Look at the blood sugar in the physical examination report! It may reflect a big problem, you'd better know it early!

Sugar, a blend of five flavors, is the first taste that the tongue feels, and it is also used by us to describe the feeling of joy and happiness. Sugar addiction is a habit engraved in human genes. But behind the sweetness, there are also many health risks hidden, such as tooth decay, obesity, and aging. In addition, excessive intake of sugar may cause fat accumulation, which in turn affects cardiovascular health and even leads to diabetes.

Mr. Wang just retired this year. He has been suffering from diabetes for 4 years. When he was diagnosed, the doctor said that he was diabetic. With his blood sugar so high, he would definitely need insulin for the rest of his life.

Since the day he was diagnosed, Lao Wang's health concept changed immediately. He paid special attention to his body and was very self-disciplined. He controlled his diet, exercised moderately, took medicine at regular times and in fixed amounts every day, and never missed the annual routine physical examinations. However, the results of the physical examinations for three consecutive years showed that his blood sugar indicators were not particularly well controlled, and there was a trend of rising year by year . This made Lao Wang wonder if his body had developed drug resistance as he had not seen much effect from taking the medicine continuously.

Lao Wang was eager to control his blood sugar, so he adjusted the blood sugar-lowering medication and dosage on his own without any doctor's advice, thinking that if there was no effect, he would go to the hospital to see a doctor.

Who would have thought that instead of waiting for the ideal result, he encountered a disaster. After adjusting the medication, Lao Wang suddenly suffered from severe hypoglycemia and was sent to the hospital in a coma . Lao Wang recalled later: "My hands were shaking badly at the time. Although I was wearing warm clothes, I was still shivering and sweating. Then my eyes went dark and I fell down and I didn't know anything." Fortunately, he was at home and his family called 120 without any delay.

In the emergency room, Lao Wang experienced cardiac arrest. Thanks to the timely medical treatment and the doctor's strenuous rescue, he was out of danger. All his physical indicators returned to normal one hour after he arrived at the emergency room. His consciousness slowly recovered. It was not until the next day that Lao Wang gradually woke up. Although he woke up, his speech was not as clear as before.

During the hospital treatment, Wang, who was still terrified when he learned about his rescue process, told the doctor everything about his physical examinations and his experience in controlling blood sugar. He blamed himself and was also confused. Diabetes should cause high blood sugar, so why did it cause low blood sugar? He couldn't help but sigh: "This time the reaction was so serious that I completely lost consciousness. I had a few times before when my eyes suddenly went black, but I was still conscious. I thought it was low blood pressure."

The doctor told Lao Wang seriously: "Don't let what you take for granted limit your imagination. Diabetic patients are generally concerned about whether their blood sugar will rise, but many people ignore the existence of hypoglycemia. Compared with high blood sugar, the harm of hypoglycemia is no less , and it may even be more dangerous . Specifically, the factors that cause severe hypoglycemia in different people are different. The most common one is excessive use of hypoglycemic drugs. In fact, hypoglycemic treatment is a double-edged sword . Insufficient medication, uncontrolled blood sugar, excessive dosage or unreasonable combination, especially when it is not in line with the patient's own health status, can easily lead to severe hypoglycemia.

Of course, it is not just hypoglycemic drugs. Many diabetic patients often have multiple underlying diseases and need to use multiple drugs in combination. These drugs may also have a certain impact on blood sugar metabolism and cause severe hypoglycemia. In addition to the main drug factors, there are also physiological factors, such as abnormal function of various organs in the body, and improper diet and exercise, which can lead to severe hypoglycemia.

If severe hypoglycemia occurs repeatedly , it may cause long-term damage to the body, such as blood clots, abnormal heart function, and damage to the nervous system, which will have a great impact on patients. And because severe hypoglycemia often occurs at night, the danger comes quietly, which also makes it quite difficult to detect and treat.

