Diabetes mellitus Modern medical treatment

Modern medical treatment: 1. General treatment: To the patients or their families about the knowledge of this disease so that patients understand the long-term treatment of eating the meaning of purpose and importance of specific measures to meet the doctors consciously and strictly controlled diet, to establish the law of life, work and rest appropriate, to master oral Hypoglycemic drugs and insulin dosage and usage. 2. Physical therapy: Strong in normal physical activity or exercise, to reduce the secretion of insulin, adrenaline, cortisol, glucagon and growth hormone secretion increased, so that the peripheral organization of sugar to reduce the use of glycogen and increase output; However, due to increased muscle blood flow Faster increase in the number of insulin receptors, a significant increase in the use of sugar, so maintaining normal blood sugar. Regular exercise can enhance insulin receptor function, in light of diabetic patients, especially non-insulin-dependent diabetes mellitus (NIDDM) patients, appropriate physical activity can make high blood sugar dropped, from special treatment, and improve lipid metabolism And enhance heart function, reduce the incidence of complications. Lost in diabetes control, a significant lack of insulin, strong physical activity contrary to make high blood sugar, or even cause ketoacidosis. Insulin injections for patients, exercise will not reduce the level of insulin, and part of the campaign, subcutaneous injection of insulin absorption by fast, easily lead to low blood sugar reactions. Strong after exercise, liver glycogen and muscle glycogen storage needed to restore the 24-48h in order to achieve the level before the campaign. Therefore exercise and after exercise to increase the carbohydrate intake is very important, otherwise we will exercise or sports after a few hours or even 10-hour response出现低血糖(insulin injections patients). Obesity light of NIDDM patients with diabetes should be restricted calorie intake on the basis of strengthening exercise. Approach to the sport mainly exercise endurance, we must combine the characteristics of each patient, select the appropriate amount of physical load. Inappropriate or too much exercise or excitement of the sport can not only be the effect, and sometimes anti-blood sugar so high. Patients with diabetes than the general body is weak, started physical therapy should be preceded by a short period of time the light physical activity, with the enhancement of the physical, and then gradually increase the amount of exercise and sports, over-exertion without benefit not only the movement, but also so that the condition Deterioration. Physical exercise to be sustained, with the exception of acute disease has not stopped outside. 3. The treatment of eating: all diabetes patients are required to control diet. (1) of the total energy needs of diabetes patients is as follows. Children need calories, 1-year-old daily 4184kJ, by every 1-year-old Canadian 418kJ. Adolescent women need daily 10042-11300kJ, man 12552-15062kJ. Adult obesity should be limited to a day in 4184-6174kJ, pregnant women, breast-feeding, malnutrition and wasting disease are to be increased as appropriate. Protein per kilogram of body weight requirements are as follows: 15 children under the age of 1.5-2.5g. Adult 1g, pregnant women, 1.4g, breast-feeding women 1.7g. Carbohydrate accounted for 50% of the total calories -65%. Calories from fat to provide the rest. In the intake of total fat, saturated fatty acids should be reduced to only a total of 1 / 3, for the rest of the unsaturated fatty acids, cholesterol at the same time will be limited to 300mg a day of the following, obese patients should reduce the total calories and fat intake If no longer be effective to reduce the intake of carbohydrates. Staple food in the morning, afternoon and evening meals in the distribution of 1 / 5, 2 / 5, 2 / 5. Appropriate activities for a long time snacks. Insulin injections patients should occur before the peak insulin activity for a long time and snacks as necessary, the use of long-acting insulin are often required before going to bed at night snacks. The food should be calculated according to the local food supply in