Diabetes is not terrible, but these six complications are extremely harmful.
The number of diabetic patients in the world continues to grow. Relevant data show that there is one diabetic in every eight adults in China and one pre-diabetic in every two adults in China.
Diabetes is not terrible, but its complications, such as cardiovascular and cerebrovascular diseases, renal failure, diabetic foot and retinopathy … These chronic complications have gradually become the main cause of death for diabetics.
Dangerous chronic complications of diabetes mellitus
Diabetes is a group of lifelong metabolic diseases caused by multiple causes and characterized by chronic hyperglycemia. The key to lowering the blood sugar level in the body is insulin, which helps glucose from food to enter cells from the blood to generate energy. When insulin is not well produced or utilized, the blood glucose level will rise, and when it rises to a certain extent, diabetes will occur.
Elevated blood sugar is not the end point of diabetes. Long-term high blood sugar damages the body, causing pathological changes in various important organs of the human body. With the extension of the course of disease and poor blood sugar control, diabetic patients will gradually develop chronic complications. Complications will have serious consequences in the later stage, such as blindness, renal failure, myocardial infarction, heart failure, stroke and amputation, which will seriously affect the quality of life of patients.
Chronic complications of diabetes are generally divided into macrovascular complications, microvascular complications, neuropathy and diabetic foot.
I. Cardiovascular diseases
Atherosclerosis is one of the main causes of cardiovascular diseases, and insulin resistance and hyperglycemia are the main factors leading to cardiovascular complications in diabetic patients. Studies have shown that diabetic patients have an increased risk of heart failure and/or cardiac dysfunction, and long-term hyperglycemia can also lead to various cardiac dysfunction, including arrhythmia and sudden cardiac death.
1. Symptoms and manifestations
There may be no symptoms in the early stage, and with the progress of the disease, discomfort symptoms such as chest pain, chest tightness, palpitation, shortness of breath and arrhythmia may appear after work. Some patients may have no obvious pain even when myocardial infarction occurs because of the influence of hyperglycemia on cardiac autonomic nerves.
2. How to screen
For diabetic patients, ECG and echocardiography should be performed at the time of diagnosis, and at least once every six months.
Hyperglycemia increases the risk of stroke. A comprehensive analysis of 102 prospective studies found that compared with non-diabetic patients, the risk of ischemic stroke increased by 2.3 times and the risk of hemorrhagic stroke increased by 1.6 times. This correlation is not only related to the incidence of cerebrovascular disease, but also related to the prognosis and functional status of the disease.
Second, cerebrovascular diseases
1. Symptoms and manifestations
If diabetic patients have symptoms such as dizziness, black eyes or blurred vision, slurred speech, numbness and weakness of one limb, they should be on high alert for possible cerebrovascular diseases and seek medical advice in time.
2. How to screen
If diabetic patients have danger signs of stroke, they should immediately have brain CT or magnetic resonance (MRI) and other related examinations.
Third, kidney disease
Diabetic nephropathy is a common microvascular complication of diabetes, which affects about 25% of diabetic patients. It has become the main cause of chronic kidney disease and end-stage renal disease.
1. Symptoms and manifestations
There are usually no obvious symptoms in the early stage, and some patients may have increased urine foam, renal function damage, hypertension and edema. When the disease develops to the advanced stage, severe renal failure and uremia may occur, and dialysis treatment is needed.
2. How to screen
Generally speaking, patients with type 2 diabetes have a urine test every six months to one year to detect the content of microalbumin. If the index rises abnormally, it is recommended to seek medical examination.
Fourth, retinopathy
Diabetic retinopathy is one of the common complications of diabetes and one of the main causes of blindness.
1. Symptoms and manifestations
There may be no symptoms in the early stage, but with the progress of the disease, symptoms such as blurred vision, visual field defect, decreased vision at night, and floaters may appear. In the late stage, it may develop into serious situations such as retinal hemorrhage and retinal detachment.
2. How to screen
It is recommended that diabetic patients have an annual fundus examination, including optometry, intraocular pressure measurement and fundus examination. Fundus examination can observe the retina by dilating the pupil.
V. Neuropathy
Diabetic neuropathy refers to the damage of diabetes to the nervous system, including the involvement of peripheral nerves and autonomic nerves.
1. Symptoms and manifestations
Common symptoms include paresthesia (such as pain, tingling and numbness), impaired motor function, digestive system problems (such as delayed gastric emptying and constipation) and sexual dysfunction.
2. How to screen
Diabetic patients should have regular nervous system examination, including foot examination, electrophysiological examination and autonomic nervous function test.
6. Diabetic foot
Diabetic foot is one of the serious and costly chronic complications of diabetes, which can lead to amputation and death. In China, the incidence of new foot ulcers in diabetic patients over 50 years old is 8.1% within one year, and the incidence of new foot ulcers in cured diabetic patients is 31.6% within one year.
