: diabetic heart disease is often found clinically in diabetic patients without heart disease symptoms, timely electrocardiogram and cardiac ultrasound examination is necessary; check the standing blood pressure to understand whether there is diabetic autonomic neuropathy and hypertension; check the shape of the foot, vascular pulsation to understand whether there is diabetic foot lesion.
5.Liver examination: Many type 2 diabetic patients often have obesity, dyslipidemia, fatty liver and abnormal liver function at the same time.
6, kidney and urine examination: diabetic nephropathy is a common chronic complication of patients. Check 24-hour urine albumin and β2 microglobulin, renal function, renal ultrasound to understand the presence of diabetic nephropathy, which is important to understand the development of renal disease and prognosis; urine routine examination to understand the presence of urinary tract infection and diabetic ketosis.
7.Electromyography can understand the presence of body neuropathy.