DIABETES

1) WHAT IS DIABETES?

Diabetes mellitus, also known as diabetes, is a chronic disease in which the body does not produce enough insulin, or cannot use insulin. Normally, starches, sugars, and other nutrients are broken down into glucose, which is carried by the blood to the cells. The cells use insulin, a hormone secreted by the pancreas, to help convert glucose into energy. If there is not enough insulin, or insulin is not used properly, glucose builds up in the blood and urine, which can cause many health problems.

2) DOCTOR, WHICH KIND OF PEOPLE COMMONLY HAVE DIABETES?

Diabetes can occur at any age or gender. However, some groups of people are still at high risk, such as people with high blood pressure, untreated dyslipidemia or abdominal obesity, people with little exercise, people who eat a lot of energy-rich foods such as fat, sweets, people who are often stressed and especially families with parents or siblings with diabetes.

In addition, the disease can occur in women who give birth to babies weighing more than 4kg, women with polycystic ovaries and people who have been diagnosed with impaired glucose tolerance or impaired fasting glucose during health check-ups. These are groups of people who are susceptible to the disease.

3) DOCTOR, WHAT IS THE CORRECT UNDERSTANDING OF PRE-DIABETES? WHEN SHOULD YOU THINK YOU MIGHT HAVE THE DISEASE?

Prediabetes is a condition in which blood sugar levels are not within normal limits, but not high enough to be diagnosed as diabetes.

These are people whose fasting blood sugar level in the morning is between 100mg/dl - 125mg/dl. Or blood sugar level 2 hours after doing a glucose tolerance test with 75g of oral glucose is 140mg/dl - 199mg/dl. Or HbA1C is from 5.7-6.4%.

People with prediabetes are at risk of cardiovascular disease and may develop type 2 diabetes in the future.

If you belong to the following risk groups:

- Little exercise.

- Have a direct family member with diabetes.

- People with high blood pressure.

- People with lipid disorders.

- Obese, overweight people.

- People who have had gestational diabetes.

- People with insulin resistance diseases such as polycystic ovary syndrome, acanthosis nigricans...

- And some other factors.

If you have one or more of the above risk factors, you are at high risk of diabetes. Therefore, to detect it early, you should go for early screening.

4) DOCTOR, CAN YOU TELL ME MORE ABOUT THE SYMPTOMS OF HYPERGLYCEMIA WHEN SUFFERING FROM DIABETES? ARE THE SYMPTOMS EASY TO RECOGNIZE? CAN YOU RECOGNIZE THEM BY FEELING OR DO YOU NEED A TESTING?

Symptoms of diabetes are easy to recognize if you always "listen" to the changes in your body. The first symptom that usually appears is that the patient urinates a lot, about more than 3 liters a day. After that, you will feel thirsty and drink more water than usual. In addition, the patient may have unusual weight changes (mainly weight loss, sometimes sudden weight gain), always feel hungry, crave food, eat a lot, especially crave sweets... However, to diagnose accurately, you still need to do tests.

The standard blood sugar level for diagnosing diabetes since 1997 is a fasting blood sugar level of 126 mg/dl or higher to be considered as having the disease. At this level, the above symptoms often appear incompletely and are not clear, so they can be easily overlooked. Therefore, regular health check-ups and blood sugar testing are still important.

5) DOCTOR, I HEAR IN THE MEDIA THAT UP TO 65% OF DIABETIC PATIENTS DO NOT KNOW THEY HAVE THE DISEASE. I AM VERY WORRIED. SO WHO IS LIKELY TO HAVE TYPE 1 DIABETES AND WHO IS LIKELY TO HAVE TYPE 2 DIABETES?

Please do not worry too much but plan for regular health check-ups for yourself. Currently, as far as we know, regular health check-ups are very easy to do at reputable medical centers.

Type 1 diabetes usually occurs in young people under 30 years old. That means the child may have had the disease in the womb. And this rate accounts for about 10-15% of diabetes cases in general. Type 2 diabetes usually occurs after 30 years old. This type accounts for 85-90%. However, type 1 diabetes can still occur in adults after 50 years old, in both men and women. And type 2 diabetes can appear in adolescence, mainly in obese children.

6) DOCTOR, HOW ARE DIABETES, HEART DISEASE, AND OBESITY CLOSELY RELATED TO EACH OTHER AND WHAT SHOULD BE DONE TO PREVENT THESE 3 PROBLEMS?

Cardiovascular complications in diabetic patients are the leading cause of death. Up to 8 out of 10 diabetic patients have cardiovascular complications, often manifested as myocardial ischemia, myocardial infarction, atherosclerosis, hypertension... In addition, complications in the brain due to atherosclerosis can cause stroke and cerebrovascular accident.

People with type 2 diabetes who are obese are at increased risk of cardiovascular complications due to increased insulin resistance.

To prevent and treat the above complications, in addition to controlling blood pressure, blood lipids, and blood sugar with medication, non-drug treatments are also very important, such as changing to a healthy lifestyle, increasing exercise, and proper nutrition.

There are currently many specialized products for diabetics that provide complete and balanced essential nutrients to help stabilize blood sugar, support cardiovascular health, control weight and waistline, and prevent dangerous complications.

