Abstract: In recent years, with the continuous improvement of living standards, diabetic patients have almost become the mainstream of patients in China. The harm of diabetes is becoming more and more serious, which may lead to acute and chronic complications such as ketoacidosis, including panretinopathy, neuropathy, paraplegia of lower limbs caused by vascular diseases and other serious sequelae. Starting with the etiology of diabetes, this paper understands the outbreak causes and clinical symptoms of diabetes, the concretization of diabetes classification in social development, and the different manifestations and reasons of different types. Popularize the clinical treatment methods and precautions of diabetes, and emphasize the importance of self-care for diabetic patients. In this regard, we should make greater efforts to study the prevention and treatment of diabetes.
Key words: diabetes self-management, diabetes classification, prevention and treatment methods, and future prospect.
Abstract: In recent years, with the continuous improvement of living standards, diabetic patients have almost become the mainstream of patients in China. The harm of diabetes is becoming more and more serious. It may lead to acute complications and chronic complications, such as ketoacidosis, including retinopathy and neuropathy, paraplegia caused by vascular diseases and other serious sequelae. Starting with the etiology of diabetes, this paper understands the causes and clinical symptoms of diabetes outbreak, the classification of diabetes in social development, and the different manifestations and reasons of different types. In order to popularize the clinical treatment methods and precautions of diabetes, the importance of self-care for diabetic patients should be emphasized. Therefore, we should make more efforts to study the prevention and treatment of diabetes in the future.
Keywords: diabetes self-management; Classification of diabetes; Prevention and treatment; Future prospects
catalogue
1 Etiology and prevalence of diabetes ..................... 3
2. 1 1 type diabetes .................................... IV
2.22 type diabetes ................................... 5
2.2. 1 genetic susceptibility .................................... 5
2.2.2 Insulin resistance and B cell dysfunction ............. 5
2.2.3 Abnormal glucose tolerance (TGP) and fasting blood glucose ..................... 5
2.2.4 Clinical Diabetes .................................... 6
2.3 ............................... such as gestational diabetes mellitus 6
3 unscientific self-management list of diabetes and correction of .......... VII
3. 1 Misunderstanding ..................................... VII
3.2 Dietary problems ..................................... VII
3.3 Sports ..................................... 8
3.4 Mental Health ..................................... 8
4 The importance and prospect of diabetes self-management ................. 9
5 Improper self-management of diabetes affects the life of the elderly. .......... 10
The elderly refer to the group after the age of 65, which is different from the vigorous posture of young adults. The elderly have irreversible damage to all parts of the body, and their physiological functions are gradually degraded, such as the decline of digestive system and metabolic function. Due to the weakness of the physical quality of the elderly, the incidence of the elderly has increased, especially among the elderly population, the incidence of diabetes ranks first. The elderly with diabetes accounts for 26% of the total elderly population every year, and this figure has been rising in recent years. Even more striking data is that nearly 6.5438+0.3 million elderly people die of diabetes every year.
With the improvement of the quality of life of the elderly and the weakening of exercise, the prevalence of diabetes [1] can not be underestimated. Moreover, diabetes has caused great physical and mental pain to many elderly people, and also brought great economic burden to these families. However, there is no one-off treatment for chronic diseases such as diabetes, which requires self-discipline and self-health control of the elderly to a greater extent, and requires a long-term struggle with diabetes.
First, the cause and incidence of diabetes
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia. Due to the absolute or relative deficiency of insulin secretion, the body's blood sugar rises. After suffering from diabetes, there are some typical characteristics: polyuria, polydipsia, polyphagia and emaciation. These methods are reference methods to judge whether the elderly have diabetes. There are three ways to accurately detect and judge whether the elderly have diabetes. The first way is to continuously detect whether the fasting venous blood glucose of the elderly is greater than or equal to 7.0mmol twice, the second way is to observe whether the postprandial blood glucose of the elderly is greater than or equal to11.1mmol/L, and the last way is that the blood glucose of the elderly is greater than or equal to1.65438 at any time. Once the above three examination results appear in the elderly, they should seek medical treatment immediately and follow the doctor's advice to achieve early detection and treatment. At the same time, insulin is decomposed from proinsulin. Every time an insulin molecule is produced, a C peptide molecule is produced. C-peptide can detect its own insulin secretion, which is very helpful to distinguish different types of diabetes.
