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Zhang Jun Jun
Endocrinology
About me
Zhang Junjun, female, member of the Communist Party of China, master's degree student, chief physician, currently working at Hunan Provincial People's Hospital, member of the Chinese Women Doctors Association Youth Committee, director of the Hunan Health Services Association Metabolism and Endocrine Health Branch, engaged in endocrine work for 5 years, authored several papers and popular science articles on endocrine diseases.
Proficient in diseases
Have extensive experience in endocrine diseases such as diabetes, thyroid, adrenal gland, gonad, osteoporosis, etc.
Voices
What are the symptoms of early-stage diabetes?
If we talk about the most common symptom of early-stage diabetes, it includes dry mouth, excessive drinking, overeating, frequent urination, and weight loss. These are the most common symptoms characterized as "three excessive and one deficient" behaviors. Additionally, some patients with early-stage diabetes may not exhibit the aforementioned symptoms. They might experience blurred vision, itchy skin throughout the body, difficulty in healing wounds, overall numbness and fatigue, as well as poor mental and appetite health when they seek medical attention. When blood sugar levels are very high, the symptoms of "three excessive and one deficient" mentioned above can appear. Many diabetic patients in the early stages do not show any symptoms, such as patients who need surgery and are then found to have high blood sugar but no symptoms initially, coupled with increased blood sugar levels. Therefore, patients with early-stage diabetes might not have any symptoms, but those undergoing physical examination should regularly monitor their blood sugar levels, including both fasting and postprandial blood sugar.
Thyroiditis Symptoms and Treatment
Thyroiditis is categorized into acute thyroiditis, subacute thyroiditis, and chronic thyroiditis. The symptoms of acute and subacute thyroiditis often manifest initially like those of a viral infection, including cough, sore throat, fever, decreased appetite, muscle soreness, excessive sweating, and other symptoms of hyperthyroidism and upper respiratory infection. The treatment primarily involves symptomatic and supportive care, using antiviral medications since it is caused by viral infections. For patients with mild symptoms, non-steroidal medications are generally used, while corticosteroid treatment might be administered for moderate to severe cases. Symptoms of chronic thyroiditis, on the other hand, are generally not obvious in the early stages but in the late stages, they mainly present as symptoms of hypothyroidism, such as a sensitivity to cold, decreased appetite, slowed heart rate, and general edema. Hashimoto's thyroiditis might present as a moderately enlarged, hard thyroid gland, while atrophic thyroiditis shows symptoms associated with thyroid atrophy. Treatment mainly depends on thyroid function, supplementing thyroid hormones timely if hypothyroidism occurs. (Please consult a doctor before using any medications, and do not self-medicate.)
Where does diabetic foot hurt?
Diabetic foot primarily involves changes in the blood vessels and nerves of the lower limbs and feet, so early symptoms may include numbness, a feeling of stepping on cotton, and weakness in the legs. Furthermore, pain can manifest as numbness and pain in both soles of the feet, or as vascular and neurological pain in the lower limbs and the inner thighs. If diabetic foot is accompanied by venous thrombosis in the lower limbs or arterial embolism, the resulting pain can affect the entire lower limbs symmetrically and present as intermittent claudication. Therefore, the main sites of pain in diabetic foot are determined by the locations of vascular and nerve damage.
Causes of thyroid nodules
Thyroid nodules are a common clinical disease, more prevalent in women and the elderly, with 5%-15% of thyroid nodules being malignant. They are influenced by age, gender, history of radiation exposure, family history, and other factors. Common causes of thyroid conditions include benign adenomas, focal thyroiditis, multinodular goiter, cysts of the thyroid or parathyroid, or thyroglossal duct cysts. Additionally, unilateral developmental defects of the thyroid can lead to hyperplasia of the thyroid on the opposite side. After surgical removal of thyroid nodules or treatment with Iodine-131, scars and hyperplasia of the remaining thyroid tissue are also common causes of thyroid nodules.
Can hyperkalemia be cured?
Hyperkalemia is treatable. The first cause of hyperkalemia is an excess of potassium, mainly seen in reduced renal excretion and excessive potassium intake, such as the infusion of a large volume of stored blood. In this case, diuretics can be used to increase the excretion of potassium. For cases of excessive potassium intake and excessive transfusion of stored blood, treatment options include diuresis and the use of glucose with insulin to lower potassium levels, or even treatment with sodium bicarbonate. In cases of shift hyperkalemia, primarily seen in hemolysis and septic shock, dialysis can be used to reduce hyperkalemia while simultaneously treating the underlying disease. The third type is concentration hyperkalemia and severe hemorrhagic shock, which causes a reduction in blood volume leading to blood concentration and relative hyperkalemia. Treatment of the primary disease first is advisable, and typically, the high blood potassium can self-correct after the primary disease is cured. There is also a condition known as pseudohyperkalemia, for example, prolonged storage of drawn blood can cause hemolysis within the tube, poor venipuncture technique, thrombocytosis, and leukocytosis can all lead to pseudo-hyperkalemia. In these cases, re-drawing blood multiple times to verify the potassium levels can address this issue. Therefore, hyperkalemia is treatable.
