Slowly Walking Down the Blood Sugar Hill - Diabetes

Author: Liu Ziye Shanghai University of Medicine and Pharmacy

Reviewer: Guo Lijun, Professor of Shanghai University of Medicine and Pharmacy

Chronic diseases, literally speaking, can be understood as diseases with a long course and slow development. Chronic diseases are like an old man who walks slowly step by step on a road with no end. Chronic disease patients need long-term treatment and care. Diabetes is one of the most common chronic diseases and is also our protagonist today.

1.Is diabetes caused by eating sugar and sweets?

This is not the case. Diabetes is divided into type 1 diabetes and type 2 diabetes. The incidence of type 2 diabetes is higher, and the incidence of type 2 diabetes in my country is about 10%. In other words, one in every 10 people around us may have diabetes, and the incidence rate has a tendency to increase year by year, which needs our high attention.

2. How does diabetes occur?

Blood sugar levels are mainly regulated by insulin secreted by pancreatic β cells. When blood sugar levels rise, pancreatic β cells are stimulated to secrete insulin to encourage tissue cells to take up glucose in the blood, thereby lowering blood sugar levels; when blood sugar concentrations decrease, pancreatic β cells secrete less insulin, keeping blood sugar levels within an appropriate range.

Type 1 diabetes: In the human body, pancreatic β cells are destroyed due to various reasons, and insulin secretion is absolutely insufficient to meet the body's needs for sugar metabolism, resulting in abnormal blood sugar. It is like the wolf pack (insulin) that has been suppressing the lambs (blood sugar) suddenly disappears, and the number of lambs will increase rapidly.

Therefore, once patients with type 1 diabetes are diagnosed, they can only rely on insulin supplementation for treatment.

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Type 2 diabetes: The pathogenesis of type 2 diabetes is different from that of type 1 diabetes. If type 1 diabetes is caused by the loss of insulin, the natural enemy of high blood sugar, and is uncontrolled, then type 2 diabetes is caused by the suppression of the natural enemy, making it unable to suppress the elevated blood sugar. The medical name is "insulin resistance". Insulin resistance will reduce the effectiveness of insulin and cannot meet the needs of sugar metabolism in the body, resulting in elevated blood sugar.

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3. Main manifestations and diagnostic criteria of diabetes

The typical manifestations of diabetes are "three mores and one less", that is, polyuria, polydipsia, polyphagia, and weight loss. In addition to the typical manifestations, it is also necessary (one of them is sufficient): ① fasting blood sugar ≥ 7.0mmol/L; ② blood sugar ≥ 11.1mmol/L 2 hours after a meal; ③ blood sugar ≥ 11.1mmol/L at any time; ④ glycosylated hemoglobin ≥ 6.5%. However, the premise is that other reasons for increased blood sugar must be ruled out, and repeated measurements are required.

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4. Harms of diabetes

The harm of diabetes mainly comes from complications that affect all systems of the body, which is the main cause of disability and death caused by diabetes. Acute complications mainly manifest as diabetic ketoacidosis, diabetic lactic acidosis, etc.; chronic complications include diabetic retinopathy, neuropathy, nephropathy, cardiovascular and cerebrovascular diseases, peripheral vascular diseases, etc. Cerebrovascular disease, retinopathy, and diabetic foot are the main causes of disability caused by diabetes; coronary heart disease is the main cause of death in diabetic patients.

5. Prevention and treatment of diabetes

Diabetes cannot be cured, but controlling blood sugar within a reasonable range can effectively prevent or delay the occurrence and development of complications and improve the quality of life. Prevention methods generally include the following: ① Diet control and balanced nutrition; ② Reasonable exercise and moderate exercise; ③ Self-monitoring and paying attention at all times; ④ Regular physical examinations to reduce the incidence rate.

When facing the long road of diabetes, we must not be afraid of difficulties, but move forward bravely and welcome the dawn!