Diabetes “three mores and one less”, do you know what it means?

Author: Chen Meilin Guangxi Zhuang Autonomous Region People's Hospital

Reviewer: Li Ni, Chief Physician, Guangxi Zhuang Autonomous Region People's Hospital

When it comes to diabetes, people often hear things like "My dad also got this disease" and "My family also got this disease." It seems that everyone has a few diabetics around them. According to statistics from the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)", the prevalence of diabetes in people aged 18 and above in China is 11.2%[]. A cross-sectional study in 2021 showed that the awareness rate of diabetes in my country was only 36.7%, and the treatment rate was 32.9%[]. This means that many people do not know that they have diabetes or are in the prediabetes stage, and they are even less aware of the need to go to the hospital for treatment. Therefore, a correct understanding of diabetes and its typical symptoms plays a positive role in early diagnosis and treatment. Early intervention can also protect pancreatic function and prevent and delay the occurrence of diabetic complications.

Prevention and intervention should start with understanding the disease. So what is the well-known "three mores and one less" (drinking more, eating more, urinating more, and losing weight)? How does blood sugar affect our health?

Figure 1 Copyright image, no permission to reprint

Glucose is the main source of energy for human cells, and it is also glucose that causes blood sugar to rise. Glucose in the human body is produced by the decomposition of various foods ingested. Under normal circumstances, glucose is transported to various parts of the body through blood circulation to provide energy to cells to maintain normal human activities. The main hormone in the body that lowers blood sugar is insulin. Once insulin "breaks down" and stops working, glucose will continue to accumulate in the body and cannot be fully utilized by cells. The cells in the body can only work "on an empty stomach", and a series of clinical symptoms will naturally appear.

Figure 2 Copyright image, no permission to reprint

When cells are "starved", they send a "hunger" signal to the brain, and after receiving the signal, the brain sends a "eat more" command to the body. However, even if more glucose enters the body at this time, it will not be able to provide "food" to the cells because "insulin" is "not working". Cells can only break down proteins and fats in the body to provide energy to maintain normal "work", which will lead to the "magical" phenomenon of diabetes "one more and one less" - eating a lot but losing weight.

So where does the glucose go? Does it magically disappear? Of course not. It stays in the blood, causing blood sugar to rise. Excessive blood sugar concentration increases the filtering pressure of the kidneys, causing the human body to urinate more frequently. With more water excreted, you naturally need to drink more water to replenish it. This leads to the other "two mores" of diabetes - frequent urination and frequent drinking of water.

Simply put, diabetes means that the human body cannot fully utilize glucose. Some of the glucose that cannot be utilized will remain in the blood, while the other part will be excreted from the body. The glucose that remains in the blood will have a negative impact on various organs of the human body. Therefore, diabetic patients will not only have the symptoms of "three more and one less", but those "candied" (glycosylated) tissues and organs will also cause serious damage to the body's functions.

It should be noted that many people only accidentally discover that their blood sugar is high during a physical examination, but there are no obvious symptoms of "three mores and one less". At this time, do not be careless and be sure to go to a regular hospital in time to find out whether you have diabetes.

In order for insulin to resume its work and regain its ability to lower blood sugar, it is necessary to improve the "working" environment of insulin and reawaken its "working enthusiasm". The "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" points out that a healthy working environment can be created for insulin through a healthy lifestyle that includes a reasonable diet, weight control, moderate exercise, salt restriction, smoking cessation, alcohol restriction, and maintaining a balanced mind, thereby preventing the occurrence and development of diabetes [1].

References

Chinese Medical Association Diabetes Branch. Guidelines for the prevention and treatment of type 2 diabetes in China (2020 edition)[J]. Chinese Journal of Diabetes, 2021, 13(4): 315-409.

Wang LM, Peng W, Zhao ZP, et al. Prevalence and Treatment of Diabetes in China, 2013-2018. JAMA, 2021, 326(24):2498-2506.