exchange of food ingredients designed to enable patients to better grasp the diet. High-fiber diet is the daily fiber intake of more than 40g, delay intestinal absorption of glucose in blood sugar and reduce the increase. (2) of the diet method: small sub-algorithms and an estimated two law: ① fine algorithm: patients with gender, age, body weight standards for calculating the daily calories needed a few cards and carbohydrates, protein and fat grams, the standard weight for height and weight people can refer to the standards table. Simple method can also be used (that is, the height -105 = weight (kg)). ② estimation: a fixed staple food, according to the physical needs) of patients a day to rest staple 200 ~ 250g, light manual 250 ~ 300g, moderate physical 300 ~ 400g, severe physical more than 400g. Huncai about 150g per day, vegetables 250 ~ 500g, cooking oil 3 to 4 key. Three meals a day by 1 / 5, 2 / 5, 2 / 5 allocation. According to everyone is different, can be early, middle and late to sort out three meals a day: 1 / 3 respectively in the 9 to 10:00 am, 3 to 4:00 pm and before going to bed around 10 o'clock. This will reduce the postprandial hyperglycemia, as well as a stronger role in the prevention of insulin at the time of low blood sugar reactions. 4. Oral hypoglycemic agents (1) sulfonylurea (su1fony1urea, SU): this class of drugs directly stimulate the islet cells to release insulin, so that the increase in endogenous insulin. Islet cells inhibited α reduce glucagon production, thus lowering blood sugar; inhibit decomposition of glycogen and gluconeogenesis, to reduce the output of glycogen; also by peripheral tissues of the role of insulin receptor. Mainly for middle-aged and older-onset non-insulin-dependent diabetes mellitus, and with the control diet plus exercise therapy are not satisfied with the control of blood sugar. Drugs commonly used are: ① tolbutamide (tolbutamide, D860): Each 0.5g. Daily 1.5 ~ 3.0g, taking fasting in three installments. ② C-methyl-urea (chlorpropamide, P607): Each 0.1g. Only once a day orally, in general 0.1 ~ 0.3g. A capacity of 0.5g. These two are the first generation of SU, D860 hypoglycemic effect is weak, less side effects. P607 hypoglycemic effect lasted for a long time, the emergence of hypoglycemic medication 4 hours, 10 hours a role in most, 24 hours after an effective, sustainable 40 to 60 hours. Yi Zhi low blood sugar reactions, and poor kidney function in elderly patients with the drug banned. ③ glibenclamide (glyburide, HB419): each 2.5mg, every day 7.5 ~ 15mg, three times to take fasting. Its role in hypoglycemic strong wind D860 is about 100 ~ 500 times. ④ Delta, Culture and Sport (topiramate-methyl urea, gliclazide): Each 80mg, every day 160 ~ 320mg, three times to take fasting. Its hypoglycemic glybenclamide role than the weak, the D860 for 10 to 20 times, characterized by anti-platelet aggregation, improve microcirculation. Can prevent and delay the complications. ⑤ Glurenorm (methyl quinoline cyclohexyl urea, g1iquidone): Each 30mg, daily 60 ~ 120mg, three times to take fasting. Its main metabolism in the liver, gastrointestinal tract after discharge. It is applicable to the merger Ⅱ diabetes and renal dysfunction, renal disease who were. ⑥ glipizide (topiramate methyl cyclohexyl urea, glipizide): each 5mg, a daily 15 ~ 30mg. Hypoglycemic effect was slightly lower than glibenclamide, the D860 to 100 times, characterized by hypoglycemia less safe. ⑦ grams of sugar Lee (MSA II urea ice, glutril, glibornuride) per tablet 25mg, daily 25 ~ 75mg. Hypoglycemic effect for 40 times the D860, with improvement in blood rheology, prevention of anti-thrombosis and atherosclerosis. ③ ~ ⑦ the above-mentioned five drugs for second-generation SU. Sulfonylurea indications: ① Ⅱ diabetes light and medium-sized patients, the diet plus exercise control over those who are not satisfied. ② Ⅱ type 2 diabetes patients with insulin every day just below 40U, 20U are less than effective. ③ 40 over the age of onset of diabetes Ⅱ fasting blood glucose> 11.1mmo1 / L, in the course of disease within 5 years, never using insulin treatment, normal weight or obese optional SU Shuanggua Lei and treatment. ④ has tried in recent years, and insulin treatment to strengthen the