ELISA kit for delaying diabetic complications

The occurrence and severity of chronic complications of diabetes are closely related to the degree of blood sugar and the course of the patient's blood sugar, but some patients still have chronic complications even if the blood sugar is well controlled. Can these chronic complications be prevented? What preventive measures can be taken to reduce or delay their occurrence? Based on the research results in recent years, the author summarizes the following 10 basic elements for the prevention and treatment of diabetes complications:

1. Eliminate excessively generated free radicals Free radicals are atomic groups or molecules or atoms with unpaired electrons; in a nutshell, they are “garbage” and “contaminants” in tissues and cells. Since a single unpaired electron has a strong tendency to form an electron pair with other electrons, the reactivity is high and can cause polymerization of certain compounds. In diabetic patients, hyperglycemia is accompanied by a large amount of free radicals, and the function of scavenging free radicals in the body is significantly reduced. Increased lipid oxidation, in turn, stimulates the self-oxidation of sugar, which results in increased vascular permeability, thickening of the basement membrane, and damage to tissues and organs. The use of natural antioxidants to capture highly active and transient free radicals has been shown to prevent chronic complications of diabetes. Such as the increase of vitamin E, vitamin C, superoxide dismutase (SOD), coenzyme Q10 (ubiquinone) intake and appropriate supplementation of selenium can effectively remove excess body "garbage" in the body, reducing or avoiding cell contamination.

2. Monitoring of risk factors and early warning indicators for complications Regularly detect risk factors and early warning indicators of complications leading to diabetes complications, so as to promptly eliminate these virulence factors, early detection and strive to reverse complications. These include: (1) blood pressure, body weight, waist circumference, dorsal artery pulsation and radial artery/iliac artery systolic pressure ratio, limb end pain, temperature, touch, fundus examination, electrocardiogram and large vessel ultrasound, electromyography, etc.; Blood sugar, glycated hemoglobin, blood lipids, uric acid, cysteine, C-reactive protein, prothrombin time and activity, fibrinogen, platelet aggregation function, etc.; (3) urine microprotein or trace transferrin excretion rate.

3. Correcting unhealthy lifestyles Avoid excessive stress, weight control, exercise, low-salt and low-fat diets, smoking cessation, and limited drinking can prevent high blood pressure and reduce heart and cerebrovascular diseases. Studies have shown that a low-calorie, low-fat, high-fiber diet can delay the absorption of blood sugar and reduce the stimulation of insulin secretion. Regular and regular activities help control weight, increase insulin sensitivity, and reduce hyperinsulinemia in patients with type 2 diabetes.

4. Elimination of insulin resistance Insulin resistance, that is, surrounding tissues such as muscle, liver and fat, is not sensitive to insulin and is considered to be a common cause of type 2 diabetes, hypertension, dyslipidemia, obesity and the development and progression of atherosclerosis. soil". Insulin resistance causes blood sugar and lipid metabolism disorders, which makes the plasma insulin levels compensatory, which can promote thrombosis, promote lipid deposition in arterial wall and proliferation of arterial smooth muscle, promote sodium retention and blood pressure, and accelerate arteriosclerosis. The process, thus eliminating insulin resistance, restores plasma insulin levels to normal and helps prevent diabetic macroangiopathy.

5. Control of blood pressure Diabetes with hypertension is four times more dangerous than non-diabetics. Experiments have shown that controlling blood pressure is more beneficial than controlling blood sugar to reduce the incidence of diabetic complications and complications-related mortality. The 2003 JNC7 report recommended that the goal of hypotensive treatment in diabetic patients should be 130/80 mmHg. However, for diabetic patients with cerebrovascular disease, the blood pressure level can be appropriately adjusted according to the patient's brain blood supply status. The choice of blood pressure lowering drugs should be based on the patient's systolic and diastolic blood pressure levels, heart rate, heart and kidney function, and the patient's economic status.

6. Adjusting blood lipid and lipid disorders is one of the important risk factors for diabetic macroangiopathy. Dyslipidemia is characterized by high triglycerides, high cholesterol, high and low density lipoproteins, and low high density lipoproteins. Adjusting blood lipids is to reduce the high harmful lipids, namely triglycerides, high cholesterol, low-density lipoprotein, to the desired level, and raise the low-fat lipid, high-density lipoprotein, to normal levels. Clinical studies have shown that long-term and targeted lipid-lowering therapy can significantly reduce the occurrence of cardiovascular and cerebrovascular accidents. Therefore, adjusting blood lipids is an important means to prevent and treat diabetic macrovascular complications.

