1, What is diabetic retinopathy?
Long-term blood sugar in diabetic patients as a result of increased metabolic disorder, caused by systemic microcirculation. Fundus easily damaged retinal blood vessels, which occurred in diabetic retinopathy (diabetic retinopathy, DR). Diabetic retinopathy is one of serious complications of diabetes, diabetes is also one of the main reasons caused by the blind.
Epidemiological survey showed that about 75% of non-importance of glycemic control in diabetic patients, 15 years occurred in the incidence of diabetic retinopathy. In diabetic patients, the occurrence of diabetic retinopathy, and more than 50%.
Diabetes pathological damage caused by the body due to high blood sugar on the micro-vascular damage, which allows retinal capillary endothelial cells and pericytes impaired, resulting in the loss of normal capillary barrier function, there is leakage, resulting in surrounding tissue edema, bleeding, followed by the occlusion of capillaries caused by retinal ischemia, a lack of blood supply and nutrition, resulting in tissue necrosis and neovascularization of the release of growth factors and thus generated new blood vessels, which will lead to a large number of retinal hemorrhage and vitreous hemorrhage in a large number of produce proliferative vitreoretinopathy. The greater age, longer duration, higher incidence of fundus. Than young people a greater risk of the elderly patients, often adverse prognosis. If control of diabetes mellitus can be timely, not only to occur in less damage to the retina at the same time lighter, otherwise progressive retinopathy, recurrent bleeding occurred, resulting in proliferative retinal changes, and even retinal detachment, or complicated cataract.
Diabetic retinopathy What performance?
Diabetic retinopathy is caused due to diabetes, with the exception of symptoms to more than drink, more food, more urine and urine, characterized by elevated blood sugar, there will also be bright red eyes appeared retinal capillary hemangioma, flame-shaped hemorrhage, the latter are off-white exudative, bright red neovascularization, vitreous prone to blood red as the main features of the fundus changes.
Does not affect the early eye macular lesions, the vision will not be affected, patients with no symptoms, and sometimes feel that patients with vision loss, or have a shadow before flying or fluttering. If the lesion development of 3-5 years or poor blood sugar control, can cause varying degrees of retinal hemorrhage, exudation, edema, hemangioma. Macular involvement, such as fundus, visual acuity may be decreased, the immediate shadow, the dark vision of the Center, the decline in visual acuity and visual symptoms such as metamorphopsia. Repeated if the retina into the vitreous hemorrhage, the patient has consciously eyes fluttering shadow. When the blood vessels or neovascularization massive bleeding into the vitreous cavity, will seriously affect the vision, even blindness.
Urine disease retinopathy should be about the prevention and control?
• blood glucose control in normal or near normal levels, while blood pressure control of 140/90 mmHg in the normal range.
• appropriate control diet, to strengthen the campaign to control blood sugar.
• early detection of vision and fundus, early treatment, to keep your vision to improve the quality of life.
2, diabetic neuropathy meet the related issues Baidu Encyclopedia "in diabetic neuropathy."
As early as 50 years ago, Chinese and foreign treatment programs are low-carb, high fat, high protein diet based. According to clinical practice has proved that such a diet for diabetic patients not beneficial to islet function, and high fat diet will increase the patient's vascular disease diabetes, high protein diet would be caused by the incidence of diabetic nephropathy increased. Medical experts are now advocating the volume of high-carbohydrate, lower-fat ratio of dietary protein intake control structure, to improve blood glucose tolerance have a better effect, the specific treatment methods are summarized as follows:
One diabetes treatment, the treatment of human immunodeficiency
On the beaches of the famous traditional Chinese medicine, "anti-cancer Pioneer Network" paper pointed out: through the body's immune chitosan special material to control the treatment of diabetes is recognized by the medical profession a good way! Chitosan in Japan, Europe and the United States, parts of mainland China and Hong Kong and Taiwan, that was the reputation of "human environmental agent," "Su-longevity", by the international and Chinese medicine as a profession are essential to human cases of the "Sixth elements of life. " Japan now control "diabetes" preferred to "chitosan."
"Diabetes" is a blood glucose of the disease easy to pile up too much. Do not foreign to it called the "silent killer" (Silent Killer), especially the "adult-type diabetes," the middle-aged over the age of 40染患rate is particularly high in Japan, over the age of 40 accounted for 10% of the population , that is, 10 people have a "diabetic" patients. Once suffering from "diabetes", will reduce life expectancy by as much as ten years, and the complications that may occur throughout the body.
