To prevent complications of diabetes, you need to do these things!

Author: Lin Lin, deputy chief nurse, Beijing Chaoyang Hospital, Capital Medical University

Reviewer: Li Guangwei, Chief Physician, Fuwai Hospital, Chinese Academy of Medical Sciences

Vice Chairman of the Chinese Medical Association Endocrinology Society

Many diabetics know that high blood sugar is not scary, but complications are. Chronic complications of diabetes are all over the body, such as diabetic foot disease, diabetic retinopathy, diabetic nephropathy, diabetic cardiovascular and cerebrovascular diseases, diabetes-related osteoporosis, oral problems, etc. Effectively controlling blood sugar is a key measure to prevent chronic complications of diabetes.

At the same time, there are some special aspects for the prevention of different chronic complications.

1. What special attention should be paid to prevent diabetic foot?

First, avoid external injuries such as bumps and don’t pick your feet frequently to avoid scratching them.

Patients with corns on their feet should seek help from professional doctors. It is not recommended to use chemical drugs or treat them with sharp instruments on their own to avoid accidental injuries.

When trimming your toenails, don't trim them too short, especially the part that is dug into the flesh. Don't trim it too hard. Just cut it evenly and polish the edges of the nails smooth.

Second, choose a pair of shoes that fit your feet.

When diabetics buy new shoes, it is recommended to buy them in the afternoon, because the feet are more swollen in the afternoon, and it will be more comfortable to wear shoes at this time.

In addition, patients are not recommended to wear pointed, hard, thin-soled or high-heeled shoes. It is recommended to choose round-toed, wide, non-pinching, thick-soled, comfortable and breathable shoes.

Third, the water for washing feet should not be too hot, and soaking feet is not recommended.

For diabetics, the water temperature for foot washing should be below 37℃. Wash your feet clean and then dry them. Soaking your feet is not recommended. If you are used to soaking your feet, do not soak for more than 10 minutes.

Because the skin of diabetics is not well nourished, they are more likely to breed bacteria and get infected than normal people. After soaking your feet, the skin becomes thinner and wrinkled, which increases the chance of infection.

Figure 1 Original copyright image, no permission to reprint

In addition, if you experience symmetrical numbness, tingling, burning sensation, or pain in both legs, or if your sense of pain, temperature, or touch is reduced or even lost, seek medical attention immediately.

2. What should we pay special attention to in preventing diabetic retinopathy?

First, once diabetes is diagnosed, it is recommended that patients undergo an eye fundus examination once a year.

Now diabetics can go directly to the endocrinology department for initial screening of retinopathy. Our department uses a handheld fundus camera to examine the fundus for diabetics, which can achieve early detection, early diagnosis and early treatment.

Second, if vision problems occur, it is recommended to seek medical attention promptly.

The main manifestations of diabetic retinopathy include blurred vision, dark shadows floating in front of the eyes, unclear vision at night, and loss or reduction of visual field, etc. Once these symptoms occur, you should consider that it may be an eye problem and seek medical attention promptly.

Third, avoid activities that increase intraocular pressure, such as constipation. Straining to defecate may cause retinal hemorrhage and lead to blindness.

Of course, if diabetics have retinopathy, they should not do diving, weightlifting and other sports that increase intraocular pressure. Of course, for diabetics who have not yet developed retinopathy, they should also try to avoid these sports.

At the same time, the diabetic population is gradually becoming younger, and some patients like to do extreme sports, such as bungee jumping, roller coasters, etc., which are also not recommended.

3. What should we pay special attention to in preventing diabetic nephropathy?

First, check kidney function regularly, and do urine microalbumin and urine albumin-creatinine ratio at least once a year.

Second, avoid using some nephrotoxic drugs, such as gentamicin, streptomycin, and amikacin. If iodinated contrast agents are needed during the examination, ask an endocrinologist to evaluate before deciding whether to use them.

Third, control protein intake, focusing on high-quality protein.

Normal people consume 0.8-1.2 grams of protein per kilogram of body weight per day. Patients with mild renal impairment are recommended to consume 0.8 grams of protein per kilogram of body weight. If severe renal impairment occurs, it is hoped that the patient will more strictly control protein intake to 0.6 grams per kilogram of body weight.

Figure 2 Original copyright image, no permission to reprint

In addition, you should also closely observe changes in your body. If you experience increased foam in the urine, increased nocturia, or edema of the eyelids and lower limbs, seek medical attention promptly.

4. What should we pay special attention to in preventing diabetic cardiovascular and cerebrovascular diseases?

There are many unhealthy lifestyles that can cause cardiovascular and cerebrovascular diseases in diabetics. So for prevention, you can start from the following aspects:

First, quit smoking.

Smoking has a very serious impact on the cardiovascular system. In my country, smoking has been identified as one of the independent risk factors for cardiovascular disease. It can affect cardiovascular endothelial function, induce and aggravate arteriosclerosis. Moreover, for patients with arteriosclerosis, long-term smoking can cause some plaque instability and induce heart disease.

Second, control your weight.

Because being overweight will increase the burden on various organs, it is recommended that diabetics weigh themselves and measure their waist circumference regularly. Overweight or obese diabetics should actively lose weight.

Third, the temperature of the bath water should not be too high or too low, and the bathing time should not be too long. Most importantly, do not stay in the bathroom for too long.

Fourth, exercise properly, sleep regularly, maintain a positive and optimistic attitude, etc. In short, it is necessary to have a healthy lifestyle, which is beneficial for preventing various diseases.

Fifth, actively control high blood pressure and hyperlipidemia, because high blood pressure and hyperlipidemia can also damage the cardiovascular and cerebrovascular systems.

5. What special attention should be paid to prevent diabetes-related oral problems?

If blood sugar is not well controlled for a long time, it will lead to decreased body immunity, secondary infection, calcium loss, and the patient will experience gum atrophy or swelling, periodontal infection or bad breath, loose teeth or even tooth loss.

Maintain oral hygiene and develop a good habit of brushing your teeth in the morning and evening and rinsing your mouth after meals. You can use dental floss and interdental brushes to help clean your mouth. If necessary, go to the dental department of a regular hospital for teeth cleaning, examination, and treatment.

Keep in mind the "five pillars" of diabetes control and keep your blood sugar within the standard range for a long time.

6. What should we pay attention to in order to prevent diabetes-related osteoporosis?

Because of the high blood sugar concentration of diabetics, when the kidneys excrete too much glucose, calcium in the blood will also be lost in large quantities with urine. In addition, due to the lack of insulin, diabetics have insufficient collagen synthesis, bone loss, and are prone to osteoporosis.

Therefore, pay attention to supplementing high-calcium foods in your daily diet, get some sun every day, and exercise regularly.

Check blood calcium, blood vitamin D, and bone density regularly. If you experience back pain or hunchback, seek medical attention promptly.

The harm of diabetes mainly comes from various complications. For diabetic complications, prevention is more important than treatment, and early treatment is better than late treatment. Therefore, you must learn to recognize the early signs of complications!