To treat diabetes, are you still controlling your diet and moving your legs? You are out of date! Experts explain the "Seven New Health Points" to you

Diabetes is one of the risk factors that threaten human health. If it is not treated for a long time, it will cause complications such as heart disease, vascular stenosis, kidney disease, eye disease, etc. At present, the awareness, treatment and control rates of diabetes in my country are low, and the management of diabetes is grim and there is a long way to go.

So, how does diabetes develop? What is the blood sugar level that is considered diabetes? Everyone says that diabetes is a disease caused by eating. How can we control diabetes by improving our diet and regulating our weight?

Recently, at the first China Healthy Lifestyle Medicine Conference (CHMC), Professor Li Xiang from the Department of Nutrition at the Fuwai Hospital of the Chinese Academy of Medical Sciences, Professor Chen Yanyan, Director of the Second Department of Endocrinology and Cardiovascular Metabolism, and Professor Yang Jingang from the Department of Cardiovascular Medicine discussed through live webcast the current hot topics of concern to "diabetics", such as the causes of diabetes and new concepts and practices for scientific management of diabetes. Focusing on diabetes education, they discussed in depth the comprehensive management of diabetes control from the aspects of diet, exercise, medication, monitoring, psychology, and prevention.

New concept of diabetes management: seven new points of health Yang Jingang: We all know that there are five driving forces for the prevention and treatment of diabetes. First, please allow Professor Chen Yanyan to introduce the new concept of diabetes management.

Chen Yanyan: In the past, comprehensive diabetes management had "five pillars", "education" was the core, "diet" was the foundation, "exercise" was the means, "drugs" were the weapon, and "monitoring" was the guarantee. Now, diabetes management has a new concept, called the "new seven points of health". "Mental health" is the premise of diabetes treatment, the five pillars are the foundation, and "preventing complications" is the ultimate goal.

"Education" is the core, that is, diabetes is a disease that cannot be cured, but it is not an incurable disease, but a completely controllable disease. So how can diabetes be well controlled? The core is to have correct patient education. Some patients have incorrect ideas, such as folk remedies to treat diabetes, and cannot correct certain bad eating habits. These ideas will prevent patients from getting a good control of their condition, which will damage their health.

The five carriages are education as the core, scientific diet, effective exercise, rational use of drugs, and enhanced monitoring. Today, the new concept of comprehensive diabetes management has added two new viewpoints on this basis, one is mental health, and the other is the ultimate goal of preventing complications.

In clinical treatment, many patients feel that diabetes is an incurable disease after being diagnosed with diabetes, that life is hopeless, and that they are in a very low mood or even depressed. This is what we often see. Some people go to the other extreme and think that diabetes is not a big deal, that they can eat and drink, and that they don’t feel any pain or itching, so they don’t take it seriously. These are not manifestations of mental health. We should have a correct understanding of the disease and treat it with a healthy mental state. This is the premise for diabetes treatment.

At the same time, preventing complications is the ultimate management goal. Judging from the updated guidelines in recent years, in the past, the management goal of hypoglycemic control was to lower blood sugar, but from a clinical point of view, some patients still cannot control the occurrence of many diabetic complications even if their blood sugar index is reduced to normal, especially large vessel diseases, such as coronary heart disease, stroke or lower limb vascular disease.

Nowadays, the ultimate goal of diabetes management is to enable diabetic patients to live a healthy life with diabetes and avoid complications as much as possible, or to control complications well even if they occur.

Nutritional therapy is a basic measure for treating diabetes. Yang Jingang: Professor Li Xiang is an expert specializing in nutrition. Please tell us about the importance of diet.

Li Xiang: According to statistics, when a person retires at the age of 60, he or she will have eaten about 65,000 meals according to the (Chinese Residents Dietary Guidelines) and the body will have processed about 65 tons of food. Our physical condition depends on the food we choose.

In the field of diabetes, there is a misunderstanding, which is also a clinical problem often encountered by cardiovascular doctors. Many patients think that taking diabetes medication or injecting insulin will normalize blood sugar and they don't need to worry about diet. This view is wrong! Diabetic patients need to control their condition in terms of diet, which is also the basic principle of diabetes treatment. Overeating or overeating are harmful to health, and diabetic patients should pay more attention to avoid it.

Therefore, nutritional therapy is a prerequisite for the treatment of diabetes. A scientific diet can reduce the burden on the pancreas, correct metabolic disorders, control body weight within a reasonable range, and control blood sugar within a normal range. Nutritional therapy can include simple diet control, simple diet control + oral hypoglycemic drugs, simple diet control + insulin injection. The scientific combination of diet, exercise, and drugs, plus diabetes education and diabetes monitoring, can effectively control the disease.

How much should a diabetic patient eat in a day? Yang Jingang: Professor Li Xiang, please tell us what aspects should be considered when calculating the diet for diabetic patients?

Li Xiang: First of all, we need to consider ethnic customs and respect the patient's religious beliefs. The daily energy supply for adult diabetics can be formulated according to body weight, activity level, gender and age. For example, a 60-year-old male, 172cm tall, 67kg in weight, who usually does light physical labor and suffers from type 2 diabetes, can be calculated based on simple dietary control: total daily energy 1750 kcal, 65g protein, 58g fat, and 240g carbohydrates.

