Diabetes


Is frequent urination diabetes?
If the urine output exceeds 2500 mL in 24 hours, this condition is called polyuria. There are many causes of polyuria; diabetes is just one of them. Additionally, physiological causes are also seen, such as eating a large amount of fruits that have a diuretic effect, like watermelon, or drinking a lot of water previously. This is referred to as physiological polyuria and does not require special treatment. Pathological causes, apart from diabetes, also include diabetes insipidus or electrolyte disturbances. For instance, long-term hypokalemia, hypercalcemia, or increased aldosterone can all lead to polyuria. It is advisable to promptly visit the urology department of a hospital for tests such as blood glucose levels, routine urine tests, and endocrine examinations to understand the causes of polyuria, and to determine whether it is caused by diabetes.


What does a diabetic diet include?
The diet for diabetes primarily includes the following aspects: First, it is recommended to eat at regular times and in fixed amounts daily. Second, avoid consuming foods with a high glycemic index, such as porridge, glutinous rice, and rice noodle rolls, as these are not recommended. Third, the diet should be bland, as many diabetic patients also suffer from high blood pressure, high blood lipids, and high uric acid. Therefore, a bland diet is emphasized. Fourth, overly sweet fruits such as lychee, longan, banana, and grapes are not suitable for consumption.


What should pregnant women with diabetes eat?
If a pregnant woman has been diagnosed with gestational diabetes during pregnancy, it is still necessary to decide what food to eat based on the specific blood sugar levels. If the current blood sugar level is relatively stable, she can follow a diabetic diet, eat smaller meals more frequently, and consume more fresh fruits and vegetables. It's important to avoid foods that cause high blood sugar, and it is essential to walk or engage in appropriate exercise 30 minutes after eating to help metabolize the blood sugar. However, if the blood sugar remains high and does not decrease significantly, insulin might be needed to lower the blood sugar levels.


Symptoms of diabetes in the elderly
Elderly diabetes often begins inconspicuously, lacking the typical symptoms of excessive thirst, urination, hunger, and weight loss. It can present with various complications such as diarrhea, constipation, urinary retention, limb numbness, skin itching, and shoulder joint pain. Elderly diabetics often have concurrent infections, particularly in the respiratory and urinary systems, as well as cholecystitis and skin infections. They may also suffer from ketoacidosis, hyperosmolar hyperglycemia syndrome, and coexist with multiple chronic diseases of old age such as heart failure, coronary heart disease, hypertension, and hyperlipidemia. They require different types of medications and are susceptible to hypoglycemia, making timely diagnosis and treatment challenging. These are the symptoms of diabetes in the elderly.


Does type 2 diabetes have a genetic component?
Diabetes has a high prevalence worldwide, especially type 2 diabetes, which accounts for over 90% of all cases. The pathogenesis of type 2 diabetes is very complex, including genetic susceptibility, as well as environmental factors, insulin resistance, and defects in the function of pancreatic beta cells. Thus, environmental factors are one of the influencing factors in the incidence of type 2 diabetes. There is evidence showing a familial clustering tendency among patients, but genetic factors are not the sole cause of type 2 diabetes; environmental factors also play a role. With changes in diet and lifestyle in recent years, the prevalence of type 2 diabetes has noticeably increased. Even with similar genetic backgrounds, the risk of developing type 2 diabetes varies among populations living in different areas. Therefore, diabetes can be considered a complex disease, where individuals with a genetic predisposition to diabetes, under the influence of adverse environmental conditions, can also develop elevated blood sugar levels and consequently diabetes.


Is there a difference between gestational diabetes and regular diabetes?
Gestational diabetes and common diabetes, although both types of diabetes, have significant differences between them. First, gestational diabetes is a disease specifically occurring during pregnancy and often only appears during the gestational period. After pregnancy, the majority of women will revert to a normal blood sugar state, so the main focus for gestational diabetes is on screening and intervention during pregnancy; Second, common diabetes is a chronic disease that accompanies an individual throughout their life, requiring long-term management of blood sugar through various methods. Therefore, the main difference between the two lies in the duration of the disease. Pregnant women with common diabetes, if they become pregnant, are referred to as having diabetes compounded by pregnancy, which also requires strict blood sugar management, but its mechanism of occurrence and principles of treatment differ from those of gestational diabetes.


Diabetes dietary taboo fruits
Many patients have a misconception after being diagnosed with diabetes; they think that fruits are sweet and they should avoid all fruits. This statement is half right—fruits are indeed sweet, but not all fruits are off-limits. Diabetes patients can still consume fruits, provided that they pay attention to the quantity and type of fruit they eat. First, let’s discuss the fruits that should not be eaten by diabetic patients, which are those high in simple sugars. Consuming these fruits can cause a rapid spike in blood sugar levels. Examples include dates, whether dry or fresh, longans, whether dry or fresh, lychees, whether dry or fresh, and bananas, which all have very high sugar content. These fruits are not recommended for diabetic patients; on the other hand, fruits like kiwis, cherries, kumquats, and grapefruits are generally suggested as suitable for diabetic patients.


How to treat early-stage diabetes?
In the early stages of diabetes, when blood sugar levels are not very high, it can be controlled through diet and exercise. This can be achieved by losing weight, reducing calorie intake, and increasing calorie consumption through exercise to lower blood sugar levels. However, for some obese patients or those who cannot control their diet, medications can also be used in the early stages to prevent further increases in blood sugar levels. Currently, medications such as metformin and acarbose, which are both effective and relatively inexpensive, are mainly recommended. (Specific medications should be taken under the guidance of a physician.)


How to treat diabetes in the elderly?
For elderly patients with diabetes, our long-term treatment goal is to delay the onset and progression of chronic diabetic complications, maintain good health and self-care ability, improve quality of life, and extend healthy lifespan through good metabolic control. The short-term goal is to control hyperglycemia and its metabolic disorders, eliminate the symptoms of diabetes, and prevent acute severe metabolic disorders. Our "five-pronged" approach to diabetes management is also suitable for elderly patients, including diabetes education, medical nutrition therapy, exercise therapy, blood glucose monitoring, and medication therapy. Therefore, for elderly diabetic patients, it is essential to keep blood glucose levels within a controllable range, delay the onset of complications, and provide a healthy twilight years for elderly diabetics.


Symptoms of Gestational Diabetes
The symptoms of gestational diabetes differ from those of non-pregnancy diabetes; non-pregnancy diabetes is mainly characterized by excessive drinking, eating, urination, and weight loss. During pregnancy, excessive drinking and eating may be physiological responses due to increased appetite, and frequent urination may be caused by the enlarged uterus pressing on the bladder during early pregnancy. Weight loss is generally not apparent in gestational diabetes due to the growth of the fetus, the uterus, and the increase in amniotic fluid. For women who had a higher body mass index before pregnancy and a family history of diabetes, it is recommended to start glucose tolerance screening from the time of planning to conceive. For those who gain weight rapidly after becoming pregnant and have a significant increase in amniotic fluid, we typically conduct routine diabetes screening between 24 to 28 weeks of pregnancy. Gestational diabetes has severe impacts on the pregnant woman, the fetus, and the newborn, thus early detection and treatment are advised.