Diabetes is "a disease that causes chronically high blood glucose levels. If left untreated, it can damage blood vessels and nerves and cause various complications. Our clinic offers comprehensive support for blood glucose control and lifestyle improvement by providing internal medicine, diabetology, and rehabilitation medicine.
Table of Contents
Initial symptoms and symptoms at the time of progression
Diagnosis of Diabetes Mellitus
Three major complications of diabetes
What we can do to prevent complications
Types of Diabetes
1. type 1 diabetes
In this type, the beta cells of the pancreas are destroyed by autoimmunity, resulting in little or no insulin production. It is most common in young people, and insulin therapy is essential.
2. type 2 diabetes
It is the most common type of diabetes, accounting for about 90% of all diabetes cases among Japanese people. It is caused by lifestyle factors (diet, lack of exercise, obesity) and heredity, and is associated with poor insulin effectiveness.
3. gestational diabetes mellitus
It is an abnormality of glucose metabolism that is first detected during pregnancy. Specialist management is important to reduce the risk of maternal and fetal complications.
Causes of Diabetes
Diabetes is caused by a combination of the following factors
Genetic background
Eating and drinking too much
Lack of exercise
Accumulation of visceral fat
Stress
Hormonal fluctuations such as pregnancy and steroid treatment
In particular, Japanese people have a genetic characteristic of "weak insulin production," and are prone to developing the disease triggered by lifestyle habits.
Initial symptoms and symptoms at the time of progression
Symptoms that may be seen in the early stages
I'm thirsty.
Increased frequency of urination
...Tired easily
Weight loss
Itchy skin
*The disease is often asymptomatic in the early stages and is increasingly being found during physical examinations.
Symptoms seen during progression
Blurred vision
Numbness in hands and feet
Wounds do not heal well.
Swelling
Palpitations, shortness of breath
By the time symptoms appear, complications may have begun.
Diagnosis of Diabetes Mellitus
Diabetes is diagnosed by the following tests
1. blood test
Fasting blood glucose
HbA1c (average blood glucose over the past month or two)
Blood sugar at any time
2. urinalysis
urinary sugar
Urine protein (important for early detection of nephropathy)
3. additional inspections
Blood insulin and C-peptide
Anti-GAD antibody (type 1 discrimination)
Glucose tolerance test (OGTT)
fasting blood sugar: 126 mg/dL or higher
- 75g glucose tolerance test 2-hour value200 mg/dL or higher
- blood sugar level at any time200 mg/dL or higher
- HbA1c6.5% or higher
The diagnosis is made after one of these criteria is met and reexamination and symptoms are confirmed.
Basis of treatment (diet, exercise, drug therapy)
The three pillars of diabetes treatment are diet, exercise, and medication.
1. diet
It reduces visceral fat by adjusting the diet to reduce the risk of raising blood glucose levels.
Adjustment of staple food (white rice → cereals, portion adjustment)
Eat a good amount of protein.
Vegetables are eaten first.
Review of snacking
2. exercise therapy
In collaboration with the rehabilitation department, the hospital recommends exercise that incorporates both muscle strength + aerobic exercise.
Squat
Walking
Core training
Stretch
3. drug therapy
If blood glucose control is required, a combination of the following is used
Oral medications (SGLT2 inhibitors, DPP-4 inhibitors, metformin, etc.)
GLP-1 receptor agonist
Insulin therapy
The treatment of diabetes mellitus isBlood sugar control and complication preventionis the objective.
Three major complications of diabetes
As diabetes persists, blood vessels and nerves may be damaged, leading to the following complications
Early detection and prevention are extremely important because they have a significant impact on quality of life.
1. diabetic retinopathy (the leading cause of blindness)
High blood sugar can damage the small blood vessels in the retina, resulting in vision loss, flying mosquitoes, and in the worst case, blindness.
An eye examination once or twice a year is recommended.
2. diabetic nephropathy (the leading cause of dialysis)
The capillaries in the kidneys may be damaged, resulting in proteinuria → decreased renal function → progression to dialysis.
