1, the first horse: dietotherapy-the horse that drives the axle!
2. The second horse: exercise therapy-the best partner of dietotherapy
3. The third horse: medication
4. The fourth horse: education and psychotherapy
5. Fifth Horse: Self-monitoring
The Troika of Diet Quality Control —— The Magic Weapon of Diabetes Diet Therapy
1, the first horse: glycemic index (GI) of diet
2, the second horse: low calorie (low fat, low cholesterol, moderately low sugar)
3. The third horse: reasonable nutrition heating ratio
4. The fourth horse: rich and balanced nutrition
5. Fifth Horse: Traditional Chinese Medicine for Strengthening the Regulation of Glucose and Lipid Metabolism
First, the first horse for comprehensive treatment of diabetes: dietotherapy (driving horse)
It contains "five horses" to control the diet quality of diabetes:
The First Horse of Diabetes Diet Quality Control: Blood Glucose Index (GI)
● The key to diabetes control is the control of blood sugar, especially postprandial blood sugar!
● So, the primary problem of diabetes diet design: glycemic index!
◆ Blood sugar index: the degree of influence of a food on blood sugar.
◆ The higher the glycemic index, the greater the impact on blood sugar, and the worse it is for your blood sugar control!
● The sugar content and calories of food are not necessarily directly proportional to the glycemic index. Please refer to the following table:
Comparison of sugar content, calories and glycemic index of some foods
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Food carbohydrate calorie glycemic index
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Potatoes 16.6 322 boiled 8 1, puffed 1 16, baked 135.
Carrot 7.6 146 133
White radish 5.7 105 104
Barley rice 66.3 1367 3 1
Soybean 25.3 1722 22
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(quoted from Weng Xiaogang et al. Dietotherapy for Diabetes P 120)
Comparison of glycemic index of several wheat varieties
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Food glycemic index
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Barley 3 1 broken wheat 65
Whole wheat bran 73 rice 83
Oatmeal 85 corn flakes 1 19
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(quoted from Weng Xiaogang's Dietotherapy for Diabetes, P 120)
The porridge problem of diabetic patients
● High glycemic index.
● Try not to drink ordinary porridge.
Cereal porridge substitute
● Tang 'an eight-treasure porridge-diabetic's own slimming porridge!
◆ Soymilk: a good health drink, with the effect of reducing blood fat and caring skin.
◆ Fresh milk: high quality protein, 250ml per day.
◆ Miscellaneous soup: vegetable wok, mixed noodles smashed into a knot, and shrimp skin can also be added.
◆ Shrimp skin and winter melon soup: reduce fat, lose weight and beautify.
The second horse of diabetes quality control diet: low calorie
● Ensure the balance of calories in and out, make you full without exceeding the total calories, and ensure the low calories of food design!
Low calorie needs careful and scientific proportion to ensure rich nutrition.
Low calorie must be designed on the premise of ensuring low glycemic index!
The third horse for quality control of diabetes diet treatment: reasonable proportion of nutritional heating
● Sugar should account for 50~60% of total calories.
Protein should account for 25% of the total heat.
● Fat should be less than 15% of total calories.
● Heating conditions of three major nutrients:
◆ Sugar -4 kcal/g
◆ protein -4 kcal/g
◆ Fat -9 kcal/g
● Because fat has the highest calorie content, it is strictly controlled.
The Fourth Horse for Quality Control of Dietotherapy for Diabetes: Abundance and Balance of Nutrition
● Increase dietary fiber content, especially soluble cellulose.
● Rich in macroelements and microelements: chromium, calcium, selenium, phosphorus, zinc, magnesium, etc.
● Rich natural vitamins: In addition to vegetables and fruits, the skins of cereals and beans are rich in content.
● Pay attention to the balance between nutrients. Three meals should include: staple food, non-staple food and fruits and vegetables.
The fifth horse of diabetes quality control diet therapy: strengthening the consumption of traditional Chinese medicine
● Medicinal and edible products for regulating sugar and lipid metabolism: yam, hawthorn, medlar, mulberry, poria cocos, lotus seeds, coix seed, etc.
● Reasonable and scientific blending processing.
● It should be supported by traditional and modern Chinese medicine pharmacology.
Pay attention to its manufacturing process and safety.
Second, the second horse of comprehensive treatment of diabetes: exercise therapy
Generally speaking, diabetic patients are suitable for mild to moderate aerobic exercise. Aerobic exercise refers to the exercise in which the body mainly provides energy through aerobic metabolism. The oxygen inhaled during exercise is equal to the oxygen needed in the body, which is an endurance exercise aimed at enhancing the inhalation and transportation capacity of the human body. The biggest feature of this kind of exercise is to meet and realize the balance between supply and demand of oxygen in human body.
