The first type: feel good about yourself, check the index is normal
Case: Li surnamed, male, 52 years old, entrepreneur, BMI 29.8 kg/m2, waist circumference 102 cm. Usually smoking, drinking (less).
Physical examination found that blood glucose increased for 5 years without obvious discomfort. Regular use of metformin sustained release tablets and daglijing tablets.
Recent examination: fasting blood glucose :5.7mmol/L; Blood glucose 2 hours postprandial :8.6mmol/L; HbA1c :5.8%;
Blood lipid profile showed low density lipoprotein cholesterol (LDL-C) :1.76mmol/L;
Blood pressure :120/80 mm Hg;
The urine microprotein/creatinine ratio was normal, the fundus examination was normal, the EMG nerve conduction was normal, the ECG was normal, and the carotid artery color ultrasound showed no obvious plaque formation.
Current diagnosis: type 2 diabetes.
Doctors’ comments: The patient felt good about herself and all the examination indicators were within the normal range. This is what we think of as the good control of diabetes and the comprehensive standard, belonging to 7% of the population.
Only when all the examination and laboratory indicators are normal and you feel good, can you be truly physically and mentally healthy. This is the direction and goal of our joint efforts.
Please keep it up.
The second type: self – paresthesia, the examination index is normal
Case: Wang, female, 54 years old, teacher, BMI 22.8 kg/m2, waist circumference 78 cm. Usually do not smoke, alcohol.
Physical examination found that blood sugar increased for 6 years, and in the past 1 year, he often felt palpitations, shortness of breath occasionally, hand numbness, fatigue, and poor sleep. Menopause for one and a half years. He sought medicine everywhere. Usually take metformin sustained release tablets and sitagliptin tablets treatment.
Recent examination: fasting blood glucose 5.4mmol/L; 2 hours postprandial blood glucose 7.6mmol/L; A1c hemoglobin (HbA1c): 5.3%;
Blood lipid profile showed low density lipoprotein cholesterol (LDL-C) :1.46mmol/L;
Blood pressure :122/75 mm Hg;
Six tests of sex hormones showed that the levels of FSH and LH were significantly increased.
The urine microprotein/creatinine ratio was normal, the fundus examination was normal, the EMG indicated that the nerve conduction was normal, the ECG and the heart color ultrasound showed no obvious abnormality, the lung CT plain scan showed no abnormality, and the carotid artery color ultrasound showed no obvious plaque formation.
Current diagnosis: type 1.2 diabetes mellitus; 2. Menopausal syndrome.
Doctor’s comment: The patient felt obviously unwell, but all kinds of tests were within the target range. This group of people also belongs to the ideal of diabetes control in our opinion, which belongs to 7% of the population.
If we feel obviously uncomfortable, as long as the results of various tests are good, it may affect our quality of life, but it is unlikely to cause chronic complications related to diabetes. At this time there are often psychological factors, we need to adjust the state of mind.
The third type: self-feel good, check the indicator is abnormal
Case: Peng surnamed, male, 57 years old, doctor, BMI 31.2 kg/m2, waist circumference 112 cm. Usually smoke and drink (a large amount).
Physical examination found that the blood glucose increased for 7 years, no obvious discomfort, usually take metformin sustained release tablets and acarbose tablets.
Recent examination: fasting blood glucose 8.7mmol/L; 2 hours postprandial blood glucose was 14.6mmol/L; HbA1c :8.3%;
Blood lipid profile showed: low density lipoprotein cholesterol (LDL-C) :3.86mmol/L, triglyceride (TG) :7.9mmol/L, total cholesterol (CHO) :6.8mmol/L, high density lipoprotein cholesterol (HDL-C) :0.56mmol/L. Blood pressure :178/105 mm Hg.
Kidney function is normal. Liver function suggested a slight increase in transaminase. The electrocardiogram suggested myocardial ischemia. Urine microprotein/creatinine ratio was significantly increased, fundus examination indicated glucose reticulum stage 3, electromyography (EMG) indicated a significant decrease in nerve conduction velocity, and carotid vascular color ultrasound indicated plaque formation. B ultrasonography suggested severe fatty liver.