The so-called "diabetic" complications in these complications, there is the highest rate of retinal disease, kidney disease and nerve barriers, known as "diabetes" and "the three major complications." These three complications in the "diabetic" patients within two decades after birth, and 80% of people will have to suffer from these diseases. Atherosclerosis as well as inside, because of excess blood glucose gradual corrosion of the body organs and their organizations consequences.
Once suffering from "diabetes," the trouble with the human body and to its, as weakened immune function, easily infected by the flu, pneumonia, tuberculosis caused by various infectious diseases, and difficult to cure. And can selectively destroy cells, phagocytic cells. Cancer cells will be greatly weakened defense function to enable the cancer cells active, aggregation, leading to trigger cancer.
Complications arising from such a wide range of diseases, in addition to "Diabetes" almost beyond rare. Because of complications, so some people say that once had "diabetes", minus the life of at least ten years.
As for the use of "chitosan" improved "Diabetes" presented 11 cases to the health of many patients hope. "Chitosan" in the "diabetic" patients demonstrated in the course of a crucial two objectives:
A drop in blood sugar level.
Second, to improve the complications arising from and in line with the gradual healing.
"Chitosan" help "diabetes" patients to achieve these two objectives by the following three aspects of the way to completion:
(A) through stimulation of the nervous system to achieve the release of oxygen. Polysaccharides in such large numbers to take the process of being absorbed into the human body, the first to reach the liver through the intestinal mucosa of portal venous system, strongly stimulate the liver to the vagus nerve, the nerve conduction to rely on a complete path through the hunger center, and then down, ultimately leading to occurrence of systemic parasympathetic excited. What is the parasympathetic state of excitement? Hungry people in all circumstances a sudden fever, shaking hands. This state is in the pathological tissue oxygen in the release of the performance, in a state of emergency to emergency food shortage in vivo, an oxygen activities. For "diabetes" people, to stimulate the vagus nerve, systemic parasympathetic excited, the release of oxygen, so bring two advantages:
(1) due to "diabetic" human metabolism the way a problem, the normal is broken down into carbohydrates into glucose, the aerobic decomposition of the body to supply the energy required to maintain the activities of our lives. And "diabetes" are often in a state of anaerobic digestion. Therefore, to help "diabetes" in patients with oxygen in the metabolic process is important. To improve the "diabetic" human metabolism way to convert to aerobic decomposition. Oxygen, especially in muscle cells of oxygen to oxygen release, because the higher the oxygen content of muscle cells.
(2) diabetes mellitus in the process of anaerobic glycolysis produce three types of material, one lactic acid, ketones Second, Third, free radicals, which cause "diabetes" person ketoacidosis. In the case of oxygen, so that in the formation of organic acids by the process of oxygen, making it too much to convert the carbonate to form carbonic acid, would be easily broken down into carbon dioxide and water, water use by cells, carbon dioxide, with the vein into the pulmonary circulation. Its metabolism is very simple, as far as possible, these two substances (lactic acid and ketones) to reduce the amount of produce, this is the role of tissue oxygen release.
(B) to correct acidosis. This acidosis is not a medical concept of the general acidosis, Japanese experts in the study of chitosan for "Diabetes" found in the course of the environmental problems of islet insulitis in the normal physiological environment, and its pH value (PH value) should be weak base (7.35-7.45) state, only in normal islet function, and "diabetes" is the cause of human insulin secretion less than absolute or relative lack of function caused by decreased glucose metabolism.
How to correct this acidosis? Eat something alkaline to acid and? Not. To play some of the blood too alkaline substances. Because the blood PH value of the regulation by heme, a lot of blood buffer chemistry right, in the body's internal environment, the extracellular pH change extremely difficult. So far, only "chitosan" The polysaccharides in the free state exists, its use in the absence of functional groups is still active into the surrounding islet effect that this kind of "chitosan" of material with two charges, it may occur the following situations: one is the direct combination of organic acids and, more so that the water molecules in body fluids changed, it claimed a positive charge, hydrogen ion concentration significantly enhanced into a basic change. Because it should be dissolved in acid, it is necessary to take away a hydrogen ion (R-NH2 + H + + OH), then use this method to improve the environment around the islet, to return to a state of weak base, thereby enhancing the insulin secretion, secretion more insulin, and glucose metabolism on the improved.
(C) of the β-cell injury repair. Of course it is impossible to entirely repair, but in general the "diabetic" people, not too much to reduce the cell, the cell is in a state of edema, if the cells are all dead, has become a full-insulin-dependent diabetes, it is extremely difficult.
Japan now control "diabetes" preferred to "chitosan." Shanghai, see more "anti-cancer Pioneer Network" of medical papers!
