Common knowledge and misunderstandings that diabetics should know

Among neurological diseases, many patients have a history of diabetes, and many of them seek medical treatment for complications of diabetes, including stroke, peripheral neuropathy and other diseases. Neurologists have always been paying attention to this group of people. In view of this, some common sense about diabetes is summarized as health science popularization to help everyone improve their correct understanding of diabetes.

Current situation: my country has the largest number of diabetics in the world, with 1.3 billion patients, 90% of whom are type 2 diabetics, and more than half of whom are not controlled to the target. This situation significantly increases the risk of complications and seriously threatens the health and life safety of patients. In recent years, there has been a trend of younger diabetics, which should attract the attention of the whole society and actively control blood sugar levels.

Complications: If diabetic patients do not control their blood sugar well, the following complications may occur:

1. Damage to large blood vessels can lead to cardiovascular and cerebrovascular diseases, including the risk of cerebral infarction, angina pectoris, myocardial infarction, etc.

2. Damage to microvessels can cause diabetic nephropathy, diabetic retinopathy, diabetic foot, and in severe cases, insomnia and amputation;

3. Damage to peripheral nerves may cause diabetic peripheral neuropathy, resulting in symptoms such as limb paresthesia and oculomotor nerve paralysis.

Strategy : If diabetic patients want to control their blood sugar, it is very important to use medication scientifically. However, if they rely entirely on medication and ignore lifestyle adjustments, the blood sugar lowering effect will not be very good.

The blood sugar level of diabetes is closely related to factors such as diet and exercise . Therefore, it is necessary to take medication in addition to adjusting the diet and exercising appropriately to achieve a better blood sugar-lowering effect.

Control target: Generally speaking, fasting blood sugar should be controlled at 4.4~7.0 mmol/L, and postprandial blood sugar should be controlled at <10mmol/L; glycosylated hemoglobin <7.0%. The control range can be appropriately relaxed for those with cardiovascular and cerebrovascular complications or the elderly.

In our clinical work, we found that many diabetic patients have insufficient knowledge about diabetes and often have the following misunderstandings. Based on consulting with endocrinologists and reviewing materials, we have summarized some knowledge and hope that diabetic patients and their families can refer to it to achieve better blood sugar control and reduce the occurrence of diabetic complications.

6 common misconceptions about diabetes

1. If you have high blood sugar, the less staple food you eat, the better?

Answer: Wrong!

For diabetes, the first thing to do is to control your diet, but control does not mean not eating. If you don't eat, the body will lack nutrients, which is bad for the body.

When it comes to a diabetic diet, the first thing to consider is daily energy intake . Many diabetic patients think that diet control is starvation therapy, and they eat very little or even no staple food at each meal. If energy intake is too low, the body is in a state of starvation, which can cause lipid metabolism disorders and even ketoacidosis.

Scientific diet to control blood sugar should follow the principle of balanced diet. Under the premise of controlling total energy, the dietary structure should be adjusted to meet the body's needs for nutrients, so as to achieve the purpose of stable sugar control, reduce blood sugar fluctuations, and prevent diabetic complications.

Diabetic patients should ensure at least 150 grams of staple food every day, and try to: match coarse and fine food, with whole grains and beans accounting for one-third of the staple food intake; prefer dry food to thin food, rice porridge, batter, and soft noodles have a high glycemic index and should be eaten less; chew slowly to increase satiety; eat staple food last, in the order of soup → vegetables → meat and eggs → staple food. In short, it is unscientific to control blood sugar by not eating staple food.

Expert reminder:

Not eating staple foods for a long time will increase the burden on the liver. For diabetic patients, severe cases may cause "starvation ketosis."

2. Can diabetics eat meat?

Answer: Wrong!

Meat is a must in the diet of diabetics! Meat is an animal protein, and protein is the material basis of all life. Moreover, meat is a high-quality protein with a higher utilization rate in the body, better than soy protein, so diabetics must eat meat!

Expert reminder:

White meat is better than red meat, fish and shrimp>chicken and duck>lean beef and mutton>pork, and it is appropriate to consume no more than 3 taels per day.

3. Can’t eat fruit if you have high blood sugar?

Answer: Wrong!

Some fruits do have a lot of sugar, but you can choose low-sugar fruits, such as apples, strawberries, grapefruits, etc. It is okay to eat them in moderation.

Because fruits contain a lot of dietary fiber, minerals and vitamins; after these nutrients enter the gastrointestinal tract, they can regulate the balance and activity of intestinal flora, and have a good regulatory effect on the body's "sugar and lipid metabolism".

Vegetables and fruits mainly provide dietary fiber and vitamins. It is recommended to eat 500-1000g of fresh green leafy vegetables and 200-300g of colorful fruits every day. Within this range, there is no need to worry about the sugar content.

Expert reminder:

It is important to note that it is recommended to eat fruit in small amounts and multiple times a day. Do not eat it immediately after a meal, but eat it between meals to avoid high blood sugar levels after meals. Also, be careful to control the amount of fruit to within 200g at a time.

4. Can I eat sugar-free foods as much as I want?

Answer: Wrong!

Although sugar-free foods do not contain refined sugars such as sucrose during production, many of them still contain a lot of starch, which will gradually decompose into glucose in the body. If diabetics eat too much, their blood sugar will also rise. Sugar or no sugar is only relative, don't be confused by the superficial name or concept. In fact, the so-called sugar-free food itself is also made of grains, which will turn into glucose after digestion and decomposition, and the sugar and calories absorbed by eating steamed bread and rice are no different.

