Dr. Long Chelsea98.com Huizhou Education_Millions of Dragons Health
Every November 14th is United Nations Diabetes Day, commonly known as World Diabetes Day. It is a memorial day set by the World Health Organization and the International Diabetes Federation since 1991 to arouse the world's attention to the dangers of diabetes. November 14 is the birthday of Canadian scientist Banting. He discovered important insulin in 1921 and won the Nobel Prize in Medicine in 1923 for this reason.
The earliest human record of diabetes began in ancient Egypt in 1500 BC. In the following three thousand years of history, diabetes was regarded as a terrible terminal illness. Later, it was discovered that insulin in the body is a hormone that regulates blood sugar and is produced in the pancreas. Diabetes occurs when the pancreas cannot produce enough insulin or the body cannot effectively use the produced insulin.
It is a group of metabolic diseases characterized by hyperglycemia. As a representative of chronic diseases, it is bringing severe challenges and a heavy burden to global health care. In terms of pathogenesis, diabetes can be divided into two types, type I diabetes and type II diabetes. Type I diabetes is often caused by congenital factors. Patients cannot secrete insulin normally and must be supplemented by injection; while type II diabetes is mainly due to the patient’s resistance to insulin, which cannot play the normal role of lowering blood sugar in the body.
According to statistics from the World Health Organization, high blood sugar can cause more than 100 complications. Current clinical data show that more than half of diabetes deaths are caused by cardiovascular and cerebrovascular diseases, and 10% is caused by nephropathy. About 10 years after the onset, patients with 30%-40% will have at least one complication, and once the complication occurs, it is difficult to reverse it with medical treatment. Every 8 seconds in the world, one person dies of diabetes; every 5 minutes, one diabetic patient has a heart attack; every 30 seconds, one person is amputated due to diabetes; 90% type 2 diabetes cases can be prevented.
Hyperglycemia or elevated blood sugar is a common result of uncontrolled diabetes. Over time, it can cause serious damage to many systems of the body, which may damage the heart, blood vessels, eyes, kidneys and nerves. Adults with diabetes face two to three times the risk of heart attack and stroke. Foot neuropathy (damaged nerves), combined with reduced blood flow, increases the likelihood of foot ulcers, infections, and eventual amputation. Diabetic retinopathy is an important cause of blindness and is the result of long-term accumulation and damage to small blood vessels in the retina. The global blindness of 2.6% can be attributed to diabetes. Diabetes is one of the main causes of kidney failure.
Types of diabetes
In addition to type I, type II diabetes, gestational diabetes, childhood diabetes and Alzheimer's, and diabetes caused by drugs or diseases, there is also a kind of asymptomatic diabetes (ie impaired glucose tolerance, IGT patients); in addition, hypoglycemia also belongs to diabetic patients. But type II diabetes accounts for more than 90%.
In 2019, the International Diabetes Federation (International Diabetes Federation) released the 9th edition of the IDF Diabetes Atlas. According to the data given by the "IDF Global Diabetes Map (9th Edition)", there are currently an estimated 463 million adults (aged between 20-79) living with diabetes worldwide, accounting for 9.3 of the world's total population of this age group. %.
Currently, the top three countries with the largest number of diabetic patients in the world are India, China, and the United States; Type II diabetes is the mainstay of the diabetic population. It is estimated that 1.1 million children and adolescents (under the age of 20) currently suffer from type 1 diabetes. The number of people in this age group suffering from type 2 diabetes is still not counted. In 2019, the death toll due to diabetes and complications is estimated at 4.2 million. In addition, it is estimated that 20.4 million newborns will be affected by their mothers' hyperglycemia during pregnancy, accounting for 15.8% of the total newborns.
In terms of medical and health expenditure, the global annual medical and health expenditure on diabetes is estimated at 760 billion US dollars. It is estimated that by 2030, expenditures in this area will reach 825 billion U.S. dollars, and by 2045, the figure will reach 845 billion U.S. dollars.
Current status of diabetes in China
China currently has 121 million (excluding Hong Kong, Macao and Taiwan data) diabetic patients, ranking first in the world, and is expected to reach approximately 168 million in 2030. According to the statistical results after adjusting for age factors, the incidence of adult diabetes in mainland China is close to 10%, which is far higher than other countries and regions. According to the "Prevalence and Control of Diabetes in Adults in China" survey research shows that the awareness rate of Chinese diabetes patients is only 30.1%, and the treatment rate is only 25.8%.
