以往大家以為糖尿病患者都會出現所謂的「三多」症狀，可能是謬誤！奇美醫學中心內分泌暨新陳代謝科醫師葉美成指出，糖尿病病人高血糖最常見的症狀是「沒有症狀」，有一部份的人會出現「多吃、多喝、多尿」的「三多」症狀。長期血糖控制不良會造成糖尿病的併發症，例如腦中風、心肌梗塞、慢性腎臟衰竭，嚴重時會需要洗腎、蜂窩性組織炎、傷口不癒合、傷口越爛越大甚至需要截肢、手腳末端感覺麻木或疼痛、糖尿病眼底病變、視力漸漸模糊甚至失明。
60歲市場賣菜的攤商林老闆，有糖尿病十幾年，在其他醫療院所拿藥服用血糖藥物也十幾年，雖然都有吃藥，但糖化血色素一直都在9%左右(一般人的正常值約小於5.7％，糖尿病人宜控制在7％以下)，最近林老闆的鄰居因為長期血糖控制不良而造成心肌梗塞，因此竹我警覺前往門診主動希望可以把自己的血糖控制更好。
葉美成表示，在糖尿病的早期就把血糖控制在良好的範圍內，才能把併發症出現的機會降到最低。由於糖尿病大多是沒有症狀的，常常因為併發症出現後才進一步檢查出有糖尿病，因此「早期篩檢、早期治療」很重要。國民健康署提供成人健康檢查，40歲以上建議每三年篩檢1次，60歲以上建議每年篩檢1次。
葉美成說，風險較高的人例如肥胖、糖尿病家族史、缺乏運動、血壓血脂異常、曾有妊娠糖尿病、曾有心血管疾病等，也建議做糖尿病的篩檢。一旦檢查出糖尿病，可以用飲食、運動和生活習慣改變做治療，如果經過生活習慣改善血糖還是高，可以經由醫師評估開立適合的血糖藥物治療。更重要的是病人執行「自我血糖監測」，如此才能適時反應出藥物、飲食、運動和生活習慣是否要做調整。
葉美成指出，「自我血糖監測」的執行方式很簡單，建議到醫療器材行買一台血糖機，每半年到一年把血糖機帶回原店家做校正，以確保血糖機的準確度。醫師會根據每個病人的情形給予測血糖的次數和時間點。血糖較不穩定的時期，每日測的次數會比較多，當血糖達到穩定狀態，醫師會根據病人的意願減少測血糖的次數。如果病人無法自己測血糖，也可以由照顧者來幫病人測血糖。但是控制血糖不是看病拿藥回家就沒事了。醫師會根據每個病人的狀況整體評估後開立適合的藥物，藥物包括口服藥、打針藥物或是口服加上打針的血糖藥。病人要按時使用藥物，並且每日執行「自我血糖監測」，回診時與醫師討論血糖值、飲食內容、運動的情形。
葉美成強調，每個人的體質不同，病人也要與醫師討論藥物是否有副作用或身體不適等等。透過良好的溝通，醫師更可以適時做藥物的調整、飲食運動的建議，通常經過雙方共同的努力，一般都可以達到良好的血糖控制。期望每個糖尿病人都可以及早將血糖控制在良好範圍內，以減少併發症的產生。
In the past, everyone thought that diabetic patients would have the so-called "three more" symptoms, which may be a fallacy! Ye Meicheng, a professor of endocrinology and metabolism at Chi Mei Medical Center, pointed out that the most common symptom of hyperglycemia in diabetic patients is "no symptoms". Some people will have "three more" symptoms of "eat more, drink more, and have more urine." Long-term poor glycemic control can cause complications of diabetes, such as stroke, myocardial infarction, chronic kidney failure. In severe cases, dialysis, cellulitis, wound healing, wounds are worse, and even amputation is required. Numbness or pain, diabetic fundus lesions, blurred vision and even blindness.
Boss Lin, a 60-year-old market seller of vegetables, has diabetes for more than a decade. He has taken blood sugar medications in other medical institutions for more than a decade. Although he has taken medicine, glycated hemoglobin has been around 9% (ordinary people). The normal value is less than 5.7%, and the diabetic should be controlled below 7%. Recently, Lin’s neighbor has caused myocardial infarction due to poor long-term blood sugar control. Therefore, I am alert to go to the clinic and hope to control my blood sugar better.
Ye Meicheng said that in the early stages of diabetes, blood sugar is kept in a good range to minimize the chance of complications. Because diabetes is mostly asymptomatic, it is often because diabetes is further detected after complications, so early screening and early treatment are important. The National Health Service provides adult health checkups. It is recommended to screen once every three years for those over the age of 40 and one screening per year for those over 60 years old.
Ye Meicheng said that people with higher risks such as obesity, family history of diabetes, lack of exercise, blood pressure and dyslipidemia, gestational diabetes, and previous cardiovascular disease are also recommended for screening for diabetes. Once you have checked out diabetes, you can use diet, exercise, and lifestyle changes to improve your treatment. If you improve your blood sugar after living habits, you can use a physician to evaluate the appropriate glycemic medication. More importantly, patients perform “self-glycemic monitoring” so that they can reflect whether drugs, diet, exercise and lifestyle habits need to be adjusted.
Ye Meicheng pointed out that the implementation of "self-glycemic monitoring" is very simple. It is recommended to buy a blood glucose machine from the medical equipment line, and bring the blood glucose machine back to the original store every six months to one year to make corrections to ensure the accuracy of the blood glucose machine. The physician will give the number and timing of blood glucose measurements based on each patient's condition. During periods of unstable blood sugar, the number of daily tests will be more. When the blood sugar reaches a steady state, the doctor will reduce the number of blood glucose tests according to the patient's wishes. If the patient is unable to measure blood sugar by himself, the caregiver can also help the patient to measure blood sugar. But controlling blood sugar is not going to see a doctor. Physicians will open appropriate medications based on the overall assessment of each patient's condition, including oral medications, injection medications or oral and injection-administered blood glucose medications. The patient should use the drug on time and perform "self-glycemic monitoring" every day. When he returns to the doctor, he will discuss the blood sugar level, diet and exercise.
Ye Meicheng emphasized that each person's physique is different, and the patient should also discuss with the doctor whether the drug has side effects or physical discomfort. Through good communication, doctors can make timely adjustments to medications and dietary movements. Usually, through joint efforts, they can generally achieve good glycemic control. It is expected that every diabetic can control blood sugar within a good range as early as possible to reduce the incidence of complications.
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