According to the report of the World Health Organization, in 20 19, about 382 million people in the world suffered from diabetes, among which the number of diabetic patients in China was 65,438+1440,000, ranking first in the world. In 2008, 9.7% of adults in China suffered from diabetes, which increased to 65,438+0.6% in 2065,438+00. What shocking evidence, and the number of diabetic patients is still growing. Based on this data, many scholars predict that the number of diabetic patients in the world will reach 578.4 million in 2030, and will continue to rise in 2045, which is most likely to be achieved. According to the data of 20 19 years, about 1 1 people have diabetes, and according to the data of 2030, about 1 people will have diabetes. What about 2045? In the long run, diabetes is self-evident. As a chronic disease, we should know more clearly how much economic troubles refractory treatment will bring to patients' families, and more and more people and families will gradually get into trouble or even fall apart because of the demon of diabetes. In addition to the intrusion of its own reasons, the complications of diabetes are various, from diabetic neuropathy to cardiovascular disease, which can not be ignored and cannot be completely cured. According to the analysis of the existing data, it can be concluded that about 15% of diabetic patients will eventually suffer from diabetic foot disease for various reasons, of which about 80% of diabetic foot patients may be amputated because of the disease, and the risk of lower limb amputation of diabetic patients is more than 15 times that of non-diabetic patients [2]. The main method to eliminate this kind of disease is the focus and significance of this paper, that is, a comprehensive understanding of diabetes.
Second, the classification of diabetes
Diabetes mellitus is a general term for insufficient adrenaline secretion. In fact, the classification of diabetes can be roughly divided into three categories.
1 type diabetes mellitus
The cause of this type is diabetic ketoacidosis caused by insufficient insulin secretion caused by the destruction or dysfunction of islet B cells. 1 type diabetes is due to the absolute lack of insulin secretion in the body, so the oral drugs for treating 1 type insulin are completely ineffective and can only be supplemented by lifelong injection. The second classification of 1 insulin is autoimmune and specific. Autoimmune diabetes can be divided into acute and slow types due to the onset time. Acute diabetes usually begins in adolescence and is prone to diabetic ketoacidosis. Chronic autoimmune diabetes, also known as adult delayed autoimmune diabetes, usually occurs between the ages of 20 and 48.
(2) Type 2 diabetes
Type 2 diabetes is the highest incidence type in diabetes classification, with an incidence rate of 95%. Its pathogenesis has obvious genetic basis, insulin resistance and abnormal B cell secretion. However, the main reasons can be analyzed from heredity and improper diet, such as increased physical load, too little exercise, too much life pressure and excessive drinking. The onset stage of this type of diabetes is divided into four stages [3]:
① Genetic susceptibility: On the basis of genetic characteristics, it is more induced by environmental factors. We can start with the aging population, obesity, reduced exercise and sudden increase in pressure, forcing the genetic genes of diabetes to be activated.
② Insulin resistance and B cell dysfunction.
Insulin resistance and insufficient insulin secretion are long-term causes. As the two main factors of type 2 diabetes, they have been lurking for many years before the onset of diabetes, looking for opportunities and waiting for opportunities.
③ Impaired glucose tolerance (TGP) and impaired fasting glucose regulation (IFG).
Generally speaking, TGP is more a manifestation of pre-diabetes, especially a type of glucose intolerance; IFG is a non-diabetic fasting hyperglycemia, and its blood sugar concentration is higher than the normal value, but lower than the judgment value of diabetes. They all represent the metabolic state between normal glucose homeostasis and hyperglycemia in diabetes, indicating that their regulation is impaired.
④ Clinical diabetes
At this stage, the erosion rate of diabetes on the body is accelerated, but due to their different physical conditions, some bodies have no obvious symptoms, some are accompanied by metabolic disorders, and even diabetic complications occur. At this stage, the secretion function of islet gradually fails, the secretion function decreases, the insulin resistance increases, the sensitivity of peripheral tissues and organs such as adipose tissue and muscle tissue to insulin decreases obviously, the intake and utilization of glucose are insufficient, the inhibitory effect of insulin on the glucose output of liver is weakened, and the glucose output is serious, thus causing postprandial blood sugar to increase, resulting in fasting and postprandial persistent hyperglycemia. In severe cases, islet B cell failure may occur, and basic insulin secretion is insufficient to suffer from ketosis [4].