effect. Sulfonylurea drug side effects: About 5% of patients with anorexia, the deterioration of vomiting, abdominal pain, diarrhea, and other gastrointestinal reactions. About 2% to 3% of patients have skin itching, rash, and so on, sometimes exfoliative dermatitis, a small number of patients have bone marrow suppression. All sulfonylureas can cause low blood sugar, low blood sugar coma and even death. (2) Shuanggua Lei: This class of drugs hypoglycemic mechanism has not yet entirely clear. However, the known and sulfonylurea, does not stimulate the release of insulin β cells. According to animal experiments and clinical observation that the hypoglycemic effect may be three. First, inhibiting cell wall to absorb glucose: As the oral phenformin can improve glucose tolerance, intravenous injection when there is no role here. Hypoglycemic and at the same time, plasma insulin concentration does not increase, the non-stimulation caused by the release of insulin. In addition to inhibiting absorption of sugar, but also inhibit amino acids, fat, cholesterol, VitB12 absorption, and so on. Second, an increase of peripheral glucose utilization of the organization. Shuanggua Lei muscle can be increased permeability of cell membranes of glucose or insulin and to strengthen the receptor-binding cells into the role of muscle to promote the use of glucose. Third, there is to strengthen the role of insulin. Shuanggua Lei drugs currently used are: ① double-p Fox (hypoglycemic Ling, phenethylbiguanide, phenformin. DBI): Each 25mg, daily 25 ~ 100mg, ② metformin (metformin, metformin): each 0.25g, per day 0.25 ~ 1.0g. Shuanggua Lei drug indications: ① Ⅱ in patients with type 2 diabetes, especially with obesity and diet control are not satisfied. ② when used with sulfonylurea plus exercise therapy are ineffective. ③ Ⅰ of type 2 diabetes patients with large fluctuations in blood sugar, insulin trial Shuanggua Lei reduced the amount. ④ the use of low-dose insulin in patients with the hope that the switch to oral medication for the treatment of allergic sulfonylurea or failure. ⑤ patients resistant to insulin. ⑥ Ⅱ of obesity in patients with blood sugar control are not satisfied, can be combined with the use of SU. Shuanggua Lei drug side effects: toxic reactions are common metal mouth taste, loss of appetite, nausea, vomiting, abdominal pain and diarrhea, and so on. This class of drugs can lead to lactic acidosis, mostly for the soul to hypoglycemic. (3) glucosidase inhibitors: α glucosidase inhibitors (acarbose) is the biosynthesis of sugar to four, after oral administration in the small intestine in α glucosidase inhibition, so that the single-strand break down starch to glucose response to the significant Weakened, slow absorption of glucose, diabetics can effectively reduce high blood sugar after a meal. Its mechanism is different from the first two, and its role in the small intestine, just below 2% of the small intestine to absorb and emit very soon. Acarbose indications: ① diet treatment on the basis of the application of the drug alone, so that the peak postprandial blood glucose decreased, while plasma insulin levels. ② for the treatment of impaired glucose tolerance. ③ for NIDDM, with sulfonylurea, Shuanggua Lei and joint use of insulin. ④ for IDDM, with the joint use of insulin. Acarbose use of the method: every 50 ~ 200mg, three times a day with rice Jiaofu together. Acarbose side effects: flatulence, abdominal discomfort, nausea, vomiting, diarrhea and Chang Ming. 5. Insulin formulations of insulin from the pancreas of animals such as pigs and cattle to extract the insulin from the preparation process. The main pharmacological effect is to speed up the use of glucose; the promotion of glycolysis and glucose Oxide; to promote the synthesis of glycogen; inhibit gluconeogenesis; inhibit the activity of lipase, the fat so that the slower rate of decomposition; to promote protein synthesis; inhibiting protein Decomposition. Clinical prevention and treatment of acute complications, to correct metabolic disorders, to improve resistance to prevent all kinds of infections, improve nutrition, promote the growth of children, and so on, but microvascular and macrovascular complications of chronic diseases such as the