What is the focus of diabetes management and treatment?

To put it bluntly, the core is not to lower blood sugar to "completely normal", but to stabilize blood sugar in a range that suits you under the premise of safety. At the same time, pay attention to early screening and prevention of complications, so that the management and control plan can adapt to your own rhythm of life. The most important thing is to be able to stick to it for a long time.

Uncle Zhang, who I met during a chronic disease follow-up in the community last month, is 52 years old and has just been diagnosed with type 2 diabetes for 3 months. He only eats boiled vegetables and only dares to eat less than half a bowl of rice. His fasting blood sugar is indeed 5.8mmol/L, but he is so weak that he can't even climb the third floor to gasp for breath. His glycated hemoglobin is up to standard, but his albumin is much lower, which is dragging down his body. What do you think this is? It is a typical example of taking "sugar control" as the only goal and going to extremes.

In fact, there is no completely unified “standard answer” for sugar control goals in the academic community. If you are under 40 years old, have just been diagnosed with diabetes, and have no underlying diseases, most people are recommended to control your sugar as strictly as possible, and keep your glycated hemoglobin stable within 6.5%. Many people can even achieve clinical remission through lifestyle adjustments and do not need to take medicine for several years.； However, if you are over 70 years old, have had a history of myocardial infarction or cerebral infarction, or live alone and are prone to hypoglycemia, excessively strict sugar control may cause syncope, falls, or even cardiovascular and cerebrovascular accidents. Many specialists will take the initiative to relax the sugar control target to 7.5% to 8%. If your blood sugar occasionally reaches 9 or 10, you don’t need to be too anxious.

When it comes to controlling sugar, it's like driving an old car. The blood sugar value is the tachometer on the dashboard. You can't just stare at the dashboard the whole time while driving. You have to look at the road conditions in front of you - that is, your own age, underlying diseases, physical tolerance, and your own driving habits. You can't force yourself to drive 10 yards to make the speed look better. On the contrary, it will delay the journey and make you more likely to be rear-ended.

The most easily overlooked thing for many people with diabetes is complication screening. Don’t think that it’s okay if your blood sugar is high and it doesn’t hurt or itch. Last year, I met a 41-year-old freight driver. He had never been screened for complications 6 years after he was diagnosed with diabetes. He always thought that he could eat and drink without problems. Last month, he saw ghosting and went to the hospital for a checkup. He already had stage III diabetic retinopathy. He might have been irreversibly blind in half a year. What a pity. In fact, if you spend more than 100 yuan a year on a fundus examination and a urine microalbumin test, you can detect the problem years in advance, and the intervention effect is much better. If you wait until symptoms appear, it is often already too late.

Don’t engage in those anti-human control plans. There used to be a young female sugar lover who loved to drink milk tea. She quit it for two months and couldn’t hold it in. She drank a whole cup of sugar tea at one time and her blood sugar soared to 17. Later I gave her an idea. When she wanted to drink it, just order three. If there is no added sugar, she only drinks half a cup each time and drinks it between meals. If she walks for an extra 20 minutes, her blood sugar will basically not fluctuate greatly. She has been controlling sugar for almost two years now, and she has never had a sudden spike in blood sugar. On the contrary, she can persist much better than people who have completely quit.

In fact, there are really not so many "musts" and "certainties" in diabetes management. The most important thing is to find a rhythm that suits you. Don't compare your blood sugar levels with others, and don't believe in any folk remedies. Just follow the doctor's plan in a down-to-earth manner, eat well and move well. It is not difficult to live peacefully with diabetes for decades.