Diabetics all know that high blood sugar is not scary, but what is really scary is the complications caused by high blood sugar. Long-term hyperglycemia can cause multiple lesions throughout the patient's body because it can cause damage to the body's large and microvessels. Every diabetic patient hopes to prevent or detect diabetic complications as early as possible to avoid serious complications to the body. Therefore, regular check-ups are an effective measure to detect lesions early. As diabetes patients, we need to know what items to check regularly.
Check urine protein regularly
Diabetic nephropathy is based on the metabolic disorder of diabetes and is complicated by extensive glomerular nodular sclerosis in the kidneys. Diabetic nephropathy is mainly caused by diabetic microvascular disease. Early diabetic nephropathy is characterized by a mild increase in urinary albumin excretion (microalbuminuria), which gradually progresses to macroalbuminuria, increased serum creatinine levels, and eventually renal failure.
Detection of trace albumin content in urine is the most commonly used method for early diagnosis of diabetic nephropathy. Urine retention methods include:
(1) Collect urine at any time point and measure the albumin and creatinine ratio;
(2) Collect 24 hours of urine and measure the amount of albumin;
(3) Collect urine within a period of time (4 hours or overnight) and measure the urinary albumin excretion rate. If the results are abnormal, the test should be repeated within 3 months to confirm the diagnosis. Specific testing methods need to be carried out in accordance with the requirements of specific hospitals.
Patients with type 2 diabetes should have urine microalbumin monitored when they are diagnosed and patients with type 1 diabetes have a disease duration of ≥5 years. After that, they need to be checked once a year to detect diabetic nephropathy as early as possible. If the urinary albumin excretion rate increases, the examination should be repeated 2 to 3 times within 3 to 6 months.
Check your eyes regularly
Diabetic retinopathy is a highly specific microvascular complication of diabetes. The main risk factors for diabetic retinopathy include duration of diabetes, hyperglycemia, hypertension, and dyslipidemia. Diabetic retinopathy may have no obvious symptoms in the early stages. Therefore, from the perspective of preventive treatment, regular fundus examinations are particularly important. If a patient with diabetes has had diabetes for a period of time before diagnosis, the incidence of retinopathy at the time of diagnosis is higher. Therefore, patients with type 2 diabetes should have their first fundus examination and other eye examinations as soon as possible after diagnosis.
Diabetic patients without retinopathy are recommended to have an examination once every 1 to 2 years; patients with mild disease should have an examination once a year; patients with severe disease should have an examination every 3 to 6 months; pregnant women need to have more frequent examinations. Eye examination items include visual acuity, intraocular pressure, angle, and fundus (observation: microaneurysms, intraretinal hemorrhage, hard exudates, cotton wool spots, intraretinal microvascular abnormalities, venous beading, neovascularization, vitreous hemorrhage, preretinal hemorrhage , fibroplasia, etc.), among which venous beading refers to the local expansion of retinal veins, like beads on a string, which is a typical manifestation of diabetes.
Self-measured blood pressure
Hypertension is one of the common complications or complications of diabetes. Hypertension in patients with type 1 diabetes is often related to aggravation of renal function damage. Hypertension in patients with type 2 diabetes is usually a manifestation of the coexistence of multiple cardiovascular and metabolic risk factors. . The coexistence of diabetes and hypertension significantly increases the risk of occurrence and progression of cardiovascular disease, stroke, nephropathy and retinopathy, and increases the mortality rate of diabetic patients. Conversely, controlling high blood pressure can significantly reduce the risk of developing and developing diabetes complications.
For patients with diabetes and hypertension, the systolic blood pressure control target should be <130 mmHg, and the diastolic blood pressure should be controlled at <80 mmHg.
Diabetic patients need to self-test their blood pressure at home on weekdays. When their blood pressure exceeds 120/80 mmHg, they should start lifestyle intervention to reduce blood pressure and prevent the occurrence of hypertension. People with blood pressure ≥140/90 mmHg can consider starting drug antihypertensive treatment. Diabetic patients with blood pressure ≥160/100mmHg or higher than the target value of 20/10mmHg should start drug antihypertensive treatment immediately, and can take Combination therapy.
Method for self-measurement of blood pressure: For those whose blood pressure does not meet the standard, it is recommended to measure blood pressure once in the morning and evening, 2 to 3 times each time, for 7 consecutive days. The average blood pressure in the next 6 days will be used as a reference for doctor's treatment. For those whose blood pressure reaches the standard, it is recommended to measure it once a week. The blood pressure measurement should be performed in a standardized manner. Rest quietly for at least 5 to 10 minutes, take a seat, tie the cuff to the upper arm, and place it on the table. During the pressure measurement, keep quiet, do not talk, and do not move. The interval between two pressure measurements is 1 minute. Record blood pressure measurement results truthfully and provide them to medical staff as a reference for treatment during follow-up visits.
Check blood lipids regularly
Common blood lipid disorders in patients with type 2 diabetes are elevated triglycerides and reduced high-density lipoprotein cholesterol, both of which are associated with a high risk of cardiovascular disease in patients with type 2 diabetes. Several studies have confirmed that statins can reduce the risk of macrovascular disease and death in patients with diabetes by lowering total cholesterol and low-density lipoprotein cholesterol levels.
