"Doctor, due to weather conditions during the May Day holiday, I have been staying at home eating and drinking a lot every day. My blood sugar levels have skyrocketed. Do I need to increase my medication dosage?" Mr. Gao, a citizen, anxiously consulted the doctor. Most people believe that if you get diabetes (this article specifically refers to type 2 diabetes), you must be unable to eat sweets and drink drinks in your life, and you need to take antidiabetic drugs for a long time. Is it true that this is the case? In recent years, a large number of research results have shown that lifestyle intervention, drug therapy, metabolic weight-loss surgery and other measures can promote diabetes patients with overweight and obesity to alleviate the disease, so that patients will be free from using hypoglycemic drugs for a long time. What is the principle? Is it applicable to diabetic patients? Guan Yan, chief pharmacist of the pharmacy department of the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine (Hunan Provincial Hospital of Traditional Chinese Medicine), said that the so-called remission of diabetes means that without the treatment of hypoglycemic drugs, blood sugar can still be in the standard state or normal state. What are the criteria for judging diabetes remission? Is diabetes remission? What are the criteria for judging? Guan Yan explained that the consensus report on "the definition and interpretation of relieving type 2 diabetes" issued by the American diabetes Association (ADA) in recent years proposed that blood samples should be taken for examination at least three months after the withdrawal of hypoglycemic drugs, and hemoglobin A1c (HbA1c)<6.5% should be regarded as the diagnostic criteria for relieving type 2 diabetes. When glycosylated hemoglobin cannot reflect the true blood glucose level, fasting blood glucose (FPG)<7.0 mmol/L, or glycosylated hemoglobin (eA1c) estimated by dynamic glucose monitoring calculation<6.5% can be used as an alternative standard for diagnosis of remission of type 2 diabetes. Among them, the remission mechanism of diabetes has the following aspects: correct islets β The cells are dedifferentiated. A certain number of islets still exist in the pancreas of patients with diabetes within 5 years β Cells, through certain lifestyle interventions, can activate the dormant islets of the pancreas β Cells resume synthesis and secretion of insulin. Under the action of insulin, blood sugar in the human body can be lowered and reach a balanced state; To correct insulin resistance, hyperinsulinemia accounted for 50% of newly diagnosed type 2 diabetes patients. With the progression of diabetes, pancreatic islets β Cell function is damaged, which leads to the impossibility of reversing diabetes. If insulin resistance is corrected, it can significantly improve pancreatic islets β Cellular function; Correct obesity, fatty liver and fatty pancreas. Overweight and obese patients with type 2 diabetes usually have fatty liver. Fat in patients with fatty liver overflows from the liver into the pancreas, leading to fat deposition in the pancreas (fatty pancreas), which may lead to islets of langerhans β Abnormal cellular function requires correction. Weight loss is the core goal of diabetes relief. Overweight or obese diabetes patients have more visceral fat. With weight loss, fat deposition in skeletal muscles, pancreas and other organs decreases, β The insulin secretion function of cells will be significantly improved. Therefore, weight loss is the core goal and means for overweight or obese patients with type 2 diabetes to achieve clinical remission. Clinical research shows that after weight loss of diabetes patients with obesity within 5 years, the remission rate of diabetes is 46%, and the more weight loss, the higher the remission rate of diabetes. When the weight loss is more than 15 kg, the complete remission rate can reach 86%.
Edit：GuoGuo Responsible editor：FangZhiYou
Source：gmw.cn
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