Mr. Chen just turned 40 years old, but found that his weight had lost 5 kg within a month. Not only did Mr. Chen not deliberately go on a diet during this time, he ate more, drank more, and urinated more. The wife felt that something was not right, so she took Mr. Chen to the hospital for a checkup. Her blood glucose level was over 400 mg/dL, and the glycosylated hemoglobin value was as high as 14%.
“This is diabetes. We have to treat it quickly and control it well.” Dr. Fan Gangzhi, from the Department of Metabolic Endocrinology, National Taiwan University School of Medicine, Hsinchu Branch, carefully explained the next treatment plan.
Just heard the diagnosis of diabetes, Mr. Chen was a bit at a loss, but quickly accepted the facts, determined to get rid of bad habits, began regular exercise, weight loss, and took medications on time and used insulin injections to control blood sugar. With the joint efforts of both doctors and patients, Mr. Chen’s glycated hemoglobin value has dropped to 7% within six months, which is a significant improvement.
When referring to this impressive case, Dr. Fan Gangzhi smiled and said: “Although diabetes is a chronic disease, as long as you understand the disease and use various methods to control blood sugar, you can greatly reduce the chance of future complications.”
You have to take care of your blood sugar on an empty stomach and after meals. Have you made the distinction?
Dr. Fan Gangzhi said that if we want to control blood sugar well, we must first understand the indicators of “fasting blood glucose”, “after-meal blood glucose”, and “glycated hemoglobin”.
Blood sugar refers to the concentration of glucose in the blood. Our pancreas usually secretes a small amount ofinsulinInto the blood to regulate blood glucose concentration. When we eat, the food is digested and absorbed, and glucose enters the blood, raising the blood sugar level. Elevated blood sugar will stimulate the pancreas to secrete a large amount of insulin to respond, lowering the high blood sugar after meals.
Dr. Fan Gangzhi said that “fasting blood glucose level” represents “the ability of the pancreas to maintain a basal level of insulin” and “blood glucose level after meals” represents “the pancreas’s ability to secrete insulin after eating.” The fasting blood glucose level of diabetic patients should preferably fall between 80 mg/dL and 130 mg/dL, and the blood glucose level after meals should be controlled between 80 mg/dL and 180 mg/dL.
The hemoglobin in the red blood cells will be combined with glucose, called “glycated hemoglobin”. The higher the normal blood sugar, the higher the ratio of glycated hemoglobin. Glycated hemoglobin can represent the average blood glucose level over the past three months, which is equal to the total average score of blood glucose before and after meals.
When the glycated hemoglobin value is 6%, it represents an average blood glucose value of about 115 mg/dL over the past three months; when the glycated hemoglobin exceeds 6.5%, the diagnostic criteria for diabetes is reached. If the glycated hemoglobin value reaches 10%, the average blood sugar value is about 250 mg/dL. Mr. Chen mentioned at the beginning of the article, the glycated hemoglobin of blood test is as high as 14%, which means that the average blood glucose value is about 380 mg/dL, which has seriously exceeded the standard.
“When seeing a doctor, patients often ask, “I measure my fasting blood glucose before meals every day. Why is the glycated hemoglobin test not very good?” This actually means that the blood glucose level after meals is not up to the standard. Ask the patient to go home for a test After the blood sugar test, they know what their problem is!” Dr. Fan Gangzhi explained: “Analyze, after the mealblood sugarEspecially high, it may be because of eating a big meal or choosing too much starch in the meal, which causes the blood sugar to soar after the meal. “
Fasting blood glucose, post-meal blood glucose, and glycosylated hemoglobin are three important indicators, which can help us judge the patient’s condition, adjust treatment methods, and control blood sugar well.
How many insulin injections should be given? The frequency has nothing to do with the severity!
Dr. Fan Gangzhi explained that insulin is an indispensable hormone for the body and a weapon to help control blood sugar. Currently, there are quick-acting, short-acting, medium-acting, and long-acting insulins that are suitable for different conditions.
Rapid-acting insulin and short-acting insulin are suitable for controlling acute hyperglycemia. About 10 to 30 minutes after injection, they can start to lower blood sugar, but the duration is only a few hours, mainly to control “after-meal blood sugar.”
Intermediate-acting insulin and long-acting insulin have a longer action time and can continuously lower blood sugar for a whole day, which can be used to simulate the natural basic concentration of insulin in the body. Intermediate and long-acting insulin helps control “fasting blood sugar”.
There are also mixed insulins, which contain short-acting and medium-to-long-acting insulins. They are suitable for sugar lovers with regular life patterns. As long as the time of eating and activity is quite fixed, you can consider using mixed insulin to reduce the number of injections.
Flexible use of short-acting, medium-acting, long-acting, and mixed insulin, so that blood glucose after meals and fasting blood glucose can reach the standard. “The frequency of insulin injections is related to the type of insulin used. Some patients need two injections a day, while others need three or four injections.” Dr. Fan Gangzhi specifically clarified, “The number of insulin injections has nothing to do with the severity of the disease. You don’t have to compare with other sugar friends, as long as it is suitable for you and can stabilize your blood sugar level, it is a good treatment!”
Is it safe to get an injection every day? Will it cause additional burden?
Hearing injections, patients may be a little worried. However, Dr. Fan Gangzhi emphasized, “Insulin is a natural hormone of the human body and a right-hand man in controlling diabetes. Because it is a hormone secreted by the body every day, supplementing insulin will not cause additional burden on the body.
Whether the body is unable to secrete enough insulin or the cells are not sensitive to insulin, injections can be used to replenish insulin. On the one hand, the pancreas can rest and recover, and on the other hand, blood sugar control can reach the standard.
Is blood sugar controlled by a ketogenic diet? Do not use it rashly!
Because eating starchy foods tends to increase blood sugar, some diabetics will try to adopt a ketogenic diet, hoping to control blood sugar by eating only protein and fat instead of starch.
However, Dr. Fan Gangzhi said that although some diabetic patients can see blood sugar drop and weight loss when they first started the ketogenic diet, blood tests may find that the patient’s cholesterol has increased due to the ketogenic diet. In this way, even if the blood sugar drops, it may increase the risk of cardiovascular disease due to the increase in the cholesterol concentration.
At present, there is no clear research report that can tell us what kind of results the long-term ketogenic diet will bring. Sugar friends should not adopt it rashly. Please be sure to discuss with the endocrinologist in advance, so as not to outweigh the gains.
Dr. Fan Gangzhi said, “Humans have used insulin to control blood sugar for a hundred years. The current insulin treatments are actually relatively safe, with very stable drug effects, and there will be no peak problems. It can also match the eating time of patients, and is flexible. Choosing to administer it can also reduce the risk of nighttime hypoglycemia. It is a good assistant for diabetics to control blood sugar throughout the day.”
Diabetes patients can discuss with their doctors, choose a treatment method that suits them, match diet and exercise, so that fasting blood sugar, post-meal blood sugar, and glycosylated hemoglobin are all up to standard!