ability to control, there are as yet no consensus. Apply to: Ⅰ diabetes; Ⅱ type 2 diabetes with diet and oral hypoglycemic agents in patients with ineffective treatment; diabetic patients with infection or wasting disease, or surgery, or pregnancy, diabetic ketoacidosis, or adult onset diabetes in elderly Acute weight loss are obvious; diabetic kidney disease and renal insufficiency who were. (1) the application of insulin: Insulin preparation and use of the principle of selection must be closely combined with the disease, the general principles of the urgent need for insulin treatment with short-acting categories, and I diabetic ketoacidosis and other acute complications and before and after surgery, his condition Those who can be a long-term stability of the preparation, the length of effect can also be used in combination. The estimated amount of insulin, the normal physiological insulin secretion each day is about 24U, the entire pancreas, after all, every day about 40 ~ 50U. Therefore, in severe cases such as the secretion of very few who can be a day to 40U, at 3 to 4 times injection. Case may be a light from small dose to start 24U, and then based on fasting glucose response to addition and subtraction, where a U-negative, the urine test was negative, or blue, not to increase the amount of insulin or minus 2U; blue-green or orange or ten ~ + + To increase 2 ~ 4U; orange or red brick +++~++++, increased 6 ~ 8U. U-positive patients should be increased according to dose. Also based on 2 hours postprandial and fasting blood glucose and a 24-hour urine volume adjustments sugars threshold for kidney patients with high blood sugar on the need to adjust the calculation method that is (now testing a few milligrams of glucose -80) × l0 × weight ( kg) × 0.6 = higher than the body's normal amount of sugar (mg), according to 2g sugar 1U need insulin. Dose required machinery can not act, we should practice law. In order to obtain precise requirements. (2) insulin treatment side effects and complications: The body can be divided into two groups and local. Systemic reaction ① low blood sugar reactions; ② allergic reactions; ③ insulin edema; ④ refractive disorders. Local reaction injection ① local red skin, swelling, heat, pain and skin nodules occurred. ② subcutaneous fat malnutrition, lack of sebum into depressed. ③ insulin resistance, insulin daily to be more than 200U, which lasted more than 48 hours, at the same time without ketoacidosis and other endocrine disease caused by diabetes are known as secondary insulin antibodies. Insulin pumps: they have the advantage of continuous injection of insulin, blood glucose levels close to the body so that the rationale for years under the conditions of the fluctuations in blood sugar regulation and better, but prevention and treatment of chronic complications can better than traditional insulin therapy is not known. Some of the transplanted pancreas and islet transplantation to carry out more foreign and domestic have been in the clinical trial, most of the post-transplant can only reduce the amount of insulin, long-term effect remains to be seen. Rejection, and other issues to be resolved. At present, the clinical use yet. 6. Acute complications of diabetes treatment (1) diabetic ketoacidosis and coma treatment of diabetic ketoacidosis as the main basis for the diagnosis ① strong positive urine sugar; high blood sugar in the majority of 16.65 ~ 27.76mmol / L (300 ~ 500mg/dl), sometimes Up to 55.5mmo1 / L (1000mg/d1); ② U strong positive; high-blood-general in the quantitative 5mmo1 / L (50mg/dl) above. Treatment should be based on severity of illness. If the early mild, not severe dehydration, acidosis lighter, non-circulatory collapse, patients with a clear mind, just enough for the regular insulin, every 4 to 6 hours, subcutaneous or intramuscular injection every 10 ~ 20U, and Encourage more drinking water, into liquid or semi-liquid, if necessary, intravenous rehydration and treatment of incentives in general are able to control, to return to pre-ketosis. For severe cases, C02 bonding in 0.898mmol / L (20% of the volume) below the blood (HC03) <10mmo1> 5mmol / L; even accompanied by circulatory failure, urinary oliguria Closed, the mind-shun die in a coma, should