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2126806 2010 年 11 月 30 日 15:59 Reading (loading. ..) Comments (0) Category: Personal Diary
Elderly Diabetic
1, Professor Guo Xiaohui, director of Peking University First Hospital, Peking University Hospital, vice president of endocrine research interests include diabetes and obesity the mechanism of insulin resistance and lipid toxicity of chronic complications of diabetes, the mechanism and prevention. (Left)
2, Jianmei Associate Professor of Endocrinology, Peking University First Hospital, deputy director of physicians to work more than ten years of clinical experience has accumulated a wealth of mechanisms of diabetic nephropathy progress made non-insulin-dependent diabetes mellitus nephropathy and other papers. (Right)
Moderator: Ladies and gentlemen, are you! Here is the China Central Television \
NARRATOR: the older people will have this experience, the body will slowly increase with age do not listen to your command, 75-year-old Jia Shuzhen aunt because toes burns, wound healing can not always, to the hospital only to find the treatment already has a very serious disease.
Jia Mother: Hospital to measure blood sugar, do not know whether the machine is broken test it out.
NARRATOR: In fact, testers are not bad, because the test does not come out of Ma Jia blood glucose meter blood glucose value exceeds the maximum limit, the doctor told us that Aunt Jia is already suffering from diabetes for a long time, the reason why she can not heal the wounds of diabetic neuropathy is caused because, due to violations to the bone marrow lesions, Jia aunt had to do a cut-off toe surgery.
family members of patients: (my mother) to do a few checks before surgery, and yesterday found a high urine sugar, diabetes.
patients: Looking back now, do have some symptoms, but I do not understand,
belstaff leather, such as dry mouth, frequent urination, eating reductions.
NARRATOR: interview, we learned that many elderly people are in physical or in the treatment of other diseases when it found itself suffering from diabetes, the proportion accounted for the number of patients 70%.
GUO Xiao-hui: years senile diabetes is an important factor involved, that is, they say, the aging, as the years of the extension of human tissues and organs in particular, and glucose metabolism For years, the organ will be subject to erosion, the gradual aging. This will appear with increasing age poor insulin secretion, insulin action is not good and so these issues. Many diabetic patients have a genetic background, with genetic factors, with time, this abnormal metabolism will gradually show. And many metabolic abnormalities of diabetes are related to each other, and these metabolic disorders such as obesity, hyperlipidemia, high blood pressure are gradually involved, these anomalies and more people have more opportunities to diabetes. China is now gradually entering the stage of aging, especially in the elderly population in the city more and more, we see older people with diabetes are more and more.
Moderator: Why the delay in many patients with diabetes find themselves out?
Jianmei: This also has its own characteristics and the relationship between diabetes, high blood sugar are often mild in general no obvious symptoms, and only to a certain degree of high blood sugar, and will show \a small \The elderly due to aging problems, thirst center became less sensitive, and most young people will be manifested as high blood thirst, while the elderly may not be obvious thirst. For the phenomenon of polyuria, the elderly often be interpreted as a bad kidney. Judging from the first of these symptoms are non-specific, easily overlooked, and some elderly people are more complications, and will not special attention to these non-specific symptoms.
Moderator: look at a movie:
NARRATOR: Wang Kui is a retired master model workers in the factory, and later became the home of the number one retirement,
belstaff outlet, in order to take good care of diabetes, his wife, the king master not only bear all the family housework, but also learned to his wife shot, helps with blood glucose monitoring. Master Wang believes life is movement, the king early in the morning every day activities of the master is coming out for two hours, the afternoon playing table tennis for one hour, in addition there are other old king did not dare to do the master a sport, \Top. \Not long ago, Master Wang felt uncomfortable in his wife's insistence, he measured a little blood sugar.
Wang Kui
his wife: a morning fasting blood glucose test is 18.5 mmol / l, postprandial 30, at 36.
NARRATOR: Peking University Hospital in the outpatient endocrine experts, Professor Guo Xiaohui Wang told the master he had the disease for a long time.
GUO Xiao-hui: islet is your own hard work, after a year of hard work, now does not work, so blood sugar was so high.
NARRATOR: According to Wang Kui master the present situation, the doctor advised him to hospital as soon as possible, the blood sugar down,
belstaff jacket, to avoid complications.
Wang Yi: normal urine should be less than 50 mg / dL, you are more than 1000 mg / dL. Normal ketone body should be less than 5 mg / dL, your ketones are trace.
Wang Kui: Check and his wife I said before, I said, if I have diabetes, and that everyone will have diabetes.
GUO Xiao-hui: We take a look at the pathogenesis of diabetes, glucose metabolism is a very important hormone insulin, insulin is the only one of the body's hormones to decrease blood sugar, other All are simply asked to confront the hormone, are elevated blood sugar hormones. Β-cell secretion of insulin is a major hypoglycemic peptide hormones. Insulin to the cells and insulin binding to find specific things, this thing we call the insulin receptor, insulin Once you find a receptor, and receptor binding after the sugar into the cells, and if you can not combine sugar in the extracellular , then the blood sugar to high. Wang Kui described above, although the good old sport, but you can see that he is quite fat, abdominal relatively large, and he certainly has the presence of insulin resistance, glucose can not enter cells.
