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Diabetes
Gestational diabetes standards
Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.
How to reduce sugar in a diabetic diet?
Dietary control is the most important method of treatment for diabetes. If dietary control is improper, all hypoglycemic drugs, including insulin, will not be very effective, and the focus of dietary management in diabetes is to control the intake of carbohydrates. Our Chinese diet is primarily based on carbohydrates like rice. Mainly, we control the amount of rice consumed, with each meal (lunch and dinner) consisting of about 100 to 200 grams of rice. This is complemented by plenty of vegetables and a certain amount of lean meat to enhance satiety. By controlling the intake of carbohydrates in our daily lives, blood sugar levels can drop significantly.
Key Points of Diabetic Foot Care
First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes. Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes. Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails. Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries. Fifth, never walk barefoot. Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet. Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth. Eighth, actively control blood sugar levels in diabetes. Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.
Gestational diabetes symptoms
Gestational diabetes shows several symptoms, the most typical being the "three more one less" syndrome, namely increased thirst, increased appetite, urination, and weight loss. The second common manifestation is fatigue, which is due to glucose not being utilized effectively in the body and being broken down too quickly, leading to insufficient energy replenishment. The third is unexplained frequent fungal infections, such as recurring candidal infections of the vulva and vagina, at which point blood sugar screening should be considered. The fourth symptom is pregnancy accompanied by excessive amniotic fluid or a large fetus. The fifth is glucose positivity in urine from two fasting morning samples.
How to test for diabetes?
The examination for diabetes primarily involves assessment based on symptoms and measuring blood glucose levels through a venous sample. Typical clinical symptoms of diabetes include "three more and one less"; where "three more" refers to dry mouth, increased thirst, and frequent urination, and "one less" refers to weight loss. Thus, generally, when these symptoms are observed, there is an awareness of the possibility of diabetes. Subsequently, one should consult a hospital for further tests, which usually include urine testing and venous blood extraction. For diabetic patients, the glucose level in routine urine tests will significantly increase. Another measure is the direct measurement of blood glucose through venous blood. A fasting blood glucose level of ≥7.0 mmol/L, or a two-hour glucose level of ≥11.1 mmol/L post-OGTT, or a random blood glucose level of ≥11.1 mmol/L, meeting any one of these conditions, combined with the symptoms of diabetes, can diagnose the disease.
Can diabetics drink alcohol?
It is not recommended for diabetes patients to drink alcohol, as alcohol consumption can lead to digestive enzyme disorders, causing problems with the blood sugar regulation mechanism in patients, significantly increasing blood sugar fluctuations. This can lead to severe hypoglycemia or severe hyperglycemia, severely affecting the patient's condition. Therefore, it is advised that diabetes patients should avoid alcohol, and it is best to quit drinking altogether.
What to eat for diabetic foot
For patients with diabetic foot ulcers, first, their diet should control blood sugar. Foods with a high glycemic index like porridge, glutinous rice, and rice noodle rolls should be avoided. Additionally, sweet foods are also off-limits; it's important for meals to be regular and measured. Second, as patients with diabetic foot ulcers need nutrients for wound healing, they can eat foods high in protein such as eggs, fish, fish soup, and lean meats to promote wound healing. Third, if the patient also has high blood lipids, it's advisable to maintain a light diet and avoid greasy foods.
Care for diabetic foot
The first fundamental step is monitoring blood glucose; good control of blood glucose levels is essential for the effective management of diabetic foot problems. Secondly, attention must be paid to the protection of the wound. It's crucial to keep the wound clean, perform regular cleaning and disinfection, and when necessary, debride necrotic tissue thoroughly. For instance, if there is a sinus tract or deep ulceration, it is essential to open the wound and ensure drainage, removing all necrotic tissue inside. Thirdly, footwear choice is critical for patients with diabetic foot; it is important to wear shoes that are loose fitting, moderately soft yet firm, and capable of evenly distributing pressure across the footbed. There are shoes specially designed for those with diabetic foot, and these can be custom-made. Other considerations include maintaining good blood pressure control and ensuring adequate nutrition to support wound healing, including sufficient protein intake, which plays a vital role in promoting wound repair.
Gestational diabetes range
Gestational diabetes refers to abnormal blood sugar levels occurring during pregnancy. This term is used if the diagnosis is made during pregnancy, and does not include patients who were already diabetic before pregnancy, who are referred to as having diabetes concurrent with pregnancy. The criteria for diagnosing gestational diabetes are based on the results of the OGTT (Oral Glucose Tolerance Test) conducted between 24-28 weeks of pregnancy. According to the OGTT results, a fasting blood sugar level ≥ 5.1 mmol/L, a one-hour blood sugar level ≥ 10.0 mmol/L, or a two-hour blood sugar level ≥8.5 mmol/L, meeting any one of these criteria confirms a diagnosis of gestational diabetes.
What should diabetics pay attention to in their diet?
There is a general principle for the diet of diabetes, which is to pay attention to controlling the total daily caloric intake. The second principle is to have a balanced diet, and to be more specific, there are several points: The first one is to eat at fixed times and fixed amounts. Fixed times means having three meals a day at regular intervals, eating on schedule and paying attention not to have extra meals. Generally, the majority of diabetic patients should not eat less in more meals. Fixed amounts mean that the portion size of each meal should be roughly the same every day, not less today and more tomorrow. The third principle is to try to eat drier foods and avoid liquid foods, as liquid foods are easy to digest and absorb, causing blood sugar to rise quickly after meals. Therefore, these are some of the points that need attention in the diet for diabetes.