With the process of urbanization and the change of lifestyle in China, the incidence of diabetes in recent years has remained high, and there are a large number of pre-diabetic patients, which has brought tremendous physical and mental pain and economic burden to patients and families. This year's report on the work of the two sessions of the CPPCC and CPPCC proposed that chronic diseases such as diabetes and hypertension should be included in the coverage of medical insurance reimbursement, thus reducing the financial burden of patients. However, the effective treatment and control of chronic diseases such as diabetes can not be separated from patients'self-discipline and self-health management to a large extent. To this end, we invite Professor Xu Zhangrong, the chief physician of the Diabetes Center of the Strategic Support Force Special Medical Center, to attend the Health Care Hall and launch a series of lectures on Diabetes Self-Health Management. Next, we invite you to listen to the 10th volume of the lecture series, Foot Coolness, Foot Anesthesia, Acupuncture Pain, Diabetic Neuropathy is the most common.
Xu Zhangrong, chief physician and professor of Diabetes Center, Strategic Support Force Characteristic Medical Center. He is also a member of the National Committee of Cardiovascular Experts, a member of the Expert Group on Public Health Services of the National Health Commission, an advisor to the Diabetes Foot and Peripheral Vascular Diseases Group of the Diabetes Society of the Chinese Medical Association, a supervisor of the Asian Diabetes Society, an editor-in-chief of 11 journals such as the Chinese Journal of Endocrinology and Metabolism, the Chinese Journal of Diabetes and the editor-in-chief of the Journ Vice-Editor of Chinese Journal of Geriatric Multiple Organ Diseases and Vice-Editor of Chinese General Medicine. He was a member of the Committee of Experts on the Prevention and Control of Chronic Diseases of the Ministry of Health, a member and Deputy Secretary-General of the Diabetes Society of the Chinese Medical Association, a member of the Endocrinological Society and a vice-chairman of the Diabetes Group, and an editor of Diabetes, Obesity and Metabolism. He has won more than 10 awards such as the first prize of national scientific and technological progress. He has published more than 370 papers, edited 29 professional reference books on diabetes and endocrine. Enjoy special government allowances issued by the State Council. Is there any regularity in the occurrence of complications of diabetes mellitus? What kind of complications are the most common? Which kind of complications is the most dangerous? It is very important to monitor the complications of diabetes mellitus and it is hoped that every newly diagnosed type 2 diabetic patient will be evaluated for the complications. Many patients do not know when they get diabetes, because of other diseases, the examination process only found that they have diabetes, precisely because of the hidden nature of diabetes, so it is recommended that patients once diagnosed with diabetes should be timely assessment of complications. The most common complication of diabetes mellitus is peripheral neuropathy. About 60% to 70% of diabetic patients have peripheral neuropathy. The prevalence of neuropathy depends on the sensitivity and specificity of the examination methods. The more sensitive the examination methods are, the higher the detection rate is. Some patients suffer from lower limb pain, numbness and other discomforts, and some patients suffer from sensation retardation or disappearance, while the latter can cause many problems, such as feet do not feel, wearing shoes at an inappropriate time can lead to ulcers, serious infection can occur after needling, and eventually develop into diabetic foot ulcers, or even foot gangrene. Cardiac autonomic neuropathy can lead to loss of heart sensation, and patients may manifest painless myocardial infarction, or even sudden death. Therefore, it is suggested that all diabetic patients should undergo standard electrocardiogram (ECG) examination and further examination according to the strength of cardiovascular risk factors.
The longer the course of diabetes mellitus, the greater the risk of fundus lesions. The probability of fundus lesions is only 10% - 20% in patients with 5-year course, and 90% in patients with 20-year course, and the severity of the lesions varies. Long-term fundus diseases can lead to visual impairment or even blindness. Diabetes mellitus has become the primary cause of blindness in many countries. At present, it is the second cause in China. Timely detection of fundus lesions can help us to do the following: First, if newly diagnosed diabetic patients find fundus lesions, suggesting that patients have at least 5 years of history of diabetes, at this time we should pay attention to it. Secondly, fundus diseases of diabetes mellitus can help differential diagnosis. Diabetic patients with hypertension often have proteinuria. At this time, if patients have fundus lesions, then it may be speculated that proteinuria is related to diabetes. If there is no problem with fundus, proteinuria is very serious. At this time, it is speculated that the relationship between proteinuria and hypertension is larger. Third, fundus lesions can be treated, so that early detection, early treatment, visual rescue, to avoid blindness. Screening for renal lesions is also important. Many diabetic patients have albuminuria, which is more likely to occur in patients with hypertension. Early proteinuria is reversible, especially early exercise-type proteinuria, occult proteinuria, microalbuminuria. If blood sugar and blood pressure are controlled well and regular living habits such as reasonable diet and exercise are added, early proteinuria can return to normal. Although late stage can not return to normal, but through treatment can delay the progress towards uremic stage. Proteinuria is like an alarm. Patients with proteinuria need to carefully and comprehensively control risk factors, especially blood sugar and blood pressure.
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