For every extra day you gain weight, your risk of developing diabetes increases.

5.4 Every extra day you gain weight increases your risk of developing diabetes.

5.4.1 What is diabetes?

With the rapid development of my country's economy and the gradual improvement of people's living standards, the incidence of diabetes is also rising dramatically. Relevant statistics show that China has become a major diabetes country in the world, with 92 million people diagnosed with overt diabetes (a prevalence rate of 9.7%), and over 100 million people in the prediabetes stage (latent diabetes).

Diabetes mellitus is a metabolic disease characterized by hyperglycemia, caused by a deficiency in insulin secretion or impaired insulin action. Clinically, it is characterized by hyperglycemia as the main feature. Typical cases may present with polyuria, polydipsia, polyphagia, and weight loss. If blood sugar is not well controlled, it can lead to complications, causing failure and damage to organs such as the kidneys, eyes, and feet. In severe cases, it can lead to uremia.

Early signs of diabetes

(1) Feeling sleepy after eating

This indicates a flawed diet. Continuing to eat like this in the long term could increase the risk of diabetes.

(2) Apple-shaped body

People with an apple-shaped body (thicker waist) have more visceral fat and are at greater risk of insulin resistance and prediabetes.

(3) Numbness in the hands and feet

Diabetes can cause peripheral neuritis, which can cause numbness, pain and burning sensation in the hands and feet. Some people may also experience a feeling of walking on cotton.

(4) Three more and one less

The patient experienced a significant increase in appetite, but weight loss, accompanied by excessive thirst and urination.

(5) Skin itching symptoms

Itching often makes it difficult to fall asleep, especially itching in the female genital area.

Diagnostic criteria for high-risk groups of diabetes

① Individuals aged ≥45 years; those with a body mass index ≥24; those with a history of impaired glucose tolerance or fasting blood glucose regulation; or those with glycated hemoglobin Alc between 5.7% and 6.5%.

②Those with a family history of diabetes.

③ Individuals with low high-density lipoprotein cholesterol (<0.9mmol/L) or high triglycerides (>2.8mmol/L).

④ Individuals with hypertension (adult blood pressure ≥140/90 mmHg) or cardiovascular and cerebrovascular diseases.

⑤ Pregnant women aged ≥30 years with a history of gestational diabetes; women who have delivered babies weighing ≥4kg; women with unexplained prolonged labor; and women with polycystic ovary syndrome.

⑥ Those who do not participate in physical activities year-round.

⑦ Use of glucocorticoids, diuretics, etc.

5.4.2 Insulin and Blood Glucose

Blood sugar levels directly affect the condition of diabetic patients, and insulin is a drug developed to stabilize blood sugar. Blood sugar refers to free glucose present in the blood. Most of the energy required for the activities of various tissues and cells in the body comes from glucose, so blood sugar must be maintained at a certain level to meet the needs of the body's organs and tissues. Insulin works by binding to insulin receptors on cell membranes (like a key to a keyhole), promoting the entry of glucose from the blood into cells.

Blood glucose circulates throughout the body via the bloodstream and is closely related to the metabolism of all tissues and cells. Therefore, the stability of blood glucose affects the body's normal physiological functions. Under normal circumstances, blood glucose is in a dynamic equilibrium, with daily consumption and replenishment occurring simultaneously. However, the blood glucose levels of diabetic patients are unstable. Insulin is the only hormone that lowers blood glucose under physiological conditions. Insulin can prevent the liver from exporting glucose, promote glucose transport and utilization, regulate glucose synthesis, and inhibit gluconeogenesis. Blood glucose levels and insulin levels mutually regulate each other, maintaining the stability of both blood glucose and insulin levels.

So, should diabetic patients use insulin as much as possible? While insulin can lower blood sugar, it can also harm the treatment of diabetes. Insulin is a hormone that can promote the growth of tumor tissue. Clinically, many diabetic patients were diagnosed in their 30s with good medical conditions and have been using insulin to control their blood sugar since the onset of the disease. However, by their 60s, their blood sugar could no longer be lowered by insulin injections, the insulin became ineffective, and their bodies developed drug resistance. This can then lead to kidney damage, soaring blood pressure, blindness, lower limb amputation, myocardial infarction, and other complications.

