Wounded but I don't feel pain? This "stunt" is so cool! Don't say too early, then look down...
As a doctor, I am more and more convinced that "live to the old, learn to be old". According to incomplete statistics, there are more than 100 million diabetic patients in China. In addition to active medication and control of diet, can diabetes effectively control blood sugar? In fact, many reasons may also cause blood sugar to rise, do not believe in you and see -
Medical record one
"Not good sleep is also the cause of high blood sugar."
There is a patient in his 60s who needs hip replacement surgery. The patient is an old patient with diabetes for more than 20 years. As the saying goes, the patient has a long-term illness and the patient's blood sugar control is quite good. Check blood sugar before surgery. /L, the patient's fasting blood glucose increased to 11.45mmol / L on the second day of surgery, I know it is the post-operative stress response. So the doctor said that the patient had increased the subcutaneous injection of insulin, but the effect was still not satisfactory the next day. So I also increased metformin, blood sugar still did not come down, I couldn't think of it. I didn't mean to ask about the patient's sleep. The family told me that the patient stayed up all night, even though the analgesic pump was applied after the operation, but still sleeping. No. So I gave the patient a doctor to open a stable film. The incredible thing is that the next day, the blood sugar has come down.
Medical record two
"Elevated blood sugar before menstruation"
There is a patient, a woman, 43 years old, 8 years of diabetes, blood sugar control is good, an accidental body test fasting blood glucose 13.55mmol / L, the patient became overwhelmed, the patient said that increased insulin dose, after breakfast I ate less than two or two rice and ate ordinary cooking. The blood sugar before lunch was 11.65mmol/L. So the doctor told me to take metformin after the meal and opened 30 mg of pioglitazone orally, but the patient still monitors blood sugar. not ideal.
I can't understand the problem, the patient's blood sugar after menstruation is inexplicably down. Later, the doctors checked the information and found that some women had a large amount of estrogen and progesterone release before menstruation, which aggravated the blood sugar caused by insulin resistance, and the patient's menstrual cycle was extremely irregular and had a history of dysmenorrhea. Inform patients to eliminate tension, increase the amount of exercise properly, and short-term blood sugar rise will not cause harm to the body.
Medical record three
"Eating a small orange, the blood sugar has risen to 18.95mmol/L."
Several aunts in the endocrinology department had a good blood sugar control after a few weeks in hospital, and they could be discharged after a few days. A few old sisters were very happy, but after measuring the blood sugar before dinner, they fell into the bottom of the valley. Zhao Auntie’s blood sugar before dinner was 16.75mmol/L. What happened? Only 5.4mmol / L before lunch, the nurse saw the blood sugar value measured is also a look of hair, is the machine malfunctioning? Just ate a little orange as for? Zhao Auntie muttered to herself, where is the problem? Report the doctor on duty, the doctor on duty, Zhao Auntie, wash your hands and measure. The blood glucose measurement was again measured, 5.85 mmol/L. Although the nurse had disinfected her hands with alcohol for Zhao Auntie, she still could not remove the fructose that the patient had eaten with orange hands. Therefore, it became a panic of rising blood sugar.
Medical record four:
"The rise in insulin without mixing"
Wang Auntie was admitted to the hospital because of cardiovascular disease, and was diagnosed with type 2 diabetes by detecting high blood sugar. After leaving the hospital, the blood sugar control is not ideal. It is strange that the insulin is injected on time according to the doctor's prescription, and the diet is also controlled. It is also active and effective, but how can the blood sugar be poorly controlled?
After the doctor's inquiry, I quickly found the answer. Wang Auntie immediately injected the skin directly under the skin, and did not shake evenly, which caused the precipitation of insulin. Insulins that need to be shaken include Novo Ling 30R refill, Novo Ling 50R refill, Novo Ling N refill, Nuo and Rui 30 refills, all of which have a common feature, that is, precipitation occurs after standing.
Why do you shake evenly before injection? Because the fast-acting insulin and the medium-acting insulin are mixed in proportion, also known as pre-mixed insulin, the insulin suspension inside needs the low-protein zinc insulin. After the insulin is left, some components will accumulate in the form of sediment. Together, shaking evenly is to mix the ingredients thoroughly, so that the insulin composition and concentration injected are accurate. Will not affect the treatment effect.
As a doctor, patients with chronic patients (such as diabetes) must be patient and careful to help them analyze the causes of high blood sugar in a timely manner, in order to actively and effectively control the primary disease.