Do you know aerobic and anaerobic exercise?
The most important thing of aerobic exercise is that a large area of muscle groups participate in activities. Make the exerciser's heart rate increase to a certain range and keep it for more than 20 minutes. Such as walking, running, swimming, aerobics and so on. All belong to this kind of sports, among which walking is more suitable for elderly friends or patients with chronic diseases.
Anaerobic metabolic exercise is a kind of exercise in which the oxygen supplied by the body can not meet the demand of the body for oxygen, and the muscles work without continuous oxygen supply. Just because of insufficient oxygen and energy utilization, it refers to some high-intensity and short-time sports, such as 100 meter running, high jump, throwing and weightlifting, which are not suitable for the elderly and cannot achieve the effect of exercise.
Diabetics are suitable for aerobic exercise!
● Benefits of exercise:
Lose weight, regulate fat, lower blood sugar, increase insulin sensitivity, increase blood vessel elasticity, enhance heart and lung function, prevent and treat hyperosteogeny, invigorate spirit and enhance disease resistance.
● Exercise amount:
Proper amount. Heart rate test method: 170- age = appropriate.
Three times a week, 30 minutes each time; Or 4 times a week, 20 minutes each time; Or five times a week, 20 to 30 minutes each time is best.
● Timing: It is advisable to start 30~60 minutes after meals.
● Exercise mode: full-body exercise. Choose your favorite sports, such as walking, aerobics, jogging, swimming, Tai Ji Chuan (sword), skipping, mountain climbing, bowling, badminton, table tennis, etc.
● Take less elevators and ride more bicycles.
● Not suitable for sports:
1, patients with poor disease control and high or fluctuating blood sugar;
2. Patients with acute complications of diabetes;
3. Patients with severe chronic complications of diabetes;
4. Patients with high or fluctuating blood pressure;
5. Patients with severe heart disease;
6, fundus bleeding and other active patients.
● Precautions:
◆ Do not exercise on an empty stomach.
◆ Don't exercise in hot summer, scorching sun or cold wind.
◆ Carry glucose or candy and sugar cakes with you to prevent hypoglycemia.
◆ You should carry a diabetes emergency card with you. See "common sense of diabetes" later.
◆ Exercise should be stopped in the following situations: when you feel tired or uncoordinated in your legs, when the pain in any part is aggravated, when you are dizzy, when you are flustered and short of breath, when you have hypoglycemia symptoms.
● Persistence, at least 3 times a week. It is best to insist on proper exercise after meals.
Third, the third horse for comprehensive treatment of diabetes: education and psychotherapy
● Health education:
Written self-education-reading books and periodicals about diabetes health education.
◆ Listen to health education lectures.
Participate in health education and recreational activities.
◆ Exchange experiences between patients.
◆ Ask your diabetes doctor.
● Psychological aftercare:
◆ Keep your mind stable: As long as you establish a scientific lifestyle and use drugs correctly, you can still live as long as a healthy person and enjoy the fun of life!
◆ Don't be too emotional.
Practice a little Confucian Qigong: close your eyes, stop listening, and breathe 200~400 times a day, 1 time.
Fourth, the fourth horse of comprehensive treatment of diabetes: self-monitoring
● Routine examination: blood lipid, blood pressure, blood sugar, weight, electrocardiogram, etc.
◆ Blood sugar: 2 hours after meals and early fasting blood sugar, postprandial blood sugar is more important! 1~ twice a week.
◆ Blood lipid: at least once every 3 months.
◆ Blood pressure: at least once every 1 week.
◆ Glycosylated hemoglobin: once every 2 months.
◆ Weight and body mass index are evaluated once every six months.
◆ Fundus: Check once every 3~6 months.
◆ Feet: Check frequently.
The fifth horse in comprehensive treatment of diabetes: drug therapy
Low just found diabetes:
◆ Don't rush to take medicine, first establish a healthy lifestyle! Especially scientific diet and exercise.
◆ Non-drug therapy (1~2 months) is ineffective before medication.
● Medication principle:
◆ The quantity should be small.
◆ There are few varieties.
◆ Choose non-toxic or low-toxic drugs.
◆ Try to use traditional Chinese medicine.
◆ Available medicinal diet
● Regularly check the toxic and side effects of the drugs used.
