Summary comments and suggestions for diabetes prevention

The prevalence of diabetes among adults in my country has now reached 11.9%, of which type 2 diabetes accounts for more than 90%. The risk of diabetes can be effectively reduced through lifestyle intervention. There is no absolute destiny that "if a family has a history of diabetes, it will definitely lead to the disease", and there is no shortcut for "eating a certain magic food to completely prevent sugar". Long-term behavioral adjustments that are suitable for individuals are the core logic of diabetes prevention.

A while ago, I met 42-year-old Uncle Zhang at a community chronic disease management station. His fasting blood sugar was fluctuating around 6.2mmol/L for three consecutive months, which is in the category of pre-diabetes. He was so panicked that he searched for sugar-lowering recipes on the short video platform every day. He ate bitter melon and steamed buckwheat every day, and did not dare to touch any polished rice or white flour. As a result, when he was reviewed last month, his fasting blood sugar rose to 6.4. He also lost 7 pounds of muscle due to insufficient protein intake for a long time, and his whole body felt limp and weak.

In fact, there are quite a few people like Uncle Zhang who fall into this trap. Everyone’s understanding of diabetes prevention is either anxious or extreme, and few people really understand the logic behind it.

There are actually two mainstream directions for diabetes prevention in the academic community. There is no absolute right or wrong, and the applicable groups are different. One is the general prevention and control standards implemented in the public health field, which we often hear: BMI is controlled between 18.5-23.9, waist circumference does not exceed 85cm for men and 80cm for women, 150 minutes of moderate-intensity exercise per week, and added sugar intake does not exceed 10% of total daily energy. This standard is based on large sample data. For most ordinary people, following this standard can basically cover 80% of sugar prevention needs.

However, in recent years, more and more scholars in the endocrinology community support the idea of ​​personalized and precise prevention and control: after all, the metabolic capabilities of people are really very different. I met a 26-year-old girl before, with a BMI of only 21 and a standard weight, but she has a natural apple-shaped figure with obvious accumulation of fat in her waist and abdomen. She usually likes to drink milk tea, but after checking, her glucose tolerance has been damaged. ； Some people are born with poor insulin sensitivity. Even if they eat whole grains according to the standard, their blood sugar after meals will be much higher than that of ordinary people. In this case, it is useless to apply universal standards. You have to adjust your diet according to your own blood sugar fluctuations.

To be honest, the current popular science on diabetes prevention on the market is a lot wrong. Either they demonize sugar and say "you will get diabetes if you drink a cup of milk tea", which makes many young people worry all day long. Even eating a piece of fruit has to calculate the glycemic index for half a day. ； Or just lie flat and say, "Diabetes is hereditary, and prevention is useless." Many people in their thirties have never checked their blood sugar. They wait until symptoms of more than one and less are detected before checking, and they have already developed diabetes.

There are still many people who ignore the impact of sleep and emotion on blood sugar. I have been exposed to the operation of an Internet company before. I am 28 years old. I am not fat, smoke, or drink, and I don’t like sweets. I just stay up until two or three o’clock every day to catch up on projects, and I have been empty for physical examinations for half a year. My abdominal blood sugar was stuck at the critical value of 5.9mmol/L. Later, I heard the advice to adjust my work and rest, try to sleep for 7 hours a day, and not worry about KPI every day. When I checked again after three months, it dropped to 5.3, which is more effective than eating no matter how much whole grains I eat.

If you really want to put your sugar prevention into practice, you don’t need to go all out to list more than a dozen commandments that you must abide by. Just start with the little habits that are easiest to change. For example, if you usually drink milk tea with full sugar every day, you can first change it to three cups of sugar, and drink two cups less every week. It will be easier to persist than quitting it completely. ； Office workers who usually sit all day long do not need to rush to the gym to apply for an annual pass and force themselves to run five kilometers. First, walk an extra stop after get off work every day, get up and stand for two minutes with a glass of water every hour, and slowly develop the habit of moving.

Oh, by the way, there is no unified conclusion in the academic community on whether to take medication for prevention: some experts believe that people with abnormal glucose tolerance can consider taking a small dose of metformin as an auxiliary if lifestyle intervention for half a year still has no effect.； Some experts also believe that as long as the diagnostic criteria for diabetes are not met, there is no need to take medication in advance to avoid unnecessary side effects. If you have been diagnosed with impaired glucose tolerance, don’t buy random medicines on your own. Just find an endocrinologist at a regular hospital for a comprehensive evaluation based on your family history and metabolic indicators.

I have been managing chronic diseases for five or six years, and to be honest, the most effective anti-sugar measure I have ever seen is not a complicated diet and exercise plan, but "regular blood sugar testing." Many people think that they take it lightly because they are young and have no one in their family with diabetes. In fact, a fasting blood sugar test should be done every year. If you have a family history, have a fat waist, or often stay up late, you can also check your blood sugar 2 hours after a meal. This will help you detect abnormalities early and make adjustments early, which is more reliable than any health-preserving remedies.

In fact, there is really nothing mysterious about diabetes prevention. To put it bluntly, don’t go against your body, don’t overeat until you’re full, don’t stay up until early in the morning every day to consume yourself, and don’t be so anxious that you embarrass yourself by eating boiled vegetables every time. Small habits that can be adhered to for a long time are far more useful than pursuing extreme short-term results. After all, preventing sugar is a lifelong matter, and comfort only goes a long way.