II diabetes treatment, diet from time to time quantitative
Based on age, sex, occupation, standard body weight [(length -100) × 0.9] is estimated that the total daily calories. Men than women daily calorie requirements by about 5% higher. Different sizes and age there are differences in the caloric needs, the general needs of every calorie kcal kg body weight for young people> middle-aged> elderly>, the average of the high 5% ~ 10% per kg body weight / day. The daily consumption of different physical energy are also different. Light manual workers per kilogram body weight daily calorie consumption 30 ~ 35kcal; Medium manual consumption per kilogram of body weight every day 35 ~ 40kcal heat; heavy manual workers required per kilogram of body weight per day for more than 40kcal heat. In general, pregnant women, nursing mothers, malnutrition and wasting disease shall, as appropriate, increase in obesity reduce it to patients to maintain normal body weight about 5% of body weight, can often be satisfied with the control condition.
Third, diabetes treatment, reasonable adjustments to the ratio of the three major nutrients
Dietary sugar, fat and protein percentage of the three major nutrients, it is necessary to make reasonable arrangements and adjustments. Not only to achieve the purpose of treating disease, but also to meet the body's physiological needs. At present, the American Diabetes Association (ADA) advocates: carbohydrate diet diabetic patients should be accounted for 55% of total calories to 60%; protein intake per day should not exceed 15% of total calories. Daily per kilogram of body weight to 0.8 ~ 1.2g appropriate. Developmental stages of young people and pregnant women, nursing mothers or special-employed persons and other complications to the patient may酌加around 1.5g; daily total fat intake should not exceed 30% of total calories to 0.6 kg body weight per day ~ 1g as well, such as obese patients, particularly high blood lipids or atherosclerosis, the fat intake should be adjusted depending on the specific situation.
Fourth, diabetes treatment, diet calorie calculation and the calculation of heat supply of the body there are three kinds of nutrients: protein, fat, carbohydrates. One per gram of carbohydrate and protein for energy 4kcal (1kcal = 4.184kj), heat per gram of fat can 9kcal (37.74kj). Diabetic patients, according to its labor intensity may be needed per person per day total calories (kcal) in accordance with the 69% carbohydrate, 15% protein, fat percentage of 25% of the total distribution, calculated the energy supply of the various components, and then heat production per gram of fat 9kcal, per gram of carbohydrate and protein 4 kcal heat production of the conversion of the supply of nutrients patients need different weight may be three meals a day or four meals. Heat distribution for three meals a day breakfast 15, lunch and dinner all 25. Energy distribution of the four meals for breakfast, 17, and the remaining three of the 27. For example: a middle-weight 60kg manual, the normal size of adult diabetes patients, according to the daily per kilogram of body weight 40kcal heat calculation, the total calories for the day 2400kcal, according to the proportion of the distribution of more than calories from carbohydrates 1440kcal that, 360kcal of heat to Since the protein, 600kcal from fat. Provide the heat required to supply 360g carbohydrate, 90g protein, 66g fat. We emphasize calorie control through diet methods are not asking for diabetic patients must be mechanically every day to calculate, but should grasp the calculation method in every weight from time to time or when a relatively large change in a calculation and worked out the next phase of diet programs, and the deprivation of sweets, greasy foods, eating only the principle of choice but to seek diversity.
Five diabetes: exercise therapy
Movement therapy is based on the function of patients and disease characteristics, the use of physical exercise to prevent disease and enhance the body resistance to help patients overcome the disease, an effective way to restore health. Movement to the physical benefits of the training listed in the following law specifically addressed. In the treatment of diabetes, exercise therapy is an important component of, especially for elderly patients, obese patients is even more important.
Sub-type 1 diabetes mellitus (type 1 diabetes) and type 2 diabetes (type 2 diabetes) and gestational diabetes (gestational diabetes). Type 1 diabetes which occur in young people, their lack of insulin secretion, and must rely on insulin treatment to sustain life. Was particularly prevalent in type 2 diabetes after 30 years of age, the elderly, their insulin secretion is not low even the high side, the main cause is the body is not sensitive to insulin (ie insulin resistance). Gestational diabetes (gestational diabetes) is derived from cells of the insulin resistance, but the insulin resistance in pregnant women because of hormone secretion (hormones) caused by. Gestational Diabetes is usually self-healing after childbirth.
Insulin is secreted in human pancreatic β cells of the body only hypoglycemic hormone. Insulin resistance refers to the tissues around the body less sensitive to insulin, organization is not sensitive to insulin, peripheral organizations, such as muscle, fat, glucose uptake of insulin to promote the role of resistance occurred.
