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*It is only for medical professionals to read for reference.
If chronic complications of diabetes are not intervened in time, you may fall into the trap of "boiling frogs in warm water"! Chronic complications are the main cause of disability and death in diabetic patients, and they are also the bulk of the treatment costs of diabetic patients.
Special attention should be paid to the management and control of chronic complications during the treatment of diabetes
.
So how can we effectively manage the chronic complications of diabetes? Dr.
An Xingxing from the Department of Endocrinology and Metabolism at West China Hospital of Sichuan University will teach you three steps to manage chronic complications of diabetes
.
Who needs early screening? The early symptoms of chronic complications of diabetes are atypical, and gastrointestinal symptoms may occur, such as nausea, vomiting, or other systemic manifestations, such as gum disease, depression, hearing loss, Alzheimer’s, osteoporosis, gastroparesis, The specific symptoms of erectile dysfunction are shown in the following table (Table 1): Table 1: Early symptoms of chronic complications of diabetes Nausea and vomiting 1.
Hypoglycemic state 2.
Diabetic ketoacidosis 3.
Diabetic nephropathy 4.
Diabetic stomach light Paralysis 5.
Diabetes, Hejing, heart disease, gum disease, bleeding, gum swelling and pain, loose teeth, depression, sadness, irritability, difficulty concentrating, changes in sleep patterns, insomnia and other hearing loss, difficulty in distinguishing sound in public places, inaccurate speech and pronunciation, singing Out-of-tune; Alzheimer’s such as dizziness, decreased sense of smell, memory decline, cognitive impairment, such as osteoporosis, limb weakness, bone pain and other gastroparesis, abdominal distension, early satiety, anorexia, nausea, vomiting, and other erectile dysfunctions.
When the above symptoms occur in diabetic patients , We should be alert to the occurrence of chronic complications
.
In addition, according to the "China Type 2 Diabetes Prevention Guidelines (2020 Edition)", when adults meet any of the following risk factors, they can be defined as high-risk groups of chronic complications of diabetes.
Early screening is recommended: Age> 40 years old A history of prediabetes, overweight, obesity, sedentary relatives, diabetes, gestational diabetes, a history of hypertension, dyslipidemia, coronary heart disease, diabetic polycystic ovary syndrome caused by hormones, insulin resistance, long-term use of antipsychotic drugs, antidepressants, and statins.
Screening items and time-early screening items include traditional items and new types of items, of which the new type items are mainly gene sequencing
.
Traditional items are divided into three categories.
The first category is the investigation of risk factors, the second category is the inspection of the organs, and the third category is the physical examination and auxiliary inspection
.
The risk factors are as mentioned above
.
The key organs include heart, brain, kidney, feet, eyes, etc.
The time points and specific contents of the examination are shown in the following table (Table 2): Table 2 Key organs for early screening of cardiovascular diseases 1.
Start immediately after the diagnosis of diabetes.
Screening once a year 2.
Ask for age, risk factors: smoking, hypertension, obesity, dyslipidemia, family history of early cardiovascular disease 3.
Main items: blood tests, heart, arterial examinations and other kidney diseases 1.
Immediately after the diagnosis of diabetes Start, screening once a year 2.
Main items: glomerular filtration rate, urine protein creatinine ratio retinopathy 1.
Begin after diagnosis of type 2 diabetes, screening every 1 to 2 years 2.
For type 1 diabetes patients, Once every 5 years 3.
If retinopathy has been combined, check once a year for mild cases, once every 3-6 months for moderate cases, and once every 3 months for severe cases.
4.
Eye examination: visual acuity, retinal examination and neuropathy 1.
Diagnosis of type 2 diabetes Start immediately afterwards, screening once a year 2.
For type 1 diabetic patients, diabetic foot once in 5 years 1.
Start after diagnosis of diabetes, screening once a year 2.
Main items: consultation symptoms, physical examination, neurological examination, vascular examination Auxiliary examination time points and specific items: measure fasting and post-meal blood glucose every week; measure glycosylated hemoglobin, blood biochemistry (blood lipids), urine routine, urine albumin-creatinine ratio, blood pressure, weight, etc.
every 3 to 12 months
.
Early screening is very important for doctors and patients to work together to promote early screening of chronic complications of diabetes, inseparable from the cooperation of doctors and patients
.
For doctors, first of all, it is necessary to emphasize the importance of early screening for each patient at high risk of chronic complications of diabetes, and to formulate individualized screening items according to the patient's condition; secondly, to be able to interpret the screening results and comprehensively analyze the condition; and finally provide an individual A customized intervention program can block or delay the occurrence and development of the disease
.
For patients, we need to "think my life and my body": Have you shut your mouth? Have you opened your legs? Is your life>
.
Expert profile An Xingxing, the attending physician, graduated from the West China Clinical School of Sichuan University and obtained the qualifications of the China Scholarship Council.
From 2018 to 2020, he went to Harvard Medical School in the United States for joint training.
Participated in the completion of a number of National Natural Science Foundation of China.
The first author I have published multiple references for SCI papers: [1]https://apph1o73byu8326.
h5.
xiaoeknow.
com/v2/course/alive/l_60d3e785e4b07e4d7fe1e3e4?app_id=apph1O73Byu8326&available=true&entry1785e&ise4eresource=&isd7products/ide4&is/resource=2001&isp4ebene=2 %E5%88%86%E4%BA%AB&share_scene=1&share_type=5&share_user_id=u_618208153d485_0seIsoIlQa&type=12.
[2] Diabetes Association of Chinese Medical Association.
Chinese Type 2 Diabetes Prevention Guidelines (2020 Edition [J].
) Chinese Journal of Diabetes, 2021 .
