This is the 3617th article of Da Yi Xiao Nursing
Sugar friend experience
Sugar friend Wang Aunt, 60 years old, diagnosed with type 2 diabetes for 5 years, usually oral "glimepiride" and "metformin" to control blood sugar, 1 year ago the detection of glycosylated hemoglobin was 7.5%. In the past six months, Aunt Wang felt that something was wrong, and her legs and feet often felt that there were small ants crawling on it, but she could pull up her pants to see, but there was nothing. Sometimes she pressed her feet hard, and the pain was not obvious. Yesterday morning when wearing socks, I accidentally found that the small toe of my right foot was worn out of a bubble by the shoe, and the bubble was broken, but she did not find out when the toe was injured. Is this "painless" a good thing?
Sugar friend Uncle Wang, 63 years old, retired for 2 years, sugar age 10 years. Currently, premixed insulin is given once daily with morning and evening injections of controlled ancestry. Half a year ago, he measured glycosylated hemoglobin once, 8.3%, and the attending doctor, Dr. Li, told him that blood sugar control is not good, must pay attention to diet, strengthen monitoring, and recently is adjusting the amount of insulin according to his blood glucose monitoring results. Because the doctor said to pay attention to diet, Lao Wang also paid special attention to it, mainly to achieve the control of the "amount" said by the doctor, in addition, the sweets and fried foods that the doctor did not let eat were absolutely not touched. Although he ate less, Lao Wang always felt that his stomach was bloated and often had the phenomenon of full burp. Two or three hours after the meal, I still feel that my stomach is rising, and I always feel that the food has not gone down. The stool is not so painful, not only can be solved once in three or four days, but every time it is solved, it is like a war, and it takes more than twenty minutes to work hard in the bathroom.
What happened to Grandpa and Auntie?
Type 2 diabetes is a slow-progressing disease, and diabetic neuropathy is one of the main chronic complications of diabetes, with diabetes lasting more than 10 years. There is often significant clinical diabetic neuropathy. Lesions can involve the central nervous system, peripheral nerves, and autonomic nerves. Diabetic neuropathy is most commonly distal symmetrical sensorimotor polyneuropathy, characterized by progressive sensory loss distal to the extremities and, in severely ill patients, motor weakness due to axonal loss of neurons. The more classic symptom is loss of sensation in a "sock-glove" distribution.
In addition, autonomic neuropathy is also more common, autonomic nerves (autonomic nerves) control the heart, bladder, lungs, gastrointestinal tract, sexual organs and other important organs, seriously affecting the ability of sugar friends to carry out daily activities.
Both Aunt Wang and Uncle Wang mentioned above need to go to the hospital for targeted examinations to determine whether there is a remote symmetric polyneuropathy and diabetic autonomic neuropathy.
What are the common symptoms of diabetic neuropathy?
Diabetic neuropathy as a chronic complication is also a looming occurrence, in the appearance of the following symptoms, sugar friends must be vigilant!
The foot is damaged, the damage is not getting better and the healing tendency is not
Infection of the foot opening (redness, swelling, burning)
The foot breaks are getting bigger and bigger
There is a burning sensation, tingling sensation, and a feeling of weakness in the hands, feet, etc., which are getting heavier and heavier, interfering with daily life and sleep!
Repeated dizziness
Indigestion: bloating, constipation, etc
Abnormal urination: not easy to excrete, etc
Decreased sexual function, men often have erectile dysfunction
These symptoms are symptoms that diabetic neuropathy can present, although this episode is not necessarily caused by diabetic neuropathy, these symptoms are also symptoms that should be treated accordingly. Early diagnosis and early treatment can control symptoms in time and prevent further exacerbation of the disease.
When the above symptoms of the patient appear, it is very important to seek medical treatment regularly, there are many possibilities behind the symptoms, diabetic neuropathy may be possible, other diseases may also be, only by clarifying the real cause, can we be targeted, appropriate diagnosis and treatment.
Risk factors for diabetic neuropathy?
The following factors in particular increase the risk of diabetic neuropathy in sugar friends!
Poor blood sugar control
This is the most important risk factor for the development of every diabetic complication, including neuropathy. Always keeping blood glucose within the target range is the most important way to prevent neurovascular and vascular disease. Sugar friends must strengthen the monitoring of blood sugar, pay attention to blood sugar on an empty stomach, after meals at various points in time, to ensure that blood sugar control in the appropriate range, sugar friends' efforts will definitely be rewarded!
Course of diabetes
The longer the course of diabetes, the higher the incidence of neuropathy, especially in patients with poor glycemic control, and the risk of neuropathy increases as the duration of the disease increases.
Kidney disease
Kidney disease can hinder the discharge of some metabolic waste products in the body, which will increase the risk of diabetic neuropathy.
Overweight or obese
An increase in body mass index also increases the risk of neuropathy. Therefore, the benefits of sugar friends to control weight are many, and we must do a good job of weight management!
smoking
Smoking can affect blood vessels and reduce the blood supply to the peripheral circulation. On the one hand, it affects the nutrient supply of the nerves, on the other hand, once a wound appears, it is not easy to heal, and it will also damage the integrity of the peripheral nerves.
Prevention of diabetic neuropathy?
The following measures can help sugar friends reduce the risk of diabetic neuropathy
Control your blood sugar well
That's the first priority!
Control your blood pressure well
Both high blood pressure and diabetes increase the risk of chronic complications of diabetes because they affect blood flow. Be sure to keep your blood pressure within the target range and check your blood pressure frequently.
Do a good job of dietary control
Diet control is an important measure for weight control, please follow the dietary recommendations in our previous article to arrange your diet reasonably. In general, coarse grains, vegetables, and fruits are all healthy foods, and we must also grasp the right amount!
Get moving every day
Proper exercise can ensure heart function, promote blood flow, and also benefit the control of blood pressure and blood sugar. Remember, the easiest way is to walk for half an hour a day!
Author: Department of Endocrinology, Tongji Hospital, Tongji University
Ying Li is the deputy chief physician