basic information
Chinese name
diabetes
name in foreign language
diabetesmellitus，DM
common symptoms
Drinking more, urinating more, eating more and losing weight
Department
Internal Medicine-Department of Endcrinology
infectious
no
directory
1 case
2. Clinic Manifestation
3. Treatment of diseases
4 Disease prevention
Pathological causes
6. Disease diagnosis
7 Inspection Methods
8 Complicated
Fold and edit this section of the case and illness
The symptoms of diabetes can be divided into two categories: One of the major categories was the manifestations related to metabolism disorder, especially the " three more and one less " related to high blood sugar, which was more common in type 1 diabetes. Type 2 diabetes was often not very obvious or only partially manifested. The other major category was the manifestations of various acute and chronic complications.
1. polyuria
It is because the blood sugar is too high, exceeding the kidney sugar threshold (8.89~ 10.0mm/L). The glucose filtered out by the glomeruli cannot be completely reabsorbed by the kidney tubulae, forming an infiltrating diuretics. The higher the blood sugar, the more urine sugar is secreted, and the more urine output. The 24-hour urine output can reach 5000~ 10000ml. However, in the elderly and those with kidney diseases, the kidney sugar threshold increases, and the urine sugar is secreted. When the blood sugar is slightly increased, the polyuria may not be obvious.
2. polydipsia
It was mainly due to the obvious increase of plasma osmolarity caused by high blood sugar, coupled with polyuria and excessive water loss, which led to dehydration in the cells and aggravated the high blood sugar, further increasing the plasma osmolarity, stimulating the thirst center, leading to thirst and polyuria, which further aggravated polyuria.
3. eat more
The mechanism of gluttony is not very clear. Most scholars tend to be caused by the decrease in the utilization rate of glucose (the difference in the concentration of glucose in the artery and vein blood before and after entering and leaving the tissue cells). In normal people, the difference in the concentration of glucose in the artery and vein blood is reduced on an empty stomach, stimulating the feeding center and causing hunger. After eating, the blood sugar increases, and the difference in the concentration of the artery and vein blood is increased (greater than 0.829mmoL/L). The feeding center is inhibited, the satiety center is excited, and the demand for food disappears. However, in patients with diabetes, due to the absolute or relative lack of hormone or the tissues are not sensitive to hormone, the ability of the tissues to absorb and utilize glucose is reduced. Although the blood sugar level is high, the difference in the concentration of glucose in the artery and vein blood is very small. The tissue cells are actually in a" hungry state", thus stimulating the feeding center, causing hunger and gluttony. In addition, the body cannot fully utilize the glucose. A large amount of glucose is secreted from the urine,
4. weight loss
Diabetics may have a normal appetite or even an increase in their food intake, but their weight loss is mainly due to the absolute or relative lack of hormone. The body cannot fully utilize glucose to produce energy, resulting in the strengthening of fat and protein decomposition. Overconsumption will lead to a negative nitrogen balance, and their weight will gradually decrease, even becoming thinner. Once the diabetes is properly treated and well controlled, the weight loss can be controlled, and even recover. For example, if the weight of a patient with diabetes continues to decrease or becomes significantly thinner during treatment, it may indicate poor metabolism control or other chronic wasting diseases.
5. weak
It was also common in patients with diabetes. Because the glucose could not be completely oxided, the human body could not make full use of the glucose and effectively release energy. At the same time, the tissues lost water, and there was an imbalance in the mitochondria and negative nitrogen balance. As a result, the whole body felt weak and listless.
6. decreased vision
Many patients with diabetes complained of decreased vision or blurred vision in the early stages of treatment. This was mainly due to the change in crystalline osmolarity caused by high blood sugar, which caused the change in crystalline refraction. In the early stage, it was generally a functional change. Once blood sugar was well controlled, vision could return to normal quickly.
[1]
Fold and edit the clinical manifestations of this paragraph
1. The typical symptoms were three more and one less symptoms, namely polyuria, and emaciation.
2. Atypical symptoms: Some patients with type 2 diabetes do not have typical symptoms, such as dizziness, fatigue, or even no symptoms. In the early stages of the disease or before the onset of diabetes, there may be symptoms of low blood sugar before lunch or dinner.
