What Is Stress Hyperglycemia?

Stress diabetes

Stress diabetes is in various critically ill patients, such as high fever, acute myocardial infarction, cerebral hemorrhage or cerebral thrombosis, major surgery, trauma such as fractures, severe burns, etc.Due to the stress state, the secretion of glycemic hormone such as glucocorticoid Usually increased by more than 10 times, glucagon, catecholamines, growth hormones, etc. are also secreted, and temporarily appear pathological phenomena of hyperglycemia, urine glucose and impaired glucose tolerance.

Stress Diabetes Disease Name

Stress diabetes

Classification of stress diabetes

Endocrinology

Stress diabetes symptoms and signs

Increased ketone bodies; polyuria; high urine specific gravity, thirst, hypertonic dehydration, azotemia, mental symptoms, coma, etc.

Stress diabetes treatment options

Stress diabetes 1. Remove the cause, pay special attention to prevention and treatment of shock and severe infection.

2. Temporary blood sugar rise in the early stage of burn, no special treatment is required.

3. Patients with continuously elevated blood glucose should be treated with insulin according to daily blood glucose and urine glucose levels. At the same time, when the glucose solution is dripped into the vein, insulin is added at 3: 1 or 4: 1. When hyperglycemia cannot be controlled after increasing insulin, hypertonic glucose solution should be stopped.

4. Pay attention to correct the imbalance of water, electrolyte and acid-base balance: the dehydration caused by hyperglycemia is hypertonic dehydration, which should be supplemented with water (oral or intravenous 5% glucose solution). Sometimes due to elevated blood glucose, intracellular fluid moves outwards, so that extracellular fluid is diluted, hyponatremia may occur. At this time, hypertonic sodium chloride solution should be used with caution.

Medication Safety for Stress Diabetes

At present, some people believe that indomethacin has sufficient sources, is inexpensive, convenient to take, and has certain clinical application value. The disadvantage is that it should prevent the induction of stress ulcers when it is used too much. Therefore, it is necessary to strictly control the dosage and observe it during the treatment.

Pathophysiology of Stress Diabetes

Stress diabetes As a response system, stress is controlled by biofeedback regulation. In the classic stress response, when the body is strongly stimulated, the stress response is mainly changed by the nerve and endocrine. The sympathetic-adrenal medulla system and the hypothalamus-pituitary-adrenal cortex axis are strongly excited and suppressed. Both physiological changes and external performance are related to the intense excitement and inhibition of these two systems. During stress, the excitement of the sympathetic-adrenal medulla system during stress can produce a series of metabolic and functional changes to promote glycogen breakdown and increase blood sugar. Increased secretion of glucocorticoids (GC) is one of the most important responses to stress. GC promotes the breakdown of proteins, transfers amino acids to the liver, and greatly enhances the gluconeogenesis process. At the same time, GC inhibits glucose in peripheral tissues, promotes glycogen decomposition, increases blood sugar, promotes fat mobilization, and increases free fatty acids in plasma, thereby ensuring that the body's increased use of energy requirements during stress increases blood sugar. GC also plays a permissive role in the metabolic functions of catecholamines, auxins and glucagon.

Causes of stress diabetes

Stress-induced blood glucose rises due to severe burn shock, major surgery, severe infections, drug effects, and large amounts of glucose taken orally or intravenously.

Stress diabetes diagnosis test

Stress diabetes 1. Measure fasting blood glucose, 2h postprandial blood glucose, and 24h urine glucose for 2 consecutive days after admission. Repeat the inspection as necessary later, but not less than once every two weeks. If fasting vein plasma glucose is less than 7.8mmol / L (140mg / d1 glucose oxidase method) and the diagnosis is not clear, glucose tolerance test can be measured. If repeated fasting blood glucose is 7.8mmol / L (140mg / d1) and 2h postprandial blood glucose is 11.1mmol / L (200mg / d1), no further glucose tolerance test is required. Blood test and urine ketone body, blood insulin or C peptide, blood lipid, lipoprotein, urinary protein, urine microalbumin, renal function, carbon dioxide binding ability, glycated hemoglobin (HbA1c) or glycated albumin, etc.

(1) Pay attention to the history of severe burn shock, major surgery, severe infections, drug effects, oral or intravenous glucose input.

(2) Pay attention to the increase in blood glucose and its duration, changes in blood and urine osmolality; the presence or absence of ketones; polyuria; high urine specific gravity, thirst, hypertonic dehydration, azotemia, mental symptoms, Coma, etc .; regular urine glucose test.

(3) Pay attention to the collection of specimens. Large-scale burns are often infused continuously for 24 hours. Avoid collecting blood glucose specimens on the ipsilateral limb vein or when glucose is being input.