Moderator: If the insulin enough, good enough, but the cells do not match,
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Jianmei: Type II diabetes, which is the major causes of morbidity, also known as insulin resistance, insulin that is a good body, but it produces insulin resistance organization, and that insulin can not play. Major general who is prone to obesity, insulin resistance. Another type of diabetes is relatively rare in the elderly, more common in children and young people.
Moderator: older people with diabetes is characterized by an insulin resistance, then what are the basic principles of control?
Jianmei: control of elderly diabetes mellitus often say that we should follow the \I feel in the clinical autonomy of elderly patients with diabetes generally particularly strong, very obey the doctor's prescription, it is with, so easy to control blood sugar better. We said there are two main principles of diet, one is to control total calories, including the food I eat throughout the day, these are the heat,
belstaff online, especially in the elderly can not eat too much fat. Also note that a balanced diet to maintain adequate nutrition need carbohydrates, protein, fat, balanced intake. Monosaccharides mainly to control things, but still want to eat the staple food, usually 4-6 a day two, if you do not eat the staple food, the body will lack energy, bringing a series of complications, such as weight loss, decreased resistance and so on.
Moderator: Many people say eating pumpkin lowering blood sugar, is it?
GUO Xiao-hui: There are hundreds of varieties of pumpkin, of which individual species can make blood sugar steady, according to reports, in fact, the biggest advantage is that pumpkin contains a lot of soluble fiber, but there are many kinds of pumpkin or sugar.
Jianmei: I had a patient control of blood glucose control had previously been good, not good control of some time ago, that is, they say that a pumpkin can lower blood sugar, eat one every morning Pumpkin Bowl, the results of a check blood sugar to rise to be 15. So still a lot of sugar pumpkin, sugar content calculation must take into staple food consumption. There is no definitive evidence that can lower blood sugar pumpkin.
Moderator: look at the story of a master Du:
Du master: I work in the field year round, lack of medical treatment, then feel weight loss, thirst, think she had diabetes. My friend said metformin gung can lower blood sugar, I went to the drugstore to buy a metformin gung. But over time on the stomach, liver are not accustomed to, especially in response to a large stomach, it hurts to urinate.
NARRATOR: Then went to open a local hospital of Chinese medicine Chinese medicine, these drugs not only failed to cure the disease du chef, but more and Du master's eyes can not see. Although in some big cities actually have some medical conditions, some patients still feel in relying on medication, the medication of patients by feel is most easily into the error of the treatment.
Patient: I just ate some small advertising of drugs, and now the morning fasting blood glucose 11.2 mmol / L, Guan Shier not finished.
Moderator: drug treatment of diabetes What is the norm?
GUO Xiao-hui: before the first treatment of the disease must have a full understanding, not the best medicine is only the most suitable individual drugs, treatment should vary with the others after effects of the medicine is not necessarily good for you. Has islet function of poor people to use the drug on insulin secretion or insulin substitute. If insulin resistance is more serious, we used insulin sensitizer.
Jianmei: Elderly diabetic medication precautions
● insulin secretion agent
yellow urea drugs: glibenclamide caution
non-yellow urea drugs: that Glenn naphthalene,
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● insulin sensitizer: to detect liver and kidney function
metformin Quack
thiazolyl oxazolidinone: rosiglitazone, pioglitazone
● glucose anhydride inhibitors
patients with weight loss and gastrointestinal diseases should not use the
● Insulin
liver and kidney function effects of bad or poor oral insulin at the earliest
Moderator: look at a movie:
NARRATOR: a lifetime of teaching at the university book LU Ping teacher later years because of serious complications of diabetes control blood sugar had admitted to the hospital.
Doctor: lower limb arterial occlusion in patients, the feet of diabetic neuropathy particularly powerful.
NARRATOR: The doctor told LU Ping teachers should take early control of blood glucose using insulin, so as to reduce complications, but the teachers have been reluctant LU Ping. Because there is no time to use insulin, Lu teacher had to endure in the age of 78, the pain of diabetic complications.
LU Ping Teacher: My legs feel cold day just like to walk the same foot cotton, the other is hurt, standing time can not be too long.
Moderator: What kind of person should use insulin it?
GUO Xiao-hui: insulin secretion in general people who should not, such people are in general relatively thin such as the elderly, in the course of treatment has been very good diet, and also increased the activity, medication is also very good, but the weight has been declining, poor blood sugar control, such a person is not enough to explain the secretion of insulin, the insulin should be used. There are people who themselves have problems of liver and kidney, the previously mentioned oral medication does not work, you should use insulin. Then there are people who have serious complications, such as diabetic nephropathy, retinopathy, etc., this person's blood sugar should be better as soon as possible to the level of control, but also need to take insulin.
Moderator: Hospital Phone (010) 66551122-5308; outpatient Jianmei time GUO Xiao-hui on Thursday morning on Tuesday and Friday throughout the day.
Das Schuhmodell
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