How should diabetics "eat" and "move"

According to the 2018 monitoring report on chronic diseases and risk factors in China, the national awareness rate, treatment rate and control rate of diabetes are only 38.0%, 34.1% and 33.1%. Symptoms should be vigilant that diabetes is a metabolic disease characterized by high blood sugar. Hyperglycemia may lead to cardiovascular and cerebrovascular diseases, diabetic nephropathy, blindness, diabetic foot and other diseases and lead to death, prediabetic people (fasting blood glucose in 6.1-7.0mmol or postprandial blood glucose in 7.8-11.1mmol). Women who have suffered from gestational diabetes or delivered macrosomia (birth weight ≥ 4kg) during pregnancy if the patient has venous blood fasting blood glucose ≥ 7.0mmol/L. Glycosylated hemoglobin ≥ 6.5% can be used as a supplementary diagnostic criteria "can reduce postprandial blood glucose fluctuations." Diabetes should follow the principle of balanced diet.

November 14 is United Nations Diabetes Day, and this year's theme is "Education protects tomorrow".

According to the latest study published by the Chinese research team in international top medical journals, the total prevalence rate of diabetes among Chinese adults is 12.8%, equivalent to one in eight people with diabetes, and the prevalence rate of prediabetes is 35.2%. This is equivalent to one in three people with abnormal blood sugar. According to the 2018 monitoring report on chronic diseases and risk factors in China, the national awareness rate, treatment rate and control rate of diabetes are only 38.0%, 34.1% and 33.1%, respectively. Diabetes health education is extremely urgent.

What are the health hazards of diabetes? How should patients "eat" and "move" scientifically? Yan Yaqiong, director of the chronic non-communicable disease prevention and control institute of Wuhan CDC, brings a detailed interpretation.

We should be on guard against the symptoms of "three more and one less" in ■

Diabetes is a metabolic disease characterized by hyperglycemia. The typical symptoms are polydipsia, polyuria, overeating and emaciation, which is called "three more and one less".

Yan Yaqiong said that the most terrible thing about diabetes is its complications. Hyperglycemia may be complicated with elevated blood pressure and blood lipids, affecting the whole body, brain, eyes, kidneys, nerves and other organs, causing cardiovascular and cerebrovascular diseases, diabetic nephropathy, blindness, diabetic foot and other diseases and leading to death. One person around the world dies of diabetes every six seconds.

Meet one or more of the following, that is, people who are at high risk of diabetes: over 40 years old; people with prediabetes (fasting blood glucose is 6.1cm-7.0mmol or postprandial blood glucose 7.811.1mmol); diabetes is found in immediate family members such as parents or siblings; overweight (28 > BMI ≥ 24) and obese people (BMI ≥ 28); concentric obese people with waist circumference of 85 cm for men and 80 cm for women People who are sedentary and lack of physical activity; women who have suffered from gestational diabetes or given birth to macrosomia (birth weight ≥ 4kg); have suffered from hypertension, hyperlipidemia or cardiovascular and cerebrovascular diseases.

So, how to diagnose diabetes clinically? Yan Yaqiong said that if a patient has venous blood fasting blood glucose ≥ 7.0mmol/L, or postprandial blood glucose ≥ 11.1mmol/L, or random blood glucose ≥ 11.1mmol/L, and has "three more, one less" symptoms, he can be diagnosed with diabetes. If the index meets the diagnostic criteria, but there are no typical symptoms of "three more, one less", it is necessary to repeat the examination another day to confirm the diagnosis. Glycosylated hemoglobin ≥ 6.5% can be used as a supplementary diagnostic criteria.

She said that more than 90% of diabetes in China is type 2 diabetes, which can be intervened by lifestyle adjustment, or even reverse pre-diabetes, in which "eating" and "moving", which are closely related to daily life, are of great significance to blood sugar control.

■ "Sugar Control" advocates low-GI Diet

"GI" refers to the glycemic index. Low-GI foods stay in the stomach and intestines for a long time, digest and absorb slowly, which can reduce postprandial blood glucose fluctuations and help blood sugar control. Yan Yaqiong said that diabetic patients should follow the principle of a balanced diet and adjust their diet structure under the premise of controlling total energy to meet the body's needs for various nutrients. One of the important skills is to choose low-GI foods as far as possible.

In staple food, the GI index of whole grain and mixed beans was significantly lower than that of milled rice, and contained more dietary fiber, B vitamins and phytochemicals, which should account for 1/3 of staple food intake. It is recommended that people with diabetes replace some fine grains with coarse grains such as buckwheat, oats and corn, and cook quickly when cooking, so as to avoid cooking for a long time.

In dishes, meals should have fresh vegetables, daily vegetable intake of about one jin, of which dark vegetables should account for half. Often eat fish and poultry, eat the right amount of livestock meat, eat less fat, try not to eat smoked, roasted, pickled and other processed meat products. Pay attention to less oil and less salt in cooking, daily oil intake no more than 30 grams, salt no more than 5 grams.

People with good blood sugar control can choose low GI varieties of fruits, such as grapefruit, peaches, cherries, plums, etc., between meals or before and after exercise, the number of fruits should not be too much.

At the same time, the diet of patients with diabetes should also pay attention to the principles of regular quantity, eating less and eating more, chewing slowly and so on. It is suggested to adjust the eating order and form the habit of eating vegetables first, then meat, and finally staple food. Pay attention to monitoring the changes of blood sugar, not only to prevent blood sugar rising too fast, but also to prevent hypoglycemia reaction.

■ carries his "identity card" with him when he goes out.

Scientific exercise can prevent and treat diabetes and significantly reduce the levels of glycosylated hemoglobin and blood lipids in patients with type 2 diabetes.

Yan Yaqiong said that people with diabetes should exercise according to the principles from least to many, from light to heavy, and from sparse to dense. Aerobic exercises such as brisk walking, jogging, cycling and swimming are recommended, supplemented by appropriate resistance exercises such as barbells, dumbbells, pull-ups and push-ups, with a duration of not less than 20 minutes each time and no less than 3 times a week. "medium intensity" has a simple way of judging, that is, feeling slightly gasping for breath, being able to talk to a partner but not singing.

Inappropriate exercise mode or intensity is easy to cause angina pectoris, sudden death, and bone joint ligament injury in patients with diabetes, so diabetic patients should pay special attention to exercise safety. In the timing of exercise, do not exercise on an empty stomach or immediately after a full meal. Patients are advised to exercise one hour after meals, not in the midday sun exposure in summer, cold winter mornings and just after insulin injection or oral hypoglycemic drugs. Be sure to choose appropriate shoes and soft socks when exercising, and check for foreign bodies or damage in the shoes. Warm up for 5-10 minutes before exercise, check your feet for signs of redness, swelling or compression after exercise, and see a doctor in time if you find a broken skin.

When blood sugar fluctuates greatly, there are serious complications such as fundus disease, nephropathy, diabetic foot, or accompanied by various organ dysfunction, arrhythmia and aggravation after activity, angina pectoris, myocardial infarction, the exercise plan must be made under the guidance of the doctor.

In order to prevent the risk of hypoglycemia caused by blood sugar fluctuations, patients are advised to keep candy in their pockets when they go out, and carry an "identity card" prominently on their neckline or chest, indicating that they have diabetes and other related information. indicate your name, address, emergency contact number, etc., so that you can get timely help from others in the event of an accident.

(Zhou Xiaoqi / tr. by Phil Newell)

Source: Changjiang Daily