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“I don’t have symptoms of thirst, polydipsia, or polyuria, why is my blood sugar exceeding the standard?”
Looking at the medical check-up sheet that says “obesity, fatty liver (moderate), pre-diabetes” and other diagnoses, 35-year-old Xiao Zhang looks confused and anxious.
Pre-diabetes is a transitional stage from normal blood sugar to diabetes. It can also be understood as one foot has stepped into the gate of diabetes.
Maybe many people are as confused as Xiao Zhang: How high is the blood sugar level to be considered prediabetes? How to avoid developing diabetes? Do you want to take hypoglycemic drugs? Is there any chance of reversal?
Today, we will help you recognize the latent “killer” of prediabetes.
img class=”content_title” height=”300″ layout=”responsive” sizes=”(min-width: 320px) 320px, 100vw” src=”https://mmbiz.qpic.cn/mmbiz_png/lZqyzfF179VXvxWouWre3iafDJvRerv8ejfoChK9HAfpgiam3WoQ7WkACYG6zc4xkZZynwnw4widthdQ0Q04IU0″jmpQ =”600″>Scientists have actually noticed for a long time that there is a slight increase in blood sugar in some populations, initially using the two types of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). A term to define this part of the high-risk population who may develop diabetes in the future.
These two mouth-watering medical terms make it difficult for ordinary people and doctors to pay enough attention.
To this end, in 2001, the American Diabetes Association (ADA) used a more popular term- Pre-diabetes to replace “impaired fasting blood glucose” and “impaired glucose tolerance”, and it was quickly promoted to the world through the ADA diabetes guidelines [2].
The Expert Consensus on Prediabetes Intervention in Chinese Adults released in 2020 [1] shows that the prevalence of prediabetes in my country is 15.5%, and the estimated There are 148 million people, a number larger than the number of people with diabetes.
Of course, in reality, it is impossible for us to directly screen everyone for diabetes. Doctors usually first pass the risk of diabetes in China. score sheet to assess diabetes risk.
This form is suitable for 20-74 year olds, span>The score range is 0~51 points, the total score≥25< span draggable="true">Scores belong tohigh-risk groups, and need to undergo oral glucose tolerance test (OGTT) screening.
If you are interested, you can give yourself a score to see if you are a high-risk group.
(Chinese Diabetes Risk Score Table[1])
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Although prediabetes is not yet diabetes, and there are no obvious symptoms of “three more and one less”, if no intervention is given, about 5% to 10% of the prediabetes population will progress each year for diabetes [1,3].
In addition, prediabetes is also associated with the risk of cardiovascular disease, microangiopathy, tumors, dementia, depression and other diseases increase correlation.
So, before it develops into diabetes, we must find an opportunity to stop it in time.
Many people are very nervous when they hear “pre-diabetes”. But in fact, as long as active lifestyle intervention is carried out in time, the disease at this stage may be delayed.
How to intervene in prediabetes? Do you want to take hypoglycemic drugs?
The “Expert Consensus on Prediabetes Intervention in Chinese Adults” recommends not to take medicine in a hurry, The important thing is to control your weight first.
That is, through diet and exercise, you can improve your body mass index (BMI) ) at or close to 24kg/m2, or at least 5% body weight loss within 3 to 6 months, and maintained for a long time. (Note: BMI=weight (kg) ÷ height (m) square)
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Long-term lifestyle intervention can reduce the risk of diabetes by 39%~58%[4].
Why is weight control so important in prediabetes? This is because in obese and overweight people, due to excessive body fat, the cells are less sensitive to glucose, have a stronger demand for insulin, and the islet beta cells are overloaded for a long time, which is more likely to become diabetes /span>.
For overweight or obese people, reduce the total daily calories by at least 400~500 kcal (1 kcal = 4.184 kJ), and control the intake of saturated fatty acids It accounts for less than 30% of total fatty acid intake [1].
In terms of sports, priority should be given to running, swimming, cycling, aerobics, Tai Chi, table tennis, badminton and other medium-intensity (a little strenuous during exercise, Aerobic exercise with fast but not fast heartbeat and breathing) for no less than 30 minutes per day[1].
If you don’t want to be called by “diabetes”, you have to pay attention to the physical examination.
Everyone should develop the habit of regular physical examination and blood sugar measurement, early detection and early intervention for pre-diabetes, and nip the risk of diabetes in the bud.
“Healthy China Action (2019~2030)” Recommendation[5]:
People aged 40 and above should have their fasting blood glucose tested at least once a year;
For people with prediabetes, check fasting blood glucose or 2-hour postprandial blood glucose every 6 months.
Any one of the following characteristics is satisfied, and belongs to the high-risk groupdiabetes. It is recommended to check blood sugar once a year[ 4]:
(1) history of prediabetes;
(2) age ≥40 years old;
(3) Body mass index (BMI) ≥24kg/m2 and/or central obesity (waist circumference ≥90 cm for men, ≥85 cm for women) ;
(4) First-degree relatives with a history of diabetes;
(5) Lack of physical activity;
(6) Women with a history of macrosomia or gestational diabetes;
(7) Polycystic ovary syndrome women with a history of symptoms;
(8) with acanthosis nigricans;
(9) with a history of hypertension, or are receiving antihypertensive therapy;
(10) high-density lipoprotein cholesterol <0.90mmol/L and (or) triglyceride>2.22mmol/L, or Patients receiving lipid-lowering drugs;
(11) with a history of atherosclerotic cardiovascular disease;
( 12) History of steroid use;
(13) Long-term treatment with antipsychotics or antidepressants;
< span>(14) The total score of the Chinese Diabetes Risk Score ≥ 25.
In general, patients with prediabetes have Like standing at a crossroads, your blood sugar and where your body will go in the future are all in your own hands.
But please believe that as long as appropriate and regular life interventions are taken, it may be reversed to a normal blood sugar population and avoid the occurrence of diabetes.
Reviewer:
Guo Qiyu | Sixth Medical Center of Chinese People’s Liberation Army General Hospital Chief Physician of Department of Endocrinology
Luo Yingying | Deputy Chief Physician of Department of Endocrinology, Peking University People’s Hospital
References:< /strong>
[1]Endocrinology Branch of Chinese Medical Association, Diabetes Branch of Chinese Medical Association, Endocrinology and Metabolism Branch of Chinese Medical Doctor Association, etc. Expert consensus on intervention of prediabetes in Chinese adults[J]. Chinese Endocrinology and Metabolism Journal, 2020, 36(5):371-380
[2]Medical Progress or the welfare of pharmaceutical companies? Science magazine bombards the concept of prediabetes right and wrong. Physician Journal. https://mp.weixin.qq.com/s/wzL0ezoM8-_SO0XkCYj0Yw
[3]Knowler WC, Fowler SE, Hamman RF, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study[J]. Lancet , 2009, 374(9702):1677-1686. DOI: 10.1016/S0140-6736(09) 61457-4.
[4] Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition) Chapter 1-4. Chinese Journal of Diabetes. https://mp.weixin.qq.com/s/_P6kfSxa05IPEIKSyi34kw
[5] Healthy China Action (2019-2030) http://www.gov.cn/xinwen/2019-07/ 15/content_5409694.htm
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