Is hyperuricemia serious?
Hyperuricemia can be divided into several stages, each with varying degrees of severity. Early on, it may be asymptomatic, manifesting either as consistent or fluctuating hyperuricemia. If it progresses to an acute gout phase, it can cause a series of harms to the kidneys, joints, and internal organs. During the chronic gout phase, there is more deposition of urate salts, primarily affecting the kidneys. Initially, it causes gouty nephropathy, leading to edema, hypertension, renal insufficiency, and even acute renal failure. The second scenario involves uric acid-related kidney stone disease, which can lead to a significant number of kidney stones, causing acute renal failure, pyelonephritis, renal abscesses, and more. Additionally, it can cause eyelid lesions, including blepharitis along the eyelid margin, and possibly gouty tophi near the eyelid margin that may rupture, adversely affecting the eyes and vision. It may even lead to retinal hemorrhage, exudation, and edema. Thus, uncontrolled uric acid levels represent a serious health concern.
How to prevent gestational diabetes
The onset of gestational diabetes is primarily due to uncontrolled diet during pregnancy, leading to rapid weight gain, which in turn causes insulin resistance and results in high blood sugar. Gestational diabetes is characterized by increased blood sugar levels caused by this insulin resistance. In the early stages, it can be managed by controlling diet and increasing physical activity to keep blood sugar within a reasonable range. If blood sugar cannot be controlled, insulin medication intervention may be necessary. How to prevent it in the early stages? Mainly, it involves keeping weight within a reasonable range, monitoring weight gain, while ensuring normal fetal development. Additionally, in terms of diet, avoid excessive intake of foods high in oil, such as animal organs; fats and oils are high in lipids, which can also exacerbate insulin resistance, leading to the development of gestational diabetes. (Please use medication under the guidance of a doctor to avoid blind self-medication).
How to cure thyroid nodules
The treatment of thyroid nodules is primarily based on whether the nodules are benign or malignant. For nodules that are highly suspected to be malignant clinically, or are confirmed to be suspiciously malignant or malignant through thyroid fine needle aspiration, surgical treatment is required and generally yields good results. The second type is benign nodules, for which studies have shown that treatment with levothyroxine can suppress and reduce the size of the nodules, but this is only effective in some iodine-deficient areas. Another type is hyperfunctioning hot nodules, which can be treated with isotope therapy and radioactive iodine. Additionally, if the thyroid nodule causes compressive symptoms, appears behind the sternum or within the mediastinum, and is associated with high-risk factors for thyroid cancer, surgical removal is recommended. For benign thyroid nodules, usually, only regular follow-up with thyroid ultrasound is required; if the ultrasound follow-up shows more than a 50% increase in the size of the thyroid nodule, further thyroid fine needle aspiration is needed, and surgery may be necessary if required.
What should I do if diabetic nephropathy causes facial swelling?
Diabetic nephropathy with facial swelling is generally due to too much protein in the urine and too little protein in the blood, causing hypoalbuminemia, which leads to edema. There are several methods to control diabetic nephropathy: First, blood sugar and blood pressure must be strictly controlled within a normal range. Blood pressure control should be even stricter for those with diabetic nephropathy, generally kept below 130/80. Second, in terms of diet, it is crucial to avoid or limit intake of bean-based foods and consume high-quality proteins instead. High-quality proteins include commonly known meats, eggs, and fish. Third, it is essential to limit or avoid the use of medications that can damage the kidneys. Fourth, if diabetic nephropathy causes general body edema, intermittent use of diuretic medications can help alleviate the swelling, along with nephroprotective medications. The final method for severe kidney disease involves early intervention with hemodialysis or peritoneal dialysis. (Please use medications under the guidance of a doctor)
Obesity is a disease.
Obesity is related to an excessive accumulation of fat in the body, or abnormal distribution of fat, leading to weight gain. The causes include environmental factors, genetic factors, and other elements interacting to trigger this metabolic disease. Nowadays, dietary patterns have resulted in an increasing population of overweight and obese individuals. Therefore, it is crucial to understand the causes of obesity. If it is a case of simple obesity, it can be managed through diet and exercise. If it is pathological obesity, such as Cushing's syndrome, this type of obesity primarily causes abdominal obesity, thin limbs, abdominal purple streaks, and may also include increased facial acne. In such cases, medical or even surgical interventions might be necessary.