According to the latest data from the International Diabetes Federation (IDF), in 2017, China's total expenditure on the treatment of diabetes and its complications was 385 billion yuan, ranking second in the world. The huge number of patients has brought a huge social and economic burden. Among the 121 million diabetic patients in China, less than half (46.4%) know that they have diabetes, and only those with less than 13% are effectively controlled. However, Chinese patients generally start late in medication and insulin, which is also a problem in diabetes management. Diagnosis and treatment of diabetes as early as possible will not only save considerable costs for the treatment of complications, active blood sugar control can also bring long-term health benefits and extend the life expectancy of diabetic patients.
Diabetes in the United States
Diabetes is the seventh leading cause of death in the United States. The latest research from the Centers for Disease Control and Prevention (CDC) shows that about 40% American adults will develop diabetes (mainly type II diabetes) during their lifetime, and the prevalence of diabetes in some ethnic minorities may even exceed 50%. A new report from HealthDay News on September 19, 2018 shows that one in seven Americans has diabetes, and many people don’t even know they have blood sugar disease.
According to the US Centers for Disease Control and Prevention, 14% of American adults have diabetes, of which 10% are aware of diabetes, more than 4% are undiagnosed, and 84.1 million people are on the verge of getting sick (prediabetes). According to statistics from the American Diabetes Association, 95% of diabetes cases are type 2, accounting for the vast majority, usually related to overweight or obesity; about 5% of diabetes cases are type 1, which may appear early in life and has nothing to do with lifestyle factors. If they are not treated in time, they will develop type 2 diabetes within 5 years, and most people in this group of people do not know that they are at risk of diabetes.
According to the report, nearly 16% of men have diabetes, and about 12% of women have diabetes. The proportion of men who are at risk of disease is 36.6%, which is higher than the 29.3% of women. In addition, the incidence of diagnosed and undiagnosed diabetes increases with age. In the 18-44-year-old population, the incidence of diabetes is 4%, the incidence of 45-64 years of age is 17%, and the incidence of 65-year-olds is 25%. In terms of population, the incidence of diabetes in Native Indians was 15.1%, 12.7% for Africans, 12.1% for Hispanics, and relatively low incidences for Asians and whites, 8% and 7.4%, respectively. White people’s disease statistics are always better, and it is related to many aspects such as social status, economic level, living habits, and education. In addition, the incidence rate for people who did not graduate from high school was 12.6%, the incidence rate for people who graduated from high school was 9.5%, and the incidence rate for people with a high school degree or above was 7.2%.
According to a report published by the United Health Group, a U.S. insurance company, in 2020, more than half of Americans will suffer from diabetes or have pre-diabetes symptoms, which will bring a burden of $3.35 trillion to the U.S. healthcare system. . The report titled "The Problem of Diabetes in the United States: Challenges and Opportunities in the Next Decade" stated that by 2020, the average annual expenditure for diabetes and pre-diabetes treatment will be nearly US$500 billion. In 2016, the cost of diabetes treatment was US$245 billion, accounting for about 20% of the total US medical expenditure. One-third of the medical expenses for diabetes in the United States goes to diabetic foot patients.
Status of diabetes in Canada
The vast majority of diabetes patients in Canada have type II diabetes, mainly due to overweight and long-term lack of exercise. According to the Canadian Medical Association, once you have diabetes, the risk of heart attack and stroke in adults will increase by 2-3 times. In particular, the nerves of the feet will also have pathological changes, resulting in nerve damage and reduced blood flow. Together, it increases the possibility of foot ulcers, infections, and eventually the need for amputation. At the same time, retinopathy caused by diabetes is a major cause of blindness. It is the result of long-term cumulative damage to small blood vessels in the retina. Currently, blindness of 2.6% in Canada can be attributed to diabetes, and diabetes is among the main causes of renal failure.
The annual direct and indirect costs and losses caused by diabetes in Canada are close to 3 billion Canadian dollars. According to statistics from the Canadian Diabetes Association, every year the provincial government subsidizes a type I diabetes patient, the annual insulin expenditure will increase between 2200 Canadian dollars and 4700 Canadian dollars, which undoubtedly increases the government's financial burden. In addition, Chinese Canadians are also a high-risk group of diabetes patients. In 2010, a special research team composed of diabetes experts and scholars from the York University School of Health conducted related research on high-risk groups of diabetes, including Chinese, South Asian, African and Caribbean. And prevention projects. At that time, this research project recruited 100 Chinese with high risk of diabetes, and the assessment of disease risk was mainly based on age (between 40-64 years), risk factors (family history, weight) and lack of exercise. In the end, it was found that one out of every three Chinese adults will develop diabetes in their lifetime.