rescue, concrete measures are as follows: ① rehydration: fluid volume and speed depending on the degree of water loss and cardiovascular function and patients, patients generally by 10% of the estimated weight and speed rehydration, such as Heavier patients, admitted to 1 / 2 to 1 hour intravenous infusion of rapid 1L, every 1 to 2 hours re-1L, gradually slow down every 8 hours up 1L, the elderly and patients with heart disease can be based on central venous pressure monitoring. ② insulin: a clear diagnosis, and blood glucose> 16.65mmo1 / L (300mg/d1) to start accession to the intravenous infusion of normal saline ordinary insulin dose per hour by 2 ~ 8U (generally 4 ~ 6U) infusion, 2 hours after the check blood sugar If the drop in blood sugar <30%> 30% of the original volume will continue to drop until the blood sugar down to <13.88mmo1 2 =" required"> 30Vol% premium to stop when the base (Note: B, E, ECF for the remainder of extracellular base). ⑤ phosphorus up: When ketoacidosis led to the loss of phosphorus, phosphorus supplement in theory is good, but differences of opinion, that there are as renal failure can be induced hypocalcemia and calcium phosphate PAP, increasing the kidney Injury is not as a routine use, remains to be seen. ⑥ induced by the elimination of factors, the positive treatment of complications. (2) diabetic hyperosmolar coma treatment: diabetic hyperosmolar coma basic pathophysiological changes as a result of high blood sugar caused by the infiltration dehydration, electrolyte loss, resulting in insufficient blood volume and shock the brain and kidney damage and dehydration. ① basis for the diagnosis of blood glucose> 33.3mmol / L (600mg/dl); strong positive urine sugar. ② effective plasma osmolality> 320mOsm / L ③ U-negative or weak positive; ④ sodium> 145mmo1 / L. ① rehydration treatment of its principles: rehydration as soon as possible in order to restore blood volume, to correct dehydration and electrolyte imbalance. As the amount of fluid infusion and the degree of dehydration, such as severe loss of the original weight of more than 1 / 10 or more should be in batches in 2 to 3 days make up; in the first hour intravenous infusion of 1 ~ 1.5L, could be the beginning of 4 hours to 1 ~ 3L; rehydration of the dispute lies in the isotonic or hypotonic, when the use of low fluid. At present, most of that to start with, and other fluid, can be avoided, such as a large number of fluid caused by hemolysis, and is conducive to the resumption of blood volume and prevent excessive drop in blood pressure caused by cerebral edema. According to the clinical blood pressure and sodium can decide whether or not to use low-permeability, the blood pressure low sodium <150mmo1> 150mmo1 / L, could start with low fluid. ② the use of insulin: low-dose insulin treatment for diabetes and the principle of ketosis is similar to when the general increase in blood sugar every 5.55mmol / L (100mg/dl) for regular insulin 10U, if there is severe dehydration, circulatory collapse may be intravenous drip , The dose per hour for 5 ~ 10U, No. 1 in total general 100U less than the smaller dose of diabetic ketoacidosis, ③ potassium supplement: with the treatment of diabetic ketoacidosis. ④ treatment of complications: a variety of complications in particular infection, the patient is often the latter part of the cause of death, so for complications from the start should be attached to the rational use of drugs. Syndrome differentiation treatment: (1) heat deficiency: Syndrome: polydipsia drink more, with the drink with thirst, Yanganshezao, good food and more hunger, red urinate constipation, less mamillata Jin Huang moss. Pulse chord slide or a few. Governing Law: Yin heat. Recipe: Diabetes flavored side. Fang pollen in order to reuse Shengjinzhike; heart with the Chinese to Reduce Pathogenic Fire; habitat, Ou Zhi, human milk, Lily Yin Runzao by liquid; stomach and ginger combined with anti-Shang Wei cold. Such as dry mouth Jiamai worse in winter, the puerarin 10g; KUI injuries were constipation plus cassia 30g; heat will increase the yellow junction 3 ~ 6g. (2) Yin Deficiency: Syndrome: fatigue, shortness of breath, spontaneous perspiration, then add to move, thirsty, drink more and more urine, five hot