Home » Health Park | Joint prevention and treatment of “sugar”, “heart” and “kidney”, diabetes complications are expected to reverse – Teller Report Teller Report

Health Park | Joint prevention and treatment of “sugar”, “heart” and “kidney”, diabetes complications are expected to reverse – Teller Report Teller Report

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Health Park | Joint prevention and treatment of “sugar”, “heart” and “kidney”, diabetes complications are expected to reverse – Teller Report Teller Report

Health Park | Joint prevention and treatment of “sugar”, “heart” and “kidney”, diabetes complications are expected to be reversedFly into the homes of ordinary people

If diabetes continues to progress without intervention, the harm can be great, and the first is the important target organ complications. As one of the most common and most harmful complications of diabetes, diabetic nephropathy has clinical characteristics such as high incidence, low awareness rate, and low treatment rate. The prevention and treatment of diabetic nephropathy has a long way to go. On the eve of World Kidney Day, clinical experts shared the latest information on the prevention and treatment of diabetic nephropathy, building a cognitive bridge for readers and sharing kidney health.

Prevention of complications becomes the primary goal of treatment

With the increase in the prevalence of diabetes, the number of people with diabetic nephropathy has increased significantly. Professor Li Xiaoying, director of the Endocrinology Department of Zhongshan Hospital Affiliated to Fudan University and deputy director of the Diabetes Branch of the Chinese Medical Association, said that in order to help patients maximize the efficacy of target organs such as the heart, brain and kidney, the authoritative diabetes guidelines at home and abroad have undergone fundamental changes, no longer simply Taking lowering blood sugar as the primary goal pursued, it is to push the benefits of cardiovascular, cerebrovascular and kidney, and standardize the treatment of important complications that endanger patients’ lives to the forefront of the treatment goals. It is believed that after more diabetic patients receive standardized drug treatment, including SGLT-2 inhibitors, GLP-1 receptor agonists, etc., diabetic nephropathy and diabetic cardiovascular disease will show a downward trend in the future.

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Professor Li Xiaoying advocates moving the threshold forward and strengthening the comprehensive prevention and control of diabetes, including lifestyle prevention such as work and rest, exercise, diet, sleep, etc., as well as intervention for risk factors. Hyperglycemia, hypertension, hyperuric acid, obesity, etc. will affect The progression of diabetic nephropathy. Diabetic patients should have the awareness and behavior to control the above health indicators within a controllable range, so as to reduce the risk of adverse events of diabetic nephropathy and the risk of death.

The “Guidelines for the Prevention and Treatment of Diabetic Nephropathy in China (2021 Edition)” recommends that all patients with type 2 diabetes and patients with type 1 diabetes with a course of more than 5 years should have urine albumin/creatinine ratio detection and glomerular filtration rate when they are diagnosed. Evaluation for early detection of diabetic nephropathy, and screening should be performed at least once a year thereafter. In addition to regular blood tests and urine tests to detect renal function indicators, B-ultrasound examinations should also be performed regularly to detect pathological changes such as kidney size and structure in time, and to treat them early. With the enrichment of innovative treatment methods and the strengthening of new drug approvals and medical insurance, the availability of drug treatment for diabetic patients has been greatly improved, and the early screening and diagnosis of diabetic nephropathy will be strengthened.

Early intervention promises to reverse diabetic nephropathy

Chronic kidney disease means that the kidneys are damaged, unable to filter the blood the way they should, and unable to control the amount of water and electrolytes in the body. This damage causes waste products to build up in the body and patients may experience a range of symptoms such as edema, tiredness, Nausea, muscle cramps, pain, joint effusion, and memory problems. Patients with end-stage renal disease require hemodialysis or peritoneal dialysis or even a kidney transplant to stay alive. Professor Jiang Gengru, Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, introduced that about 40% of patients with type 2 diabetes will develop chronic kidney disease, and these patients are at high risk of kidney disease progression and cardiovascular events. The presence of microalbumin in urine is an early sign of diabetic nephropathy. If diabetic nephropathy is detected and treated early, the disease can be well controlled or even reversed. Once the early treatment opportunity is missed, massive proteinuria occurs, the glomerular filtration rate decreases, and eventually renal failure may occur, which is life-threatening.

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It has become clear that diabetes, chronic kidney disease and cardiovascular disease are interconnected. Professor Jiang Genru pointed out that some diabetic nephropathy patients died of serious cardiovascular complications before they entered dialysis. The treatment of diabetic nephropathy requires the joint management of multiple clinical disciplines such as endocrinology, nephrology, urology, and nutrition. Prevention and treatment mainly focus on the control of blood sugar, blood pressure, blood lipids, body weight and other indicators. The main treatment drugs include α-glucosidase inhibitors, GLP-1 receptor agonists, SGLT-2 inhibitors and other hypoglycemic drugs; angiotensin-converting enzyme Antihypertensive drugs such as inhibitors and angiotensin II receptor blockers. The EU has also recently approved the first non-steroidal selective mineralocorticoid receptor antagonist, which fills the gap in the treatment of diabetic nephropathy and will bring new options for patients in the future.

Professor Jiang Genru reminded patients of the importance of diet and treatment. The overall dietary principle is to control the total amount, with a variety of varieties and reasonable matching, and choose high-quality proteins that are easy to digest and absorb, such as milk, eggs, and lean meat. Control the intake of salt, not more than 6 grams per day, and control about 3 grams per day for patients with severe illness. The cooking method is equally important. It is best to blanch dark green leafy vegetables first to reduce the intake of purines and trace elements phosphorus. Drink an appropriate amount of water daily. At the same time, moderately participate in physical activity every day, and choose a suitable exercise program with reference to the professional advice of the doctor.

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(Pan Jiayi)

Editor: Pan Jiayi

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