What to do when diabetes encounters hyperuricemia? How are diets and treatments arranged?

Diabetes mellitus and hyperuricemia are common metabolic diseases, these two diseases, often have a common pathogenic basis, for example, obesity or bad living habits, resulting in excess nutrition and insulin resistance, and this condition is related to diet or alcohol, thereby increasing the risk of cardiovascular and cerebrovascular diseases. So, the blood sugar has not yet dropped, and the uric acid has risen again, what should I do? How to arrange diet and treatment? Let's solve your doubts now.

Diabetes and hyperuricemia often go hand in hand and affect each other. In diabetic patients, in the state of insulin resistance, the intermediate products generated during glycolysis will transfer to ribose 5 phosphate and pyrophosphate, resulting in increased uric acid production. Patients with diabetes mellitus may have hyperinsulinemia, which promotes sodium ion exchange in the kidneys, increases the reabsorption of negative ions, including uric acid, and reduces uric acid excretion. Patients with type 2 diabetes often have complications, the body's oxidative stress levels rise, and uric acid production increases accordingly, in order to alleviate the damage of oxidative free radicals. In addition, patients with diabetes may develop kidney function impairment, decreased filtration of uric acid by glomeruli, and increased lactate production, which makes hyperuricemia worse.

Diabetic patients, if they encounter hyperuricemia again, the condition will be more complicated. First of all, hyperuricemia is an independent risk factor for diabetic complications, which can cause microangiopathy, macrovascular disease, and neuropathy. Hyperuricemia causes the deposition of uric acid crystals, leads to inflammation of renal arterioles and interstitials, aggravates kidney damage, and accelerates the progression of diabetic nephropathy. After elevated uric acid, if urate is deposited on the wall of arterial vessels, it will lead to damage to the endovascular lining, increase the risk of retinopathy, and also contribute to the occurrence and development of coronary heart disease and cerebrovascular disease. In addition, hyperuricemia can aggravate insulin resistance, promote the production of angiotensin, aggravate hypertension, and make blood pressure difficult to control.

For ordinary people, it is necessary to soberly realize that diabetes and hyperuricemia are related to each other and affect each other, so indicators such as weight, blood sugar, blood pressure, blood lipids, and blood uric acid should be jointly included in the management goals. At the same time, pay attention to details, such as lifestyle changes in diabetes treatment plans that emphasize increased physical activity, but limit overactivity when hyperuricemia causes arthritis. For example, the diet of diabetics advocates high protein, low calorie, and hyperuricemia, requiring strict restriction of meat to prevent excessive purine intake. In addition, certain hypoglycemic drugs can affect purine metabolism. If these problems are not handled well, in the treatment and daily life, there will be the phenomenon of holding down the gourd and floating the scoop, taking care of one or the other.

When diabetics experience hyperuricemia, the total calorie control should be focused on dietary arrangements. There are four specific measures. 1st, control staple foods and reduce carbohydrate intake. Second, eating more dietary fiber-rich foods, such as melons or tubers, and most leafy greens, can help improve insulin sensitivity and reduce the risk of gout. Third, drink more water, don't drink alcohol. Drink 2500 ml of water per day, and make up water in small quantities and multiple times. 4th, supplemental protein, you can choose milk or eggs, lean meat intake, should not exceed 100 grams per day, gout attacks, need to strictly limit meat intake. In addition, pay attention to cooking methods, reduce frying, use less condiments, and control the intake of sodium salt.

In diabetic patients, if hyperuricemia occurs at the same time, the choice of treatment regimen becomes more complicated. Therefore, it is recommended that patients choose a general practitioner who can be trusted, and at the same time, strengthen comprehensive examination, timely find abnormal indicators, and when seeing a doctor, they need to explain their condition to the doctor in detail. The formulation of treatment plans should be considered comprehensively. For example, when hyperuricemia causes gout attacks, if glucocorticoids are used, blood sugar may be significantly increased, but in order to avoid deterioration of kidney function, it has to be used, and when encountering such a dilemma, it is necessary to closely monitor kidney function and changes in blood sugar. In addition, the choice of hypoglycemic drugs needs to avoid affecting uric acid metabolism so as not to induce or aggravate gout.

Currently, in exceptional cases, glycosidase inhibitors, such as acarbose and migliglisol, are generally recommended. In addition, metformin can promote uric acid metabolism by suppressing appetite, helping to reduce weight, lower triglyceride levels, increase insulin sensitivity, and at the same time, reduce apoptosis of tubular epithelial cells. Overall, drugs that lower blood uric acid may help lower blood glucose levels, but some hypoglycemic drugs may cause elevated uric acid. Therefore, it is necessary to consider comprehensively and try to choose hypoglycemic drugs that are conducive to uric acid excretion.

It is necessary to remind everyone that the level of uric acid is too high, which will increase the risk of diabetes by 3 times, and hyperuricemia is also a related factor in the increased risk or aggravation of a variety of chronic diseases, so it is necessary to strengthen the control of uric acid levels. However, uric acid has a neuroprotective effect, so the uric acid level cannot be lowered too low. Ordinary people should strengthen scientific understanding and take comprehensive countermeasures from the perspective of metabolic level management. Weight management, for example, is at the heart of it. Because too much adipose tissue builds up, it increases insulin resistance and produces and secretes more uric acid, and if a healthy weight and body fat ratio can be maintained, it is beneficial for the prevention and treatment of diabetes and hyperuricemia.

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