1. Symptoms and manifestations
In the early stage, numbness and abnormal temperature sensation of the foot may occur, and then redness and skin breakage may occur, which will gradually increase.
2. How to screen
All diabetic patients should have their feet examined regularly.
Check the foot skin for abnormal cyanosis and ulceration;
Check whether the pain, temperature and touch of extremities are normal;
Check whether the pulsation of dorsal foot artery and posterior tibial artery is weakened;
If you suspect vascular diseases, you can check the vascular ultrasound of lower limbs.
"Misunderstanding" of Diabetes
The complications of diabetes are closely related to the degree of blood sugar control. Only by paying attention to the changes of blood sugar can we prevent and control the acute and chronic complications of diabetes. In this regard, there are some misunderstandings that need special attention.
1. Is there no problem without symptoms?
Answer: Wrong!
Many patients often neglect the treatment and management of diabetes in the early stage of diabetes because the symptoms are not obvious, which leads to long-term substandard blood sugar and poor control, which further affects all systems of the whole body and increases the risk of complications.
Once you are diagnosed with diabetes, whether you have symptoms or not, you should insist on regular, scientific and reasonable treatment. Only in this way can we effectively control blood sugar and reduce complications.
Experts remind that the severity of diabetes can not be judged only by the severity of symptoms.
2. Can I stop hypoglycemic drugs without authorization?
Answer: Wrong!
Diabetes is a lifelong disease, and it can’t be cured at present. Just because the symptoms disappear and the blood sugar drops to normal after regular treatment does not mean that the diabetes has been cured, and the drug treatment can be stopped immediately.
The vast majority of patients still need to continue to receive medication after their condition is stable. If the drug is stopped at will, the blood sugar will fluctuate. At this time, the original dosage may not achieve the ideal hypoglycemic effect, and it may be necessary to increase the dosage or even use a variety of hypoglycemic drugs in combination, which will also cause certain damage to the body.
Experts remind: strictly following the doctor’s instructions for drug treatment is the key to control blood sugar and reduce complications.
3. If the blood sugar control is normal, can you relax your diet management?
Answer: Wrong!
In the treatment of diabetes, diet management is very important, which is called one of the "five carriages" of diabetes treatment. Others include exercise, medicine, blood sugar monitoring and self-management education. Failure to control diet is likely to lead to large fluctuations in blood sugar, which is not conducive to maintaining a stable metabolic state and weight.
Experts remind that diet management should run through the whole process of diabetes treatment, so don’t let your guard down just because the blood sugar results are normal, so as to avoid serious consequences due to the unpredictable risk factors such as inaccurate blood sugar monitoring results and drug taboos.
Do all diabetics have complications?
Not all diabetics will have complications.
At present, in clinic, there are many patients whose blood sugar, blood lipid, blood pressure and other indicators have reached the standard, and the course of disease is as long as 30-40 years. It can be seen that diabetic patients should pay attention to the control of blood sugar and cannot ignore the condition.
At the same time, we should follow the doctor’s instructions for drug treatment, and we should not stop taking drugs at will. Diet management is also very important in the treatment of diabetes, even if blood sugar control is normal, diet management can not be relaxed. In addition, not all diabetic patients will have complications, and following the standard treatment can reduce the risk of complications.
1. Control blood sugar, blood pressure and blood lipid.
Achieving the standard of blood sugar is the key to prevent complications in diabetic patients. The general ideal targets are: fasting blood glucose 4.4 ~ 7 mmol/L, postprandial blood glucose ≤10mmol/L, glycosylated hemoglobin (HbA1c)<7.0%, depending on the patient’s age and complications.
Even for patients with well-controlled blood sugar, blood sugar should be monitored 2 ~ 4 times a week. For patients with high blood sugar fluctuation or high blood sugar, blood sugar should be monitored 7 times a day, and treatment should be adjusted in time.
The control of blood pressure and blood lipid plays an important role in reducing the complications of diabetes and the risk of heart disease. Blood pressure should be monitored every time you visit a doctor, and blood lipid and electrocardiogram should be checked at least once a year.
Step 2 change your lifestyle
Reasonable diet, low fat and less oil, small amount of meals, regular quantitative meals. Quit smoking and limit alcohol, exercise properly, work and rest regularly, and control weight.
Step 3 check regularly
Diabetic patients should go to the hospital regularly for relevant examinations, which is not only beneficial to blood sugar control, but also can actively prevent complications and strive for early detection and early treatment. Screening mainly includes blood biochemical examination, glycosylated hemoglobin, urine routine, microalbuminuria, electrocardiogram, fundus examination, neuropathy screening, vascular B-ultrasound, etc., so as to achieve early detection and early treatment.
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