Daily Care Guidelines for Patients with Hyperglycemia: Key Points for Bowel Movements, Oral and Eye Health

Regular bowel movements are recommended: After the food we eat is digested and absorbed by the gastrointestinal tract, the residue is expelled through the anus. The frequency, timing, and consistency of bowel movements are generally consistent; this is what we call bowel habits. Diabetic patients should develop good bowel habits. This requires the following:

(1) Have a bowel movement at a fixed time each day, ideally after waking up in the morning or after meals, gradually establishing a routine.

(2) Do not do other things while defecating.

(3) Use gentle pressure when defecating.

(4) Keep the anus clean and dry, and wash with warm water after defecation.

(5) If necessary, take a sitz bath with warm water or a 1:5000 potassium permanganate solution for 15-20 minutes each time, with the water temperature ideally between 40-50℃.

(6) Eat more high-fiber foods, less spicy foods, and avoid strong alcoholic beverages.

Oral hygiene is recommended: Diabetes has a very wide impact. It not only has pathological effects on organs, tissues, and cells, but also causes oral diseases. Poorly controlled oral diseases can further aggravate diabetes, leading to dental problems, primarily including:
* **Alveolar bone osteoporosis:** This is a common complication of diabetes, especially type 2 diabetes. It manifests as decreased bone density in the upper and lower jawbones around the teeth, significant alveolar ridge bone resorption, loose teeth, difficulty biting, weakness in chewing, inability to chew food properly, exposed tooth roots, and gum recession.

* **Periodontal infection:** Diabetic patients have a 2-3 times higher risk of periodontal infection than non-diabetic patients. Severe cases can lead to periodontal abscesses, and even tooth loosening or displacement, which can counteract the effects of hypoglycemic drugs, causing elevated blood sugar and worsening diabetes.

* **Loose teeth:** Loose teeth are a common complication of diabetes. Because diabetic patients often have chronic destructive diseases such as gingivitis and periodontitis, especially alveolar ridge bone resorption, tooth stability is often affected, causing loose teeth, displacement, or malocclusion, which in turn induces periodontal infection, and in severe cases, tooth loss.

Root caries: The main symptoms are gingival recession, simultaneous decay of multiple teeth, and sensitivity to hot and cold stimuli, accompanied by pain. If these symptoms appear, you should consult a dentist promptly. Otherwise, it may lead to pulpitis and periodontitis, making treatment more difficult.

Therefore, to prevent these complications, diabetic patients should pay attention to oral hygiene and clean their mouths regularly.

Eye protection is also important: Neglecting eye hygiene during diabetes can lead to diabetic retinopathy.

Diabetic retinopathy can be divided into six stages. The first three stages are called background retinopathy, which can be completely reversed with good control. The latter three stages are proliferative retinopathy, where the progression of diabetic retinopathy is not only difficult to control but also difficult to improve.

The characteristics of each stage of diabetic retinopathy are as follows:

Stage I: Microaneurysms appear in the fundus. These microaneurysms are not true tumors, but rather formed by the coiling and tortuous nature of capillaries in the fundus.

Stage II: Hard exudates appear on the basis of microaneurysms; these are fatty spots left after retinal edema.

Stage III: Soft exudates appear; these are scars left by punctate hemorrhages in the fundus.

Stage IV: Proliferative retinopathy begins, characterized by the appearance of new blood vessels in the fundus. These new blood vessels are very fragile and often bleed significantly due to poor blood sugar control or high blood pressure.

Stage V: Vitreous hemorrhage occurs, followed by the formation of organized tissue.

Stage VI: The so-called organized tissue is actually initially composed of blood clots attached to the retina. When the blood clots contract, it marks stage VI of retinopathy.

Diabetic retinopathy seriously threatens the patient's vision and is a major cause of blindness in diabetic patients. This must be taken seriously. Unfortunately, in the background stage of diabetic retinopathy, diabetic patients do not experience any abnormalities. Once vision declines significantly, the disease is irreversible. Therefore, prevention remains the most important aspect of treatment.

First, controlling blood sugar and blood pressure is crucial for preventing diabetic retinopathy. Elevated blood sugar can further damage the blood vessels in the retina, while high blood pressure significantly increases the likelihood of retinal hemorrhage.

Second, early detection and treatment of retinopathy are essential. Patients should have an eye exam at least once a year, and more frequently if retinopathy is present, to monitor disease progression. Ignoring symptoms until vision deteriorates can delay treatment and worsen the condition.

Third, appropriate medication is vital. Patients in stage III or higher should be encouraged to switch to insulin therapy for optimal efficacy, slow disease progression, and potentially improve the condition of patients with concurrent microaneurysms, hard oozes, or soft oozes.

Finally, laser therapy can be used for patients in stage III or higher. Lasers can coagulate hemorrhages and seal new blood vessels, showing good results in more severe cases of diabetic retinopathy.