13(4): 315-409.
If chronic complications of diabetes are not intervened in time, you may fall into the trap of "boiling frogs in warm water"! Chronic complications are the main cause of disability and death in diabetic patients, and they are also the bulk of the treatment costs of diabetic patients.
Special attention should be paid to the management and control of chronic complications during the treatment of diabetes
.
So how can we effectively manage the chronic complications of diabetes? Dr.
An Xingxing from the Department of Endocrinology and Metabolism at West China Hospital of Sichuan University will teach you three steps to manage chronic complications of diabetes
.
Who needs early screening? The early symptoms of chronic complications of diabetes are atypical, and gastrointestinal symptoms may occur, such as nausea, vomiting, or other systemic manifestations, such as gum disease, depression, hearing loss, Alzheimer’s, osteoporosis, gastroparesis, The specific symptoms of erectile dysfunction are shown in the following table (Table 1): Table 1: Early symptoms of chronic complications of diabetes Nausea and vomiting 1.
Hypoglycemic state 2.
Diabetic ketoacidosis 3.
Diabetic nephropathy 4.
Diabetic stomach light Paralysis 5.
Diabetes, Hejing, heart disease, gum disease, bleeding, gum swelling and pain, loose teeth, depression, sadness, irritability, difficulty concentrating, changes in sleep patterns, insomnia and other hearing loss, difficulty in distinguishing sound in public places, inaccurate speech and pronunciation, singing Out-of-tune; Alzheimer’s such as dizziness, decreased sense of smell, memory decline, cognitive impairment, such as osteoporosis, limb weakness, bone pain and other gastroparesis, abdominal distension, early satiety, anorexia, nausea, vomiting, and other erectile dysfunctions.
When the above symptoms occur in diabetic patients , We should be alert to the occurrence of chronic complications
.
In addition, according to the "China Type 2 Diabetes Prevention Guidelines (2020 Edition)", when adults meet any of the following risk factors, they can be defined as high-risk groups of chronic complications of diabetes.
Early screening is recommended: Age> 40 years old A history of prediabetes, overweight, obesity, sedentary relatives, diabetes, gestational diabetes, a history of hypertension, dyslipidemia, coronary heart disease, diabetic polycystic ovary syndrome caused by hormones, insulin resistance, long-term use of antipsychotic drugs, antidepressants, and statins.
Screening items and time-early screening items include traditional items and new types of items, of which the new type items are mainly gene sequencing
.
Traditional items are divided into three categories.
The first category is the investigation of risk factors, the second category is the inspection of the organs, and the third category is the physical examination and auxiliary inspection
.
The risk factors are as mentioned above
.
The key organs include heart, brain, kidney, feet, eyes, etc.
The time points and specific contents of the examination are shown in the following table (Table 2): Table 2 Key organs for early screening of cardiovascular diseases 1.
Start immediately after the diagnosis of diabetes.
Screening once a year 2.
Ask for age, risk factors: smoking, hypertension, obesity, dyslipidemia, family history of early cardiovascular disease 3.
Main items: blood tests, heart, arterial examinations and other kidney diseases 1.
Immediately after the diagnosis of diabetes Start, screening once a year 2.
Main items: glomerular filtration rate, urine protein creatinine ratio retinopathy 1.
Begin after diagnosis of type 2 diabetes, screening every 1 to 2 years 2.
For type 1 diabetes patients, Once every 5 years 3.
If retinopathy has been combined, check once a year for mild cases, once every 3-6 months for moderate cases, and once every 3 months for severe cases.
4.
Eye examination: visual acuity, retinal examination and neuropathy 1.
Diagnosis of type 2 diabetes Start immediately afterwards, screening once a year 2.
For type 1 diabetic patients, diabetic foot once in 5 years 1.
Start after diagnosis of diabetes, screening once a year 2.
Main items: consultation symptoms, physical examination, neurological examination, vascular examination Auxiliary examination time points and specific items: measure fasting and post-meal blood glucose every week; measure glycosylated hemoglobin, blood biochemistry (blood lipids), urine routine, urine albumin-creatinine ratio, blood pressure, weight, etc.
every 3 to 12 months
.
Early screening is very important for doctors and patients to work together to promote early screening of chronic complications of diabetes, inseparable from the cooperation of doctors and patients
.
For doctors, first of all, it is necessary to emphasize the importance of early screening for each patient at high risk of chronic complications of diabetes, and to formulate individualized screening items according to the patient's condition; secondly, to be able to interpret the screening results and comprehensively analyze the condition; and finally provide an individual A customized intervention program can block or delay the occurrence and development of the disease
.
For patients, we need to "think my life and my body": Have you shut your mouth? Have you opened your legs? Is your life>
.
Expert profile An Xingxing, the attending physician, graduated from the West China Clinical School of Sichuan University and obtained the qualifications of the China Scholarship Council.
From 2018 to 2020, he went to Harvard Medical School in the United States for joint training.
Participated in the completion of a number of National Natural Science Foundation of China.
The first author I have published multiple references for SCI papers: [1]https://apph1o73byu8326.
h5.
xiaoeknow.
com/v2/course/alive/l_60d3e785e4b07e4d7fe1e3e4?app_id=apph1O73Byu8326&available=true&entry1785e&ise4eresource=&isd7products/ide4&is/resource=2001&isp4ebene=2 %E5%88%86%E4%BA%AB&share_scene=1&share_type=5&share_user_id=u_618208153d485_0seIsoIlQa&type=12.
[2] Diabetes Association of Chinese Medical Association.
Chinese Type 2 Diabetes Prevention Guidelines (2020 Edition [J].
) Chinese Journal of Diabetes, 2021 .
13(4): 315-409.