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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 medication is used for hyperkalemia?
Hyperkalemia is primarily treated by promoting diuresis to enhance the elimination of potassium, while calcium gluconate can also be administered intravenously to counteract the inhibitory effects of potassium on the heart. Additionally, concentrated glucose with insulin can be used to shift excess potassium ions from the blood. Sodium bicarbonate can also be used to alkalinize the blood's pH to help reduce potassium levels. All these treatments must be conducted safely. In cases of severe hyperkalemia, dialysis may be necessary. If arrhythmias, bradycardia, or myocardial depression occur, the installation of a temporary pacemaker, along with hemodialysis, may be required. (Medication should be administered under the guidance of a physician.)
How to relieve pain in diabetic foot?
If diabetic foot is combined with pain, it often depends on the severity of the diabetic foot. It has a Wagner grading system. If there is an obvious wound that extends to the bone, anti-infection treatment is very important, and surgical assessment is necessary to determine if the foot can be saved. If the wound is superficial and only involves the epidermis, local anti-infection and circulation improvement are fundamental. In such cases, COX-2 inhibitors and non-steroidal analgesic drugs may be used. If the pain is caused by peripheral neuropathy, the first step is to nourish the nerves, for example with mecobalamin, and treat the neuropathy with drugs like epalrestat, along with drugs like cilostazol that improve microcirculation. Effective treatments targeted at this type of neuropathic pain include drugs like pregabalin and etoricoxib, designed for bone pain, and gabapentin-related medications can also be used. (Medication should be used under the guidance of a doctor.)
Early symptoms of diabetes in men
Symptoms of diabetes in men in the early stages first require distinguishing by gender. Diabetes can be characterized by "three excesses and one deficiency": excessive drinking, excessive eating, excessive urination, and weight loss, which are typical symptoms. Of course, many patients, such as those in the early stages of type 2 diabetes, may have atypical symptoms such as itchy skin, blurred vision, and foamy urine which appears more foamy. There might also be dental cavities characterized by severe decay, or some men might experience sexual dysfunction. These symptoms may be related to diabetes, and if these symptoms appear, it is important to consider checking blood sugar levels to confirm the presence of diabetes.
Care of diabetic foot wounds
In terms of caring for diabetic foot wounds, medical treatment, surgical intervention, or debridement is of course necessary. Regarding foot care, it's important to examine the condition of the wound. The primary principle is first, in dietary care, to ensure a high protein diet under the allowance of liver and kidney functions, and then a low-fat diet. It's important to include high-quality protein, which is beneficial for wound healing. Locally, the wound area must be kept clean and dry. It is crucial to maintain a concept of sterility, avoiding actions like breathing over the wound with the mouth or touching the wound area with hands. The wound should be cleaned or locally disinfected regularly every day. Additionally, foot wounds in diabetics should slightly elevate the feet to facilitate blood return. Moreover, regular observations of changes in the wound should be made and communicated timely to the doctors at the hospital.
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.