-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*For medical professionals only
Be cautious when using these cold medicines!
Compared with normal healthy people, diabetic patients have significantly lower immunity, so whenever the seasons turn or the temperature plummets, patients are prone to colds and fevers, especially elderly patients, which are often not spared
.
A cold and fever may not be a big deal for the average person, but if it occurs in diabetics, the problem is much
more serious.
Once improperly handled, it will not only lead to uncontrolled blood sugar, induce acute complications such as "ketoacidosis", but also cause the spread of infection and pneumonia, or lead to hypertension, cardiovascular and cerebrovascular diseases, chronic heart failure and other comorbidities, resulting in aggravation of the condition and life-threatening!
Therefore, the following 6 points, endocrinologists must be clear!
1
How does a cold and fever affect blood sugar?On the one hand, cold and fever, as a stress response, stimulate the body to secrete a large number of stress hormones (such as cortisol, epinephrine, glucagon, etc.
), these "stress hormones" have the effect of antagonizing insulin, can Cause a significant increase in blood sugar, severe cases can induce "ketoacidosis", "non-ketotic hyperosmolar coma" and other acute complications
of diabetes.
On the other hand, due to unwell and poor appetite when you have a cold, you tend to eat less than usual, so your blood sugar may drop
somewhat.
In addition, poor sleep, mood changes, reduced activity, irregular meals and medication can also have a certain impact
on blood sugar.
Therefore, cold and fever can cause significant fluctuations in blood sugar, which may rise or fall, so it is especially important
to strengthen blood glucose monitoring during illness.
2
How do I arrange my diet during my illness?During illness, appetite will definitely be affected to varying degrees, in order to reduce this effect, patients can eat light and easily digestible food to meet the basic caloric needs of the body and avoid hypoglycemia
.
If the patient has difficulty swallowing dry rice, it can also be changed to liquid, semi-liquid, or soft foods such as porridge, noodles, wontons, cereals, milk, juice, etc
.
If your appetite is too poor, you can take small and frequent meals and eat
them multiple times.
For example, eat foods containing 15g of sugar every 1~2 hours, or 50g of sugars every 3~4 hours (which is equivalent to about 1 bowl of rice).
If the blood sugar at night is lower than 5.
6mmol/L, carbohydrate foods should be supplemented to avoid hypoglycemia
.
In addition, fever, sweating, vomiting, diarrhea will cause a large amount of body fluids and electrolytes to lose patients, therefore, we must pay attention to supplement enough water and electrolytes (such as warm water, light salt water, weak tea, etc.
), insist on drinking 2000~2500 ml of water every day; If the patient cannot eat, he can also choose to drink some rice porridge, fresh fruit and vegetable juice and so on
.
Oral rehydration solutions not only prevent dehydration, but also help improve circulation, thin the blood, lower blood sugar, increase urine output, and remove ketones
.
3
How is the condition monitored?As mentioned earlier, patients with large blood glucose fluctuations during cold and fever are prone to induce ketoacidosis, so it is necessary to strengthen the monitoring
of blood glucose and urine ketones.
Generally, it is necessary to test according to the frequency of measuring blood glucose at 7 time points per day, that is, before three meals + after three meals + before
going to bed.
If abnormal blood sugar fluctuations occur in the morning, blood glucose measurement at 2 or 3 a.
m.
should be added if necessary.
In addition, when the blood sugar > 13.
9mmol/L (250mg/dl), urine ketones should be measured every 4~6 hours, which is very necessary, especially for patients with type 1 diabetes
.
If persistent high blood glucose or a positive ketone urine test is found, the patient should be informed to come to the hospital
promptly.
4
How to choose cold medicine for diabetics?Cold symptoms, development and course of the individual differences are large, to diabetic patients to choose cold medicine according to the individual condition scientific selection, the following points can be used as a reference principle:
(1) most of the cold drugs have antipyretic and analgesic effect, antipyretic often accompanied by a lot of sweating, resulting in fluid loss, hemoconcentration, Patients should pay attention to replenishing water after taking antipyretics to maintain fluid balance
.
In principle, try not to use hormonal drugs (eg, dexamethasone) cools down because of its pronounced glycemic effect
.
(2) Diabetic patients with cardiovascular and cerebrovascular diseases and hypertension should be cautious with cold medicines containing vasoconstrictors (such as pseudoephedrine hydrochloride, etc.
), which may induce vasospasm, lead to increased blood pressure, and induce angina, myocardial infarction or stroke
.
(3) Try not to use sugary cough and phlegm drugs, such as acute branch syrup, Chuanbei loquat ointment, cough syrup, etc
.
Such drugs have high sugar content and are easy to cause blood sugar fluctuations, and sugar-free preparations
such as ambroxol and fresh bamboo drain can be selected.
(4) Patients who eat poorly and need rehydration, when intravenous glucose infusion, should pay attention to adding ordinary insulin
in proportion.
(5) If the patient has bacterial infection at the same time, antibiotics should be added as
appropriate.
5
How do you keep your blood sugar steady during illness?During the infection and fever, the body is in a state of stress, and the secretion of various glycemic hormones in the body, such as glucocorticoids, glucagon, catecholamines, etc.
, is increased, even if the patient has a poor appetite and eats little, blood sugar may be very high, therefore, even if you cannot eat normally during illness, the patient cannot stop the drug (including insulin) rashly, Failure to do so may lead to serious acute complications
such as ketoacidosis.
▎The correct thing to do is:
Close glucose monitoring, according to the results of blood glucose monitoring and the patient's eating situation, under the guidance of professional doctors to adjust the dosage
.
In addition, patients who cannot eat and who are strongly positive for urine ketones should be treated
with insulin.
6
When do I need to be hospitalized?Colds and fevers can easily induce serious problems
in diabetics.
For safety reasons, it is recommended that patients be hospitalized once they have the following conditions:
(1) the infection control is not ideal, and the fever does not subside;
(2) Vomiting and diarrhea for several days, difficulty in eating and water intake, and obvious dehydration;
(3) The patient's symptoms of "three more and one less" are aggravated, and there are obvious digestive tract reactions (nausea, vomiting, abdominal pain, etc.
), severe dehydration and other symptoms (dry and cracked lips and tongue), unconsciousness, deep breathing, exhaled air with apple smell, and positive urine ketone body test;
(4) High blood sugar (fasting or preprandial blood glucose level exceeds 13.
9mmol/L, postprandial or random blood glucose exceeds 17mmol/L) or frequent severe hypoglycemia
.
The 2022 American Obesity Week was recently held
online and offline.
Every year, Obesity Week brings together cutting-edge advances in the field of obesity and brings advanced obesity diagnosis and treatment to
clinicians.
This time, the "Medical Endocrinology Channel" is honored to invite the Department of Endocrinology of Shanghai Tenth People's Hospital to share an academic feast with everyone~
Don't want to miss the hot research? Please lock the "Medical Endocrinology Channel", wonderful interpretation will be launched soon!
Where to see more endocrinology clinical knowledge? Come to the "doctor's station" and take a look 👇