The study found the prevalence of insulin resistance in type 2 diabetes, accounting for almost 90%, type 2 diabetes may be one of the main factors of morbidity.
Patients with type 1 diabetes in the 5 years after diagnosis of chronic complications rarely occur, on the contrary,
In patients with type 2 diabetes have been diagnosed before the occurrence of chronic complications. According to statistics, 50% of newly diagnosed patients with type 2 diabetes has been in existence for one or more of the chronic complications, some patients because of complications with diabetes found.
Therefore, the diabetes drug therapy should be for their causes, focus on improving insulin resistance, and pancreatic β-cell function must be selected to improve the insulin resistance of the drug. More drug is insulin sensitizer, so diabetic patients an effective and timely treatment of the root to prevent the occurrence of chronic complications of diabetes and development.
Insulin sensitizer can increase the body's own insulin sensitivity of insulin to make their own "resurrection" and give full play to the role, this would enable the glucose to the body re-uptake by tissue cells and the use of, so that decline in blood glucose to long-term stability blood glucose control and comprehensive purpose, so that the body can enjoy their own long-term insulin secretion.
Diabetes treatment must be based on diet control, exercise therapy for the premise. Diabetics should avoid sugar and sugary foods, reduce the consumption of high fat and high cholesterol food, moderate consumption of high fiber and starch food, eating to. Choice movement should be carried out under the guidance of doctors should be done as far as possible, the whole body movement, including walking and jogging and so on. On this basis the application of the appropriate type of insulin sensitizer drugs, rather than excessive use of drugs to stimulate insulin secretion in order to achieve long-term effective control of blood sugar purposes.
Hypertension and diabetes mellitus the relationship between the
Clinically, in particular, many hypertensive patients with diabetes is often accompanied by obesity, and diabetes is also associated with higher blood pressure, known as homologous, therefore the two diseases. The reason is as follows:
Hypertension and diabetes may be the existence of common genetic factors; diabetic patients with vascular boost the role of the angiotensin-sensitive; diabetes easily cause kidney damage, kidney damage will take high blood pressure. In addition, because of hyperglycemia in diabetes, increased blood viscosity, vascular wall damage, increased vascular resistance and easy to cause high blood pressure.
From this high blood pressure and diabetes are related to high blood cholesterol, so prevention and treatment of hypertension and diabetes should also hypolipidemic. Patients understand the reason, the contrast the differences between similar products of advantages. Currently, there are lower blood pressure to buy drugs, hypoglycemic agents are single-function, and most of hypolipidemic drugs on liver damage have a certain role.
With the deterioration of the environment and highlighted the issue of food safety, China's birth defect rate in Western developed countries have been much higher than the 3% level to achieve the 5%! According to this proportion born in China each year 20 million population, about one million newborns, physical disabilities exist. More and more people are concerned about the children in a variety of plastic deformity correction work, for this purpose, this reporter visited the Hebei Children's Hospital significantly Zhang, director of plastic surgery, plastic surgery on the children's interviews with a number of issues. Reporter: Shaping children, parents are most concerned about security issues, will operate on such a small child safe? Answer: shaping the face of the treatment is a healthy body, not because of suffering from the disease, but because the appearance, form or function of the reconstruction of the problems to be repaired, so in relation to general surgery, the security is very high of. In addition, Children's Hospital has pediatric anesthesia, surgical, nursing advantage of other adult hospitals unmatched, from newborn to 18-year-old children are able to carry out plastic surgery. So please parents can rest assured the majority of children come to medical treatment in our hospital. Reporter: the sooner the better children's plastic is it? Answer: In addition to some involved in the abnormal growth of bone, other soft tissue abnormalities should be treated the sooner the better. This is because: first, the smaller the operation and leave behind their children in the surgical scar left by the smaller; Second, younger children its stretching of the skin, the better, the better postoperative recovery; Third, children adults with unparalleled access to sports and the ability of compensatory function, early treatment can be very good after the compensatory function; Fourth, most of today's children are only children, with social competition, the psychological pressure on parents in increased; Fifth, the rapid development of changes in society make sense of their own children in the age of physical deformity in advance, in the past that children 4-6 years old have this awareness, but more and more facts have proven that this age group in advance, individual has moved up to 2 years of age, therefore, vulnerable to the impact of abnormal mental health of children, often leading to low self-esteem is the psychological impact of the healthy growth of children; Sixth, the physical aspects of disability are privacy, out of a sense of self-protection These privacy do