7) I went for a regular check-up and after getting the results, the doctor advised me that my blood sugar level was high and I was at risk of diabetes. So could you please tell me if I need to eat, drink, or limit anything to reduce this risk?

If your blood sugar levels are high but not yet diabetes, you can try the following lifestyle changes:

- Increase physical activity. The average daily exercise time is at least 30 minutes or more (or greater than or equal to 150 minutes per week). You should be active at an average level, choosing the types of activities that you enjoy.

- Change your diet: you need to get advice on the amount of energy you should eat each day depending on your weight, as well as the ratio of nutrients in a meal. You should limit fast food, foods that are too high in energy, soft drinks...

- You need to control your body weight and maintain an ideal body weight with a BMI of 19-23kg/m2 (BMI formula = weight : height squared). If you are overweight, you need to lose at least 7% of your weight. If you are underweight, you need a proper diet to reach your ideal weight.

- If you are a man, you should quit smoking, drinking alcohol, and avoid stress...

The above measures have been shown in studies in Europe and Asia to be effective in reducing the risk of developing diabetes.

8) DOCTOR, IN ADDITION TO MEDICATION AND INSULIN INJECTION, ARE THERE ANY OTHER FOLK TREATMENTS FOR DIABETES?

Up to this point, in the treatment of diabetes, the effectiveness has been proven through large domestic and foreign studies, the use of hypoglycemic pills and insulin injections is still the top priority.

Currently, diabetes is a chronic disease that requires lifelong medication to stabilize blood sugar, help prevent and limit complications, but cannot be completely cured.

Scientists around the world are continuing to research methods that can cure diseases such as gene therapy, stem cell therapy...

Folk methods, if any, are only supportive and not a substitute. For example, you can eat or drink bitter melon juice, wild bitter melon vines... You should not listen to unscientific information to avoid "losing money and getting sick".

9) DOCTOR, CAN YOU TELL ME MORE ABOUT NUTRITION FOR PEOPLE WITH DIABETES?

Diabetes is a metabolic disorder, which means it is related to eating. Therefore, to treat this disease well, a reasonable diet for each person, depending on the disease, habits, preferences... is extremely important. This is also the first step in treating the disease. So what is a reasonable diet?

First of all, a reasonable diet must ensure stable blood sugar, maintain ideal weight, limit complications, especially cardiovascular, kidney, and infectious complications... and ensure a normal quality of life for the patient. Therefore, to build a diet, people need to rely on factors such as age, gender, height, weight, nature of daily work... Accordingly, the total energy consumed in a day must include 3 main components: starch (vermicelli, noodles, rice, pho, vermicelli, rice noodles, potatoes, corn...) accounting for about 50-65% of total energy; protein (meat, fish, vegetable protein) accounting for about 15-20% of total energy; and fat (vegetable oil, animal fat) accounting for 20-30%.

In addition, it is necessary to pay attention to supplementing vitamins, fiber... found in vegetables, tubers, fruits and fruits... because these ingredients will help stabilize blood sugar, reduce fat and avoid constipation. Besides, it is necessary to pay attention to the amount of water every day, ensuring to provide about 1.5-2 liters (including drinking water, soup, milk...).

The general rule is to eat 3 main meals, if you are using insulin, you can have an extra snack. You should not snack too much. Sometimes, due to the nature of work or illness, patients cannot eat meals as usual, so they can use alternative meals such as milk. It is important to choose a type of milk that ensures adequate energy, has enough ingredients that are beneficial for health, especially for cardiovascular health, is low in saturated fat, has fiber... And these types of milk also need to ensure a stable weight for the user.

10) DOCTOR, MANY PEOPLE HAVE DIABETES. CAN YOU TELL ME HOW TO PREVENT THIS DISEASE? AT WHAT AGE ARE MANY PEOPLE SUFFERED FROM THIS DISEASE?

Currently, the number of people with diabetes is increasing in the world as well as in our country. Therefore, disease prevention for healthy people as well as people at high risk of diabetes is very important. General preventive measures for everyone include:

Lifestyle changes:

You should maintain a healthy diet (eat foods that provide enough energy for the body with a balanced ratio of nutrients, including adequate carbohydrates, protein, lipids, fiber and vitamins in one meal).

You should participate in activities that increase your physical activity depending on your habits and health status. Exercise for at least 30 minutes a day or 150 minutes a week.

You should give up bad habits that are harmful to your body such as smoking, drinking too much alcohol, eating too much fast food with lots of energy, drinking too much soft drinks or not exercising enough.

Avoid stress.

Everyone should have regular health check-ups including blood sugar testing.

If someone is in a high-risk group for diabetes, they should be screened every year from age 45, even if their blood sugar results were normal the previous year.

The age group that often gets diabetes is usually 60 years old and above. However, type 2 diabetes is getting younger and younger, there are cases of type 2 diabetes detected at the age of 11. Therefore, everyone needs to pay attention to early detection of diabetes.

November 14th of each year is chosen by the World Health Organization and the International Diabetes Federation as "World Diabetes Day". The slogan of the 2013 action program is: "Let's protect our future". Therefore, everyone should join hands to prevent diabetes by raising awareness about the disease, widely disseminating knowledge to everyone and joining hands to take action.