Author: Chen Gang doctor
"pipe shut, stride leg" is the basis of magic diabetes diagnosis and treatment.
However, there are so many people who cannot move their legs, such as stroke patients, fracture patients, paraplegia patients, etc.
Sugar friends who can’t control their diet, they can’t control their mouths, and there are many clinically, and most of them are fat (hahaha), often in the following situations:
1, I don’t want to control it; z0, want to control it, But it can’t be controlled, it belongs to the kind of weak willpower: nostalgia for food, nostalgia for friends gathering;
3, there are many people who have no ability or awareness of self-control at all, such as mentally retarded patients, many stubborn elderly .
I remember a dozen years ago, a sugar friend in her 50s was hospitalized. I asked her: Can I control my diet?
Answer: No.
What can you do if you don't let it eat? For example, you love bananas, but your child takes away the banana in front of you.
I cry and throw things.
There are many sugar control experts on the Internet, and the same expert as oil sellers: the estimated results of blood sugar measurement when you eat how much food is almost the same as the actual measured value.
read my "Doctor Chen Gang talks about sugar", and I have been persuading sugar friends to learn about diet. It is even said that sugar lovers who do not manage their diet and exercise are very difficult to control blood sugar.
For obese people with diabetes, less exercise and more eating are the only rules. However, there are indeed many people who have eaten very little and have not lost weight. In fact, the human body is not a simple machine. When you eat very little, your body will activate the "starvation protection" mode, and your body's basal metabolic rate will be lowered to cope with your "less eating". Once you let go of your diet a little bit, this "protection" will make you feel: "You will grow more flesh if you drink cold water." To truly achieve weight loss, you must "grind your teeth" and persist. To survive this "self-protection period", you must persist for at least half a year to truly benefit from the improvement of weight.
For these fat sugars, patients who fail to control their diet or are very difficult for various reasons, there is no need to blame themselves too much. Is the body such a machine? What can I do about
?
When you have worked very hard, you still can’t control your diet, you still have a good appetite, and you’re still fat, sugar friends: you might as well try these solutions.
Bariatric Surgery:
Regarding metabolic surgery, China’s Type 2 Diabetes Prevention and Control Guidelines stipulate: “For those aged 18-60, generally in good condition, with low surgical risk, type 2 diabetes that is difficult to control through lifestyle intervention or various medications Or patients with type 2 diabetes who have concomitant diseases and meet the following conditions can refer to metabolic surgery: 1. For type 2 diabetes with or without comorbidities, BMI ≥ 32.5 kg/m2, metabolic surgery is feasible.” For BMI <32.5>
In other words, if you really can’t control your diet and cause a very fat sugar friend, you can consider surgery.
makes you so edible, I will control your gastrointestinal tract first, hahaha. What is the concept of
BMI32.5kg/m2?
Answer: It is 170cm tall and 94kg weight.
was taken for not controlling my diet, I would definitely not choose it.
Metformin :
For obese patients with type 2 diabetes, metformin has always been the first choice. It can improve insulin sensitivity, inhibit glycogen output, and inhibit glucose absorption. These are all introductions in textbooks.
Metformin can suppress appetite. For obese sugar lovers, try not to choose insulin or sulfonylurea secretion promoters that promote appetite, and the maximum amount of metformin can be used, which is 2000-2550 mg per day. The role of
glycosidase inhibitor
glycosidase inhibitor is to slow down the decomposition of starch in food into glucose, thereby slowing down the absorption of glucose, or leaving a part of it without being absorbed. Z5z
GLP-1 receptor agonists
and other drugs can stimulate insulin secretion, inhibit glucagon, and reduce blood sugar. It has many extra-pancreatic effects: it can slow down the peristalsis of the gastrointestinal tract, delay the emptying of the gastrointestinal tract, and can also reduce the output of glycogen. It can also suppress appetite, reduce food intake, and so on.
Among these drugs, liraglutide has been approved for weight loss in the United States.