3. The symptoms of acute complications: the condition worsened under stress and other circumstances. There may be loss of appetite, nausea, vomiting, abdominal pain, aggravation of polyuria, dizziness, lethargy, blurred vision, difficulty breathing, coma, etc.
4. The main symptoms of chronic complications:
1. Diabetic-induced retina disease: whether there is a decline in vision and the degree and time of the decline; Whether or not the patient has had a fundoscopic examination or a fluorescent examination; Have you ever received retina photocoagulation treatment?
2. Diabetic-type kidney disease: whether there is swelling, increased foam in the urine or protein urine.
3. Diabetic-related neuropathy: The skin of the limbs feels abnormal, numbness, acupuncture, and ant-like sensation. The feeling of stepping on cotton on the soles of the feet, alternating diarrhea and constipation, urine preservation, half-body sweating or sweating from time to time, sexual malfunction.
4. Repeating infections: For example, repeated skin infections such as boils, carbuncles, and long-lasting leg and foot sores. He had repeated urological infections and rapidly developing lung cancer. Female vulva itching.
5. Diabetic-foot
Fold and edit this section of the disease treatment
The treatment of diabetes includes education, diet therapy, exercise therapy, medication, blood sugar monitoring, and the detection and control of other risk factors for cardiovascular disease
Folded Diabetics Knowledge Education
Once diagnosed with diabetes, the patient should be educated about the disease, including general knowledge of diabetes, self-monitoring of blood sugar and urine sugar. The usage of hypochondriac drugs, the observation and treatment of adverse reactions, etc. And the performance and prevention of various complications [4].
Folded diet therapy
It was the primary measure for the basic treatment of various types of diabetes. The principle of diet therapy was to control total calories and weight. Reduce the fat content in food, especially the saturated fatty acid content, increase the fiber content of food, and make the proportion of calories, fat, and protein in food reasonable. Control the total energy intake of the diet and distribute various nutrients in a reasonable and balanced manner. Maintain a reasonable weight. The goal of weight reduction for overweight/obese patients is to lose 5% to 10% of their weight within 3 to 6 months. People who are emaciated should recover and maintain their ideal weight for a long time through a balanced nutrition program.
Fat: The energy provided by fat in the diet should not exceed 30% of the total energy, and the intake of saturated fatty acid should not exceed 10% of the total energy. The amount of food intake was 300 milligrams per day.
2. Carbohydrates: The energy provided by carbs in the diet should account for 50%-60% of the total energy. Food should be rich in fiber.
3. protein: For patients with normal kidney function, the recommended protein intake accounts for 10%-15% of total energy. For patients with dominant proteinuria, the protein intake is 0.8g/kg body weight/day. From the time of the decrease in the glomerular fat rate, a low-protein diet of 0.6g/kg body weight/day should be implemented, and at the same time, the compound a-keto acid preparation should be supplemented.
Drinking alcohol: Diabetics are not recommended to drink alcohol. No more than 1-2 standard servings per day (one standard serving is: 350ml of beer, 150ml of red wine or 45ml of low-alcohol white wine, each containing about 15g of alcohol)
Salt: Salt intake should be limited to 6 grams per day, and patients with high blood pressure should strictly limit their intake.
Folded diet guide
It was generally advocated that the protein in the daily diet should be given according to the standard weight of 0.6-0.8 g/kg, and the proportion of high-quality protein should be increased within the limited range. For patients with stages 3 and 4 of diabetes, they should master the quality and quantity of daily protein intake while insisting on other principles of nutritional therapy for diabetes.
Diabetic-Kidney Disease [2] patients did not develop a scientific and reasonable diet plan for themselves. Once their kidney function was impaired, their blood pressure would rise and their whole body would be weak. In severe cases, there would be kidney malfunction, swelling, male impotency, and testicular contraction. In the worst case, they would completely lose their ability to take care of themselves or even lose their lives.
Fold the foods that people with diabetes should eat less.
1. Eat less fruit
Fruits contain more glucose and glucose, which can be quickly absorbed by the body, causing blood sugar to increase. Therefore, patients with severe diabetes should not eat too much fruit.
