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Diabetes has recently emerged as a serious health problem worldwide. The causes include economic and social changes including population aging, increased consumption of processed foods, sugars and beverages, obesity, a decrease in physical activity, and unhealthy lifestyles. In particular, type 2 diabetes, which accounts for most of the diabetic patients and is commonly seen in adults, is recently increasing in children and adolescents.
Increase in diabetes and pre-diabetes in Korea
According to the Korean Diabetes Association, as of 2020, about 1 in 6 adults over the age of 30 (16.7%) and about 3 out of 10 adults over the age of 65 (30.1%) in Korea have diabetes. In addition, in the case of ‘pre-diabetes’ including impaired fasting glucose, it is estimated that about 14.79 million adults aged 30 years or older have 4 out of 10 adults aged 30 years or older (44.3%), and about 2 out of 65 years old adults. This corresponds to 1 person (50.4%). In particular, as it has been reported that about 2.08 million adults in their 30s already have prediabetes, more active efforts are needed to prevent the occurrence of diabetes in the younger age group. Despite the increasing awareness of diabetes compared to the past, the control rate of domestic diabetic patients is still less than 30%. In addition to preventing diabetes, it is necessary to actively manage it, including improving awareness and treatment rates for diabetic patients.
Diabetes symptoms and complications
Diabetes often does not show any special symptoms, but if the blood sugar level is severe, symptoms such as fatigue, lethargy, weight loss, drinking a lot of water or urinating frequently, or eating a lot of food due to hunger may appear. In diabetic patients, various complications can occur due to hyperglycemia and metabolic abnormalities caused by it. Chronic complications caused by exposure to high blood sugar for a long time include ‘macrovascular complications’ such as cerebrovascular disease, coronary artery disease, and peripheral vascular disease, and ‘microvascular complications’ such as diabetic nephropathy, retinopathy, and neuropathy. According to several epidemiological studies on diabetes, active blood glucose control in patients with type 1 and type 2 diabetes reduces the incidence of macroangiopathy and microvascular complications and slows the progression of complications. Chronic complications not only reduce the quality of life, but also cause serious disability or death, so prevention through blood sugar management is important.
Blood sugar management in diabetic patients
The Korean Diabetes Association recommends a glycated hemoglobin test and self-monitoring of blood glucose to monitor and evaluate the degree of blood sugar control in diabetic patients. Through glycated hemoglobin, not only can the degree of blood sugar control for 3 months before the test be judged, but also the accuracy of self-monitored blood glucose measured by the patient can be judged. Glycated hemoglobin can be tested every 2 to 3 months. Depending on the individual’s condition, the inspection period can be adjusted, but at least twice a year is recommended. A general glycemic control target is less than 6.5% of HbA1c in adults with type 2 diabetes and less than 7.0% in adults with type 1 diabetes.
Self-monitoring of blood glucose is an important factor that informs diabetic patients whether they are responding to individual treatment or whether they have reached control goals after treatment. In addition, it is useful as an index to prevent hypoglycemia or to control the degree of medical nutrition therapy, exercise therapy, and drug therapy. Recently, with the development of medical information and communication, continuous blood glucose monitoring devices capable of frequently measuring blood sugar levels of diabetic patients without blood collection have also been used for blood sugar management.
lifestyle management
Typically, lifestyles can be managed through medical nutrition therapy and exercise therapy. It is recommended that you actively manage your lifestyle immediately after diagnosis of diabetes.
Medical nutrition therapy is an integral part of diabetes self-management and aims to improve overall health, including controlling blood glucose and serum lipid levels, achieving or maintaining an appropriate body weight, and reducing the risk of cardiovascular disease. Individualized management is necessary according to individual characteristics, such as the number of meals eaten per day, whether family members are present at meals, and drinking/snack habits.
It is known that glycated hemoglobin can be reduced by 0.3-2% through medical nutrition therapy. In particular, 34% of diabetic patients who lost 5-10% of their body weight and 86% of diabetic patients who lost more than 15% of their body weight were confirmed to achieve a HbA1c of less than 6.5%, and it was reported that their metabolic status was significantly improved. . In medical nutrition therapy, the amount of food consumed per day (total calories) and the maintenance of lost weight are more important than the distribution of nutrients.
Exercise improves serum lipids, blood pressure, and blood flow in diabetic patients, thereby reducing risk factors for cardiovascular disease, reducing weight, and increasing insulin sensitivity, thereby facilitating blood sugar control. In addition, there are advantages such as reducing the dose of insulin and oral hypoglycemic agents, improving quality of life by improving muscle strength and joint function, and reducing stress.
However, there are risks such as hypoglycemia, so if a diabetic patient exercises, it is necessary to consult with the doctor in charge. If there is no particular contraindication, it is generally recommended to do aerobic exercise at least 3 days a week at moderate intensity for 150 minutes or more a week, and if possible, do not take a break for more than 2 days in a row.
Aerobic exercise refers to exercise that requires full-body movement, such as brisk walking, jogging, swimming, cycling, and climbing stairs. Exercises such as lifting heavy weights should be avoided as they may worsen blood pressure or damage muscles and bones. Even if it is not a full-fledged exercise, it is important to reduce the time sitting during daily life and increase the time moving or standing. It is recommended to check the state of the whole body before and after exercise, and to measure blood sugar to check for hypoglycemia or hyperglycemia when the exercise intensity changes or the exercise time is prolonged.
prevention of diabetes
First, risk factors for diabetes such as overweight, lack of exercise, wrong eating habits, high blood pressure, drinking, and smoking can be systematically managed to prevent diabetes. Maintaining a normal weight, improving eating habits, and exercising regularly are recommended for the high-risk group for diabetes.
Secondary prevention is early detection, and it is necessary to prevent diabetes through active intervention in the stages of impaired fasting glucose and impaired glucose tolerance, which are the pre-diabetes stages. Even people who have already developed diabetes can minimize body damage due to complications by detecting it as early as possible. Complications can occur even in the pre-diabetic stage, and several studies have reported that the risk of cardiovascular disease increases. Therefore, by early detection and management of pre-diabetes, progression to diabetes can be delayed or prevented, and the risk of diabetes-related complications and cardiovascular disease can be reduced.
Diabetes is often referred to as a ‘lifestyle disease’. We cannot change genetics or age at will, but if we improve our lifestyle, such as losing weight, exercising, eating less, not smoking, drinking less alcohol, and being less stressed, we can help prevent diabetes and manage it healthily without complications even if we have diabetes. You will be able to.
(Data provided by the Ulsan Branch of the Korea Health Care Association)
Article summary = Reporter Shin Ji-hye
[저작권자ⓒ 울산종합일보. 무단전재-재배포 금지]
2023-06-29 04:23:53
#diabetes #blood #sugar #lowering