Current diagnosis: Type 1.2 diabetes mellitus, diabetic retinopathy (stage III), diabetic nephropathy (stage III), diabetic peripheral neuropathy, diabetic peripheral vascular disease;
- Hypertension grade 3 (high-risk group);
- Dyslipidemia (mixed);
Metabolic syndrome; 4.
- Coronary heart disease, myocardial ischemia, cardiac function level 1.
The doctor’s comment: the patient’s self-feeling is OK, but there are obvious abnormalities in various laboratory indicators, and the population with diabetes within 10 years accounts for about 70%-80%.
There is no obvious discomfort, but there are obvious abnormalities in various detection indicators. Such patients have a significantly increased probability of diabetes complications, which will certainly affect their quality of life and life expectancy. However, such patients still have the opportunity to strengthen the control of various indicators to prevent the occurrence and development of serious complications.
The fourth type: self – paresthesia, abnormal examination indicators
Case: Wang surnamed, male, 59 years old, police, body mass index 33.2 kg/m2, waist circumference 122 cm. Usually smoking, drinking (a large amount).
Physical examination showed that blood glucose rose for 9 years and edema accompanied by blurred vision for half a year. Had a history of “myocardial infarction” for 1 year, and underwent PCI; He has a history of “cerebral infarction” for half a year, and now his left limb is weak and walking is limited.
He did not control his blood sugar 7 years ago and insisted on subcutaneous insulin injection after suffering myocardial infarction in the past 2 years.
Recent examination: fasting blood glucose 9.7mmol/L; 2 hours postprandial blood glucose 18.6mmol/L; HbA1c :8.8%;
Blood lipid profile showed: low density lipoprotein cholesterol (LDL-C) :4.26mmol/L, high density lipoprotein cholesterol (HDL-C) :0.35mmol/L, triglyceride (TG) :5.2mmol/L, total cholesterol (CHO) :6.8mmol/L.
Blood pressure :188/112 mm Hg.
Serum creatinine :340umol/L, estimated glomerular filtration rate (EGFR) : 25.6ml/min/1.73m2;
Fluorescence fundus angiography showed diabetic retinopathy (stage IV).
Electromyography (EMG) showed obvious abnormal nerve conduction velocity.
Color ultrasound of carotid artery indicated obvious plaque formation and partial stenosis.
Current diagnosis: Type 1.2 diabetes mellitus, diabetic retinopathy (stage IV), diabetic nephropathy, chronic renal insufficiency (pre-uremia), diabetic peripheral neuropathy, diabetic peripheral vascular disease;
- Coronary heart disease, myocardial infarction after PCI, cardiac function grade 4;
Sequelae of cerebral infarction; 3.
- Hypertension Grade 3 (high-risk group);
The doctor’s comment: this belongs to the self-feeling obvious discomfort, the detection indicators are also obviously abnormal, the course of disease of this kind of patients within 10 years accounts for about 10%-15%.
Once the self-feeling has been obviously uncomfortable, the detection indicators are also obviously abnormal, this kind of people often miss many best treatment opportunities, can only be treated as soon as possible to delay the occurrence and development of complications.
It is inevitable that the quality of life is not high, which affects the duration of survival, and even the serious outcomes such as myocardial infarction, cerebral stroke, diabetic foot disease or uremia, and blindness will occur.
Dear reader, what kind of people do you belong to?
If you belong to the first and second categories, then congratulations on your good health and keep it up.
If belong to the third category, then suggest you find professional medical personnel as soon as possible, as soon as possible to recuperate each health index, so as not to enter the fourth category of people.
If you are now unfortunate to have belonged to the fourth group of people, so in this regrettable to tell you: can only be “after it is too late to mend” type care for health. You still need to adjust a good attitude in time and cooperate with the doctor for various treatments, which will significantly improve the quality of life, enjoy a good life, extend the length of life to the extreme, and there will be no regrets in this life!
In this advice: diabetic patients must not rely on feeling to go, the need to regularly detect the body related to the health indicators. Only feel good plus normal detection indicators to belong to the body and mind is really healthy!