Both hyperuricemia and diabetes are metabolic diseases. Both share a common pathogenic basis—overnutrition. Both are clearly related to insulin resistance, and both are related to risk factors such as diet and alcohol intake. Both are related to cardiovascular disease. risk factors.
So, what should we do when hyperuricemia meets diabetes?
Hyperuricemia refers to the fasting blood uric acid level of >420 μmol/L (7 mg/dl) in men and >360 μmol/L (6 mg/dl) in women under a normal diet at different times. Joints, soft tissues and kidneys, which cause arthritis, skin lesions and kidney damage, belong to gout, which are different states of the same disease.
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia due to disorder of human glucose metabolism.
If you have hyperuricemia and diabetes at the same time, treatment may be in a dilemma.
Diabetes treatment requires more exercise, while active arthritis caused by hyperuricemia restricts excessive exercise; diabetes advocates high-protein, low-calorie diet, and hyperuricemia strictly controls meat intake, etc.; certain hypoglycemic drugs May also affect purine metabolism.
When hyperuricemia meets diabetes, experts suggest that it can be treated from the following 4 points:
1. Adjust the diet structure and control the total calories of the diet
(1) Low carbohydrate diet.
Controlling staple foods helps control blood sugar.
(2) Eat more fruits and vegetables rich in dietary fiber, Vit B1 and Vit C.
Gout patients can eat lemons, cherries and olives, most melons, tubers, roots and most leafy vegetables, watermelons, coconuts, grapes, strawberries, plums and peaches can be eaten in moderation. These fruits and vegetables can effectively prevent and control In gout, dietary fiber can increase insulin sensitivity.
At the same time, it is not advisable to eat more plant foods with high purine content such as mushrooms, straw mushrooms, asparagus, seaweed, kelp and grain germ, and reduce some fruits (apples, bananas, figs, pears, oranges, longan, lychee, grapefruit, persimmon and Pomegranate, etc.), vegetables (beets, lotus roots, water chestnuts, etc.) and other fruits and vegetables with high fructose intake, but also avoid drinking alcohol.
(3) Drink more water.
Increasing water intake can be one of the measures of non-drug treatment for gout patients.
In the absence of contraindications such as kidney disease and heart failure, it is recommended that patients with gout drink water, with a total daily water intake of 2 to 3L; it is recommended to drink water in divided doses, and the amount of water to be drunk three times in the morning, afternoon and evening reaches about 500ml; try to choose weak Alkaline, small-molecule water; lemonade can be drunk (such as 1-2 fresh lemon slices added to 2-3 L of water); soft drinks are prohibited.
(4) When gout patients eat animal food, they should pay attention to the type, quantity and processing method.
Avoid eating animal offal such as liver, kidney, heart, intestine, etc., choose milk, eggs and moderate amount of non-mammalian meat (including chicken, duck, goose and some freshwater fish, etc.) with lower purine content.
The meat should be mainly lean meat. The daily meat intake should not exceed 100g. Try to eat fresh meat. It is recommended to discard soup after boiling. Avoid using too much salt, sugar and spices. During the acute phase, all meat should be fasted.
2. Choose drugs that have little effect on uric acid
Here are 4 things to keep in mind when choosing a drug:
hypoglycemic drugs.
Insulin and sulfonylureas (glimepiride, gliclazide) have a certain effect on uric acid, and the use of these drugs should be balanced.
Diuretics.
Thiazide diuretics (hydrochlorothiazide) and loop diuretics (furosemide) can affect uric acid excretion and induce increased blood sugar, while potassium-sparing diuretics (spironolactone, triamterene) can promote uric acid excretion.
Antihypertensive drugs.
ARBs are the first choice for antihypertensive drugs in hyperuricemia patients with diabetes mellitus.
ARB has the effect of lowering uric acid, and angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) can reduce insulin resistance.
Glucocorticoids.
Glucocorticoids are associated with weight gain, insulin resistance, and should be avoided during gout attacks.
3. Weight Management
Adipose tissue produces and secretes more uric acid and increases insulin resistance.
Body mass index is positively correlated with the incidence of gout. Abdominal obesity can also increase the risk of gout. Weight loss can reduce blood uric acid levels and reduce gout attacks.
4. Regular and moderate exercise
Low-intensity aerobic exercise can reduce the incidence of gout, while moderate-to-high-intensity exercise may reduce uric acid excretion and increase blood uric acid levels, which in turn increases the incidence of gout.
Therefore, appropriate exercise can be used as one of the non-drug treatment measures.
5 sports principles to keep in mind:
Regular exercise is recommended for patients with hyperuricemia; exercise for gout patients should start at low intensity, gradually transition to moderate intensity, and avoid strenuous exercise. In the acute stage of gout, rest should be the main focus, and exercise should be interrupted; the frequency of exercise should be 4 to 5 times a week. For 0.5 to 1 hour each time, you can choose jogging, tai chi, etc. During or after exercise, avoid drinking a lot of water quickly, and drink water in moderation to promote uric acid excretion; for those with cardiovascular and pulmonary underlying diseases, exercise should be moderately reduced Intensity and shortening of exercise time.
This article is scientifically checked by Wang Tao, chairman of the Medical Science Popularization Special Committee of the Chinese Popular Science Writers Association.
Contribution of "Da Yi Xiao Nu"