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Chen Xie
Endocrinology
About me
Loudi Central Hospital, Endocrinology Department, attending physician, has been engaged in clinical work in endocrinology for many years, with rich clinical experience in the diagnosis and treatment of endocrine system diseases.
Proficient in diseases
Specialize in common diseases related to the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, and the reproductive axis.
Voices
What to eat with gestational diabetes
The dietary control for gestational diabetes adheres to the same overall principles as non-pregnant diabetes management, mainly focusing on controlling total caloric intake and eating smaller, more frequent meals. This approach helps manage blood sugar levels and reduces the occurrence of hypoglycemia. Additionally, it is important to consider the nutrients required for fetal growth and development. Generally, carbohydrate intake should make up 50%-60% of the diet, proteins 15%-20%, and fats should not exceed 30%. Foods that quickly increase blood sugar levels and are high in fat should be consumed minimally. Instead, it is beneficial to consume a lot of vegetables, at least 500 grams daily, to ensure adequate intake of vitamins and fiber.
The difference between thyroid enlargement and thyroid nodules
Thyroid enlargement generally refers to simple thyroid enlargement, which is typically diffuse thyroid enlargement, mainly caused by iodine deficiency, commonly seen in endemic goiter and physiological thyroid enlargement. Thyroid nodules, on the other hand, are nodular hyperplasia of the thyroid caused by certain physical and chemical factors. Thyroid nodules can manifest as benign hyperplasia or malignant hyperplasia. Therefore, the risks associated with thyroid nodules are relatively greater than those of thyroid enlargement. However, some patients with thyroid enlargement, as the disease progresses, can develop nodular hyperplasia of the thyroid. These are the differences between the two.
Can pregnant women with gestational diabetes eat pumpkin?
The general principle for dietary control in patients with gestational diabetes is to manage total calorie intake and to eat smaller, more frequent meals. Eating five to six meals a day can not only help control blood sugar levels but also reduce the occurrence of hypoglycemia. Additionally, it is important for patients with gestational diabetes to eat less of foods that can rapidly increase blood sugar levels, as well as those high in sugar, starch, and fat content since these can easily convert into glucose, causing a rise in blood sugar. Pumpkin, for example, is a food high in carbohydrates and should be consumed in limited quantities. However, this does not mean it cannot be eaten at all. For patients with gestational diabetes, if pumpkin is consumed, it is necessary to reduce the intake of staple foods and rice, treating the pumpkin as a staple food substitute to maintain a balance of total calories and to prevent significant fluctuations in blood sugar, thus keeping it stable.
Hypokalemia is formed in what way?
Hypokalemia refers to a condition where the serum potassium level is below 3.5 millimoles per liter. The primary cause of hypokalemia is the loss of potassium in the body. Hypokalemia can be classified into three types based on its cause: potassium deficiency hypokalemia, redistributive hypokalemia, and dilutional hypokalemia. Potassium deficiency hypokalemia is mainly characterized by insufficient intake or excessive excretion. Insufficient intake is typically seen in patients who are fasting, have selective eating habits, or suffer from anorexia, while excessive excretion is mainly through gastrointestinal or renal loss of potassium. Redistributive hypokalemia usually occurs due to metabolic or respiratory alkalosis, the recovery phase of acidosis, heavy usage of glucose, instances of periodic paralysis, acute emergency situations, and the use of folic acid and vitamin B12 in treating anemia or repeat transfusions of cold stored washed red blood cells. Dilutional hypokalemia, on the other hand, is mainly caused by the retention of extracellular fluid, leading to excessive water or water intoxication-induced hypokalemia.
Gestational diabetes check at how many weeks?
Screening for gestational diabetes is generally recommended between 24 to 28 weeks of pregnancy, using a 75g glucose tolerance test to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. However, for pregnant women with high-risk factors, it is recommended to screen for blood glucose at their first prenatal visit. High-risk factors include women with a history of gestational diabetes, a history of delivering a large baby, obesity or polycystic ovary syndrome, those with a first-degree relative with a history of diabetes, positive fasting blood glucose or urinary glucose in early pregnancy, those who have had multiple unexplained miscarriages, fetal malformation, stillbirth history, and women who have given birth to newborns with respiratory distress syndrome. These women should all be screened for blood glucose at their first prenatal visit.
Can you get pregnant with thyroiditis?
Patients with thyroiditis can become pregnant, but they must keep their thyroid function within the normal range. During the course of thyroiditis, it can manifest in three phases: hyperthyroidism, euthyroidism, and hypothyroidism. When thyroid function is overactive, it is necessary to maintain thyroid function at a basically normal level, and then plan for pregnancy under the guidance of a doctor. For patients with reduced thyroid function, it is even more necessary to maintain thyroid function within the normal range. It is advisable to consult a doctor and plan for pregnancy only after ensuring thyroid function is normal, as reduced thyroid function can impair fetal intellectual development.
Gestational diabetes blood sugar standards
The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.
Gestational diabetes symptoms
Gestational diabetes refers to the abnormal glucose tolerance that occurs during pregnancy, typically characterized by mild, asymptomatic elevated blood sugar levels without obvious symptoms such as dry mouth, excessive thirst, and frequent urination. However, when blood sugar levels are high, symptoms typical of diabetes such as dry mouth, excessive thirst, and frequent urination may occur. If excessive amniotic fluid, a large fetus, or recurrent infections of the external genitalia occur during pregnancy, it is important to be vigilant for the presence of diabetes. It is generally recommended that patients undergo the OGTT (Oral Glucose Tolerance Test) during the mid-stage of pregnancy to confirm whether gestational diabetes is present. Women's blood sugar levels generally return to normal after childbirth, but the risk of developing diabetes later increases significantly. Therefore, patients with gestational diabetes should be screened for diabetes 6-12 weeks postpartum and monitored over the long term.
How should thyroid cysts be treated?
Thyroid cysts refer to fluid-containing sac-like formations found in the thyroid gland. For their treatment, thyroid cysts are a type of benign tumor of the thyroid. In imaging studies, if the nodule's diameter is less than one centimeter, it usually presents no clinical symptoms or signs. Regular follow-ups with thyroid ultrasonography and thyroid function tests are advised. If there is no trend of enlargement, continued observation without surgical intervention can be appropriate. However, if the nodule's diameter is greater than one centimeter, or if it is located on the surface of the thyroid, the local skin may show a protrusion or bulge, and the cyst may continue to grow, pressing on the trachea or even the esophagus, causing symptoms such as chest tightness, difficulty breathing, a feeling of swallowing, and obstruction. It is important to seek medical attention in a timely manner, undergo a fine needle aspiration biopsy if necessary, and surgical treatment may be required if needed.
Exercise for Gestational Diabetes
Exercise can increase insulin sensitivity and can lower blood sugar independently of insulin. Therefore, patients with gestational diabetes can also exercise appropriately, which is beneficial for the utilization of blood sugar and helps lower it. The exercise for gestational diabetes generally involves regular, rhythmic aerobic exercises, which can include upper body exercises, gymnastics, and previously mentioned activities. The duration of exercise should generally be around 20-30 minutes, and it is advisable to exercise about one hour after meals. The frequency of exercise should be three to five times per week. During exercise, the heart rate should not exceed 120 beats per minute to avoid intense physical activity.