Diabetes


How to treat diabetic foot?
Diabetic foot is one of the most severe complications of diabetes. It is caused by a combination of factors including peripheral vascular disease and diabetic peripheral neuropathy associated with diabetes. In such cases, treatment can involve internal medicine, interventional vascular treatment, and surgical treatment cooperatively managed by multiple vascular departments. Early treatment focuses on controlling blood sugar, improving circulation, and nourishing nerves. If ulcerations and skin breakdown have already occurred in the foot, further debridement and anti-infection treatments are necessary. It is essential to conduct an ultrasound of the lower limb vessels to assess for any vascular narrowing. If severe vascular occlusion occurs, vascular surgery may be needed to restore blood flow. In cases of severe diabetic foot with infection, surgical debridement or even amputation may be necessary. Thus, it is crucial to control blood sugar well in the early stages of diabetes to prevent these complications and potentially avoid the onset of diabetic foot.


How to Control Gestational Diabetes
During pregnancy, if the pregnant woman has diabetes, it is essential to control blood sugar reasonably. Otherwise, high blood sugar can seriously affect both the fetus and the pregnant woman, and in severe cases, it can cause diabetic ketoacidosis in the pregnant woman and fetal death in utero. Diabetes in pregnant women can be intervened in the following ways: First, through dietary control, eat less sugary foods, such as sweets, pastries, and fruits. Second, it is necessary to be moderately active during pregnancy, taking a walk or maintaining 5,000 to 10,000 steps daily, which helps in the consumption of glucose in the body. Third, if the above two methods are ineffective, insulin should be used to control diabetes.


How to reduce swelling in diabetic foot
How to reduce swelling in diabetic foot depends on the condition of the swelling. If the swelling is due to a wound on the diabetic foot causing localized redness and swelling, this condition needs anti-infective treatment. It is recommended to culture the wound secretion and choose a sensitive antibiotic; if the swelling is diffuse in the foot, it is also recommended to perform an ultrasound of the lower limb vessels, including arteries and veins. If this indicates poor venous return in the lower limbs or venous thrombosis, treatment to prevent thrombosis and improve venous return should also be added.


How is type 2 diabetes treated?
The treatment of type 2 diabetes includes the following aspects. First, dietary treatment is recommended, advising regular and quantitative meals three times a day, and avoiding late-night snacks and extra meals. Second, appropriate exercise. Third, self-monitoring of blood glucose; it is best to purchase a glucometer for home use and show the recorded blood glucose levels to the doctor during hospital visits. Fourth, diabetes education. Fifth, medication treatment, which includes oral medications and insulin therapy. It's important to visit an endocrinology specialist promptly to determine the most suitable medication under the guidance of a doctor.


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.