7. Non-enzymatic glycation of proteins blocking non-enzymatic glycation refers to the reaction of the aldehyde group of glucose with the ε-amino group of lysine or hydroxylysine in the protein molecule to form a glycosylated protein, ultimately forming glycosylation. End product (AGE). The level of blood sugar, the half-life of the protein, and the lysine and hydroxylysine content of the protein are the main factors affecting glycosylation. After saccharification of the protein, the structure, physical and chemical properties and functions of the protein are changed. Every chronic complication of diabetes is closely related to protein saccharification. Therefore, taking various measures to control the glycosylation process and reduce the formation of AGE can effectively prevent chronic complications of diabetes. Clinical observations have found that strict control of blood sugar, increased intake of vitamin C, and appropriate use of drugs such as aspirin can effectively block the non-enzymatic glycation of protein.

8. Inhibition of excessive activation of the polyol pathway The aldose reductase (AR) and sorbitol dehydrogenase (SDH) together form the polyol pathway, also known as the sorbitol pathway. In the hyperglycemia state of diabetes, glucose fermentation reaches its limit, AR activity increases, and the amount of glucose metabolism through the polyol pathway reaches four times that of normal. As a result, cells synthesize a large amount of sorbitol and fructose. Because sorbitol is a very polar compound, it can not freely enter and leave cells, the accumulation of sorbitol in the cells, resulting in hypertonicity, a large amount of extracellular fluid infiltration, causing cell edema and rupture; the accumulation of sorbitol damages the cell membrane , so that a large amount of inositol is lost. On the other hand, the stereo configuration of glucose and inositol is similar. In hyperglycemia, glucose competes with inositol to inhibit the uptake of inositol by nerves. Inositol is an important component of neurophospholipid metabolism. The decrease of inositol content in the nerve interferes with the metabolism of neurophospholipids and reduces the activity of Na-K-ATPase, which in turn causes nerve conduction velocity and axonal transport to slow down.

9. To correct the prothrombin time in patients with hypercoagulable state, the platelet aggregation function and fibrinogen were significantly higher than the normal control group. When combined with microvascular disease, the factor VIII-related antigen reflecting endothelial cell damage was significantly increased. However, fibrin (original) degradation products are only slightly elevated. Platelet dysfunction in diabetic patients is mainly characterized by easy activation, adhesion, aggregation and release of platelets. Damage to the vascular endothelium is caused by an increase in platelet membrane phospholipase activation. Patients with type 2 diabetes are also often associated with decreased endogenous plasmin activity, which in turn contributes to thrombosis and macrovascular disease. The drugs commonly used in clinical anti-diabetic patients are: aspirin, warfarin, plasminogen activator (tPA), defibrase (such as lumbrokinase, python antithrombotic enzyme), ticlopidine.

(Editor's note: During the application of the above drugs to prevent chronic complications of diabetes, changes in blood coagulation and fibrinolysis systems should be closely monitored to prevent severe major bleeding.)

10. Overexpression of antagonistic growth factors Clinical observations show that growth hormone (GH) levels are closely related to chronic complications of diabetes. For example, in patients with diabetes after pituitary apoplexy, GH levels decrease and diabetic retinopathy improves. Studies have shown that diabetes is associated with rare retinopathy of GH alone, and arteriosclerosis is also rare. The level of GH with retinopathy was significantly higher than that of diabetic patients without retinopathy.

This is due to the absolute or relative deficiency of insulin in diabetic patients, and the lack of intracellular energy substrates, thereby stimulating the increase of GH secretion. The increase in GH secretion promotes the production of insulin-like growth factor-1 (IGF-1), which in turn causes the micro-arterial basement membrane glycosylated protein to synthesize and thicken it, which is the cause of early renal hypertrophy and proliferative retinopathy in diabetic patients. Important risk factors, therefore reducing GH secretion levels, reducing the production of IGF-I, help prevent and reduce the occurrence of vascular lesions. The use of GH antagonistic agents to prevent diabetic complications remains to be confirmed clinically. Angiotensin-converting enzyme inhibitors, calcium antagonists and pentoxifylline can indirectly inhibit the expression of growth factors in tissues.

The above 10 basic elements for preventing chronic complications of diabetes have different focuses for diabetic patients, but monitoring the risk factors and early warning indicators, correcting bad lifestyles, eliminating insulin resistance and blocking proteins. Non-enzymatic glycation is a must for all patients with type 2 diabetes.

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