2. No Drinking
Alcohol contains 14.64 kilojoules (3.5 kilocalories) per gram, which is a high-calories food. It has the effect of consuming the body's calories. Overconsumption of alcohol can lead to hyperlipiduria or cause metabolism disorder, increasing the burden on the liver. Diabetics eat some carbo foods when drinking alcohol, and their blood sugar will rise, causing their diabetes to go out of control. Often drinking alcohol without eating food can suppress the decomposition of liver glycogen, so that the amount of grape sugar in the blood (grape food) is reduced, and the symptoms of low blood sugar (blood sugar food) appear. Therefore, people with severe diabetes and hepatobiliary diseases, especially those who were using hormone and oral hypoglycemics, should not drink alcohol.
3. Eat less high-sugar and high-salt food
When it came to understanding diabetes, doctors usually restricted their diet, especially the consumption of foods with high sugar content, as an important prevention and treatment method to guide patients. However, the restriction of salt intake was rarely noticed. Modern medical research showed that excessive salt could enhance the activity of starch and promote the digestion of starch (digesting food). It could also promote the absorption of free glucose in the small intestine, which could cause an increase in blood sugar concentration and aggravate the condition. Therefore, patients with diabetes should not eat too much salt.
folding exercise therapy
It was also one of the basic treatments for diabetes. They should choose the appropriate exercise program according to the patient's actual condition. They should do it according to their ability and step by step. The most important thing was to support them. The method, intensity, and frequency of exercise should be determined according to the patient's actual condition. It is generally recommended to have moderate intensity of cardio exercise (such as brisk walking, Tai Chi, biking, golf, and garden activities) for at least 150 minutes per week. When the blood sugar level is 14-16 mmole/L, there is obvious malnutrition or large blood sugar fluctuation, there are acute metabolism complications of diabetes, and serious chronic complications of various heart and kidney organs are not suitable for exercise.
Fold to quit smoking
Smoking was harmful to one's health, especially for patients with type 2 diabetes who were at high risk of having large blood vessel disease. Every smoking patient with diabetes should be advised to stop smoking, which is one of the important contents of lifestyle intervention.
basic information
Chinese name
diabetes
name in foreign language
diabetesmellitus，DM
common symptoms
Drinking more, urinating more, eating more and losing weight
Department
Internal Medicine-Department of Endcrinology
infectious
no
directory
1 case
2. Clinic Manifestation
3. Treatment of diseases
4 Disease prevention
Pathological causes
6. Disease diagnosis
7 Inspection Methods
8 Complicated
Fold and edit this section of the case and illness
The symptoms of diabetes can be divided into two categories: One of the major categories was the manifestations related to metabolism disorder, especially the " three more and one less " related to high blood sugar, which was more common in type 1 diabetes. Type 2 diabetes was often not very obvious or only partially manifested. The other major category was the manifestations of various acute and chronic complications.
1. polyuria
It is because the blood sugar is too high, exceeding the kidney sugar threshold (8.89~ 10.0mm/L). The glucose filtered out by the glomeruli cannot be completely reabsorbed by the kidney tubulae, forming an infiltrating diuretics. The higher the blood sugar, the more urine sugar is secreted, and the more urine output. The 24-hour urine output can reach 5000~ 10000ml. However, in the elderly and those with kidney diseases, the kidney sugar threshold increases, and the urine sugar is secreted. When the blood sugar is slightly increased, the polyuria may not be obvious.
2. polydipsia
It was mainly due to the obvious increase of plasma osmolarity caused by high blood sugar, coupled with polyuria and excessive water loss, which led to dehydration in the cells and aggravated the high blood sugar, further increasing the plasma osmolarity, stimulating the thirst center, leading to thirst and polyuria, which further aggravated polyuria.
