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Luo Han Ying
Endocrinology
About me
A senior endocrinologist at Hunan Provincial People's Hospital.
Proficient in diseases
Specializing in: diabetes, thyroid diseases, hyperuricemia, gout, hypertension, coronary heart disease, primary aldosteronism, Cushing's syndrome, polycystic ovary syndrome.
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Diabetes dietary taboo fruits
Many patients have a misconception after being diagnosed with diabetes; they think that fruits are sweet and they should avoid all fruits. This statement is half right—fruits are indeed sweet, but not all fruits are off-limits. Diabetes patients can still consume fruits, provided that they pay attention to the quantity and type of fruit they eat. First, let’s discuss the fruits that should not be eaten by diabetic patients, which are those high in simple sugars. Consuming these fruits can cause a rapid spike in blood sugar levels. Examples include dates, whether dry or fresh, longans, whether dry or fresh, lychees, whether dry or fresh, and bananas, which all have very high sugar content. These fruits are not recommended for diabetic patients; on the other hand, fruits like kiwis, cherries, kumquats, and grapefruits are generally suggested as suitable for diabetic patients.
Is hypoglycemia dangerous?
For diabetic patients, hypoglycemia is defined as glucose levels less than 4 mmol/L, and for non-diabetic individuals, or healthy people, low blood sugar is characterized by levels less than 2.8 mmol/L. Hypoglycemia initially causes metabolic abnormalities in the brain since brain cells in the middle of the brain can't break down fats or proteins; they can only use the simplest sugars, which is the glucose in our blood, as their energy source. When the concentration of sugar in the blood decreases, the brain cells fail to absorb enough energy, which can lead to abnormalities in brain function, resulting in symptoms like fatigue and drowsiness. If glucose is not consumed at this point, the further deficiency in energy for brain cells may lead to coma, making hypoglycemia a very dangerous condition.
Is early diabetic nephropathy reversible?
Diabetic nephropathy clinically mainly manifests as an increase in urine protein on routine urine tests. Thus, diabetic nephropathy can be classified into different stages. In the early stages, microalbuminuria appears, and at this early phase, diabetic nephropathy is actually reversible. However, if the condition progresses with significant proteinuria, it becomes difficult to reverse diabetic nephropathy through intervention treatments. Most clinical patients may experience a slight reduction in urine protein or maintain this condition long-term without further progression. However, some patients have already experienced an increase in creatinine levels by the time they reach this stage of diabetic nephropathy, making it particularly challenging to reverse the condition once creatinine levels rise. Therefore, for diabetic nephropathy, early detection and treatment are crucial, with the most important goal being the prevention of the disease's onset.
What should I do about gestational diabetes?
As prenatal checkups are becoming increasingly popular, many expectant mothers undergo a glucose tolerance test between the 24th and 28th week of pregnancy to diagnose gestational diabetes. More and more expectant mothers are finding their blood sugar levels exceeding the diagnostic thresholds and are being diagnosed with gestational diabetes. Most of the time, gestational diabetes in expectant mothers is caused by reduced physical activity and overeating during pregnancy. For such expectant mothers, we can advise them to control their weight, strictly manage their diet, and increase their physical activity to maintain proper blood sugar levels. In fact, only a small portion of pregnant women diagnosed with gestational diabetes require insulin injections to control their blood sugar.
The difference between thyroid cysts and nodules
Thyroid cysts are a benign change in the thyroid, and are generally classified as first or second level in clinical analysis. Thyroid nodules may be solid or may have mixed echogenicity. The biggest difference between a thyroid nodule and a cyst is their composition: cysts usually contain fluid, whereas nodules may contain other substances. Secondly, the vast majority of cysts are benign, classified as sub-level. Nodules, however, may potentially be malignant, and are classified as third, fourth, or even fifth level. If it is a thyroid cyst, there is no need for excessive worry. If it is a thyroid nodule, it is crucial to complete an ultrasound classification and then schedule regular follow-up exams.
Is gestational diabetes easy to treat?
Gestational diabetes nowadays is often related to excessive supplementation for pregnant women, meaning eating too much and too well. Families tend to be overprotective, and there is no need for exercise. Additionally, during pregnancy, insulin resistance and some special bodily changes occur. Therefore, between the 24th and 28th weeks, high blood sugar levels can be detected. After the diagnosis of gestational diabetes, first and foremost, it is necessary to adjust one's mindset and control the diet strictly. During pregnancy, it is sufficient to ensure adequate protein intake, and it's not about eating more or better. Secondly, for gestational diabetes, exercise can be intensified to control blood sugar levels.
What should not be eaten with hyperkalemia?
Potassium is an important element in human blood. Typically, the electrolytes we measure in blood tests include sodium, potassium, chloride, and calcium. Both low and high levels of potassium can have adverse effects on the body, especially hyperkalemia, which can cause sudden cardiac arrest and is considered dangerous in clinical settings. Patients with normal kidney function are less likely to develop hyperkalemia, which is more commonly seen in those who may have consumed Chinese herbal medicines containing high amounts of potassium for a long time. In patients with renal insufficiency, due to impaired kidney excretory function, hyperkalemia occurs more easily. Patients with hyperkalemia should generally avoid ACE inhibitors and ARB medications. For example, drugs like ACE inhibitors and spironolactone can further exacerbate hyperkalemia, so these types of medications are definitely not advisable. (The use of medications should be under the guidance of a professional doctor.)
Where to massage for diabetic foot
For diabetic patients, we do not recommend foot therapy. Why is that? First, the foot therapy institutions outside are not very professional; many individuals start working without proper training. The massage might lack strength, and the hygiene standards are often not met, which can lead to local injuries and infections. Second, diabetic patients have a specific bodily constitution due to high blood sugar levels, making their tissues particularly susceptible to damage. Once damaged, these tissues do not heal easily. If the hygiene is substandard, the feet of diabetic patients are especially prone to infection. Diabetic foot patients, because of poor blood supply, are also more susceptible to fungal infections. Therefore, given these factors, it is advised that diabetic patients avoid foot therapy.
What to eat for hyperlipidemia?
The definition of hyperlipidemia mainly depends on which type of lipid is elevated in the blood, the most common being hypercholesterolemia and hypertriglyceridemia. Hypercholesterolemia is generally caused by abnormal metabolism in the body, and at this time, it is mainly necessary to take statin drugs to ensure that the blood lipids reach a normal value range. Because hypercholesterolemia usually accompanies hyper-low-density lipoproteinemia, the increase in low-density lipoprotein is damaging to the cardiovascular system. Another type of lipid disorder is hypertriglyceridemia, which in most cases is related to diet. Therefore, at this time, it is necessary to advise the patient to follow a low-fat diet, and if the triglycerides are greater than 4.5 mmol/L, it is advisable for the patient to take fibrate drugs to reduce lipids. (Please take medication under the guidance of a professional physician.)
What department should obesity be treated in?
Obesity should be considered based on the specific situation. If the patient has uniform obesity, meaning that the limbs and torso are equally fat, then they should visit the nutrition department for guidance on dietary control, diet adjustments, and increased exercise. However, if the patient's obesity appears different, for example, if they have a very thick back, a larger belly, a red face, and acne, then I suggest they consult the endocrinology department because it might be related to Cushing's syndrome, which involves centripetal obesity.