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Yang Li
Endocrinology
About me
Yang Li is the associate chief physician of the Department of Endocrinology at Hunan Provincial People's Hospital. She holds a Ph.D. and serves as the research secretary of the Department of Endocrinology. She graduated with a Ph.D. in Endocrinology from Xiangya Second Hospital in 2012. She has presided over one project funded by the National Natural Science Foundation, two projects funded by the Provincial Natural Science Foundation, and one project funded by the Health Department's cadre health special subject. She has published multiple SCI papers and domestic journal articles.
Proficient in diseases
Specializing in bone metabolism, obesity, and diabetes complications.
Voices
What to eat for diabetic foot?
Typically, patients with diabetic foot have had diabetes for a long period, and often have diabetic nephropathy, or serious hypoproteinemia and malnutrition. In such cases, patients with diabetic foot need to supplement with protein, specifically high-quality protein, and must avoid low-quality protein. What constitutes low-quality protein? This includes soy products and plant proteins. High-quality protein, on the other hand, includes sources like milk, eggs, poultry, and meat. However, if renal insufficiency is present and creatinine levels have increased, the amount of protein must be limited. Protein intake should be calculated based on body weight and creatinine levels, using different coefficients to determine the total daily protein allowance. It is crucial to make these protein adjustments within the framework of a diabetic diet.
Can diabetic foot be cured?
Diabetic foot can potentially be cured, and it can improve, but it depends on the specific circumstances. Diabetic foot varies in severity and is classified into different levels. In medical terms, it is classified based on its appearance, and different classifications have different prognoses. Even within the same classification, factors like the patient's vascular condition, baseline nutritional status, age, duration of diabetes, and many other factors can influence whether diabetic foot can be cured. In clinical practice, there are many diabetic foot patients who, after comprehensive treatment, achieve complete wound healing. Therefore, whether diabetic foot can be cured depends on many factors.
Why does pneumonia cause a decrease in white blood cells?
When the severity of pneumonia is very severe, there can also be a decrease in white blood cells, which often suggests a higher possibility of severe pneumonia. Additionally, another scenario is viral pneumonia, where a decrease in white blood cells can also occur due to viral infections. Furthermore, there are special cases of infection, such as tuberculosis or infections caused by Mycoplasma or Chlamydia, where the use of anti-infection medications might also lead to a decrease in white blood cells. Another situation is when a patient inherently has a low white blood cell count, leading to weakened immunity and subsequently contracting pneumonia. In such cases, white blood cell counts might also not be high. Hence, severe bacterial pneumonia and decreases in white blood cells are relatively common in viral infections.
Is excessive sweating a symptom of diabetes?
Diabetes typically presents with symptoms of polydipsia, polyuria, polyphagia, and weight loss, commonly known as the "three excesses and one deficiency." However, diabetic patients often have accompanying autonomic dysfunctions or peripheral neuropathy, which can also lead to excessive sweating. Clinically, it is observed that some patients might sweat excessively in specific areas. For instance, some might report excessive forehead sweating or localized sweating on certain body parts, or even unilateral sweating. In such cases, it is necessary to consider whether the symptoms might be a complication of diabetes. To diagnose this, one should firstly conduct diagnostic tests for diabetes, such as the oral glucose tolerance test (OGTT), to determine if the blood glucose levels meet the diagnostic criteria for diabetes. Additionally, it is important to perform electromyography to check for any neuropathic complications that might affect nerve conduction velocities. This helps in determining whether excessive sweating is a specific symptom of diabetes. However, not all cases of hyperhidrosis are specific to diabetes; other conditions, such as hyperthyroidism (thyrotoxicosis), can also cause excessive sweating and should be considered.
Early signs of diabetic foot disease
Some early signs of diabetic foot disease include a decrease in skin temperature of both feet, such as constantly feeling coldness in the feet, which indicates insufficient blood supply. Another symptom is peripheral neuropathy, which manifests as numbness or burning in both feet, and unusual sensations like stepping on cotton or feeling like ants are crawling. These are also early signs of diabetic foot disease. Once there is a break in the skin surface, it is crucial to be vigilant as it might be diabetic foot disease. Diabetic foot disease is a very serious condition and one must take early preventive measures. At the slightest sign of any skin break, it is essential to seek proper treatment at a standard hospital.
Can leukopenia cause fever?
Leukopenia can lead to fever. White blood cells are the guardians of the human body, protecting it against external invasions such as infections. When white blood cells are decreased, the patient's resistance to infections can be significantly reduced, making them particularly susceptible to infections. This can lead to fever, as often seen in hematological patients with leukopenia who frequently experience fevers due to their chronic infection states. Therefore, when leukopenia is accompanied by fever, it is advisable to seek hospital treatment as soon as possible, as proactive infection management is crucial.
Does leukopenia lead to leukemia?
First of all, a concept to clarify: generally, leukemia is associated with a very high white blood cell count. So, does a decrease in white blood cells lead to leukemia? There is no direct causal relationship between the two. A reduction in white blood cells generally requires an analysis of its cause—whether it is due to a decline in hematopoietic function, a deficiency in raw materials, or an increase in destruction. These situations essentially involve issues in the production factory or where they are used. We cannot say that people with reduced white blood cells will not develop leukemia, nor can it be stated in that way. They may also, over a period, exhibit a reduction in white blood cells due to certain factors. So, if there are genes causing leukemia combined with other factors, leukemia might occur, but there is no direct causation between the two.
Harms of Obesity
In the case of obesity, it is first necessary to distinguish between physiological obesity and pathological obesity. For pathological obesity, further examination of the adrenal glands is required, such as respiratory syndrome, some problems with the pituitary gland, or conditions caused by Cushing's syndrome, all of which can lead to pathological obesity. The risks associated with obesity are quite significant. Firstly, it directly causes disturbances in the body's energy metabolism, hyperlipidemia, hypertension, or other issues. Obesity can also lead to fatty liver, lipid deposition in the heart, kidneys, and other organs, resulting in corresponding organ damage. Additionally, it can cause infertility due to the deposition of fat in the ovaries, and in terms of joints, it places excessive load on the human joints, leading to various joint diseases, and consequently increasing the risks of cardiovascular diseases and sudden death risks.
Surgical treatment of obesity
Surgical treatment for obesity is applicable under certain conditions. This requires the obesity to reach a specific level, defined by indicators such as a BMI of over 35, and in the absence of severe diabetes or complications associated with diabetes. Considering surgical interventions for weight loss, these primarily involve bariatric surgeries like gastric bypass or gastroenterostomy which reduce food intake and absorption, thereby decreasing calorie absorption to achieve weight loss. While the effects of surgical weight loss are generally quite good, it can lead to some long-term postoperative complications, so careful consideration is required.
Can obesity get pregnant?
Obesity firstly needs to be differentiated, whether it is a type of physiological obesity or a pathological obesity, such as diseases of the growth gland, Cushing's syndrome, etc., which cause pathological obesity. In this case, some corresponding examinations are required for differentiation. If it is simple obesity, further tests for insulin resistance, blood glucose, blood lipids, and other metabolic indicators are necessary to determine if they are normal, as well as liver and kidney functions. If these conditions are all acceptable, pregnancy is possible. However, it is still important to monitor these indicators during pregnancy. Obesity is not an absolute contraindication for pregnancy, but of course, it is best to control the weight before getting pregnant.