Hyperuricemia and diabetes are both metabolic diseases, and both share a common pathogenesis—overnutrition, and both are clearly related to insulin resistance, and both are related to risk factors such as diet and alcohol intake. Risk factors for vascular disease. So, what should we do when hyperuricemia meets diabetes?
Hyperuricemia refers to the fasting blood uric acid level of >420μmol/L (7mg/dl) in males and >360μmol/L (6mg/dl) in females under the normal diet. Gout is caused by the deposition of urate crystals in joints, soft tissues and kidneys, causing arthritis, skin lesions and kidney damage, which are different states of the same disease.
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia due to disorder of human glucose metabolism.
If you have hyperuricemia and diabetes at the same time, treatment may be in a dilemma. Diabetes treatment requires more exercise, while active arthritis caused by hyperuricemia restricts excessive exercise; diabetes advocates high-protein, low-calorie diet, and hyperuricemia strictly controls meat intake, etc.; certain hypoglycemic drugs May also affect purine metabolism.
When hyperuricemia meets diabetes, experts suggest that the following 4 points can be treated:
1. Adjust the diet structure and control the total calories in the diet
(1) Low carbohydrate diet. Controlling staple foods helps control blood sugar.
(2) Eat more fruits and vegetables rich in dietary fiber, VitB1 and VitC. Gout patients can eat lemons, cherries and olives, most melons, tubers, roots and most leafy vegetables, watermelons, coconuts, grapes, strawberries, plums and peaches can be eaten in moderation. These fruits and vegetables can effectively prevent and control In gout, dietary fiber can increase insulin sensitivity. At the same time, it is not advisable to eat more plant foods with high purine content such as mushrooms, straw mushrooms, asparagus, seaweed, kelp and grain germ, and reduce some fruits (apples, bananas, figs, pears, oranges, longan, lychees, grapefruit, persimmon and Pomegranate, etc.), vegetables (beets, lotus roots, water chestnuts, etc.) and other fruits and vegetables with high fructose intake, but also avoid drinking alcohol.
(3) Drink more water. Increasing water intake can be one of the measures of non-drug treatment for gout patients. In the absence of kidney disease, heart failure and other contraindications, it is recommended that patients with gout drink water, with a total daily water intake of 2 to 3L; it is recommended to drink water in divided doses, and the amount of water to be drunk three times in the morning, afternoon and evening reaches about 500ml; try to choose weak Alkaline, small-molecule water; you can drink lemonade (such as 1-2 fresh lemon slices added to 2-3L of water); soft drinks are prohibited.
(4) When gout patients eat animal food, they should pay attention to the type, quantity and processing method. Avoid eating animal offal such as liver, kidney, heart, intestine, etc., choose milk, eggs and moderate amount of non-mammalian meat (including chicken, duck, goose and some freshwater fish, etc.) with lower purine content. The meat should be mainly lean meat. The daily meat intake should not exceed 100g. Try to eat fresh meat. It is recommended to discard soup after boiling. Avoid using too much salt, sugar and spices. During the acute phase, all meat should be fasted.
2. Choose drugs that have little effect on uric acid
When choosing drugs, pay attention to the following 4 kinds of drugs:
hypoglycemic drugs. Insulin and sulfonylureas (glimepiride, gliclazide) have a certain effect on uric acid, and the use of the above drugs should be weighed.
Diuretics. Thiazide diuretics (hydrochlorothiazide) and loop diuretics (furosemide) can affect uric acid excretion and induce increased blood sugar, while potassium-sparing diuretics (spironolactone, triamterene) can promote uric acid excretion.
An antihypertensive drug. ARBs are the first choice for antihypertensive drugs in hyperuricemia patients with diabetes mellitus. ARB has the effect of lowering uric acid, and angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) can reduce insulin resistance.
Glucocorticoids. Glucocorticoids can increase weight, insulin resistance, and should be avoided as much as possible during gout attacks.
3. Weight Management
Adipose tissue can produce and secrete more uric acid and increase insulin resistance. Body mass index is positively correlated with the incidence of gout. Abdominal obesity can also increase the risk of gout. Weight loss can reduce blood uric acid levels and reduce gout attacks.
4. Regular and moderate exercise
Low-intensity aerobic exercise can reduce the incidence of gout, while moderate-to-high-intensity exercise may reduce uric acid excretion and increase serum uric acid levels. Levels rise, but increase the incidence of gout. Therefore, proper exercise can be used as one of the non-drug treatment measures. Please keep in mind the 5 exercise principles:
Patients with hyperuricemia are advised to exercise regularly; exercise for gout patients should start at low intensity, gradually transition to moderate intensity, avoid strenuous exercise, and rest mainly in the acute phase of gout , interrupt the exercise; the number of exercise should be 4 to 5 times a week, 0.5 to 1 hour each time, you can choose jogging, tai chi and other methods; during or after exercise, avoid drinking a lot of water quickly, and drink water in moderation to promote uric acid excretion ; People with underlying cardiovascular and pulmonary diseases should moderately reduce exercise intensity and exercise time.
This article is scientifically checked by Wang Tao, chairman of the Medical Science Popularization Special Committee of China Science Writers Association.
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