● Toxic and side effects of commonly used drugs
◆ Sulfonylurea drugs: D860, glibenclamide, Mepida (Disha Tablets), Keteli, Tang Shiping, Dameikang (Gliclazide), glimepiride, etc.
◆ Five defects of sulfonylureas:
1, promoting the lag of insulin secretion;
2. Insulin is not released as needed;
3. Delayed chronic hyperinsulinemia;
4. Entering islet cells to interfere with its secretion;
5, increase the burden of islets, causing secondary failure!
(quoted from foreign medicine? Endocrine fascicle 2002.3:P 154)
◆ Hepatorenal toxicity of biguanides: such as metformin and Jiangtangling (obsolete).
◆ Glucosidase inhibitors affect the absorption of nutrients, abdominal distension, excessive exhaust, and even abdominal pain and diarrhea, such as acarbose and voglibose.
◆ Increased liver enzymes, increased blood volume and edema of sensitizers, such as rosiglitazone and pioglitazone.
◆ Insulin aggravates obesity, hypoglycemia risk and acupuncture pain. Commonly used are insulin and insulin analogues.
● Use of commonly used drugs
1, insulin: used for 1 type diabetes, gestational diabetes (but insulin analogues are not available for the time being), acute complications of diabetes and severe chronic complications of diabetes, diabetes in an emergency state, diabetes before and after surgery, etc.
2. Insulin sensitizer:
◆ thiazolidinediones: rosiglitazone (Avandia) and pioglitazone (Etienne)
◆ biguanides: metformin, Jiangtangling (obsolete)
Indications: when non-drug treatment such as diet therapy is not ideal.
3. Glucosidase inhibitors:
◆ Acarbose (Tang Ping) and voglibose (Beixin)
Indications: When the effect of non-drug therapy such as diet therapy is not ideal,
4, insulin secretagogue:
Repaglinide (Novolone) and nateglinide (Li Tang)-hypoglycemic, lipid-lowering and simulated insulin physiological secretion.
◆ Sulfonylureas: D860, glibenclamide, Mepida (Disha Tablets), Keteli, Tang Shiping, Dameikang (Gliclazide), glimepiride, etc. Because of many shortcomings, it is recommended to use drugs instead.
Indications: Type 2 diabetes has good islet function. Use when the effect of non-drug therapy, insulin sensitizer and glycosidase inhibitor is not ideal.
[Attached]
Acupuncture treatment of diabetes mellitus
Acupuncture includes acupuncture and moxibustion. Acupuncture transmits therapeutic information to the corresponding zang-fu organs through "getting qi", adjusts the whole body function, endocrine and metabolism, and achieves the purpose of getting rid of diseases and strengthening the body.
1. Shang Xiao: Excessive drinking is the main symptom.
Main acupoints: Shu Fei, Pishu, Yishu, Shenshu, Zusanli, Sanyinjiao, Taixi and Chengjiang.
Acupoint matching: for those with severe dry mouth, Shu Ge and thenar are added; Those who eat more and are hungry and thin, add Shu Wei and Zhongwan; For those who urinate too much, add Guanyuan and Shuidao.
Manipulation: taking acupuncture to get qi as an index. You can also tonify deficiency and stop diarrhea, slowly twist and gently stimulate once a day for ten consecutive days as a course of treatment.
2. Consumption: The main symptoms are eating too much and being hungry.
Main attractions: Pishu, Shu Ge, Guanyuan, Shuidao and Shu Wei.
Matching points: Shu Fei and Chengjiang are added to those who are bored; Weakness, laziness and abdominal distension, plus Shu Wei, Sanyinjiao, Yanglingquan and Zusanli.
Manipulation: twist the needle from left to right once a day for ten days as a course of treatment.
3. Low fever: polyuria is the main symptom.
Main acupoints: Shenshu, Yishu, Ganshu, Taixi, Taichong and Sanyinjiao.
Matching points: For those who eat more and lose weight, add Shu Wei and Zusanli; If you are thirsty, you will be slippery, and you will be mixed with grain.
Manipulation: gently twist once a day for ten days as a course of treatment.
4. Acupoints for complications: ① dizziness and headache, plus Baihui and the sun; ② For those with palpitation and shortness of breath, add Xinshu and Neiguan; (3) backache and abdominal pain; 4 dizziness, dizziness, plus the sun, Fengchi point, Tianzhu; ⑤ Lower limb pain, plus Taiyang, Ququan, Zusanli, Yinling Spring and Yangling Spring; 6 nocturnal emission and impotence, plus Guanyuan.