Diabetes is more insidious, in addition to the typical manifestations of polydipsia, polyuria, polyphagia and weight loss, the initial manifestations may be far from the symptoms of diabetes that many people think, and repeated infections are one of the manifestations. Soft tissues and teeth are the most common sites of diabetes infection, especially infection. In addition, inflammation such as bleeding, redness and swelling of the gums may also be accompanied by an increase in blood sugar, so it is best to check blood sugar as soon as possible.
Case. Folliculitis in young men is an early change in diabetes.
20-year-old Xiao Li has had folliculitis in the past two years, and boils have repeatedly appeared on his chest, back, face, and even buttocks. He went to the Department of Cosmetology of Xiamen Hospital of Traditional Chinese Medicine for treatment, and Chief Physician Zhao Wenjie inquired about his medical history and learned that the cause of Xiao Li's folliculitis was unknown. Zhao Wenjie suspected that it was the first change in the early stage of diabetes, and suggested that he do a blood sugar screening, and the results showed that Xiao Li did have diabetes.
Zhao Wenjie said that the most common complication of diabetes is infection, and data show that 30%-90% of diabetic patients will have one or more lesions, of which infectious diseases are the most common. Xiao Li's folliculitis is induced by fungal infection, fungal folliculitis is prolonged, slow to heal, often **, trunk, back, buttocks and even lower limbs have repeated boils. At this time, controlling blood sugar can be effective** folliculitis.
Analyse. Uncontrolled diabetes **Infection is difficult**.
Zhao Wenjie introduced that when diabetes occurs, the patient's blood sugar rises, neurotrophic function decreases, the chemotaxis and phagocytic function of white blood cells decrease, as well as vascular lesions, peripheral neuropathy and other comprehensive factors, resulting in a decrease in local immunity and easy to develop bacterial, fungal, and viral infections. Fungi such as Malassezia and Candida albicans, and bacteria such as Escherichia coli and Staphylococcus epidermidis are all resident bacteria, and patients with low resistance are prone to infection. Infected patients are prone to boils, carbuncles, styes, multiple and stubborn folliculitis, etc., and may also often appear "thrush" in the oral area, or ringworm diseases such as ringworm of the hand, tinea corporis, jock itch, tinea pedis, etc. In more severe cases, coccal pyoderma, erysipelas, and cellulitis occur due to the entry of bacteria into the deep tissues. Viral infections are mainly manifested by viral exanthems, such as herpes zoster.
If the diabetes of such patients is not well controlled, it is difficult to get infected. Over time, small vessel damage, peripheral neuropathy, and diabetic foot development can occur. When the infection is severe, it can aggravate the disorder of sugar, fat and protein metabolism, promote the aggravation of diabetes, and make the condition change rapidly and difficult to control. On the basis of the aggravation of diabetes caused by **infection, acidosis and sepsis can be induced, which can threaten the life of the patient.
Recurrent unprovoked** infections.
Blood sugar screening is done.
Zhao Wenjie also pointed out that ** infection cannot be used as evidence for diagnosing diabetes, especially to distinguish between special triggers and unexplained ** breakage. For example, folliculitis and acne caused by staying up late or eating unbalanced diet, eating food that is easy to catch fire, etc., are different from recurrent ** infections of unknown causes. Recurrent unprovoked ** infections should be taken seriously, and blood glucose screening should be performed to rule out diabetes.
No matter what kind of infection you have, don't use it casually, you need to be screened by a doctor before taking medication. For example, in folliculitis caused by a fungal infection, antibiotics are not effective**, and antifungal drugs** are needed.
Case. Frequent bleeding gums are caused by elevated blood sugar.
Mr. Lee, 50, recently noticed that he had frequent bleeding gums, sometimes even bleeding gums in his sleep, resulting in a bloody smell in his mouth when he woke up in the morning. He tried flossing and mouthwash, but bleeding gums and bad breath did not improve. When he went to the hospital, the doctor found that Mr. Li's gums were red and swollen and there were obvious bleeding spots. Further examination revealed that Mr. Lee's blood glucose level was significantly higher than normal, while his blood clotting was normal, and his dental examination revealed periodontal disease.
