The system takes me for surgery

The man asked: "But if you have diabetes and don't take medicine, is it serious?"

Liang Yi asked, "Is it you?"

The man nodded and said, "That's right."

Well, what is this saying? Diabetes is not difficult to diagnose now. Liang Yi felt very strange. He said, "You still look very young."

Although diabetes tends to be younger, Liang Yi still finds it a bit weird.

He asked, "How old are you?"

"I'm 20," the man said.

This looks a bit old at 20 years old. Looking at the 35-year-old appearance, Liang Yi asked, "When did you find out about diabetes?"

"I don't know if it's diabetes. I fainted suddenly last month. My co-workers woke me up at night when they came back and found out. After eating some food, I got better. I heard from my co-workers that my mouth smelled like rotten apples. , His grandma used to have diabetes, and she also had this smell when she was about to die. The more I thought about it, the more scared I became, so I came to the hospital today to ask about it. I heard that your doctor will charge you for asking, right?"

He should be talking about the rotten apple smell of ketoacidosis in diabetic patients. Liang Yi said, "Consult with me, there is no charge." Seeing that the man mentioned money all the time, he said that there would be no charge and dismissed his request. Concerned, said: "Let me go and test your blood sugar, you sit here first."

Liang Yi went to take a simple blood glucose meter to test him, and the blood sugar was only 2.9. He asked, "Did you not eat at night?" Too much food."

"Why don't you have dinner tonight?"

"Eating at night is easy to gain weight."

"You're so skinny, you're afraid of gaining weight." Liang Yi was a little displeased with lying to him.

The man's dark cheeks flushed instantly, scratched his head, and said with some embarrassment: "I don't have much money to eat. I don't have to work at night, so I save some money."

"Aren't you working on a construction site? How come you have no money to eat? Did you gamble or spend your money elsewhere?"

The man smiled awkwardly and said: "Our kind of rough labor costs more than 200 yuan a day, but in reality it may only work for about half a month. If you spend a little by yourself, you will not have much money left for your parents and sister. .”

His words are very simple, not like lying.

Liang Yi was really touched by the strong sense of family responsibility of this slightly elderly 20-year-old young man.

Liang Yi patiently explained to him: "You need to do some tests, because there are many reasons for fainting, and your condition may not be caused by diabetes, but may also be caused by starvation ketosis."

The man couldn't understand the word starvation ketosis, so he asked, "This check needs a lot of money, right?
Liang Yi said: "About 100 yuan, this inspection is very necessary." In fact, the 100 yuan is not enough, but he knows that if it is more expensive, the man will definitely not be willing to check, so he plans to make up the excess money by himself. superior.

The man hesitated and said, "Then let me make one."

The test results came out, it was starvation ketosis.

Although starvation ketosis and diabetic ketosis are both manifested as positive urine ketones, accompanied by nausea and vomiting and other gastrointestinal symptoms, the former has normal or low blood sugar, while the latter has high blood sugar, which is completely opposite.

If insulin secretion is insufficient in diabetic patients, even if the body has high blood sugar levels, ketone production is highly stimulated by low insulin, resulting in excessive fatty acid decomposition, which can also cause ketoacidosis.

Starvation ketoacidosis is due to the long-term lack of glucose as the main energy source in the human body, fatty acids replace glucose as the main metabolic fuel, thereby continuously producing ketoacids and accumulating in the blood.At the same time, long-term starvation will not increase blood sugar, and does not require the body to secrete a large amount of insulin to consume blood sugar, resulting in a decrease in body secretion of insulin, which also stimulates fat breakdown.

Liang Yi explained to him in the most easy-to-understand way: "Your disease is caused by health problems caused by eating too little. You need to eat normally in the future. You can save money by eating less. How much money can you save?" In the end, the body is damaged and you can’t work, otherwise the gain outweighs the loss.”

The man smiled awkwardly: "Yes, I can't save much money. The main reason is that I earn less. I think my sister is in her third year of high school. I have to save more money for her, otherwise I heard that going to college is very expensive."

Liang Yi nodded to express his understanding, and said, "You still have to keep up with your diet, otherwise it will be very serious if you get sick. By the way, you can't overeat."

"Thank you, doctor." The man thanked and left the hospital with a smile on his face.

The reason why Liang Yi reminded him not to overeat is because under the condition of long-term hunger, the body will produce a series of remedial measures, and will gradually adapt to the situation after remediation.If you suddenly ingest a large amount of nutrition, on the one hand, your stomach and intestines will not be able to digest it; on the other hand, you will even do bad things with good intentions, directly leading to death!The scientific name of this phenomenon is "refeeding syndrome".

Refeeding syndrome refers to the electrolyte disturbance, fluid retention, glucose metabolism changes and a series of metabolic disorder syndromes that occur in patients with severe malnutrition or fasting after receiving energy supply again. In severe cases, life-threatening low Phosphate

After seeing the man, Liang Yi felt mixed feelings.

He had just settled down and another patient came in. This patient seemed to weigh two hundred catties and was helped in by a woman in her sixties.

When Liang Yi came in, he noticed that the obese man was dressed in a weird way. He looked like he was in his 30s, with an unshaven beard. The man had been snuggling in the woman's arms since he came to the consultation room.

The man was wearing a cartoon Ultraman coat, which was exactly the same as that worn by the fractured children before, except that his clothes were twice the size of the children's clothes. He also spoke like a child, always talking in front of his mother and behind his mother.

Although Liang Yi felt that this man was a bit weird, he still asked in the most ordinary tone: "What's wrong with him?"

The man immediately cried and begged for mercy, "Mom, I'm afraid, I'm afraid of the doctor's injection."

His mother said in a gentle tone, "Don't be afraid, baby."

It is unbelievable that a mother who is nearly 60 years old actually faces a man who is about 30 years old.Liang Yi asked, "Do you have any questions?"

"It's my baby, my baby was diagnosed with diabetes before, and he fainted and said ketoacidosis at home.

The woman said that the man had diabetes. Judging from the man's body shape, Liang Yi was not surprised at all.

"Then do you want to do some inspections this time? Or what?"

"I plan to come and prescribe a medicine, and then consult with you."