An example of the recipe is that breakfast includes 250g of milk, 50g of eggs, and 50g of staple food; lunch includes 100g of staple food, 75g of lean meat, 300g of 3% green vegetables, and 10g of oil; dinner includes 100g of staple food, 75g of lean meat, 300g of 3% green vegetables, and 10g of oil; and snacks include 25g of staple food.

At the same time, diabetic patients should eat a variety of foods, mainly cereals, with a combination of coarse and fine foods. In addition, diabetic patients should pay attention to the intake of trace elements and sufficient dietary fiber. It is recommended to choose more natural foods, such as coarse grains, kelp, konjac, green leafy vegetables, etc. Patients should also be wary of sweet drinks. If blood sugar and urine sugar are not well controlled, it is best for patients to avoid eating fruits; if blood sugar and urine sugar are relatively stable, they can try a small amount of fruit between meals or before going to bed at night. It should be noted that 200 grams of fruit is equivalent to 25 grams of staple food.

Choice of protein and fat Yang Jingang: Regarding the choice of protein and fat for diabetic patients, what clinical suggestions does Director Chen have?

Chen Yanyan: Regarding the distribution of protein, it should account for 15-20% of the total calories according to the patient's liver and kidney function. It is recommended that patients consume a variety of high-quality proteins, such as eggs, milk, lean meat, fish, shrimp, poultry, etc.

Regarding the misunderstandings about protein diet, everyone should pay attention to avoid eating too much protein and less staple food; carbohydrates have the effect of saving protein; because sufficient carbohydrates can reduce the oxidative decomposition of protein, so appropriate carbohydrates are necessary and other incorrect concepts.

To calculate the amount of protein you should consume daily, first determine how much protein you should consume in a day. For example, a man who is 1.75 meters tall should consume "175-105=70 grams" of protein per day, while an egg (of normal size) contains about 7 grams of protein, a bag of milk (250 ml) generally contains about 7 grams of protein, 100 grams of pure lean meat contains nearly 20 grams of protein, 300 grams of cereals contain 28 grams of protein, 100 grams of tofu contains 8 grams of protein, etc.

Types of fat include saturated fatty acids (such as lard), polyunsaturated fatty acids (peanut oil), and monounsaturated fatty acids (such as olive oil and tea oil). Dietary fats include cholesterol and triglycerides.

Cholesterol is only found in animal foods, such as egg yolks, animal brains, livers, meat fat layers, fish roe, and butter. Triglycerides are found in both animal and plant foods, accounting for 95% of the total fat. Dietary fat should account for 25-30% of total calories.

Since 100 grams of flour can be made into 160 grams of steamed buns, which produces 360 kcal of calories, and 162 grams of fried dough sticks, which produces 626 kcal of calories, etc., it is recommended to stay away from fried foods.

Can people with diabetes drink alcohol? Yang Jingang: Can people with diabetes drink alcohol?

Chen Yanyan: Alcohol has a significant impact on diabetes and can cause side effects with oral hypoglycemic drugs, such as causing hypoglycemia. In addition, alcohol can increase blood lipids, cause high blood pressure, and excessive drinking can also increase weight, which in turn affects blood sugar levels. Patients are advised to avoid drinking on an empty stomach. If they must drink, they should not drink more than twice a week, 25 grams each time for men and 15 grams for women. They should drink slowly and avoid toasting.

Can patients with diabetes enjoy eating? Yang Jingang: In fact, eating should be a kind of enjoyment, but the diet of patients with diabetes does need to be restricted. Could you please tell us more about how patients with diabetes can enjoy eating?

Li Xiang: When eating, diabetic patients should take into account both psychological pleasure and physical health, and pursue the unity of emotional and rational eating. They should feel the color, aroma and taste of the food, eat with their brains, rationally follow the matching proportions, and make good food ratios.

Exercise should be gradual, within one's ability and persistent. Yang Jingang: Exercise for diabetics is a topic that is often discussed and always new. Let's ask endocrinologists to tell us more about it.

Chen Yanyan: Scientific exercise is beneficial to controlling blood sugar, reducing weight, enhancing insulin sensitivity, reducing insulin resistance, improving blood lipid levels and cardiovascular function, and is beneficial to disease prevention and mental health, and enhancing organ function. Diabetics should keep in mind the principles of exercise, that is, gradual progress, doing what one can, and persevering.

If hypoglycemia occurs during exercise, you should immediately take the candy you carry with you; if you experience fatigue, chest tightness, shortness of breath, leg pain and other discomfort, you should stop exercising immediately and rest on the spot; avoid heatstroke when exercising in summer. Once symptoms of heatstroke appear, sit down in a cool and ventilated place immediately, drink some cool salt water, and breathe fresh air as much as possible. For patients who are prone to hypoglycemia, it is recommended that you exercise with companions as much as possible.

Some diabetics like to do morning exercises. In fact, we recommend that you exercise in the evening, when blood pressure is most stable and psychological stress resistance is best. In the early morning, blood viscosity is high, making heart disease more likely to occur. Exercise on an empty stomach is also more likely to cause hypoglycemia.