upset, constipation big knot, Yao Xi fatigued, short tongue or mamillata dark side of the tongue have Chihen, moss Jin low thin white, moss or less, thin and delicate veins. Governing Law: Yiqiyangyin. Recipe: Modified ShengmaiYin. Fang benefit ginseng vitality, Shengjinzhike; Ophiopogon Yin Chun-sheng; Schisandra Jin-sheng convergence solution. If the weak, spontaneous perspiration, shortness of breath are serious astragalus Health Canada 30g; more than good food to hungry odoratum plus 10 ~ 15g; thirst worse pollen plus 30g. (3) Yin and Yang deficiency: Syndrome: lack spontaneous perspiration, cold-Zhileng, Yao Xi limp, Jiaogan helix, more and more to drink urine, such as turbidity cream, or edema oliguria, Wu Geng or diarrhea, impotence premature ejaculation, tongue moss white light, pulse Shen Not fine. Governing Law: Yin Yu-yang. Recipe: Jingguishenqi pill. Aconite to Fang, cinnamon warming and recuperating the Kidney-Yang, the fire yuan; Liuweidihuang Shenyin nourishment, in order to Yin-Yang, the co-ordination of yin and yang. If the number of nocturnal or wealth of the people of urine, such as those Alpinia vera increases, the son of silk, the Health ginkgo 10 ~ 15g; oliguria or swelling of Health to increase Astragalus 30g, Atractylodes 10g, Menispermaceae 10 ~ 20g; psoralen plus those who spilled Wu Geng 10 ~ 15g, Wu Yu 10g, nutmeg 10g; of male erectile dysfunction, premature ejaculation Faerie spleen plus 10 ~ 15g, Curculigo 10 ~ 15g. (4) Blood and evidence: Syndrome: the above-card and could see blood stasis syndrome, such as noodles have petechiae, physical pain, numbness, headache, chest pain, Xie Tong, paraplegia, a tongue petechiae, or purple veins under the tongue or Nu Zhang, Blood disorders, such as the microcirculation. Governing Law: promoting blood circulation. Recipe: Taohongsiwu soup. Angelica Fang, Chuanxiong, peony, and Huang, nourishing and promoting blood circulation; peach kernel, safflower blood circulation. If the blood stasis can be used to light the top of the Senate Gadahn, the Leonurus 30g; stasis weight increase while leech 10g, Scorpio 3 ~ 5g. (5) stricken Yin and Yang (found in diabetic ketoacidosis or diabetic coma hyperosmolar coma patients): Syndrome: lack of consciousness, inactive, stupor, drowsiness, coma, dyspnea deep breathing have one taste, dry skin, urine, dry mamillata, vein or micro-stricken and several minor veins. Treatment: back to save Yin Yang Recipe: Modified Shengmaisan. Fang Dabu ginseng vitality, Yang back to save the inverse; japonicus, Schisandra convergence shade Tianjin, thirst heat. If the clock to increase micro-stricken Aconite 10 ~ 15g to reverse back to YANG save; if flaming hot invagination pericardium, which can be closed off outside the application, where appropriate, Angongniuhuang Pill or the crown of heat fails to grasp the situation with Dan. Recipe: (1) black bean soup: black beans (speculation) transfer trichosanthin is not equal to, for batter-Wan Ru Wu, each serving 30 to 50, twice a day, Diabetes Kidney rule. (2) Yu Hu pill: melon wilt root, ginseng equal to the end, such as Wu Shui Wan-large, serving 30 per pill, Ophiopogon soup, for the Diabetes-Yin Deficiency. (3) dry winter Guarang: 30g, Shuijian Fu, governance Diabetes upset. (4) Health root porridge, "Chinese Medicinal Diet": fresh root 30g, japonica rice 50g, to 1500ml water boiled root, Qu Zhi Zhu Yu 1000mL of food. (5) Trichosanthes root winter melon soup, "Chinese Medicinal Diet": de root wilt, claw winter, drinking stew. (6) of pig pancreas soup, "Chinese Medicinal Diet": Canadian pig Yizi yi meters 30g, astragalus 60g, Huai yam 120g, Shuijian Fu. Qigong: Meridian Qi Gong will enable the smooth, high blood, be able to adjust to achieve a balance of yin and yang. General Dynamic sub-Gong Gong and static two broad categories. Jing Gong, such as diabetes common ① cater to the needs of law: that is, conscious breathing training, including the thoracic and abdominal breathing. ② intended to abide by the law: that is, the idea of a centralized body to the site, reaching into the quiet, comfortable realm of law practice. ③ relaxation method: consciously to allow the body to gradually relax the practice of natural law. Practice, quiet environment, to clean air, light eyes