Diabetic patients should have their blood lipids checked once when they are diagnosed, and then once a year (including low-density lipoprotein cholesterol, total cholesterol, triglycerides and high-density lipoprotein cholesterol). Patients who receive lipid-lowering treatment should have their blood lipids checked based on the evaluation of efficacy. The number of inspections needs to be increased.
liver function
Diabetic patients with fatty liver are because the glucose and fatty acids in the patient's body cannot be absorbed, and lipoprotein synthesis will be blocked, causing most of the glucose and fatty acids to be converted into fat in the liver and accumulated in the liver, leading to fatty liver. Liver function tests are used to detect whether there is liver disease, the degree of liver damage, and the cause of liver disease.
Whether liver function is normal is also one of the criteria for selecting drugs for diabetic patients. The liver is the main drug metabolizing organ in the human body. The liver will weaken the toxicity of drugs through oxidation, reduction, hydrolysis, conjugation, etc., and then the drugs can enter the blood circulation and be exerted. Most drugs need to be metabolized by the liver to be effective, including hypoglycemic drugs. Drugs are only metabolized by the liver and do not directly damage liver function. Therefore, as long as diabetics have normal liver function, they do not have to worry about the effects of drugs on the liver. However, in patients with abnormal liver function, the drug may have adverse effects on the liver during metabolism through the liver. If the liver function is obviously abnormal, it is best to switch to insulin treatment.
Patients with type 2 diabetes should have their liver function checked when diagnosed, and then once a year.
kidney function
The kidney is an important organ for drug metabolism and excretion in the human body. When diabetic patients have kidney problems, they may suffer from kidney function damage. Regular checks of kidney function can help detect diabetic nephropathy in time. When diabetic patients develop renal insufficiency, some oral hypoglycemic drugs tend to accumulate in the blood, thereby increasing the risk of adverse reactions such as hypoglycemia. Patients with renal dysfunction should choose a safer hypoglycemic solution under the guidance of a doctor.
People with type 2 diabetes should have their kidney function checked when they are diagnosed, and then once a year.
electrocardiogram
Electrocardiogram is a widely used clinical method for examining heart diseases. Electrocardiogram can help diagnose arrhythmia, myocardial ischemia, myocardial infarction and its location, help diagnose heart enlargement and hypertrophy, and determine the impact of drugs or electrolytes on the heart. Type 2 diabetes patients need an electrocardiogram when diagnosed, and then once a year to help detect heart disease early.
thyrotropin
Diabetes and thyroid disease are the two most common diseases in the endocrine and metabolic system. There is a complex interaction between the two and they often coexist. Hypothyroidism is a disease in which the body's metabolism is reduced due to reduced synthesis and secretion of thyroid hormone, or insufficient physiological effects. Type 1 diabetes and hypothyroidism are both autoimmune diseases. Type 1 diabetes patients are prone to be complicated by hypothyroidism. Most of them have no typical symptoms. Only a small number of them develop painless goiter, weight gain, growth retardation, fatigue, anorexia, Constipation, fear of cold, drowsiness and bradycardia, etc. Type 1 diabetes combined with hyperthyroidism may cause weight loss, heat intolerance, irritability, tachycardia, tremor, etc. Blood sugar is often difficult to control, and the dose of insulin needs to be increased.
Hyperthyroidism, hypothyroidism and diabetes are both endocrine system diseases. They are mostly caused by autoimmune abnormalities and the influence of environmental and emotional factors. Diabetic patients are also a group with a high incidence of thyroid disease. Screening for thyroid disease in diabetic patients is conducive to early detection and early treatment.
Diabetic patients should undergo a thyroid stimulating hormone test when diagnosed, and then recheck once a year.
neuropathy test
Diabetic neuropathy is one of the most common chronic complications of diabetes. The disease can affect the central nervous system and peripheral nerves, with the latter being the most common. Diabetic peripheral neuropathy refers to the symptoms and/or signs related to peripheral nerve dysfunction in diabetic patients when other causes are excluded, such as distal symmetric polyneuropathy, such as pain, numbness, and abnormal sensation in the limbs. ; Such as autonomic neuropathy, which manifests as orthostatic hypotension, dysphagia, gastroparesis, difficulty urinating, loss of sexual desire, abnormal sweating, dry and cracked hands and feet, etc.
To prevent diabetic neuropathy, regular screening is required. All patients should be screened for diabetic peripheral neuropathy at least once a year after being diagnosed with diabetes. For patients with a long course of disease or patients with fundus lesions, nephropathy and other microvascular complications, they should be screened every 3 to Review in 6 months.
Palpation of dorsalis pedis artery
Diabetic foot disease is one of the most serious and expensive chronic complications of diabetes, and can lead to amputation in severe cases. Lower extremity vascular disease is one of the important factors leading to diabetic foot, and peripheral arterial disease is one of the important factors causing foot disease. Patients with severe peripheral arterial disease may have typical symptoms of intermittent claudication, but most of them are complicated by severe peripheral arterial disease. Some patients may develop foot ulcers without this symptom, or after the foot that lacks sensation is injured, ischemic lesions aggravate the foot lesions. Peripheral artery lesions can be detected in time through palpation of the dorsalis pedis artery. The dorsalis pedis artery is a continuation of the anterior tibial artery. Apply the same pressure with the index fingers of both hands to feel the strength of the pulse of the dorsalis pedis artery on both sides. If the pulse weakens or disappears significantly, it is abnormal.
Diabetic patients need to have the dorsalis pedis artery palpated once when they are first diagnosed, and then every 3 months.
