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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
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.
Symptoms of gestational diabetes
Gestational diabetes refers to abnormal glucose tolerance that occurs during pregnancy. It usually involves only mild, asymptomatic hyperglycemia without the typical symptoms of diabetes such as dry mouth, excessive thirst, frequent urination, and weight loss. However, significant increases in blood sugar can lead to symptoms such as dry mouth, excessive thirst, frequent urination, and weight loss. It is important to be vigilant for gestational diabetes in patients who exhibit symptoms such as excessive amniotic fluid, a large fetus, or recurrent urinary tract infections. Therefore, it is generally recommended for pregnant patients to complete an OGTT (Oral Glucose Tolerance Test) by the 24th week of pregnancy to confirm whether they have gestational diabetes. After childbirth, blood sugar levels in women with gestational diabetes generally return to normal, but the risk of developing Type 2 diabetes in the future significantly increases. Therefore, patients with gestational diabetes should undergo diabetes screening 6 to 12 weeks postpartum and be monitored over the long term.
Hashimoto's thyroiditis diagnostic indicators
Hashimoto's thyroiditis is a type of autoimmune thyroiditis, which can present in various phases regarding thyroid function, manifesting as hyperthyroidism, hypothyroidism, or normal thyroid function. Therefore, for patients with Hashimoto's thyroiditis, it is necessary to check thyroid function to understand its status. Since Hashimoto's thyroiditis is an autoimmune thyroiditis, the thyroid peroxidase antibodies and thyroglobulin antibodies are generally elevated. Additionally, it is necessary to perform thyroid ultrasound to assess the thyroid's condition. For some difficult-to-distinguish patients, a further examination such as a 131I uptake test can be conducted, where the uptake rate in Hashimoto's thyroiditis is reduced. Even further, a fine needle aspiration biopsy of the thyroid can be performed, where we can observe significant lymphocyte infiltration.
Gestational diabetes screening time
The screening time for gestational diabetes refers to all pregnant women undergoing a 75-gram glucose tolerance test between 24 to 28 weeks of pregnancy to measure blood sugar levels and determine the presence of gestational diabetes. However, for pregnant women at high risk, including those with a history of gestational diabetes, delivery of a large fetus, obesity, polycystic ovary syndrome, a family history of diabetes, positive urinary glucose in early pregnancy, or unexplained recurrent miscarriages, fetal malformations, stillbirths, or even a history of childbirth with neonatal respiratory distress syndrome, blood sugar should be monitored as early as possible to understand the situation.
How to reduce blood sugar in gestational diabetes
Gestational diabetes cannot be treated with oral medications, as they can affect the fetus. Currently, the main treatment for gestational diabetes in China is insulin, with options for short-acting or rapid-acting insulin. If fasting blood glucose is high, long-acting insulin can be used to control fasting blood glucose levels. If post-meal blood glucose is high, short-acting or rapid-acting insulin can be used to control post-meal blood glucose levels. The blood glucose control standards for gestational diabetes are fasting blood glucose between 4.0 and 5.3, and two hours post-meal blood glucose between 4.4 and 6.7.
High-risk factors for gestational diabetes
High-risk factors for gestational diabetes include: women older than 35 years, those with a history of gestational diabetes, history of delivering large babies, obesity, patients with polycystic ovary syndrome, first-degree relatives with a family history of diabetes, early pregnancy checks showing fasting hyperglycemia or positive glucosuria, patients who have had multiple spontaneous miscarriages without obvious causes, fetal malformations, stillbirths, and patients with a history of delivering newborns with respiratory distress syndrome. Women with the above high-risk factors should undergo early testing for fasting blood glucose and a 75-gram glucose tolerance test to diagnose gestational diabetes and initiate early intervention.
Can Hashimoto's thyroiditis patients eat iodized salt?
Hashimoto's thyroiditis is an autoimmune thyroid disease, which can manifest in three thyroid function states: hyperthyroidism, euthyroidism, and hypothyroidism. The dietary requirements for iodized salt vary depending on the thyroid state. When Hashimoto's thyroiditis coexists with hyperthyroidism, an iodine-restricted diet is necessary. When thyroid function is normal in Hashimoto's thyroiditis, iodine intake should still be limited, as excessive iodine can cause a thyroiditis that changes from euthyroid to dysfunctional. Therefore, iodized salt can be consumed, but the intake of iodine-rich foods such as kelp, seaweed, and seafood should be restricted. When Hashimoto's thyroiditis coincides with hypothyroidism, iodized salt can be consumed without specific restrictions; both iodized and non-iodized salt are acceptable. This is because, at this stage, thyroid function primarily requires hormone replacement therapy, so the consumption of iodized salt has no effect.