3. eat more
The mechanism of gluttony is not very clear. Most scholars tend to be caused by the decrease in the utilization rate of glucose (the difference in the concentration of glucose in the artery and vein blood before and after entering and leaving the tissue cells). In normal people, the difference in the concentration of glucose in the artery and vein blood is reduced on an empty stomach, stimulating the feeding center and causing hunger. After eating, the blood sugar increases, and the difference in the concentration of the artery and vein blood is increased (greater than 0.829mmoL/L). The feeding center is inhibited, the satiety center is excited, and the demand for food disappears. However, in patients with diabetes, due to the absolute or relative lack of hormone or the tissues are not sensitive to hormone, the ability of the tissues to absorb and utilize glucose is reduced. Although the blood sugar level is high, the difference in the concentration of glucose in the artery and vein blood is very small. The tissue cells are actually in a" hungry state", thus stimulating the feeding center, causing hunger and gluttony. In addition, the body cannot fully utilize the glucose. A large amount of glucose is secreted from the urine,
4. weight loss
Diabetics may have a normal appetite or even an increase in their food intake, but their weight loss is mainly due to the absolute or relative lack of hormone. The body cannot fully utilize glucose to produce energy, resulting in the strengthening of fat and protein decomposition. Overconsumption will lead to a negative nitrogen balance, and their weight will gradually decrease, even becoming thinner. Once the diabetes is properly treated and well controlled, the weight loss can be controlled, and even recover. For example, if the weight of a patient with diabetes continues to decrease or becomes significantly thinner during treatment, it may indicate poor metabolism control or other chronic wasting diseases.
5. weak
It was also common in patients with diabetes. Because the glucose could not be completely oxided, the human body could not make full use of the glucose and effectively release energy. At the same time, the tissues lost water, and there was an imbalance in the mitochondria and negative nitrogen balance. As a result, the whole body felt weak and listless.
6. decreased vision
Many patients with diabetes complained of decreased vision or blurred vision in the early stages of treatment. This was mainly due to the change in crystalline osmolarity caused by high blood sugar, which caused the change in crystalline refraction. In the early stage, it was generally a functional change. Once blood sugar was well controlled, vision could return to normal quickly.
[1]
Fold and edit the clinical manifestations of this paragraph
1. The typical symptoms were three more and one less symptoms, namely polyuria, and emaciation.
2. Atypical symptoms: Some patients with type 2 diabetes do not have typical symptoms, such as dizziness, fatigue, or even no symptoms. In the early stages of the disease or before the onset of diabetes, there may be symptoms of low blood sugar before lunch or dinner.
3. The symptoms of acute complications: the condition worsened under stress and other circumstances. There may be loss of appetite, nausea, vomiting, abdominal pain, aggravation of polyuria, dizziness, lethargy, blurred vision, difficulty breathing, coma, etc.
4. The main symptoms of chronic complications:
1. Diabetic-induced retina disease: whether there is a decline in vision and the degree and time of the decline; Whether or not the patient has had a fundoscopic examination or a fluorescent examination; Have you ever received retina photocoagulation treatment?
2. Diabetic-type kidney disease: whether there is swelling, increased foam in the urine or protein urine.
3. Diabetic-related neuropathy: The skin of the limbs feels abnormal, numbness, acupuncture, and ant-like sensation. The feeling of stepping on cotton on the soles of the feet, alternating diarrhea and constipation, urine preservation, half-body sweating or sweating from time to time, sexual malfunction.
4. Repeating infections: For example, repeated skin infections such as boils, carbuncles, and long-lasting leg and foot sores. He had repeated urological infections and rapidly developing lung cancer. Female vulva itching.
5. Diabetic-foot
Fold and edit this section of the disease treatment
The treatment of diabetes includes education, diet therapy, exercise therapy, medication, blood sugar monitoring, and the detection and control of other risk factors for cardiovascular disease
Folded Diabetics Knowledge Education
Once diagnosed with diabetes, the patient should be educated about the disease, including general knowledge of diabetes, self-monitoring of blood sugar and urine sugar. The usage of hypochondriac drugs, the observation and treatment of adverse reactions, etc. And the performance and prevention of various complications [4].
Folded diet therapy
It was the primary measure for the basic treatment of various types of diabetes. The principle of diet therapy was to control total calories and weight. Reduce the fat content in food, especially the saturated fatty acid content, increase the fiber content of food, and make the proportion of calories, fat, and protein in food reasonable. Control the total energy intake of the diet and distribute various nutrients in a reasonable and balanced manner. Maintain a reasonable weight. The goal of weight reduction for overweight/obese patients is to lose 5% to 10% of their weight within 3 to 6 months. People who are emaciated should recover and maintain their ideal weight for a long time through a balanced nutrition program.