closed, rule out the ideas and personal considerations, arrived on the E-tongue. Qigong more schools, there are many monographs introduced. The best time in practice experienced teachers under the guidance of qigong exercises in order to avoid bias. Chinese medicines: (1) Liuweidihuangwan: nourishing Shen Yin, Shui Wan, each serving 10 ~ 15g, day 3. Charge of Diabetes Shenyin inadequate. (2) Jinbian Shenqi Pill: warming recuperating the Kidney-Yang, Shui Wan, each serving 10 ~ 15g, day 3. Diabetes attending recuperating the Kidney-Yang deficiency. (3) Yuquan Pill: Yiqiyangyin, Shuiwan or capsules, by taking note, attending Yin Deficiency of Diabetes. Acupuncture and massage therapy: (1)-pin: Differentiation can eliminate the three main diagnosis and treatment. This disease complicated skin infections easily, the needle must be strictly disinfected. ① extinction on: Dazhui, Feishu, fish, He Gu, too yuan, Jin Jin, Yu Ye, and other points, divided into two groups to use the turn. Dazhui, fish, Hegu needle with diarrhea law, Feishu, too yuan, with pin-up Ping Xie, Jin Kim, Yuyejici not leave needles all the rest can be left pin hole 30 minutes a day of acupuncture: the next day or needle Spurs 1. ② extinction in: Ping-ping up the spilled Pi Yu, stomach and Yu Wan; with diarrhea three adequate needle method, in chambers, and He Gu Chi song, 30-minute stay needle, a needle a day or the next day acupuncture 1. ③ under extinction: reinforcing method Shenshu needle, liver Yu, Yuan Guan, Sanyinjiao point, and so on, point to stay within 30 minutes, 1 second acupuncture every other day. (2) ear: pancreas, endocrine, lung, thirst, hunger, stomach, kidney, bladder, and other off point. Every time the election 3 to 4 points, leaving 20 to 30 minutes needle, a needle or the next day, or buried Ear acupuncture. (3), massage with massage spleen kidney, blood circulation. Xie Qing heat of the role of the desirability of Pi Yu, Shenshu, in Wan, Zusanli, springs, such as pulp for points. In addition foot massage also point to a certain effect, massage the foot reflex zones, such as the head, pituitary, pancreas, kidney, adrenal gland, ureter, bladder, celiac plexus, and so on. Efficacy and prognosis: The Diabetes Control Standards Diabetes is the treatment of diabetes so that the patient's mental and physical strength returned to normal. Blood glucose, blood lipids and HbA1c decreased to normal or near normal levels, to ensure that sick children and young people with normal growth and development and have a strong ability to physical activity. Adult patients were asked to maintain normal work and social activities. Obese patients should lose weight. Since each patient's age. The type of disease and other circumstances vary, treatment and control of individual needs. The elderly are too stringent control of blood sugar, hypoglycemia risk, and even induced complications such as heart disease or coronary heart disease, and should be avoided. 1. Hematuria sugar control (1) the ideal control of fasting plasma <6.1mmol> 25g; Ⅱ diabetes> 10g. After a reasonable recuperate under medical treatment of diabetes, blood, urine sugar control in the normal range, and can prevent complications and delay the occurrence and development, but not eradicate, it should adhere to long-term treatment. Prevention: Diabetes prevention is more important than treatment. Should launch a wide range of medical, health workers, such as diabetes patients and their relatives to work together, learn prevention and treatment knowledge of this disease in order to carry out long-term control measures can achieve better results. The main disease of the treatment diet, medication and physical activity. Avoid over a five-chi, a long-term tension in the spirit of the thought. Appropriate attention to the work and rest, adhere to the physical training to maintain weight and prevent obesity, not to Feigan Anopheles, free hot drinks and tobacco, and sexual restraint. Pay attention to early detection and treatment of a variety of complications, hypoglycemic agents with the treatment of attention when changes in blood sugar, blood glucose decreased significantly, hypoglycemic agents should be adjusted in a timely manner to prevent the occurrence of low blood sugar.