Because of this, we must be clear about what hypoglycemia is. At the same time, it is very necessary for diabetic patients to understand and master certain methods to deal with severe hypoglycemia.

Clinically, the diagnosis of hypoglycemia should be based on the actual situation of the patient, which can manifest as dizziness, palpitations, sweating, hand tremors, mental cognitive impairment, convulsions, and even coma. So let me emphasize again: the key to the treatment of severe hypoglycemia is to identify it early and raise blood sugar as early as possible to minimize damage to brain cells.

In medicine, different groups of people have different criteria for determining hypoglycemia. Diabetic patients are considered to have hypoglycemia as long as their blood sugar level is ≤3.9mmol/L, while non-diabetic patients are considered to have hypoglycemia when their blood sugar level is <2.8mmol/L. The scary thing is that some patients often do not have typical hypoglycemia symptoms and may only show drowsiness. If this is not taken seriously, it is likely to increase the risk of death.

It is recommended that families should always have some honey, juice, or candy on hand. In this way, when hypoglycemia occurs, timely sugar replenishment can relieve the symptoms of hypoglycemia as soon as possible. In addition, do not have any fluke mentality, seek medical treatment in time, and ask the doctor to provide a more complete diagnosis and treatment plan. "

After listening to the doctor's detailed explanation, Lao Wang realized the harm of hypoglycemia. However, there was a reason for adjusting the medication and dosage: his blood sugar control was not ideal for 3 years , and he was indeed anxious about this matter.

The doctor said: "This practice is extremely dangerous. The vast majority of patients with chronic diseases and cardiovascular and cerebrovascular diseases have to take long-term medication. It is worth noting that the same drug and the same dose may not be suitable for all patients with the same disease. There are individual differences in the efficacy and toxic side effects of different people after taking the drug. These differences are not limited to combined medication, age, gender, clinical symptoms/comorbidities, smoking, diet, and family history. Under the same demographic characteristics and physiological and pathological conditions, genetic polymorphism is the most important factor affecting individual differences in drug response.

Our traditional medication is to give medication plans (including drug selection and dosage) based on the doctor's diagnostic experience. In this case, different patients may experience adverse drug reactions or poor drug efficacy, so the medication plan needs to be adjusted repeatedly, which may miss the golden treatment time, and the consequences are even more difficult to predict. Not to mention spending more money, delaying treatment time, and failing to achieve satisfactory results, if adverse reactions occur, it may be fatal to the body.

Precision medicine is to conduct genetic testing on different patients, combine clinical information, guide doctors to use gene-directed medicine , select drugs and appropriate dosages in a targeted manner, and buy time for patients' treatment. Precision medicine can help each patient get a precise and personalized medication plan, making treatment safer and more effective. "

In addition, the doctor told Lao Wang: "With the deepening of pharmacogenomics research in our country, more and more drug metabolism is linked to genetic variation. Therefore, it is recommended to conduct corresponding genetic testing before taking the medicine to find out your body's basic reaction to the medicine, prescribe the right medicine and reasonably adjust the dosage according to your own situation."

Lao Wang listened to the doctor's advice and immediately did a genetic test. Based on the test results, the doctor gave him a clear medication plan and selected the right drug and dosage for him. This finally solved the problem that had been bothering Lao Wang for three years.

Lao Wang was relieved now, thinking that everything would be fine if he took the right medicine. The doctor hurriedly shook his head and advised: "On the one hand, using the right medicine can reduce the peak blood sugar level, but on the other hand, it is also easy to overlook. To reduce the fluctuation of blood sugar , the fluctuation of blood sugar is like a roller coaster, which damages the blood vessels even more than stable high blood sugar. Especially after taking the medicine, you must pay attention to monitoring the fluctuation of blood sugar. Careful monitoring of blood sugar can also bring a sense of ritual to life. You must know that haste makes waste in curing diseases, and too much is as bad as too little. Choosing the right medicine, taking medicine alone is not a panacea. It is a long-term solution to move your legs, control your diet, improve your living habits, and fundamentally reduce the fluctuation of blood sugar."

