Turns out it's not diabetes.
"Lao Zheng's condition really looks like diabetes. But look at the dark brown rash on his hands and arms, and his mental state is poor. We suggest that he systematically evaluate the disease and exclude other diseases. " Wu Fangzhen, the attending physician of the Department of Rheumatology and Endocrinology of the Second People's Hospital of Fujian Province, said.
"A check shocked me: many tests such as blood routine showed anemia, abnormal iron metabolism indicators, and blood sugar values were three or four times higher; Not only liver cirrhosis, portal hypertension and splenomegaly, but also many iron nodules were found in the spleen. " Wu Fangzhen explained.
From this point of view, Lao Zheng's condition is not only diabetes, but also needs multidisciplinary joint consultation to be diagnosed. Attending physician Wu Fangzhen reported the medical history of Lao Zheng to Director Zhao, and invited the departments of gastroenterology and imaging for consultation. After multidisciplinary discussion, it was diagnosed as "hemochromatosis".
The incidence of hemochromatosis is only one in ten thousand.
Some symptoms are similar to diabetes.
hemachromatosis
It is an iron metabolism disorder disease with excessive iron load, which was also called pigmentary cirrhosis and bronze diabetes in the past. It is one of the special reasons why patients suffer from diabetes. Literature reports that hemochromatosis is a rare disease in China, with an incidence of only 0. 1 ‰-0.25 ‰, with diabetes as the first symptom.
Hemochromatosis can be divided into primary and secondary. Primary hemochromatosis is a recessive genetic disease, which is more common in men. Secondary hemochromatosis is mainly caused by excessive iron storage in severe chronic anemia after long-term massive blood transfusion (generally, blood transfusion 100 times or more), and a few cases occur after years of intake of a large amount of drug iron or dietary iron (such as alcoholism).
Be alert to these symptoms!
"Because some clinical manifestations of hemochromatosis are similar to diabetes, it is easy to be misdiagnosed clinically." Wu Fangzhen reminded that when there are typical symptoms of hemochromatosis, such as iron gray (dark brown or bronze) pigmentation on the skin, fatigue, lethargy, weight loss, hyperglycemia and so on. It is recommended to go to the digestive department and endocrinology department for treatment.
Some cases of hemochromatosis complicated with diabetes can be treated by comprehensive treatment such as exercise, diet control and insulin control of blood sugar.
Different people have different levels of blood sugar control.
"It should be emphasized that the standard values stipulated in the diabetes-related guidelines are for reference only, and the blood sugar control level of different people is different and varies from person to person." Wu Fangzhen said, "A few days ago, the department received a diabetic hypoglycemia coma patient. Older patients realize that the level of blood sugar control should meet the standards of young people, and double use of hypoglycemic drugs causes hypoglycemia, leading to coma. "
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