SGLT2 inhibitor
Glucose in the blood of normal people will be reabsorbed into the blood after being filtered from the glomerulus into the renal tubules, so there will be no glucose in the urine. When blood sugar exceeds a certain range and the reabsorption capacity of renal tubules reaches the limit, urine sugar will appear. Such drugs as
inhibit the reabsorption of glucose in the renal tubules, so that more glucose is eliminated from the body.
The 24-hour urine glucose excretion of the three types of SGLT2 inhibitors in the FDA instructions:
In other words, one tablet of dapagliflozin a day will excrete 70g of glucose in 24 hours, which is equivalent to 4 taels of rice. The other SGLT2 inhibitor is similar.
Therefore, such drugs can reduce weight.
eat a lot, but you need to change the diet
for diabetic people who have a good appetite and want to pursue "satisfaction", you can also experiment with changing diet. For example, the more popular "ketogenic diet". The
ketogenic diet means that the amount of carbohydrates in the daily diet should be strictly controlled, and the calorie ratio is more recommended:
- 55%~60% of the calories come from fat
- 30%~35% of the calories come from protein
- 5%~10% of the calories come from carbohydrates It is also very difficult for the compound
to completely achieve this kind of eating. However, it is necessary to reduce the amount of staple food for each meal, and appropriately increase meat, dried fruits, vegetables, etc., or consider experimenting.
Homemade vegan steak
There is also a popular " light fasting " in the field of weight loss:
The most popular one is the "5/2 fasting method". It is a new method of weight loss initiated by the British medical doctor Michael Moseley, that is, for 2 non-consecutive days of the week, women only consume 500 kcal per day or men 600 kcal of energy food, and free diet for the remaining 5 days , Do not control.
It is advisable to choose some foods with high protein content but low glycemic index within two days of fasting. It is not recommended to completely ban carbohydrates, but you should try to avoid eating foods with high calories and high glycemic index.
There is also a kind of "light fasting" which is "no food after lunch". It is to eat breakfast and lunch normally, and stop eating carbohydrates and other foods after lunch. In this way, there is more than 16-18 hours of non-staple food for 24 hours a day.For dinner, eat some lean meat, vegetables, and a small amount of dried fruit.
For obese people with diabetes who have difficulty in controlling their diet, one or more of the above options can be selected. The above-mentioned programs are all treatment strategies for low blood sugar and low risk. If blood sugar is not up to standard, the maximum dose can be used gradually. Some of them ideologically suppress appetite to eat less; some can suppress the absorption of food and act as a "passing through the intestine pattern" of being eaten and pulled out; some are absorbed after eating, but are "urinated" again; Eating changes the dietary structure, and has the effect of "eat a meal and a full episode" (eating a meal, eat more meat with index fingers; a full episode, a gathering, is a rural assembly, usually every 3-5 days).
When these methods are exhausted, blood sugar is still very unsatisfactory. Adding insulin should start with long-acting insulin analogs that have low risk of hypoglycemia and relatively weak appetite stimulation.
Many people use the "strengthening program" with 4 injections again. Don't you know that the appetite stimulation effect of insulin has poor diet management and self-control sugar friends. In many cases: . Think twice before using
.
is really not good, you can only recognize that your blood sugar is in a higher range.
has been said since ancient times: fish and bear paw can not have both!
Last month, a friend brought a 42-year-old obese, single, and mentally handicapped patient. He had just diagnosed diabetes and had a fasting blood sugar of 16.5mmol/L. I told him that in theory, for a newly diagnosed type 2 diabetes, short-term insulin intensification is the best option, and many people can induce "clinical remission." However, it is difficult for him who is mentally disabled to go home and rely on his old mother to take care of him. I prescribed: Metformin extended-release tablets gradually increased to 1500 mg per day, dapagliflozin, 10 mg per day. The frequency of taking medicine, once a day, is good enough to be able to persist.
is not the best, only better.
International studies have shown that for obese diabetics, if they lose 15 kg in one year, 86% of diabetics can achieve "clinical relief." However, there are so many people who lose weight, how many percent of them can really lose weight? People who have this perseverance or self-discipline may rarely get diabetes.
Stealing your mouth and opening your legs are always the most economical and basic sugar control magic weapon.
Don’t seek comfort for yourself, I hope all beings are free from suffering