After further examination, Chen Ning, chief physician of the Department of Endocrinology and Metabolism and deputy director of the Department of Endocrinology of Fudan Zhongshan Xiamen Hospital, was diagnosed with diabetes, and his periodontal disease was closely related to elevated blood sugar. It turns out that high blood sugar can lead to oral microangiopathy, weaken the resistance of oral tissues to infection, and increase the risk of oral infection, which can lead to oral problems such as gingivitis and periodontitis, resulting in bleeding gums.
Analyse. Diabetes causes periodontal tissues to be deprived of oxygen.
Leads to the "invasion" of bacteria and toxins
It is reported that patients with periodontal disease are often accompanied by high blood sugar and even diabetes. "The probability of periodontal disease in diabetic patients is also relatively high," Chen Ning explained, diabetic patients have high blood sugar, poor ability to resist infection, are prone to microcirculation disorders, and slow blood flow, resulting in hypoxia of periodontal tissues, which can easily lead to the "invasion" of bacteria and toxins; Periodontal disease causes an increase in inflammatory factors in the blood, which in turn aggravates insulin resistance and promotes an increase in blood glucose. In addition, the sialic acid content of diabetic patients decreases, and the saliva pH value decreases, which reduces the self-cleaning power of the oral cavity and changes the oral environment, which is easy to cause the breeding and reproduction of various pathogenic microorganisms.
Some common symptoms from everyday life.
"Clues" of abnormal blood glucose may be found
Chen Ning added that there are some common symptoms in daily life, which seem to have nothing to do with blood sugar, but may hide "clues" of abnormal blood sugar. Diabetic patients have a higher chance of contracting inflammation, including periodontal disease, blurred vision, chronic eczema, refractory wounds, athlete's foot, etc.
For example, blurred vision is not necessarily a problem with the eyes themselves, but may be one of the manifestations of high blood sugar. This is related to the increased water absorption of the lens to reduce the concentration of glucose, and the lens swells, which naturally blurs vision. In autumn and winter, itching is a common symptom that is quite annoying, and there are many reasons for itching, including the increase in glucose content in **, which stimulates nerve endings and autonomic nerves, making dysfunction and causing itching. For groups with these manifestations, Chen Ning suggested that it is best to pay attention to it and do a blood sugar test.
Ideas. If your blood sugar is not particularly high.
Diet and exercise can be adjusted.
Chen Ning said that diabetes should take into account many factors. For example, if blood sugar is not particularly high, diet and exercise can actually adjust a significant proportion of people with mildly elevated blood sugar. If the blood sugar is significantly elevated, hypoglycemic drugs should be considered.
However, although diet and exercise are simple to say, it is not easy to personalize the plan and stick to it, and some patients find it difficult to adhere to regular medication. To this end, Chen Ning believes that when dietitians formulate dietary plans, they should consider the patient's living situation, self-management ability, economic ability and acceptance at the same time, and the plan formulated on this basis is an effective plan.
As a doctor who treats chronic diseases, Chen Ning believes that metabolic diseases have entered a period of blowout development, which has some relationship with social development, lifestyle, stress, and dietary structure. Advocating lifestyle improvement, through consistent and reasonable diet and exercise, the body's metabolism can be greatly improved.
Link. Risk factors for diabetes.
The first is genetics. For example, if there is a family history and one member of the father's or mother's immediate family who has diabetes, then the risk of diabetes is higher. In addition, obesity is also an important risk factor for diabetes, which can lead to insulin resistance, which is one of the most important links in the occurrence and development of type 2 diabetes. Patients with high blood pressure, hyperlipidemia, hyperuricemia, etc., are also more likely to develop diabetes.
Text: Xiamen Evening News reporter Gong Xiaoguan, Wang Yanni, correspondents: Jiang Changming, Chen Jiajun, cartoons, Niu).