Fat: The energy provided by fat in the diet should not exceed 30% of the total energy, and the intake of saturated fatty acid should not exceed 10% of the total energy. The amount of food intake was 300 milligrams per day.
2. Carbohydrates: The energy provided by carbs in the diet should account for 50%-60% of the total energy. Food should be rich in fiber.
3. protein: For patients with normal kidney function, the recommended protein intake accounts for 10%-15% of total energy. For patients with dominant proteinuria, the protein intake is 0.8g/kg body weight/day. From the time of the decrease in the glomerular fat rate, a low-protein diet of 0.6g/kg body weight/day should be implemented, and at the same time, the compound a-keto acid preparation should be supplemented.
Drinking alcohol: Diabetics are not recommended to drink alcohol. No more than 1-2 standard servings per day (one standard serving is: 350ml of beer, 150ml of red wine or 45ml of low-alcohol white wine, each containing about 15g of alcohol)
Salt: Salt intake should be limited to 6 grams per day, and patients with high blood pressure should strictly limit their intake.
Folded diet guide
It was generally advocated that the protein in the daily diet should be given according to the standard weight of 0.6-0.8 g/kg, and the proportion of high-quality protein should be increased within the limited range. For patients with stages 3 and 4 of diabetes, they should master the quality and quantity of daily protein intake while insisting on other principles of nutritional therapy for diabetes.
Diabetic-Kidney Disease [2] patients did not develop a scientific and reasonable diet plan for themselves. Once their kidney function was impaired, their blood pressure would rise and their whole body would be weak. In severe cases, there would be kidney malfunction, swelling, male impotency, and testicular contraction. In the worst case, they would completely lose their ability to take care of themselves or even lose their lives.
Fold the foods that people with diabetes should eat less.
1. Eat less fruit
Fruits contain more glucose and glucose, which can be quickly absorbed by the body, causing blood sugar to increase. Therefore, patients with severe diabetes should not eat too much fruit.
2. No Drinking
Alcohol contains 14.64 kilojoules (3.5 kilocalories) per gram, which is a high-calories food. It has the effect of consuming the body's calories. Overconsumption of alcohol can lead to hyperlipiduria or cause metabolism disorder, increasing the burden on the liver. Diabetics eat some carbo foods when drinking alcohol, and their blood sugar will rise, causing their diabetes to go out of control. Often drinking alcohol without eating food can suppress the decomposition of liver glycogen, so that the amount of grape sugar in the blood (grape food) is reduced, and the symptoms of low blood sugar (blood sugar food) appear. Therefore, people with severe diabetes and hepatobiliary diseases, especially those who were using hormone and oral hypoglycemics, should not drink alcohol.
3. Eat less high-sugar and high-salt food
When it came to understanding diabetes, doctors usually restricted their diet, especially the consumption of foods with high sugar content, as an important prevention and treatment method to guide patients. However, the restriction of salt intake was rarely noticed. Modern medical research showed that excessive salt could enhance the activity of starch and promote the digestion of starch (digesting food). It could also promote the absorption of free glucose in the small intestine, which could cause an increase in blood sugar concentration and aggravate the condition. Therefore, patients with diabetes should not eat too much salt.
folding exercise therapy
It was also one of the basic treatments for diabetes. They should choose the appropriate exercise program according to the patient's actual condition. They should do it according to their ability and step by step. The most important thing was to support them. The method, intensity, and frequency of exercise should be determined according to the patient's actual condition. It is generally recommended to have moderate intensity of cardio exercise (such as brisk walking, Tai Chi, biking, golf, and garden activities) for at least 150 minutes per week. When the blood sugar level is 14-16 mmole/L, there is obvious malnutrition or large blood sugar fluctuation, there are acute metabolism complications of diabetes, and serious chronic complications of various heart and kidney organs are not suitable for exercise.
Fold to quit smoking
Smoking was harmful to one's health, especially for patients with type 2 diabetes who were at high risk of having large blood vessel disease. Every smoking patient with diabetes should be advised to stop smoking, which is one of the important contents of lifestyle intervention.
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