Audit expert: Peng Guoqiu
Deputy Chief Physician of the Fourth Medical Center of Chinese People's Liberation Army General Hospital
Recently, the topic #Diabetes is like soaking organs in sugar water# has rushed to the hot search. High blood sugar is like a slow knife, which can damage the heart, kidneys, nerves and other tissues and organs little by little. Long-term blood sugar exceeds the standard, and the body is like soaking in high-concentration sugar water. There are 141 million diabetics in mainland China, which is equivalent to 1 in 10 adults around us.
Source: Weibo
Is it true that diabetes can't be cured? It doesn't seem to be.
Recently, according to the surging news, "Cell Discovery" published the world's first autologous regenerative islet transplantation to cure diabetes, the patient has been completely weaned from insulin for 33 months, which is the world's first use of stem cell-derived autologous regenerative islet transplantation, successfully cured of severe impaired islet function of diabetes.
Screenshot of the paper Source: Baidu
The patient has a 25-year history of type 2 diabetes and has developed end-stage diabetic nephropathy, also known as uremia. In the later stage, due to the near-failure of its pancreatic islet function, it requires multiple insulin injections per day, and there is a great risk of serious complications of diabetes in the future. The research team performed autologous regenerative islet transplantation for him, and gradually began to completely wean himself off exogenous insulin after surgery, and the dose of oral hypoglycemic drugs was gradually reduced, and the drug was completely withdrawn in the later stage, and the patient has been completely weaned from insulin for 33 months. The 25-year-long diabetes mellitus was successfully cured, and this is the first time in the world that autologous-derived islets have been used to treat patients with T2D with impaired islet function.
Seeing this, did someone say, "It's okay, I have low blood sugar, I can't get diabetes", it seems that everyone also has some misunderstandings about low blood sugar, today, let's talk about low blood sugar.
When does hypoglycemia occur?
In daily news reports, we often hear that someone faints due to low blood sugar, or that something dangerous happens. Moreover, the harm of hypoglycemia is calculated by minutes, even seconds.
First of all, you need to know what hypoglycemia is. Hypoglycemia refers to a fasting blood glucose concentration of less than 2.8 mmol/L in adults and a blood glucose level of ≤ 3.9 mmol/L in diabetic patients. The symptoms of hypoglycemia are mainly manifested as sweating, hunger, palpitation, paleness, etc., and patients with severe hypoglycemia can also have lack of concentration, agitation and irritability, and even coma.
Normally, you will be hungry for a day, but you will not necessarily have low blood sugar because the body has glycogen and fat energy reserves, which are converted into sugar and sent to the bloodstream when starving. If you starve for a long time, your blood sugar will be lowered, but not to the point where severe hypoglycemia will make you unconscious.
Hypoglycemia and diabetes coexist?
Many people believe that diabetes and hypoglycemia do not appear in a person at the same time, however, this is not the case. In fact, diabetic patients may also experience hypoglycemia symptoms during treatment, or due to the influence of drugs, diet, exercise and other factors.
Why is that?
First, learn what diabetes is. It is a metabolic disease characterized by hyperglycemia, which is caused by a defective secretion of insulin or a biological impair, or both.
Comparison chart of normal blood sugar and high blood sugar Source: Internet
Therefore, for diabetic patients, due to the impaired self-regulation ability of blood sugar, it is necessary to pay attention to avoid factors that cause hypoglycemia in addition to paying attention to elevated blood sugar. Common causes of diabetic hypoglycemia include:
(1) Drugs: insulin or insulin secretagogues: insulin, sulfonylureas and non-sulfonylurea insulin secretagogues can cause hypoglycemia.
(2) Failure to eat on time, or eating too little;
(3) increased amount of exercise;
(4) Alcohol intake, especially on an empty stomach.
It could just be low blood sugar
As mentioned earlier, patients with symptoms of hypoglycemia do not necessarily have diabetes, so sometimes, it may just be hypoglycemia.
For example, physiological hypoglycemia, commonly known as "fainting from hunger", where the blood sugar drop is a normal body reaction and has nothing to do with the disease. When you forget to sleep and eat for work, study, and when you look in the mirror, your body is anxious, and you are determined to quit carbs, low blood sugar will quietly come to your door.
There is also a case of hypoglycemia in pregnant women, because pregnant women need to deliver a lot of nutrients to the fetus, and they are prone to hypoglycemia before meals, so they should pay attention to adding meals.
What to do if you have low blood sugar
Hypoglycemia is always acute and suddenly "knocks you down", what should you do?
If you are a diabetic patient, you should be alert to factors that may induce hypoglycemia during treatment, such as blood sugar control is usually very good, and suddenly you start exercising greatly throughout the day, or suddenly you eat very little at a meal, or increase the amount of medication, and your blood sugar will drop too low. At this time, you should seek medical attention in time, adjust your medication according to the doctor's instructions, and try to be regular in your diet and exercise, with no ups and downs.
If you are not a diabetic patient, you can give preference to simple sugars that can make your blood sugar rise the fastest, such as cola, sprite, white sugar water, sugar that can be chewed quickly, etc., and eat some staple foods such as bread after the symptoms are relieved, so as to ensure that your blood sugar does not fall.
If blood glucose is not replenished continuously, further damage can occur, not least of which is damage to the brain. The brain is vital to us. Normally, the energy required by our brain cells comes almost entirely from glucose, and although brain cells choose to use ketones for energy during hypoglycemia, ketones take a certain amount of time to produce, so the brain lacks enough energy.
When hypoglycemia occurs, brain cells are still consuming glucose, and if we are unable to replenish glucose, brain function will show symptoms of disorder, and some functions of brain tissue, such as neurotransmitter metabolism, blood-brain barrier function, and electrolyte transport, will be impaired, resulting in acute stress brain damage.
If hypoglycemia lasts for a long time or occurs repeatedly, brain nerve cells may undergo changes such as degeneration and necrosis, cerebral edema, and even lead to permanent impairment of brain function or death.
In short, don't underestimate hypoglycemia, it looks like it's just a dizziness, but in fact, the risk factor behind it is not inferior to hyperglycemia, and sometimes even more dangerous. Therefore, it is important to carry food to prevent hypoglycemia and a first aid card with you, and to seek medical attention in time when hypoglycemia occurs frequently, so as to minimize the risk.