Regular checkups by blood and urine tests are important.
3. diabetic neuropathy (cause of foot ulcer and gangrene)
Numbness, pain, and loss of sensation in the legs may occur and worsen without the injury being noticed.
Observation of the feet and assessment of blood flow can help prevent this.
What we can do to prevent complications
We offer the following comprehensive support services to "prevent the progression" of diabetes and "improve the quality of life".
・Detailed blood tests (HbA1c, renal function, lipids, liver function)
Urinalysis (early detection of nephropathy)
Fundus examination and collaboration with ophthalmology department
Nerve and blood flow check of feet and legs
Evaluation of MASLD (fatty liver) comorbidity
Exercise and nutritional guidance
Tailor medications to the patient's lifestyle
We emphasize regular follow-up and provide medical care to prevent "complications that progress unnoticed.
Diabetes Series - Related Article List
1. Know the basics of diabetes
- What is Diabetes - Why does blood sugar rise? Causes and Mechanisms Explained
Introduces the root causes of diabetes, including "insulin resistance," "heredity," and "lifestyle," which are all related to the development of diabetes, in an easy-to-understand manner. - Early Symptoms of Diabetes - Don't Miss the Early Detection Signs
Early signs that are difficult to recognize, such as thirst, polyuria, and weight loss, are carefully explained. - Diagnostic criteria for diabetes - Difference between HbA1c, blood glucose and OGTT and latest criteria
It summarizes the numerical values used for diagnosis and the key points of the recently revised diagnostic criteria. - Diabetes Testing - Comprehensive evaluation of blood, urine, and even complications
Introduction to the comprehensive examination system available at the Ikejiri-Ohashi Sera Clinic, including fundus examination, ABI, and carotid artery echocardiography.
2. Treatment and lifestyle modification
- Diabetes Treatment - Protecting Blood Sugar and Blood Vessels with Diet, Exercise, and Medication
Explains treatment strategies to "prevent complications" rather than "lower the numbers. - Diabetes Diet - Control Blood Sugar Effortlessly with Locavore
A practical diet that emphasizes how to eat, not what not to eat. - Diabetes and Exercise - Muscle is Medicine! The Science of Aerobic x Muscle Training
The benefits of exercise to directly lower blood sugar and how to create an easy to follow exercise routine. - Drug Therapy for Diabetes Mellitus - Latest Treatment Policies and Multi-Drug Approaches
The characteristics of DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 agonists are compared, and the latest treatment trends are presented.
3. To prevent complications
- Complications of diabetes - Complication measures to remember with "shimeji" and "enoki" mushrooms
The six major complications of neuropathy, retinopathy, nephropathy, gangrene, stroke, and cardiac disease are explained together. - Neuropathy due to diabetes - Mechanisms and countermeasures for numbness and pain in hands and feet
Early signs of peripheral neuropathy and ways to improve life that should be done early. - Diabetes and Renal Dysfunction - Importance of Urine Albumin Testing and Habits to Protect
Practical approaches to reduce the burden on the kidneys and prevent dialysis. - Diabetes and Eye Disease - Causes of Blurred Vision and Early Detection of Retinopathy
Explains how fundus camera examinations work and the risks of neglect.
4. Prevention and early intervention
- Prevention of Diabetes - Reduce blood sugar waves and make your body less prone to diabetes.
Introduces diet, exercise, and sleep regimens to "get in shape before it happens," rather than "fix it after it happens. - Characteristics and constitution of people prone to diabetes - Self-check that you can do now
Early intervention is recommended by sorting out the risk of developing the disease, including heredity, fatty liver, and lack of exercise.
5. Our features and support system
- Lifestyle-related disease treatment at Ikejiri-Ohashi Sera Clinic - Cross-cutting management of diabetes, MASLD, hypertension and dyslipidemia
Includes a comprehensive evaluation system including physician supervised exercise therapy, locavore diet support, fundus, ABI, and carotid artery echocardiography.