2. Stay for 4 periods of urine per day (after breakfast to lunch, after lunch to dinner, after dinner to bedtime, after bedtime to breakfast the next day) or 4 times urine (before breakfast, lunch, and dinner) , Before going to bed) use urine glucose test paper for urine glucose qualitative test; or for capillary blood glucose monitoring.

3. ECG, chest X-ray examination, fundus and refractive media examination. Cardiac mechanical diagram, nerve conduction velocity measurement. If there is abdominal discomfort, a B-mode ultrasound may be performed to determine the presence of gallstones.

Food therapy for stress diabetes

Stress diabetes Pueraria congee: 100 grams of japonica rice and 30 grams of pueraria powder. After washing the kudzu root, cut it into pieces, grind it with water and grind it into starch. After precipitation, take the starch and dry it for future use. Japonica washed out. Put the rice into the pot, add the right amount of water, and boil it with the wuhu, then boil it over medium heat, cook until the rice is half cooked, add pueraria powder, and then continue to cook it until the rice rots into porridge.

Bitter gourd mussel soup: 250 grams of bitter gourd and 100 g of mussel meat. Live mussels are raised in clear water for 2 days to remove mud smell, then take the meat and cook the soup with bitter gourd; season with salt oil. Drink soup and eat bitter gourd and mussel meat. The number of days of consumption is determined as appropriate, suitable for upper consumption, nourishing yin and clearing heat, moistening dryness and thirst.

Yam porridge: yam 50 ~ 60 grams (fresh product 100 ~ 120 grams), 60 grams of japonica rice. Wash and cut yam into pieces, and cook porridge with japonica rice. For four seasons breakfast, for those who are hungry.

Fresh radish stewed abalone: 500 grams of fresh radish, 50 grams of dried abalone. Wash and slice the radish and cook it with the abalone. Take it twice a day or every other day for 15-20 days.

Raw yam and Zhimu juice: 30 grams of raw yam powder, 15 grams of pollen, 15 grams of zhimu, 10 grams of gold powder in raw chicken, 10 grams of schisandra, 10 grams of kudzu powder, first add simmered schisandra and schisandra 500 grams of water, decoction 300 Ml, remove the residue, and then paste the yam powder, pueraria powder, smallpox powder, and internal gold powder in cold water, and pour into the liquid while the liquid is boiling. Take 100 ml 3 times a day. For frequent urination, lower limb edema, clearing heat and reducing fire.

Wolfberry stewed rabbit meat: 15 grams of wolfberry, 250 grams of rabbit meat, vegetables, oil and salt each amount. First wolfberry and rabbit meat are cooked with water, then seasoned with vegetables, oil and salt. Drink soup and eat meat every 1 to 2 days. Regular consumption can treat diabetes, diarrhea, drowsiness, weakness, and frequent urination.

Stress Diabetes Psychotherapy

Stress diabetes .Biofeedback Relaxation Therapy

Spiritual and physical relaxation is an effective method of psychotherapy. Relaxation training can be performed with full body relaxation or biofeedback. Biofeedback treatment can significantly reduce blood glucose in patients with fasting and 2 hours after a meal compared with before treatment. However, there are inconsistent results, and case selection may be the key to successful treatment.

2. Cognitive Therapy

Educate patients how to properly deal with interpersonal relationships, marriage, family, work and social issues, improve the coping skills of daily life stress, correct bad behaviors, eliminate bad psychology of patients, enhance confidence, improve blood sugar stability, and improve disease.

3. Mental Support Therapy

Listen patiently and understand the patient's mental illness. Through patient comfort, counseling, and evidence-based conversation, the patient's mood is relaxed, the stress is reduced, the spirit is relaxed, and his confidence is doubled.

4. Self-psychological adjustment

For those who suffer from psychological imbalances and mood swings caused by negative life events or cognitive impairment, self-psychological adjustment can be eliminated through diabetes education.

Preventive measures for stress diabetes

1. Develop good habits. A reasonable diet and a good lifestyle can minimize the incidence of diabetes. Stress diabetes

It is a non-communicable disease. Although there are certain genetic factors at play, the key factors are acquired life and environmental factors.

2. Take your blood sugar regularly. Blood glucose measurement should be included in routine physical examination items for middle-aged and elderly people. Those who have traces of stress diabetes, such as abnormal skin sensation, decreased sexual function, poor vision, polyuria, cataract, etc., should be measured and identified in time, diagnosed as early as possible, and valuable time for early treatment can be obtained.

3 Early detection of complications. Stress diabetics are prone to other chronic diseases and are easily life-threatening due to complications. Early prevention is the main point, and late stage treatment is not effective. Early diagnosis and early treatment can often prevent complications and enable patients to live a life close to normal people for a long time.