5.4.3 Types and Risks of Diabetes

Diabetes can be classified according to its cause: primary diabetes (the diabetes we usually talk about), secondary diabetes, and diabetes caused by other reasons. In clinical practice, the classification system proposed by the World Health Organization (WHO) based on the etiology of diabetes is generally used. This classification system suggests dividing diabetes into one main type: type 1 diabetes, type 2 diabetes, other special types of diabetes, gestational diabetes, and secondary diabetes.

(1) Type I diabetes (insulin-dependent)

Type 1 diabetes accounts for 5% to 10% of all diabetes cases. It typically occurs in people under 30 years old, with lower incidence in adults and the elderly. Type 1 diabetes requires insulin injections; otherwise, ketoacidosis can occur, which can be life-threatening if left untreated. Patients may experience sudden ketoacidosis, even coma, or lose 5-10 kg in a few days or 10 days. They may become insulin-sensitive and thin. However, some patients experience a slower onset, and some initially develop non-insulin-dependent diabetes but gradually transition to insulin-dependent diabetes.

(2) Type II diabetes (non-insulin dependent)

Type 2 diabetes accounts for 80% to 90% of all diabetes cases. Most cases develop after age 35, with a slow and insidious onset; some patients are diagnosed during routine health checkups. Overweight or obese individuals are the most common culprits. Type 2 diabetes often develops in adulthood, particularly in old age, but it can also occur in childhood. Insulin treatment is generally not required.

[Classification] Types of Diabetes:

Type 1 diabetes: The cause is a lack of insulin secretion, and patients must rely on insulin to treat the disease and maintain their lives.

Type 2 diabetes: The insulin secretion is not low, but the body is not sensitive to insulin (i.e., insulin resistance).

(3) Other special types and gestational diabetes

The causes of type 1 and type 2 diabetes are not well understood and are called primary diabetes. Other specific types of diabetes generally have identifiable causes, such as impaired insulin synthesis due to pancreatic disease, concurrent use of medications that raise blood sugar, excessive secretion of hormones that counteract insulin due to other endocrine factors, long-term malnutrition, or low protein intake. Gestational diabetes is a unique type of diabetes diagnosed during pregnancy. Clinical data shows that 2% to 3% of women develop diabetes during pregnancy, and nearly 35% of pregnant women experience symptoms of gestational diabetes. These women may develop type 2 diabetes.

(4) Secondary diabetes mellitus

Secondary diabetes refers to diabetes with a known cause, such as pancreatotomy, acute or chronic pancreatitis, Cushing's syndrome, or acromegaly. Additionally, long-term use of certain medications, such as prednisone and hydrochlorothiazide, can also induce diabetes. Secondary diabetes is less common than primary diabetes. Unless otherwise specified, when we refer to diabetes, we generally mean primary diabetes.

The Dangers of Diabetes

1) Harm to the cardiovascular and cerebrovascular systems. Cardiovascular and cerebrovascular complications are fatal complications of diabetes.

2) Harm to the kidneys. High blood sugar, high blood pressure, and high cholesterol lead to abnormally elevated glomerular microcirculation filtration pressure, promoting the occurrence and development of diabetic nephropathy. Early symptoms include proteinuria and edema, while late-stage symptoms include kidney failure, which is the leading cause of death in type II diabetes.

3) Harm to peripheral blood vessels. The main harm of diabetes to peripheral blood vessels is atherosclerosis of the lower extremities. Due to elevated blood sugar, diabetic patients may develop peripheral vascular disease, leading to decreased sensitivity of local tissues to damaging factors and insufficient blood perfusion. When external factors damage local tissues or local infections occur, they are more prone to local tissue ulcers than the general population. The most common site of this risk is the foot, known as diabetic foot.

4) Damage to nerves. Diabetic neuropathy is one of the most common chronic complications of diabetes and a leading cause of death and disability in diabetic patients. Peripheral neuropathy and autonomic neuropathy are the most common forms of diabetic neuropathy.

[Harm to different groups of people]

For men: Diabetes can cause prostate enlargement and difficulty urinating. In middle-aged men, it can lead to disharmony in their marital life.

Women: Women with diabetes are particularly prone to spontaneous abortion or fetal malformations.

Children: Children with a long history of diabetes are particularly prone to developing diabetic complications.

Elderly people: are prone to complications such as diabetes, hypoglycemia, and cataracts.

Pregnant women: Diabetes can cause difficult labor during childbirth, resulting in the birth of a macrosomic baby.