Diabetes preventive health care knowledge

Control your weight within a reasonable range, adjust your diet, maintain regular activities, and do regular blood sugar screenings every year.

I have been doing follow-up work on chronic diseases in the community for more than half a year, and I have met many people who either don't take it seriously even though they have reached the pre-diabetes stage, or they are so nervous that they dare not touch white rice. They are two extremes. Uncle Zhang, a 42-year-old salesman I met at the free clinic last week, is a typical example. His beer belly is about to reach the size of six months of pregnancy. After socializing, he always likes to drink a bottle of iced Coke to relieve his tiredness. His fasting blood sugar was found to be 6.8mmol/L, which belongs to the pre-glycemic stage of impaired fasting blood sugar. At that time, his face turned pale and he thought he would have to rely on insulin for the rest of his life. However, after two months of adjustment, he checked again and found that his blood sugar had returned to the normal range.

When it comes to sugar control, many people's first reaction is to quit refined rice and noodles. In fact, the industry's mainstream views on sugar control diets have always been divided into two schools: one group advocates a short-term low-carb diet, cutting the intake of refined rice and noodles by two-thirds, and replacing it with whole grains, mixed beans and potatoes. It can indeed quickly reduce the post-meal blood sugar peak, and is suitable for people who are already pre-sugar and overweight to make quick adjustments.； However, many nutritionists have pointed out that long-term strict carbon restriction can easily lead to a lack of B vitamins. It can also lead to retaliatory eating of high-sugar foods because the rules are too strict. Therefore, it is recommended that ordinary people adopt a mild Mediterranean diet for a long time, eat more dark green vegetables, high-quality protein, and less refined sugar and highly processed foods. You don’t have to completely abstain from carbohydrates. Just replace one-third of the white rice and white noodles with oats, quinoa, and sweet potatoes. It really doesn’t make eating a bite of steamed bread feel like a mistake.

To be honest, many people have stepped into the pitfall of "eating sugar-free food as much as you want". It should be mentioned here that the current controversy over sugar substitutes in the industry is actually not small: some studies believe that sugar substitutes such as erythritol and stevia will not increase blood sugar and are suitable for people who want to quit sugar to satisfy their cravings occasionally.； However, other long-term follow-up data shows that long-term consumption of large amounts of sugar-substitute foods will disrupt the balance of intestinal flora and reduce insulin sensitivity, which is detrimental to long-term sugar control. I once met a girl in her 20s who drank 3 bottles of sugar-free sparkling water every day and replaced all her snacks with sugar-free biscuits in order to quit sugaring. As a result, she gained 8 pounds in half a year and her fasting blood sugar reached the critical value of 5.9mmol/L. She almost joined the pre-sugar team. In fact, I am really greedy for sweetness. It is okay to drink half a cup of normal milk tea and eat two bites of cake. It is much more reliable to stop with a small taste than to eat sugar substitute foods every day.

Don’t think that you can just sit back and relax if you eat the right food. I followed a programmer before. He had a very strict diet, including whole grains, boiled vegetables, and lean meat, and no sugar at all. However, he stayed up until two or three o’clock every day to change the code, and slept all day on weekends without moving at all. Last year, he was found to have abnormal glucose tolerance during a physical examination. Do you think it was unfair? Many people’s understanding of exercise is to run 5 kilometers and walk 10,000 steps a day. In fact, it is not necessary. Our clinical follow-up found that if you don’t slump on the sofa for half an hour after a meal, stand and check your phone for a while, or go downstairs and walk slowly for 15 to 20 minutes, it is much more effective in controlling post-meal blood sugar than if you save up to walk 10,000 steps in the evening. It would be better if you could do 20 minutes of resistance exercise two or three times a week, lift mineral water bottles, practice squats, and increase your muscle mass - muscles are natural "sugar storage" and are particularly helpful in long-term stabilization of blood sugar.

In fact, weight control is the most intuitive indicator, especially for those with abdominal obesity. If the waist circumference exceeds 90cm for men and 85cm for women, you must pay more attention. Belly fat is not only unsightly when wearing clothes, it secretes various inflammatory factors and lowers insulin sensitivity, which is one of the biggest risk factors for type 2 diabetes. Among the pre-diabetic patients I work with, as long as they can lose 5% to 10% of their weight, most of them can return their blood sugar to normal levels without taking medicine at all.

Another point that is most easily overlooked is screening. There are almost no obvious symptoms of diabetes in the early stage. By the time you develop symptoms of polydipsia, polyuria, and weight loss, half of the pancreatic islet function has often been lost. It is recommended that people over 40 years old, with a family history of diabetes, and who are overweight should add glycated hemoglobin during the annual physical examination of fasting blood glucose, which can reflect the average blood sugar level in the past three months and is much more accurate than a single fasting test. Don’t be too troublesome. Early detection and early adjustment are much better than long-term medication control after diabetes develops.

Uncle Zhang came for a review last week and found that his waist circumference had decreased by 3 centimeters and his fasting blood sugar had dropped to 6.0mmol/L. He also said that now after dinner, he drags his wife downstairs for a walk. He no longer drinks ice cola and drinks fresh lemonade instead. His overall energy has improved a lot. You see, diabetes prevention is really not something that is out of reach. You don’t have to act like an ascetic. Just change your daily habits, drink a few sips of sweet drinks less, sit on the sofa for half an hour less, and spend tens of dollars more to check your blood sugar every year. Most people can avoid this "sweet killer".