Expert reminder:

Any food that provides calories can increase blood sugar levels and cannot be eaten without limit. If you want to eat these "sugar-free foods", you must calculate their calories in the total daily calorie intake and reduce the amount of staple food accordingly.

5. Is it possible not to take medicine if diabetes has no symptoms?

Answer: Wrong!

If the symptoms of diabetes are mild, the disease occurs early, and the blood sugar is not particularly high, through diet control and proper exercise, if the blood sugar can be controlled to the normal range, that is, it can reach below 6.1mmol/L when fasting and below 7.8mmol/L after meals, it is not necessary to take medicine. However, as the disease progresses, typical symptoms of "three mores and one less" will gradually appear, that is, eating more, drinking more, urinating more, losing weight, or complications. Therefore, even if there are no obvious symptoms in the early stage, active treatment is still needed.

Expert reminder:

If blood sugar cannot be well controlled, you need to take hypoglycemic drugs or inject insulin under the guidance of a doctor to control blood sugar levels to reduce the occurrence and development of complications.

6The faster blood sugar lowers, the better?

Answer: Wrong!

High blood sugar has a huge impact on health, but if you want to lower your blood sugar, you must do it steadily and not too quickly, as this will have obvious adverse effects on the body.

Expert reminder:

If the blood sugar level is lowered too quickly, the body will not be able to adapt, which may induce hypoglycemia, rebound hyperglycemia, blurred vision, dizziness, etc.

About diabetes - 5 important tips

1. Match the coarse and fine staple foods

In principle, the staple food of diabetic patients should account for 55% to 65% of the total daily calories, generally 200 to 300 grams per day.

As for the choice of staple food, it is recommended to combine coarse and fine grains, replacing some refined rice and flour with coarse grains. This combination will help delay the increase in blood sugar after meals.

The staple food should be rationed, the main sources of carbohydrates should be whole grains, various beans, vegetables, etc., and the amount of fruit should be limited;

Vegetables should be included in every meal, 500g per day, of which dark vegetables should account for more than half;

Consume milk and soybeans every day, eat fish, poultry, eggs and meat regularly, which are good sources of protein.

Reduce the intake of fatty meat, eat less smoked, baked, pickled and other processed meat products, and control the amount of salt, sugar and oil used.

2. Eat fruits for health

For diabetic patients, fruits can be eaten, but special care should be taken in choosing them so as to supplement nutrition without exceeding blood sugar levels.

Fruits suitable for diabetics: cherries, papayas, plums, strawberries, lemons, nectarines, apples, grapefruits, oranges, prunes, kiwis

3. Exercise moderately

Exercise not only helps control blood sugar levels, but also helps patients lose weight. Exercise makes patients more sensitive to insulin. Aerobic exercise is recommended 3 to 7 times a week for a total of 150 to 300 minutes of moderate intensity exercise. If it is high-intensity exercise, it is recommended to exercise 75 to 150 minutes a week. The recommended exercise time is 1 hour after a meal, which can help control blood sugar and prevent unsafe events such as hypoglycemia.

According to your own situation, you can choose the sport that suits you, such as: walking, Tai Chi, cycling, jogging, swimming, playing ball, etc.

4. Check blood sugar

Patients with different conditions can flexibly choose the time and frequency of blood sugar monitoring according to their own conditions: patients with good blood sugar control can measure fasting blood sugar and 2 hours after meals 1 to 2 days a week; patients with poor blood sugar control are best to monitor blood sugar throughout the day 4 to 7 days a week, 4 to 7 times a day; patients with high risk of hypoglycemia should pay attention to midnight blood sugar, pre-meal blood sugar and immediate blood sugar when there are symptoms of hypoglycemia.

5. Focus on comprehensiveness

The treatment of diabetes is a comprehensive treatment. On the basis of diet control and regular exercise, the correct and regular use of hypoglycemic drugs can achieve better therapeutic effects.

Professor Xu Yaoming

Chief Physician and Postgraduate Supervisor of the Department of Neurology, Affiliated Hospital of Inner Mongolia University for Nationalities

Visiting scholar of the Light of the West of the Organization Department of the CPC Central Committee;

Member of the Translational Medicine Society of the Chinese Stroke Society;

Member of the Cerebral Venous Disease Branch of the Chinese Stroke Society;

Member of the Cerebrovascular Disease Branch of the Chinese Geriatrics Society;

Standing Committee Member of the Neurointervention Branch of the Inner Mongolia Medical Association;

Vice Chairman of the Rare Diseases Branch of the Inner Mongolia Medical Association

Member of the Neurology Branch of the Inner Mongolia Medical Association;

Standing Committee Member of the Neurology Branch of Tongliao Medical Association;

The title of Inner Mongolia Innovation Pioneer;

Outstanding scientific and technological worker of Tongliao City;

Tongliao City Top Ten Youth Science and Technology Award;

Advanced Individual in Scientific and Technological Innovation of Tongliao City;

Tongliao City May 1st Labor Medal;

Young editorial board member of Drugs and Clinical Medicine

Participated in the compilation of the White Paper on Innovation of Medical Device Industry for Ischemic Cerebrovascular Disease in China.

Participated in writing the "Chinese Expert Consensus on the Diagnosis and Treatment of Head and Neck Venous Reflux Obstruction",

Chief editor of the monograph "Acute Ischemic Stroke - From Theory to Practice"

Graduated from: Xuanwu Hospital of Capital Medical University, studied under Academician Ji Xunming, Vice President of Capital Medical University

Contributing author: Chief physician and postgraduate tutor of the Department of Neurology, Affiliated Hospital of Inner Mongolia University for Nationalities

Professor Xu Yaoming