After listening to the doctor's words, Lao Wang finally had an epiphany, and was full of regret for his previous ridiculous behavior. He never dared to joke with his body again, and followed the doctor's advice. After taking the medicine prescribed by the doctor for a period of time, Lao Wang came to the hospital for a re-examination. The results showed that all physical indicators were very ideal, and the blood sugar index had returned to the normal range. He happily said to the doctor: "There have been no symptoms of hypoglycemia since then." Lao Wang's problem was solved, and his face was filled with a long-lost smile. He was secretly happy in his heart that he could finally enjoy a stable retirement life.

Popular science about diabetes : China is a country with a high prevalence of diabetes. The number of diabetes patients in China has exceeded 100 million, ranking first in the world. In the latest "Summary of China's Cardiovascular Health and Disease Report 2021", previous diabetes prevalence surveys show that the prevalence is also rising year by year . According to statistics, 1 in 10 people suffers from diabetes.

The harm of diabetes mainly causes many complications, including microvascular disease, macrovascular disease, neuropathy, etc. Roughly speaking, wherever there are blood vessels, they may be damaged, such as the brain, retina, heart, kidneys, feet, etc.

The causes and pathogenesis of diabetes are very complex. Generally speaking, it is the result of the combined effects of genetic factors, environmental factors, autoimmune factors, etc. If there is a family history of diabetes, the risk of disease will increase.

Genetic factors are related to the occurrence of diabetes. At present, there is a consensus and guidelines among domestic and foreign experts that detecting diabetes-related pathogenic variants through genetic testing is beneficial to the diagnosis and treatment of the disease. For monogenic diabetes, genetic testing is the gold standard for diagnosis .

Who are the high-risk groups for diabetes? (As shown in the picture)

If one or more of the above conditions exist, the risk of diabetes will increase significantly, so adhering to a healthy lifestyle is the most effective way to prevent diabetes. First of all, weight management : ideal weight "height (cm) -105" can also be used to calculate the body mass index (BMI) to make a preliminary judgment on your weight. BMI = weight (kg) / height (m2). For most people, the normal range of BMI is 18.6-23.9Kg/m2. If it is higher than 23.9 Kg/m2, you need to be alert to the problem of overweight/obesity. Secondly, you should eat a reasonable diet , choose "high-quality carbon water" whole grain foods, increase vegetables and fruits appropriately, and reduce the intake of refined processed foods and sugar. Don't forget to take in high-quality protein, such as: a combination of meat, eggs, and dairy foods. You should also choose a suitable exercise method , quit smoking and limit alcohol, and maintain a good attitude . For diabetic patients, they need to rely on stricter diet control, exercise, hypoglycemic drugs, blood sugar monitoring, and patient education, none of which can be missing.

In fact, in daily life, diabetes seems to have become synonymous with "eating too well", and there are countless people who have the same experience as Lao Wang in the case. The first thing that everyone thinks of is to control blood sugar by adjusting their regular work and rest, strengthening exercise and diet control, and taking medicine on time. However, we all have individual differences , and our absorption and metabolism of sugar are different. In addition, the metabolism and excretion of drugs in the body are different for each person and are affected by many factors, including genes .

Polymorphism is the primary cause of individual differences, so it is far from enough to improve lifestyle alone. It is necessary to combine precision medicine, detect individual genetic polymorphisms , and then clarify the relationship between genetic polymorphisms and individual drug response differences, and choose individualized medication plans (tailored to individual needs) to effectively delay or even avoid the occurrence of complications. This will be of practical significance in clinical treatment. At the same time, some types of diabetes are caused by genetic factors (such as monogenic diabetes), and genetic testing can be used to make a clear diagnosis, so that early detection, early diagnosis, and early intervention can be achieved. This is the key to achieving personalized precision treatment.

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