How to treat early-stage diabetes?

Written by Zhao Xin Lan
Endocrinology
Updated on March 27, 2025
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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.)

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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.

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What should diabetics pay attention to in their diet?

There is a general principle for the diet of diabetes, which is to pay attention to controlling the total daily caloric intake. The second principle is to have a balanced diet, and to be more specific, there are several points: The first one is to eat at fixed times and fixed amounts. Fixed times means having three meals a day at regular intervals, eating on schedule and paying attention not to have extra meals. Generally, the majority of diabetic patients should not eat less in more meals. Fixed amounts mean that the portion size of each meal should be roughly the same every day, not less today and more tomorrow. The third principle is to try to eat drier foods and avoid liquid foods, as liquid foods are easy to digest and absorb, causing blood sugar to rise quickly after meals. Therefore, these are some of the points that need attention in the diet for diabetes.

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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What is gestational diabetes like?

Gestational diabetes refers to diabetes that appears during pregnancy, or is detected during pregnancy, or is an abnormal glucose tolerance of any degree. Gestational diabetes affects both the pregnant mother and the fetus. Although the mortality rate of pregnant women with gestational diabetes has significantly decreased, complications are still quite common. It may increase the rate of spontaneous miscarriages and preterm births for fetuses. Secondly, it can cause fetal or neonatal death, and intrauterine growth retardation. Thirdly, it leads to excessive amniotic fluid and macrosomia, and may result in neonatal polycythemia, fetal malformations, neonatal respiratory distress syndrome, neonatal hypoglycemia, as well as neonatal hypocalcemia and hypomagnesemia. For the mother, it can lead to pregnancy-induced hypertension syndrome, infections during pregnancy or childbirth, and in severe cases, diabetic ketoacidosis.

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Early symptoms of type 2 diabetes

The typical symptoms of type 2 diabetes are referred to as "three excesses and one deficiency." The three excesses include excessive thirst and dry mouth, increased appetite with frequent hunger, and increased urination. The one deficiency refers to weight loss; these are the more typical symptoms. Some patients might often find out about their elevated blood sugar during routine health checks at work. Others may seek medical advice due to issues like skin itchiness or wounds that heal poorly after injury. Some might mainly experience numbness in their hands and feet, or blurred vision among other symptoms.