For diabetic patients complicated with gastric diseases, blood glucose control and gastrointestinal protection should be carried out simultaneously. The treatment course usually lasts more than 8 weeks. Such patients need to adjust their hypoglycemic regimen, optimize dietary structure, and treat gastric lesions at the same time.
- Adjustment of Medication Selection
Some hypoglycemic drugs may aggravate gastric discomfort, such as metformin, which often causes gastrointestinal reactions. Consider switching to drugs with less gastric irritation and combining them with gastric protective agents.Patients with gastric diseases should increase blood glucose monitoring to 4 times a day, focusing on postprandial blood glucose fluctuations. - Phased Dietary Management Acute phase (first 2 weeks): Low-residue semi-liquid diet, 5–6 meals a day, with a single intake limited to less than 200 ml.
Remission phase: Gradually switch to a low-glycemic-index diabetic diet, avoiding spicy and high-fat foods.
For patients with delayed gastric emptying, dinner should be finished at least 3 hours before bedtime. - Modified Exercise Methods
Avoid exercising on an empty stomach or immediately after meals.Low-intensity exercise is recommended 1 hour after meals, lasting no more than 30 minutes each time.Patients complicated with gastroesophageal reflux should avoid movements that increase abdominal pressure, such as bending over and sit-ups. - Combined Traditional Chinese Medicine Treatment
For symptoms of epigastric distension and fullness, acupoint application combined with moxibustion can be used. Common acupoints include Zhongwan (CV12) and Zusanli (ST36).Pay attention to the interval between taking Chinese herbal medicine and Western medicine, which is recommended to be more than 2 hours.
Seek medical attention immediately if symptoms persist without improvement, or if hematemesis, melena, etc., occur.During treatment, recheck gastroscopy and glycosylated hemoglobin every 4 weeks, and adjust the plan according to the results.When weight loss exceeds 5% of baseline body weight, nutritional support therapy should be initiated.