Treatment and adjuvant treatment
Insulin is one of the core treatments for diabetes, which can effectively lower blood sugar and reduce complications and costs related to treatment of complications. Since humans used animal insulin to treat diabetes in 1920, in 100 years, about 9 major types of diabetes treatment drugs have been discovered and invented globally: sulfonylureas, biguanides, glycosidase inhibitors, insulins, Thiazolidinediones (TZDs), Glinides, GLP-1, DPP-IV inhibitors, SGLT-2 inhibitors. As the course of the disease progresses, patients' reliance on exogenous blood sugar control methods will gradually increase. According to the different stages of the patient's disease (the ability of pancreatic β-cells to secrete insulin gradually decreases), blood sugar control, complication risk status and other factors, there is often a clinical need for oral drugs and between oral drugs and injections of hypoglycemic drugs (insulin, GLP- 1 receptor agonist) combination therapy.
In China, half of the top ten diabetes drugs are insulin drugs, and the rest are common traditional drugs such as acarbose and metformin. On a global scale, the non-insulin drug market is dominated by the latest hypoglycemic drugs, including GLP- 1 Receptor agonists, DPP-4 inhibitors and SGLT-2 inhibitors, among which two drugs with GLP-1 mechanism are among the top five in sales of hypoglycemic drugs.
In order to inspire people to look for medicines that can cure diabetes, on July 7, 1989, Queen Eliza of the United Kingdom lit the Flame of Hope in Banting Square, London, Ontario, Canada. According to regulations, this torch will continue to burn until mankind finally discovers a cure for diabetes, and the inventor of this method will extinguish it himself. The Torch of Hope is a commemoration of Frederick Grant Banting, a Canadian doctor who discovered insulin. It is also a reminder to us. It reminds us that there are still countless patients suffering from diabetes. It reminds us that in the end There is still a lot of work to be done on the road to overcome diabetes.
Traditional Chinese medicine believes that diabetes often begins with obesity, gradually develops into "spleen spleen (dān)", and eventually turns to "diminish thirst" and cause various complications. Diabetes, literally means weight loss and thirst, which is often referred to as "three more and one less", that is, polydipsia, polyphagia, polyuria and weight loss. Chinese medicine divides diabetes into two categories: "spleen spleen" and "spleen spleen". "Spleen spleen" is a more common type, accounting for more than 80%. This part of patients is characterized by obesity, often accompanied by abnormalities in blood lipids, blood pressure and blood uric acid levels. Most of them are type 2 diabetic patients; "Spleen spleen" is mainly seen in type 1 Diabetes (including type I diabetes in children and late-onset autoimmune diabetes in adults, etc.) is characterized by weight loss when it occurs. Chinese medicine divides diabetes into 4 stages: depression, heat, deficiency, and injury, which correspond to the pre-diabetes, early, middle and late stages (complication stage) respectively.
A large number of studies and clinical practice have confirmed that "Chinese medicine cannot directly lower blood sugar" has become history. The simple application of traditional Chinese medicine compound (such as the combination of Chinese traditional medicine such as Coptis, Phellodendron chinensis, Zhimu, etc.) can not only achieve the hypoglycemic effect comparable to western medicine such as metformin, but also improve dyslipidemia, metabolic hypertension, hyperuricemia, obesity, etc Metabolic syndrome manifests, and has a certain effect on early and mid-term diabetes complications.
Although traditional Chinese medicine has good effects on lowering blood sugar, improving metabolic syndrome and diabetic complications, diabetes is still a lifestyle disease in the final analysis, and no matter how good medicine is, it cannot offset the impact of bad lifestyle habits. The "five carriages" theory is universally applicable in Chinese and Western medicine. It must be clear that Chinese medicine is not a panacea, and western medicine is needed when necessary. For example, when the pancreatic islet function of the patient is severely depleted, it must be treated with western medicine and insulin if necessary; in the late stage of diabetic foot, if the extremities are necrotic, amputation has to be done; the kidney disease develops to the end stage and can only rely on dialysis, etc. Ways to sustain life. For type I sugar lovers whose islet function is nearly exhausted, insulin must be controlled for sugar control. The role of Chinese medicine is to improve physical fitness.
3, Nutritional therapy and health management
For the symptoms of blood sugar, an organic combination of "hypoglycemic drugs", "appropriate exercise" and "diet management" must be achieved. Facts have proved that exercise is a good way to prevent and control diabetes blood sugar; and the health management of diabetes includes diet management, energy management and functional nutrition management.
(1) Diet management: Glycemic index (GI) is an indicator used to measure the increase in blood sugar within 2 hours of eating sugar. This concept was developed by Professor David J. Jenkins of the University of Toronto in Canada. It was developed by Jenkins and colleagues in 1980-1981 when they studied the most suitable diet for diabetic people. It was mainly used to measure the effect of sugar (carbohydrate) on blood sugar (Blood Sugar).
