There are more and more people with high blood sugar and diabetes in China, and the largest number of them is type 2 diabetics. In 2018, relevant surveys and studies show that the incidence of diabetes in our country has increased to 11.2%, so the current conservative estimate of the number of diabetes in China has exceeded 140 million, counting the number of people in prediabetes. Behind so many diabetics, the question that many patients want to ask the most is "Diabetics, how should they be reviewed?" "Today Dr. Zhang will come to tell you about this topic.
To answer this question, I would like to divide the items that diabetics should review into two, the first part is the daily monitoring of blood glucose, and the second part is the monitoring of target organ damage, or complications. Let's make it clear to you separately.
1. Monitor blood glucose
People with diabetes, as well as some people in prediabetes, should pay special attention to the monitoring of their own blood sugar. The blood glucose mentioned here mainly includes 3 parts, namely fasting blood glucose, postprandial 2 hours blood glucose and glycosylated hemoglobin. Among them, fasting blood glucose and postprandial 2 hours of blood glucose monitoring, most people are self-monitoring at home, generally need a home blood glucose meter, the patient himself on time to self-test fingertip blood glucose, the measurement time is generally before the meal fasting and 2 hours after the meal. The measurement of glycosylated hemoglobin is generally to the hospital for follow-up, every 2-3 months monitoring, because this indicator reflects the blood glucose situation in the past 2-3 months, everyone checks once in 2-3 months, there is no need to check every month.
2. Monitoring of target organ damage and complications
In general, diabetics, especially those with a long history of diabetes, should pay special attention to monitoring complications in addition to monitoring their own blood glucose. Generally speaking, it is the examination of the three important organs of the heart, brain and kidneys.
The heart should not be vigilant against coronary heart disease, that is, whether the coronary arteries of the heart have atherosclerotic plaques, and the primary examination in this regard is the electrocardiogram, cardiac ultrasound and other items. If a diabetic patient develops typical symptoms of coronary heart disease, cardiac enzymes, troponin, coronary CTA, and coronary angiography can even be checked. Because diabetic patients are prone to microangiopathy, if you want to understand the metabolism of myocardial muscle, many times you also need to check the myocardial radionuclide imaging test.
Whether there is atherosclerotic lesion caused by high blood sugar in the cerebral blood vessels, the more primary one can check the carotid ultrasound to initially see whether the carotid artery has atherosclerotic plaques. Many times some diabetics also need to have a ct of the skull, or even MRI, and some patients even need to check the strengthened CTA or MRA of the cranial blood vessels. This is all to see if the cerebral blood vessels have undergone atherosclerotic changes due to blood sugar.
In addition, the kidneys are also a organ that is particularly susceptible to damage by high blood sugar. In general diabetic patients, if you want to see early kidney damage, you can check the indicator of urine microalbumin/urine creatinine (ratio), and the evaluation index of severe kidney damage in the later period can look at kidney indicators such as glomerular filtration rate.
The above is Dr. Zhang's answer to the question of how to review diabetics, and I hope that my introduction can help you. In fact, diabetics need to find a professional doctor for regular review, which the majority of diabetics must not ignore.