1. What is diabetes?
Diabetes mellitus is a group of metabolic disorders caused by absolute or relative deficiency of insulin secretion, or insulin utilization disorder, or both. Hyperglycemia is the main sign, leading to multi-system damage, which can lead to blindness, amputation, renal failure, cardiovascular and cerebrovascular diseases and so on.
The most famous symptoms of diabetes are "eating too much, drinking too much, urinating too much and losing weight", but these typical symptoms do not appear until the late stage. At present, most diabetic patients are found during physical examination, or "by the way" when they go to see a doctor for blood tests because of other diseases.
At present, there are two main criteria for diagnosing diabetes in China, fasting blood glucose and 2-hour postprandial blood glucose. Fasting blood glucose refers to the blood glucose measured after 8- 12 hours of fasting, and 2 hours after meals refers to the blood glucose 2 hours after eating the first meal. Note that it is the first meal, not the main meal.
Normal blood sugar: fasting blood sugar is less than 6. 1mmol/l, and less than 7.8mmol/l 2 hours after meals.
Blood sugar standard of diabetes: fasting blood sugar is greater than or equal to 7.0mmol/l, and it is greater than or equal to11.1mmol/L 2 hours after meals or at any time. As long as the blood sugar reaches this standard, diabetes can be diagnosed, and there is no need for "three more and one less" or other symptoms. However, for patients with abnormal blood sugar for the first time, it is prudent to check it another day, or to carry out glycosylated hemoglobin test as an auxiliary diagnosis.
Impaired fasting blood glucose means that the fasting blood glucose value is higher than normal, but it does not meet the diagnostic criteria of diabetes, but it is normal 2 hours after meals.
Impaired glucose tolerance means that fasting blood glucose is normal or fails to meet the diagnostic criteria of diabetes, and it exceeds normal 2 hours after meals but fails to meet the diagnostic criteria of diabetes.
In the diagnostic criteria of diabetes, please pay special attention to one term, one is impaired fasting blood glucose and the other is impaired glucose tolerance, which is an important knowledge point of the problem we are going to discuss today.
2. What is the golden point for diabetes to return to normal?
Under the influence of pathogenic factors, diabetes develops in three stages, in which insulin resistance runs through the whole process.
What is insulin resistance? Insulin is secreted by islet β cells in the pancreas. For example, in pigs, the pancreas is called "pig pancreas" by northerners and "pig belly" by southerners. The function of insulin in the body is to lower blood sugar, "transport" glucose absorbed from food to various tissues and organs of the body for decomposition and utilization, and then the glucose in the blood will drop. Insulin resistance refers to the decreased sensitivity of tissues and cells to insulin. Normal amount of insulin can no longer make tissues and cells decompose and use blood sugar, so more insulin needs to be taken out from islets to play its role. Over time, islet β cells are overwhelmed and "exhausted", and their functions begin to decline, so the secretion of insulin will decrease. Without intervention, the course of diabetes will continue to develop, and islet β cells will develop into functional failure, "failure" and completely lose their secretory function.
According to the above development process, the development of diabetes can be divided into three stages.
The first stage: simple insulin resistance stage, corresponding to the early stage of diabetes, especially the stage of impaired fasting blood glucose and abnormal glucose tolerance. At this time, the serum insulin level is normal or elevated, which is the golden age to reverse diabetes. After this village, there is no such store, and correct intervention is expected to completely return to normal.
The second stage: insulin resistance+islet cell dysfunction. This period is the "depletion" period of islet β cells, and the amount of insulin detected in serum is lower than normal, so it is difficult to reverse diabetes.
The third stage: insulin resistance+islet cell failure. This period is the "depletion" period of islet β cells. The amount of insulin detected in serum has obviously decreased, so it is necessary to carry out insulin replacement therapy in clinic. There is no chance to reverse diabetes during this period.
3. What is the correct intervention method for diabetes to return to normal?
Correct intervention measures can reverse pre-diabetic diabetes. What kind of measures are correct? We need to know the cause of diabetes so that we can win every battle.
At present, the cause of diabetes is not fully understood. Generally speaking, it is the result of the joint action of genetic factors and environmental factors. Genetic factors are innate and have no choice, so there is no need to discuss them. Environmental factors refer to external reasons. Epidemiological and clinical medical research has made it very clear that unhealthy lifestyle is the cause of diabetes. In the period of simple insulin resistance, diabetes can be completely reversed through lifestyle intervention. At present, the guidelines for diagnosis and treatment of diabetes recommend lifestyle intervention as the main treatment for early diabetes. There are thousands of diseases in human body, but diabetes is almost the most obvious disease that can benefit from life intervention. It is very important and indispensable to prevent and control the progress of diabetes.
4. What are the specific lifestyle intervention methods?
Diet and exercise are the two most important aspects.
Dietary principles include reasonable control of total calories, appropriate increase of total energy for underweight people, pregnant women and nursing mothers, and appropriate reduction for overweight people, so as to control the weight within the ideal weight range. Ideal weight formula: ideal weight = height-105, weight in kilograms, height in centimeters, for example, height is 170cm, and ideal weight is 170- 105 = 65kg. In addition, the intake of staple food and fat should be reduced appropriately, and the intake of protein and vegetables should be increased. For diet, please refer to the core recommendation 20 17 of China Dietary Guidelines for Diabetes.
Pay special attention to the staple food, mainly coarse grains and flour and rice, with coarse grains accounting for one third, and the daily total should not exceed 250-400g. If obesity is controlled at 200-250g; Meat is mainly aquatic products, eggs, milk, beans and lean meat of livestock. Eat less high-fat foods to increase insulin resistance, and eat less fat, fried and barbecue foods. Vegetables are more than 500 grams per day, and fruits should be controlled, not exceeding 200 grams per day; Try not to drink sugary drinks and foods with too much sugar. Finally, pay attention to the order of eating. The correct way is to eat vegetables first, then meat, and finally vegetables. Vegetables can form a fibrous web in the gastrointestinal tract, form a barrier, and slow down the absorption of carbohydrates, thus helping to control postprandial hyperglycemia.
Exercise therapy. Exercise can increase the sensitivity of tissues and cells to insulin, reduce insulin resistance, and help control weight and blood sugar. According to the illness and age, as well as physical condition, step by step. It is best to conform to the recommendation of Dietary Guidelines for China Residents, and walk 6000 steps every day, which requires moderate-intensity exercise, three times a week, and the cumulative time is 150 minutes. The easiest way to judge moderate-intensity exercise is that if you feel a little tired, but you can speak freely during the exercise, it can be regarded as moderate-intensity exercise. But try not to exercise on an empty stomach in the morning to avoid hypoglycemia. For sugar lovers with high blood sugar after meals, it is best to start exercising half an hour after meals, which is conducive to reducing high blood sugar after meals.
Others: combination of work and rest, quitting smoking and limiting alcohol, peace of mind and so on.
Summary: Diabetes can be said to be a lifelong disease. In the whole development process, only in the early stage of diabetes can lifestyle intervention be expected to reverse diabetes and return to normal. However, it is necessary to find and intervene in time during this period, otherwise it is difficult to return to normal when the function of islet cells declines. All kinds of remedies in the Jianghu are IQ taxes. Eating well, exercising well and keeping a healthy lifestyle are the right way.