not want to be aware of any outsiders, parents and the desire to seek an urgent mood. But we can not make generalizations, and some malformations or defects in repair and reconstruction is complementary to the child's physical development and physical development have to wait a certain period of time in order to carry out treatment, such as external ear reconstruction. Some deformity or disease is currently no good treatment, but did not continue to expand the scope of disease does not affect the physical appearance does not affect other parts of the development and growth, it can not be emphasized as early as. This time is the best way to wait and wait for the emergence of new technologies, waiting for new material and equipment available. Reporter: Now, more and more children were born there face and body surface lesions such as birthmarks, anxious parents in particular, will be how to deal with such situations? Answer: These phenomena are closely related to environmental degradation. Usually we are talking about two distinct types of birthmarks: pigmented and vascular birthmark birthmark. Laser treatment of pigmented birthmarks well, vascular birthmark in addition to the use of laser treatment, surgical treatment can be chosen, in addition to various kinds of mole, blue nevus, blue plaques of skin lesions, etc., can be used frozen , laser treatments, such as burning, but there are more obvious scar. Therefore, the comparison to surgical resection as well. In the treatment of these birthmarks are not the age limit. Reporter: more than a means of birth deformity surgery can you? A: Multi-fingered (toe) is a malformation autosomal dominant disease, is a common deformity in children, one of treatment to surgical resection of the main shape. Generally means more than simple, particularly the ulnar and more simple means, there is no metacarpal and metacarpophalangeal joint supernumerary, the baby should be completed within 0-6 months of surgery; complex multi-finger, such as radial and complex multi-fingered Central multi-fingered and means, such as surgery may be appropriate to defer the time, but should be completed before the 2-year-old in order to facilitate the parents in the psychological comfort as soon as possible, children will not have a psychological barrier. Supernumerary finger (toe) in the non-functional or does not affect the epiphytic metacarpophalangeal function can be removed at any time after birth. Reporter: The children you can do cosmetic surgery? Answer: In principle, can not. Because the children before the age of 18 the body is not mature, the body systems and organs are in the growth changes, the so-called "18 women big change" is the reason, it is not suitable for pre-adult purely cosmetic surgery (including double-fold, nose, long chin, mandibular angle osteotomy, breast enhancement, etc.). But sometimes the plastic and there is no strict boundaries of beauty, plastic is designed to recovery (renewal) function and beauty, or both function and beauty. If it is because some diseases, trauma, deformity and aesthetic impact of the need for beauty, is a different matter.
April 7, 2009 -- Too much "good" protein makes bad fats worse, new research suggests.
A high-fat diet may lead to insulin resistance, a major step on the path to type 2 diabetes. But cutting back on fat may not help those who continue to eat too much protein, find Christopher Newgard, PhD, director of the Sarah Stedman Nutrition and Metabolism Center at Duke University, and colleagues.
"There's not only fat in that hamburger but plenty of protein," Newgard tells WebMD. "We are overconsuming calories composed of all the different macronutrients, and together they have harmful effects."
When they began their studies, Newgard and colleagues weren't trying to give protein a bad name. They were just trying to find out how the metabolism of obese people differs from that of lean people.
To do this, they collected vast amounts of information -- including high-tech lab tests on blood and urine samples -- from 74 healthy obese people and 67 healthy lean people.
Unexpectedly, obese people had a distinct metabolic "signature" related to a particular subtype of amino acids called BCAA (branched-chain amino acids). About 20% of the protein in the typical American diet is made up of BCAAs.
Lean people's bodies tend to make new proteins out of BCAAs. In obese people, Newgard and colleagues suggest, this process gets overloaded. Instead of making new protein, the BCAAs are diverted into a deviant pathway that leads to insulin resistance.
Can too much protein really be bad? Yes -- at least in lab rats. Newgard's team fed rats all the high-fat food they wanted. Two other groups of rats got less food: either standard chow or chow enriched with fats and BCAAs.
The rats on the BCAA/fat diet didn't eat as much food or gain as much weight as the rats on the high-fat diet -- but they became just as insulin resistant.
"Under circumstances of overconsumption, not only does excess fat and carbohydrate have injurious effects, but also the protein component of the diet can lead to some of the co-morbidities of obesity," Newgard says.
Human studies will be needed to confirm the rat findings. But Ronald B. Goldberg, MD, director of the lipid disorders clinic at the University of Miami, says the findings could have major implications.
"What they show is that the combination of high fat and protein might be what's important in developing insulin resistance," Goldberg tells WebMD. "The truth is that in Western diets we do eat a high-protein, high-fat diet. The stress previously has not been on the high-protein component."
The Newgard study appears in the April 8 issue of the journal Cell Metabolism.