Eosinophil Levels in Type 2 Diabetes: What You Need to Know - Family Medicine

Dr. Xiao Yongxun reply Family Medicine

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Dear Mr.
AC:
1.
The main causes of eosinophilia (eosinophilic leukocytosis) include allergic diseases, parasitic infections, and certain cancers (such as Hodgkin's lymphoma).
Your eosinophil count is indeed slightly elevated, but not significantly so; it may be a normal variation or due to a mild allergic predisposition.
Clinically, the recommendation is primarily to observe and monitor, without excessive concern.
2.
Your AC sugar level is 115 mg/dL (normal range: 70-100 mg/dL); HbA1C is 6.3% (normal range: 4-6%).
Other values for lipids, liver function, kidney function, uric acid, and microalbuminuria are all normal, indicating good control.
3.
The use of Metformin is currently the first-line medication recommended for the treatment of type 2 diabetes in Taiwan, the United States, Japan, and various European countries.
It can moderately lower blood glucose levels, but when used alone, it does not cause hypoglycemic coma.
Like all medications, Metformin has side effects, including the potential for vitamin B12 deficiency, the risk of lactic acidosis in patients with poor kidney function, and possible gastrointestinal discomfort or liver function effects.
In practice, cases of liver and kidney damage due to Metformin are relatively rare; rather, poor blood glucose control leading to fatty liver and kidney damage is more common.
Therefore, I believe your physician's choice of medication is very reasonable and commendable.
4.
However, the control of blood glucose in diabetes primarily relies on dietary management, regular exercise, and lifestyle adjustments, with medication as an adjunct.
Dietary control includes eating until 80% full, avoiding eating too quickly or too much, and steering clear of high-sugar, high-fat, and high-calorie foods or beverages, as well as instant coffee, cakes, and fried foods.
Dinner should not be too heavy, and moderate activity should follow meals before going to bed.
If you feel particularly hungry during or after meals, it may occur in individuals who eat quickly, leading to rapid increases in blood glucose, which in turn stimulates incretin secretion and a subsequent surge in insulin, causing a rapid drop in blood glucose and feelings of hunger.
If one continues to eat excessively at this point, it can lead to stomach distension until satiety is reached.
However, this often results in discomfort and even nausea; this condition can improve significantly with appropriate post-meal walking.
It is important to note that such eating habits can lead to excessive caloric intake, resulting in obesity and even fatigue or drowsiness.
The key solution is to chew slowly and savor each bite, aiming to eat until 80% full or just enough to avoid hunger.
5.
Moderate exercise can utilize glucose-based energy and increase insulin receptor sensitivity, thereby lowering blood glucose levels—both fasting and postprandial.
Regular and consistent exercise can also enhance the biochemical conversion between body fat and glucose; in addition to weight loss, it can help maintain a lean physique.
Therefore, regular and moderate exercise is strongly recommended for blood glucose control.
Post-meal activities should include walking for at least 30 minutes; engaging in overly intense activities is not advisable.
This allows for a balanced distribution of blood volume between the gastrointestinal system and skeletal muscle, facilitating energy transport.
Sitting for prolonged periods immediately after meals can prevent the energy produced from digestion from being utilized, leading to excessive insulin action converting it into fat storage.
When fat storage becomes excessive, additional glucose and carbohydrates require more insulin for conversion into fat.
When insulin secretion approaches exhaustion, elevated blood glucose levels will occur.
Conversely, engaging in intense exercise immediately after meals can divert blood flow to the skeletal muscle, hindering digestion and absorption in the gastrointestinal tract, which can also be harmful to the body.
Thus, all aspects must be considered carefully.
6.
Your physician's management is very appropriate, and I hope you have a pleasant collaboration with them.
If you have further questions, please discuss them thoroughly with your physician or visit a regional hospital's metabolic clinic for care.

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Reply Date: 2020/06/19