Diabetes mellitus is an endocrine and metabolic disease characterized by maintaining a high blood sugar level, which leads to metabolic disorders such as sugar, protein, fat, water and electrolyte, and makes the body in a state of hyperglycemia. The patients mainly reported polydipsia, polyuria, polyphagia, emaciation and fatigue. Severe ketoacidosis, pruritus of skin and vulva, urinary tract infection, unhealed wounds of various infections, diabetes, etc. can also lead to many complications, such as hypertension and coronary heart disease. Macrovascular atherosclerosis, retinopathy, diabetic nephropathy, neuropathy, acrogangrene, cataract, etc. Seriously endanger people's physical and mental health. Diabetes is asymptomatic in the early stage, and many patients don't know it. We found many patients when we gave residents a free physical examination. Some patients don't admit the reality and doubt their illness. This requires our community medical workers to make an overall goal to help residents understand diabetes knowledge.
The population of our community is 30,000, and the prevalence rate is 4% and 6%. Our community hospital plans to hold 200 diabetes health education studies before 20 10 and 10. Community doctors will hold lectures in community hospitals or neighborhood committees, explain diabetes knowledge to community residents through pictures, multimedia and other forms, popularize diabetes knowledge in the community, improve the awareness rate of community residents' knowledge of diabetes prevention and treatment, advocate healthy lifestyles and habits, and achieve proper exercise, weight control, reasonable diet and proper diet. Teach residents to identify the symptoms of diabetes and the auxiliary examination items that should be done for medical treatment. Such as: more than three symptoms, thirst, repeated hypoglycemia before meals, urinary tract infection, wound healing after various infections. By adopting the method of dividing age groups, the high-risk groups are gradually moved to the general population, and combined with the general health survey, community residents are organized to regularly measure blood sugar and urine sugar, screen high-risk individuals, and establish community files of diabetic patients, with a filing rate of 60%. Dynamic management is implemented, and the management rate reaches 50% and the control rate reaches 30%. The awareness rate of prevention and control knowledge was 65%, the participation rate was 70%, and the change degree of quality of life was 50%.
The diabetes health plan mainly includes the following four aspects:
1 dietary guidance
(1) Make a diet plan according to the patient's height and weight, and calculate the total daily calories.
(2) Explain the importance of dietotherapy to patients, and make them pay attention to and understand the basic knowledge of diet. No matter what type of diabetes, no matter whether the condition is light or serious, whether there are complications, whether to use drugs, oral drugs or insulin, we should adhere to diet treatment for a long time.
(3) Explain the purpose of reasonable diet to patients: ① Reduce the burden of insulin. 2 lose weight or gain weight. ③ Reduce postprandial hyperglycemia. ④ Correcting the metabolic disorder that has occurred. ⑤ Prevention and treatment of acute and chronic complications. ⑥ Improve the overall health level.
2 sports guidance
(1) Physical exercise is of great benefit to diabetic patients. Explain the basic knowledge of exercise therapy to patients: ① It should be done 30 minutes after meals, 20-30 minutes each time, and 3-4 times a week is the most appropriate. ② Drink plenty of water before exercise. 3 take candy, drinks, etc. It is easy to take with you and prevent hypoglycemia reaction. Diabetic patients wear information cards. ④ Do low-intensity activities for 5~ 10 minutes before exercise. ⑤ Wear soft cotton socks and sports shoes that fit.
(2) Exercise precautions: ① Patients with blood sugar higher than 15mmol/L should not exercise. ② Patients with diabetic nephropathy should not exercise. ③ Those with systolic blood pressure greater than 1.80 mmHg should not exercise. (4) When you get up in the morning, you should move slowly, not violently, to prevent cerebrovascular accidents in the head with concentrated blood, to keep the stool unobstructed, to prevent the abdominal pressure from increasing, and to be accompanied by family members during exercise to prevent falling.
3 Prevention and guidance of complications
(1) Always maintain personal hygiene and cleanliness, wear cotton and loose clothes, move gently, change underwear frequently, and cut nails frequently to prevent skin from being infected.
(2) Pay attention to eye hygiene, close your eyes often, and don't watch TV or books too much.
(3) Pay attention to rest, don't be tired, and keep warm in winter, that is, warm head, back and feet to prevent upper respiratory tract infection caused by the invasion of exogenous pathogens.
(4) Soak your feet with warm water before going to bed at night. The water temperature is lower than 50℃, which promotes blood circulation and is beneficial to sleep.
4. Blood sugar monitoring and drug treatment guidance
Diabetes treatment must be based on diet control and exercise therapy. People with diabetes should avoid sugar and sugary foods, reduce the intake of high-fat and high-cholesterol foods, eat high-fiber and starch foods in moderation, and eat less and more meals. The choice of exercise should be carried out under the guidance of a doctor. Try to do full-body exercise, including walking and jogging. On this basis, appropriate insulin sensitizing drugs should be used, rather than excessive use of drugs to stimulate insulin secretion, in order to achieve the purpose of long-term effective control of blood sugar. The specific treatment is as follows:
(1) Regular blood glucose measurement is beneficial to the adjustment of treatment plan. The loss of the body's ability to regulate glucose metabolism in diabetic patients, such as weather changes, improper diet, tension and fatigue, mood swings, etc., will lead to changes in blood sugar. At this time, it is necessary to self-monitor some indicators of blood sugar in order to adjust the treatment plan of diet, exercise and medicine in time.
(2) Drug therapy includes oral drugs and insulin injection: (1) Oral drugs: When a single drug with a conventional dose cannot effectively control blood sugar, it should be combined as soon as possible. Generally, two drugs are used, and at most three drugs are used.
⑵ Insulin injection: ① Applicable people: Under normal circumstances, patients with type I diabetes and type II diabetes who have poor oral drug effect should be injected with insulin. ② Injection site: The commonly used injection sites are the outer sides of the upper arms, the sides of the abdomen and the outer sides of the thighs. ③ Precautions: The injection site should be rotated each time. If mixed insulin is needed, quick-acting insulin should be extracted first, and then medium-acting or long-acting insulin should be extracted. In order to prevent skin infection, disposable syringes should be used correctly and the skin should be strictly disinfected before injection. ④ Preservation: The unopened insulin should be kept in a refrigerator at 2 ~ 8℃, which can be kept for two years without freezing. The activated insulin can be stored for 65,438+0 months at room temperature of 25℃, avoiding high temperature and direct sunlight.
The author believes that with the joint efforts of medical staff in our community, the awareness rate of diabetes among community residents will be gradually improved, and the quality of life of residents will be gradually improved, so that medical staff and residents in our community can jointly create a healthy and harmonious community.