Diabetes is a metabolic disease characterized by high blood sugar. Long-term high blood sugar can induce a variety of diseases, leading to chronic damage and dysfunction of organs such as the heart, kidneys, fundus, blood vessels, nerves, etc., and seriously affect the physical and mental health of patients.
Diabetes is a lifelong disease. Once it becomes ill, it needs to be treated and controlled for life; friends often ask: Can diabetes be prevented? Can diabetes be reversed? Can you not take medicine? In fact, type 2 diabetes is completely preventable. If sufficient attention is paid in the pre-diabetes and early stages, the occurrence of diabetes can be prevented or delayed; let’s learn about the prevention and reversal of diabetes.
1. The normal range of blood glucose and the diagnostic criteria for diabetes
The normal range of blood glucose is: fasting blood glucose <5.6 mol/L, postprandial blood pressure <7.8 mol/L;
The diagnostic criteria for diabetes are: fasting blood glucose ≥ 7.0 mol/L, and 2 hours postprandial blood glucose ≥ 11.1 mol/L.
2. Impaired fasting blood sugar:
If 5.6mol/L≤fasting blood glucose <7.0mol/L, that is, the elevated fasting blood glucose has exceeded the normal blood glucose range, but has not yet reached the diagnostic criteria for diabetes, which is called impaired fasting blood glucose.
3. Impaired glucose tolerance:
If 7.8.0mol/L≤2 hours postprandial blood glucose and urine <11.1mol/L, that means postprandial blood glucose rises and exceeds the normal range, but it has not yet reached the diagnostic criteria for diabetes. We call it impaired glucose tolerance or diabetes mellitus. damage.
Patients with impaired fasting blood glucose or impaired glucose tolerance, or both impaired fasting blood glucose and impaired glucose tolerance, are called prediabetes, also known as impaired glucose regulation, when the blood glucose rises above the normal range, but It has not yet met or exceeded the diagnostic criteria for diabetes. According to statistics, the prevalence of pre-diabetes is as high as 15%.
Five, the hazards of pre-diabetes
Pre-diabetes is the only way to the natural course of diabetes
Patients with prediabetes are particularly prone to develop diabetes, and the risk of cardiovascular and microvascular complications is significantly increased. Pre-diabetes is the only way to the natural course of diabetes. If there is no intervention, most people will develop diabetes. Studies have shown that after 4 years of pre-diabetic patients, 10.8% to 20.9% of people will develop type 2 diabetes. Studies have shown that people with impaired fasting blood sugar have a 5-fold increase in the risk of diabetes.
Pre-diabetes, also pre-cardiovascular disease
Pre-diabetes people are not only high-risk groups of diabetes, but also high-risk groups of cardiovascular and cerebrovascular diseases, because pre-diabetics already have cardiovascular risk factors such as insulin resistance (that is, insensitivity to insulin), dyslipidemia, hypertension, etc., which have appeared The early changes of atherosclerosis, that is, before the onset of diabetes, cardiovascular damage has already begun. This is the reason why many people with diabetes are found to have symptoms as soon as they are diagnosed with diabetes.
6. Pre-diabetes can be reversed
Although pre-diabetes is the only way for the development of diabetes, it does not necessarily develop into diabetes. Pre-diabetes is a reversible stage. Diabetes research in my country and the diabetes prevention programs in Finland and the United States have found that if early intervention is carried out, The risk of diabetes is reduced by 30% to 40%.
Therefore, it is recommended that patients with prediabetes reduce the risk of diabetes through diet control and increased exercise, regular blood sugar check, and long-term adherence; at the same time, strictly control other risk factors for cardiovascular and cerebrovascular diseases (such as smoking, obesity, high blood pressure, high uric acid, high blood pressure). Homocysteine, proteinuria and dyslipidemia, etc.), and give appropriate treatment.
The 30-year follow-up of the Daqing Diabetes Research in my country has proved that early lifestyle intervention can not only delay the onset of diabetes, reduce the incidence of cardiovascular events and microvascular disease, but also reduce all-cause mortality and prolong life. Tests have proved that patients with pre-diabetes and early diabetes can be prevented or even reversed through lifestyle intervention, but the premise is that they are in the pre-diabetes or early stage, and the corresponding complications have not occurred, lifestyle intervention should be carried out; when diabetes is diagnosed In the future, regardless of whether diabetes is reversed, long-term lifestyle intervention will still be the most important measure in the treatment of diabetes.
Lifestyle intervention: the most important
Relevant studies at home and abroad show that in order to prevent the development of diabetes from pre-diabetes, lifestyle intervention is the most important measure, and the following should be done:
(1) Weight reduction by 7%;
(2) At least 150 minutes of moderate-intensity exercise (such as running, swimming) per week;
(3) The intake of saturated fatty acids (mainly derived from animal fat) accounts for less than 30% of the total fatty acid intake.
Control other risk factors:
Patients with prediabetes often have obesity, smoking, alcoholism, lack of exercise, high blood pressure, hyperlipidemia, high uric acid, high homocysteine, urine protein and other risk factors for cardiovascular diseases. These factors affect each other, which are cardiovascular Disease is also a risk factor for diabetes and its complications. The more risk factors that are combined, the higher the risk of cardiovascular and cerebrovascular diseases. Therefore, these risk factors must be discovered in time and strictly managed and controlled; the treatment goal is to keep blood pressure below 130 /80mmHg, low-density lipoprotein cholesterol <2.6mmol/L, if combined with cardiovascular diseases such as coronary heart disease or cerebral infarction, it should be <1.8mmol/L; triglycerides <1.7mmol/L, urine microalbumin and creatinine The ratio is less than 30mg/g.
Drugs to prevent the occurrence and development of diabetes:
Patients with prediabetes who are still unable to meet the standard after lifestyle intervention can be treated with drugs under the guidance of a doctor. Studies have proved that: Metformin and acarbose can prevent or delay the development of pre-diabetic diabetes: Metformin is safe and effective for long-term treatment, and is especially suitable for overweight or obese pre-diabetic patients; Acarbose works by delaying carbohydrates in the small intestine Decomposition and absorption, to achieve the purpose of lowering blood sugar after a meal, so it is particularly suitable for patients with impaired glucose tolerance. A number of studies in recent years have confirmed that acarbose can significantly reduce the incidence of cardiovascular events in patients with diabetes and hypertension, and even has the effect of delaying atherosclerosis in patients with impaired glucose tolerance.
Seven, the treatment of diabetes
If you miss the pre-diabetes lifestyle intervention and have already developed into the diabetes stage, then lifestyle intervention is still effective. In the process of diabetes treatment, lifestyle intervention must always be adhered to.
In addition, if there are no contraindications, metformin should also be kept in the diabetes treatment plan. On this basis, other types of hypoglycemic drugs should be added as soon as possible according to their own specific conditions, and blood sugar and other risk factors should be controlled within a reasonable range as soon as possible. We must not blindly pursue the “reversal” and “radical cure” of diabetes and walk on the path of wrong treatment of diabetes.