(3), gestational diabetes.
The onset of this type of diabetes is concentrated in pregnancy, which can be avoided by controlling diet and proper exercise during pregnancy [5]. Even if this type of diabetes will recover after delivery, 22%-50% of pregnant women will develop type 2 diabetes, and there is a 50% chance of recurrence when they are pregnant again [5]. On the other hand, gestational diabetes has to be emphasized that if the blood sugar of pregnant women is not well controlled during pregnancy, their children are likely to suffer from metabolic syndrome such as diabetes and obesity [6].
Third, list and correct the unscientific self-management of diabetes
The self-management of diabetes must follow a scientific and reasonable prevention and treatment plan, which will get twice the result with half the effort in the prevention and treatment of diabetes, but an unreasonable self-management will definitely make patients wallow in the depths, aggravate their illness and lead to complications of diabetes [7]. Therefore, sorting out the misunderstanding of diabetes self-management and guiding and correcting it can greatly avoid unscientific diabetes self-management and be of great help to patients and their families [7].
(A) misunderstanding
A set of data released on 20 17 shows that in China, one person will suffer from cancer every 30 seconds, one person will suffer from diabetes every 30 seconds, and at least one person will die of cardiovascular and cerebrovascular diseases every 30 seconds, which also creates another situation. Some patients and their families are concerned about diabetes and have cognitive errors. They think that once they get diabetes, they will be sentenced to death, thus giving up treatment and leading to. Another part of the patients didn't care much about diabetes in the early stage because they didn't have obvious symptoms of diabetes, so they felt "it doesn't matter" and "I'm not sick, just eat well". Some patients even give up continuing treatment and think that they have recovered after using drugs, but they will face more serious consequences [9].
(2) Dietary problems
Diabetic patients must pay attention to a balanced diet and a reasonable collocation in their daily diet. The daily calorie intake of patients is mainly provided by carbohydrates, protein and fat [10]. In addition, other substances in the human body, such as water, trace elements, vitamins, mineral salts, etc., are used as auxiliary substances to balance human nutrition. However, some pessimists think that there is not much time left, so they eat a lot and think that they should not "treat themselves badly"; There are also patients who use hunger therapy, which leads to nutritional deficiency. In fact, the above two psychological understandings are incomplete and incorrect. People with diabetes need to control their intake, but that doesn't mean they have to bear the shackles of dieting [1 1].
Because the daily calorie intake of diabetic patients should remain basically unchanged, some patients may choose unchangeable dietary substances in order not to make mistakes, ignoring the diversity of diet [12], which will cause patients' boredom. In the diet management of diabetes, patients' diet can be changed under the condition of keeping the calorie intake unchanged [13]. At the same time, don't plan your meal time. Irregular eating time and quantity is extremely unfavorable to the self-management of diabetic patients. Diabetic patients should eat less and eat more, eat regularly and quantitatively, and quit smoking and drinking [14].
Sports problems
Because the body of the elderly can't bear high-intensity exercise, more and more elderly people choose to rest at home, but scientific adjustment shows that proper exercise is helpful to the health of the elderly. What about diabetics? Kunming Xinhua News Agency reported on May 9th that 20 18: Scientists of the Chinese Academy of Sciences conducted a four-year experiment on macaques. The final data of this experiment reveals that obesity is the chief culprit of diabetes and confirms that diabetes is an independent risk factor. This achievement has been published in the international journal American Physiology-Endocrinology and Metabolism. Liang Binru, a researcher at Kunming Institute of Zoology, Chinese Academy of Sciences, said that the relationship between obesity and diabetes is simply that during the transition from obesity to diabetes, the energy metabolism of human liver has changed, and fat has accumulated to branched-chain amino acids for degradation. Therefore, it is recommended that diabetics exercise more, such as some low-intensity aerobic exercise, walking, Tai Chi, diabolo, square dance and other sports. Compared with living at home, going out to exercise is of great help to the physical and mental health of diabetic patients [15]. However, some patients are confident in their physical and mental quality, and may choose a kind of strength exercise such as pull-ups and push-ups, but this is very irrational. According to the analysis of medical data, strength exercise usually obviously increases the patient's heart load in a short time, which is very likely to cause heart disease [16].
