Persistent diabetes, also known as intractable diabetes or difficult-to-control type of diabetes in the blood, refers to a clinical condition in which, under lifestyle intervention and regulated drug treatment (including multiple oral glucose reduction combinations, or insulin therapy), blood sugar remains uncontrollable for a long period of time (glucose levels do not reach the glycemic index) or blood sugar fluctuates greatly, resulting in repeated high blood sugar and low blood sugar. Persistent diabetes is not an independent disease diagnosis, but reflects the difficulties and challenges in managing diabetes, which are common in patients with long-term diabetes, multiple complications, multiple disruptors or syndromes, and long-term low blood sugar, which significantly increases the risk of cardiovascular and major complications. Common causes of persistent blood sugar control include: treatment of sexual dysfunction (leakage of medications, irregular injection of insulin, self-stopping of insulin); dietary and exercise management (incapacity for eating, structural abnormalities, lack of regular exercise); insulin resistance (severe obesity, metabolic syndrome) or insufficient insulin function; Inadequate or inadequate dose selection, inadequate adjustment; complications and complications affecting infection, acute stress, thyroid dysfunction, Cushing's syndrome, chronic liver disease, impaired liver function affecting drug metabolism and excretion; other medications interfere with glucose metabolism; certain diuretics, β-receptor blockers; blood sugar monitoring is insufficient and cannot be adjusted in a timely manner; psychological factors such as anxiety, depression, stress; sleep apnea, pregnancy, and other special conditions.
Persistent high blood sugar itself can also exacerbate insulin resistance to β-cell damage, and lead to malignant cycles. Persistent diabetes is clinically manifested by persistent high blood sugar at its core: hunger and (or) significantly elevated post-meal blood glucose levels, long-term hypoglycemia; patients with typical 'three or three or fewer' symptoms (over-drinking, overeating, over-urine, weight loss), weakness, blurred vision, or no obvious symptoms; low blood sugar fluctuations (heart attack, sweat, coughing, hunger) can be accompanied by high blood sugar, and repeated low blood sugar suggests that insulin doses or dietary combinations are inappropriate and timely. Long-term poor blood sugar control can accelerate the development of complications such as diabetes, retinal disease, epilepsy, neurological disorders, cardiovascular disease, and more.
The assessment of persistent diabetes requires a comprehensive look at the reasons for the difficulty in controlling blood sugar. Monitoring: strengthening self-blood sugar monitoring (fasting, after meals, before bed, when necessary, dynamic blood sugar monitoring), accurate assessment of the blood glucose spectrum; checking: checking glucose, insulin function (CQ), hepatic function, thyroid function, urine routine, and so on; checking for combinations and complications; assessing the performance and psychological state of drug use, sexual dietary movement. Treatment of persistent diabetes emphasizes 'comprehensive governance, individual strengthening'.
It is based on strong lifestyle interventions: medical nutritional therapy, personalized diet regimens, control of total calories, balanced nutrition, regular eating, regular exercise, oxygen + resistance, at least 150 minutes per week, weight management. Treatment requires 'multipoint combination, timely intensification': oral glucose lowering medications of several different mechanisms combined (dihydroxyl+DPP-4 inhibitors/SGLT-2 inhibitors/GLP-1 receptor activators, etc. ), SGLT-2 inhibitors and GLP-1 receptor activators have a cardiovascular protective effect in addition to glucose lowering; oral medications need to activate insulin as early as possible when uncontrollable, the insulin regimen requires individualized adjustment of the baseline insulin, the pre-mixing insulin or the baseline meal regimen, and, if necessary, the continuous subcutaneous insulin injection of insulin insulin; Dynamic blood glucose monitoring in conjunction with insulin pumps to form an 'artificial pancreas' can significantly improve blood glucose control, reduce low blood glucose.
At the same time, it can treat syndromes (high blood pressure, hyperglycemia, obesity, thyroid disease), treat stress and infections, improve sleep and mood. Regular follow-up, multidisciplinary associations (nootropics, nutrition, psychology) help break the blood glucose control bottle. Management of persistent diabetes requires a high level of coordination and ongoing support from the patient's medical team.
Patients should adhere to the regulation of treatment, regular monitoring, such as real-time recording of dietary movement and blood glucose, close communication with doctors, and timely adjustment of programs; Do not use medications because of a lack of blood sugar or self-incrimination. Actively control blood sugar, blood pressure, blood fat, weight, comprehensive management can effectively delay complications, improve quality of life and long-term prognosis.
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