1, poor blood sugar control, heart disease
Diabetes is not only the fluctuation of blood sugar level, long-term poor blood sugar control, may be complicated with cardiovascular disease, induce myocardial infarction and die! The doctor said that the current guidelines for the treatment of diabetes suggest that hypoglycemic drugs should take into account the role of protecting cardiovascular health, but the application targets are different. Sugar friends can communicate with doctors in detail before use, so as to avoid stepping on mines by mistake and greatly reduce the health care effect.
According to the top ten causes of death in 65438+2004 recently published by the Ministry of Health and Welfare, diabetes * * * caused 9530 deaths, ranking fifth. In addition, diabetes itself is a systemic metabolic disorder, and long-term poor blood sugar control will also cause diseases and dysfunction of other organs and functions. Cardiovascular disease is an obvious example.
Wu Zhuo, an attending physician at the headquarters of National Taiwan University Hospital, said that diabetic patients in China have different degrees of cardiovascular diseases, ranging from hypertension, hyperlipidemia and metabolic syndrome to arteriosclerosis, coronary artery stenosis and even myocardial infarction, accounting for about 2-50% of the total. It can be seen that hypoglycemic drugs need to take into account the importance of heart and cardiovascular health.
2, control blood sugar to protect the heart.
The concept of controlling sugar while protecting the heart originated from the rosiglitazone incident in 2007. At that time, it was pointed out that hypoglycemic agents containing such ingredients would increase the risk of cardiovascular disease, myocardial ischemia and myocardial infarction, which caused controversy. Let the US Food and Drug Administration (FDA) order that all new diabetes drugs produced since 2008 must have research with this cardiovascular event as the main end point, and conduct clinical trial follow-up for 3 to 5 years to determine the safety of the drugs and not harm cardiovascular health before they are allowed to go on the market.
Dr. Wu Zhuo _ said that the new generation of diabetes drugs are not only safe to use, including GLP- 1 (glucagon-like peptide) drugs for injection and SGLT-2(_- glucose transporter) inhibitors for oral use, but even five years of randomized clinical trials have confirmed that they have a positive protective effect on the heart and blood vessels, and can reduce the complications of cardiovascular diseases, coronary arteriosclerosis and occlusion.
Because of the different mechanisms and functions of various diabetes drugs, the guidelines for diabetes drug treatment published by American Association of Clinical Secretory Doctors (AACE) suggest that metformin is still the first choice for the treatment of type 2 diabetes, but if the patient's blood sugar is too high or the treatment effect cannot be achieved by single use, it is suggested that GLP- 1 drug or SGLT-2 inhibitor can be used instead or in combination. As for sulfonylureas (sulfonylureas), they may affect the cardiovascular system and cause the risk of hypoglycemia, so they are the sugar control drugs selected in the later stage.
The current guidelines for the treatment of diabetes suggest that hypoglycemic drugs should consider the role of protecting cardiovascular health.
3. Carefully choose heart-protecting and hypoglycemic drugs.
Dr. Wu Zhuo explained that oral SGLT-2 inhibitor can inhibit the absorption mechanism of renal sugar and lower blood sugar, which is not only suitable for people with poor renal function, but also not suitable for patients with three highs. Such drugs may cause dehydration of the body and infection of the female private parts outside the female genitals. In addition, although it can reduce the risk of cardiovascular diseases, it has a relatively weak protective effect on acute and severe diseases such as myocardial infarction and stroke.
GLP- 1 drugs stimulate the pancreas to secrete insulin, which is similar to the natural secretion metabolism of human body, and achieves the function of regulating and stabilizing blood sugar. There will be no coma caused by hypoglycemia, suitable for most diabetic friends. In particular, incretin itself has anti-inflammatory and antioxidant effects, which can reduce the risk of coronary heart disease. 105 also found that GLP- 1 drug can protect cardiovascular health. Long-term use can significantly reduce 13% of major cardiovascular adverse events, significantly reduce the mortality rate of cardiovascular diseases by 22%, and significantly reduce all-cause deaths.
Dr. Wu Zhuo pointed out that in addition, obese people who used GLP- 1 drugs in large doses abroad to lose weight, with a body mass index of more than 30, lost an average of 5 to 8 kilograms after 56 weeks of continuous use; After three years of follow-up, the average weight of diabetic patients who continue to use it has also dropped by 3 to 5 kilograms, breaking the stereotype that ordinary people are easy to gain weight by controlling sugar through injection.
4. Insulin is independent.
Lifelong injection? New sugar control drugs for injection are not afraid of dependence.
Dr. Wu Zhuo said that diabetics in China love to take medicine to control their blood sugar, fearing that once they get an injection, they will never get rid of it. In fact, there is more than one drug to treat blood sugar by injection. The traditional insulin is to directly supplement the insulin that the human body lacks, but with the weakening of insulin secretion function of pancreatic β cells, the dosage is increasing.
GLP- 1 Drugs promote the human body to naturally and stably secrete incretin, which is the original intestinal hormone of human body, so there is no need to worry about dependence. Dr. Wu also stressed that controlling blood sugar cannot rely solely on drugs. People who love sugar should also pay attention to a balanced diet, regular exercise and multi-pronged approach to stabilize blood sugar.
5. Prevention of diabetes
1, change bad eating habits
Adjust the diet structure reasonably and control the intake of protein, fat and sugar. Some people worry that eating more fat will lead to high blood pressure and arteriosclerosis, and correspondingly increase carbohydrate intake, which just provides regulation for the occurrence of diabetes.
2. Increase activity.
Exercise can improve the function of endocrine system, increase the body's disease resistance, inhibit obesity, lose weight, improve fat metabolism and promote glucose oxidation.
Step 3 cheer up.
When you are in a good mood, you should treat unpleasant things calmly and properly to avoid impatience.
4. Have a regular physical examination.
Test blood sugar and urine sugar, and actively strengthen prevention when impaired glucose tolerance is found.