Food can be quickly decomposed in the process of digestion, and quickly release glucose into the circulatory system of the human body. It can be called high glycemic index (high GI); on the contrary, it can slowly decompose food and gradually release glucose into the human body. Sugars are called low glycemic index (low GI). Most medical institutions divide the glycemic index from 0-100 into three types: high glycemic index, medium glycemic index and low glycemic index. The higher the glycemic index, the easier it is to accelerate the increase in blood glucose concentration. In turn, it triggers a large amount of insulin secretion, which makes people easy to feel hungry and induce appetite and increase food intake. The consequence is that fat accumulates in the body in large quantities and quickly. Therefore, a low-GI diet can achieve the goal of blood sugar control and fat reduction. For details on how to choose and match, please pay attention to the "Canada Dr. Dragon Detox Body Sculpting Immune Repair Training Course".
(2) Energy management: Energy is a measure of the conversion of material movement. There can be multiple levels of mutual transformation between energy and matter, which can be expressed in various states, such as energy from outside the human body (the universe) and from inside the human body Energy (small universe). These states and transformations make the human body in a state of self-balance based on the overall view. Energy management is divided into three levels: energy from food, energy from oneself, and energy from the outside world.
Pre-diabetes or diabetic patients should accept an individualized energy balance plan, the goal is to achieve or maintain ideal weight, but also to meet the nutritional needs of different situations. Overweight or obese diabetic patients should lose weight. It is not recommended for type II diabetic patients to receive very low-energy (<800 kcal/d) nutritional therapy for a long time. For obese patients with diabetes, long-term diet (low energy intake) is not recommended! Weight control should be carried out under the guidance of a professional doctor or nutritionist! The energy provided by fat in the diet should account for 20%-30% of the total energy. The intake of saturated fatty acids should not exceed 7% of the total energy of the diet, and the intake of artificial trans fatty acids should be minimized.
Energy from oneself refers to the self-release and self-operation of energy, such as meditation, consciousness, meridian, blood qi, acupuncture points, etc.; energy from the outside refers to the acceptance and absorption of energy, such as music (music therapy), Hydrotherapy, and other natural treatments. For specific content, please pay attention to "Canada Boshilong Detox Body Sculpting Immune Repair Training Course".
(3) Nutrition management: It is mainly the intervention of functional nutrients or functional nutritional preparations. Microecological preparations (probiotics + growth factors + metabolites, etc.) can increase the abundance of intestinal flora in patients with type 2 diabetes, increase the diversity of intestinal flora, adjust the proportion of intestinal flora, improve sugar metabolism, and have a definite effect. Penicillin, curcumin, and coenzyme Q10 are the most critical nutrients to effectively improve type II diabetes. Others include proanthocyanidins, lycopene, ginkgo, gynostemma, spirulina, garlic essence, etc. In addition, diabetic patients are prone to lack of B vitamins, vitamin C, vitamin D, calcium, chromium, zinc, selenium, magnesium, iron, manganese and other micronutrients, which can be supplemented in appropriate amounts according to the results of nutritional assessment. Those who take metformin for a long time should prevent vitamin B12 deficiency. There are also some functional nutrients that can promote insulin secretion, repair pancreatic islet function, improve insulin resistance and so on. For specific content, please pay attention to "Canada Boshilong Detoxification Body Sculpting Immune Repair Training Course"
to sum up
Although WHO’s goal is to encourage and support effective measures to monitor, prevent and control diabetes and its complications, especially in low-income and middle-income countries, it is specific to each of our communities and families in order to avoid A series of health problems caused by elevated blood sugar can reduce the family’s extra financial or time expenditure, and reduce the family’s financial burden. The "Canada Boshilong Health Management Center" recommends the following health management principles:
1. Reach and maintain a healthy weight, even if it is genetically overweight or obese;
2. Persist in activities: regularly carry out at least 30 minutes of moderate-intensity activities to promote blood circulation;
3. Ensure a healthy diet: reduce the intake of refined rice noodle sugar and artificial additives;
4. Avoid using tobacco: Smoking increases the risk of diabetes and cardiovascular disease;
5. Regular physical examination, timely blood pressure, blood sugar and blood lipid, as well as screening and treatment of retinopathy;
6. Timely screen for early signs of diabetes-related kidney disease and initiate active treatment.
The "Health Management of Hyperglycemia and Diabetes Patients" series of lectures will be released in the near future. Friends who are interested, welcome to continue to pay attention to the blog post of the registered dietitian and registered health manager in Canada-Dr. Long.
2. International Diabetes Federation (IDF) Diabetes Map 9th Edition
6. "Nutrition Bible"
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Chelsea98.com--Wise Week Million Dragon's Great Health Project Dr. Kyle Long, registered dietitian, registered health manager, from Smart Week Smart Financial Education Group-Sincere, clear and efficient personalized FAH financial quotient and health quotient education