Core tips: Patients with hypertension in the early diagnosis of fasting blood glucose examination to determine whether complicated with diabetes.
Uncle Li is 78 years old this year. He has suffered from hypertension for more than ten years. To control his blood pressure, the dosage of this medicine is also increasing.
"When people get old, everything is decreasing, but the amount of medicine is increasing, and the types of medicine are also increasing." Uncle Li said and swallowed several antihypertensive drugs in his mouth.
After taking the antihypertensive drugs, Uncle Li began to play chess with the old guys. It seems that there is no difference between peacetime. The chess fight is tense. No one noticed that Uncle Li was sweating a lot today. Maybe even the highly nervous Uncle Li didn't notice that he was sweating a lot, which is not commensurate with the cold winter.
Finally, the game was divided and everyone went home. But Uncle Li didn't stand up and fainted.
He was sent to the doctor in an emergency. After examination, the doctor determined that Uncle Li had hypoglycemia. After adding glucose, his condition improved quickly.
After the false alarm, Uncle Li was about to go home, but the doctor gave advice on screening diabetes.
"I'm hypoglycemic. Why screen for diabetes?" Uncle Zhang didn't understand.
"Uncle Li, diabetic patients are more prone to hypoglycemia than ordinary people due to the disorder of glucose metabolism. Because of your age, physical condition, and other high-risk factors for diabetes, we suggest that you do a diabetes screening." The doctor explained patiently.
After fasting blood glucose, 2-hour blood glucose, urine sugar, glycosylated hemoglobin, and other tests, Uncle Li was diagnosed with diabetes.
Hypertension complicated with diabetes, these three mistakes should not be made
After the diagnosis of diabetes, the doctor further determined the cause of hypoglycemia and found that the problem still lies in Uncle Li's antihypertensive drugs. The doctor said that hypertension complicated with diabetes, these three mistakes should not be made, Uncle Li has made.
1. There should be no lack of inspection
At the beginning of diagnosis, patients with hypertension should have a fasting blood glucose test to determine whether they are complicated with diabetes. But the further physical examination, Uncle Li has not done. He said, my body, I know, my blood pressure is a little high, there is no other discomfort, take antihypertensive drugs have done their part.
In this way, in every review, Uncle Li just simply measured his blood pressure and did nothing else.
2. These two kinds of drugs should not be used
Uncle Li is also suffering from diabetes because he did not do the examination, he did not know, the attending doctor did not know. With the development of the disease, Uncle Li has launched a four-drug antihypertensive program. The drugs Li used were dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibitors, thiazide diuretics, and beta-blockers.
Doctors said that patients with hypertension complicated with diabetes are not recommended to use diuretics and beta-blockers as antihypertensive drugs.
On the one hand, thiazide diuretics can reduce insulin sensitivity, on the other hand, its pharmacological effect of promoting urination will lead to the decrease of water content and blood volume in the body. Under the combined action of these two factors, it is easy to lead to an increase in blood glucose concentration.
Beta-blockers can reduce insulin sensitivity and affect the recovery of blood glucose levels after the use of hypoglycemic drugs. When diabetic patients taking beta-blockers have hypoglycemia, they often only have sweating symptoms, which affects the timely detection and treatment of hypoglycemia.
Some studies have shown that the combination of diuretics and bet blockers can increase the risk of diabetes in diabetes susceptible populations, so the combination of diuretics and beta-blockers should be avoided as far as possible.
3. Lifestyle intervention should not be ignored
At the beginning of the diagnosis of hypertension, the doctor advised Uncle Li to start lifestyle intervention and formulated a detailed guidance plan for him. When Uncle Li saw it, he couldn't eat it or move it. There were too many restraints, so he didn't abide by them. This has led to the deterioration of the disease, hypertension control more and more difficult.
Strict lifestyle intervention for patients with chronic diseases can completely reverse the abnormal indicators of the body in the early stage of illness or the early stage of chronic diseases.