mental health
According to scientific analysis, some diabetic patients are psychologically prone to depression after suffering from diabetes, and the probability of mental patients suffering from depression is much greater than that of ordinary people, which is particularly obvious in elderly diabetic patients. Especially due to the repeated illness, patients may feel tired of interpersonal communication, lethargy, loss of appetite and even falls, but more because we can't empathize with patients, it is difficult for us to understand the psychological changes of diabetic patients and then ignore them. Once a patient has a tendency to disobey the doctor's advice and resist treatment, it is often difficult for family members to understand, resulting in contradictions between patients and their families and worsening patients' mood [17].
In the daily treatment of diabetic patients, psychological treatment can be appropriately increased to reduce the psychological burden of diabetic patients. In daily life, communication between patients and their families is also essential. The two go hand in hand, which can deeply understand the inner world of patients to a great extent, and then solve the psychological problems of patients [18].
The Importance and Prospect of Diabetes Self-management
Up to now, the incidence and disability rate of diabetes are still high and difficult to cure, but a reasonable and feasible diabetes self-management system will effectively curb the incidence of diabetes. Self-management of diabetic patients is a set of social ecological model based on the patient level, aiming at controlling the blood sugar drawn by diabetes, so as to achieve the purpose of stabilizing the disease and preventing diabetic complications. Self-management of diabetes can improve patients' health and happiness index [19].
At present, diabetes self-management is mainly divided into four categories: diet control, exercise control, psychological examination and drug management. Based on drug management, that is, self-management of patients in accordance with doctor's advice. Scientific research has proved that the perfection of self-management system is directly related to the life span of patients. Therefore, the treatment of diabetes depends more on self-management in life [20].
In the treatment of diabetes, we should actively mobilize all social resources around us to create an efficient and convenient way for diabetic patients, so that patients have enough space and medical level to improve their self-management ability [2 1]. At the medical level, it is necessary to allocate more resources to diabetic patients, strengthen the research and clinical trials of new drugs for treating diabetes, mix Chinese herbal medicine with western medicine, explore ways, and also consider artificial intelligence. It may also help us to conquer diabetes and prevent diabetes from becoming a intractable disease that will plague China society in the future. At the social level, give more help to diabetic patients, help their families with financial burden, and carry out psychological treatment; At the same time, increase the propaganda of diabetes, so that ordinary people have a certain degree of understanding of diabetes, so as to achieve early detection and early prevention [22]. And provide some self-management reference for some patients' families to avoid the patient management deviation caused by knowledge blind area. With the development of medical level in the world and even in China, the cure of diabetes will be greatly improved. Through the active supervision of patients' families and patients' self-management, all walks of life make joint efforts to create good medical conditions for diabetic patients. With the improvement of the treatment level and self-management level of diabetic patients in China, it is believed that the gospel of diabetic patients in the future can be expected [23].
Influence of improper self-management of diabetes on the life of the elderly
For long-term diabetic patients, the level of self-management determines the quality of life. Middle-aged and elderly people occupy the main position in the high-risk group of diabetes [24], so the elderly play a key role in self-management and nursing of diabetes. From the social point of view, this task is not simple. Because there are many empty nesters in society now, children have gone out to work, and the perfection of self-management cannot be completely guaranteed. [25]① The lack of knowledge about diabetes among the elderly makes it impossible for them to fully grasp many points of self-management and evaluate their physical health completely and correctly. Including the confusion of family members' knowledge about diabetes [26], may lead to the decline of the comfort of the elderly and temporarily restrict travel. Blind treatment may lead to further deterioration of diabetes. ② Self-management On the basis of understanding the basic knowledge, we began to control diet and exercise. The old man's body is degraded and his exercise endurance is poor. If self-management is improper, it may lead to more serious complications, such as ketoacidosis [27], diabetic renal failure and respiratory failure or paraplegia caused by vascular diseases, which will aggravate the life tragedy of the elderly. In the face of the far-reaching influence of improper self-management of diabetes, it is even worse in the little time left by the elderly, so the elderly are enjoying a happy old age while doing self-management well [28].
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