First, we need to clarify what kind of disease diabetes is.

It is a chronic condition, with its most notable characteristic being its slow progression.

Its main manifestations include a gradual onset, concealed symptoms, and a prolonged course.

Many patients accidentally discover abnormal blood sugar levels during routine check-ups. They often experience no disruption to their daily eating and drinking habits, nor any discomfort. Moreover, in the early stages, many do not exhibit the classic symptoms described in medical literature, such as increased thirst, hunger, urination, or weight loss. As a result, the condition is easily overlooked, and abnormalities may not be detected promptly.

Furthermore, many people only consider themselves ill when they actually feel pain, numbness, or other perceptible discomfort. In the early stages of diabetes, most patients experience no noticeable symptoms. Even if elevated blood sugar is detected, it may not receive sufficient attention, leading to delays until complications arise. This entire disease course can be quite lengthy.

In summary, diabetes is a condition that requires long-term management and control by those affected. Unlike a common cold or diarrhea, it cannot be resolved with a short course of medication. Additionally, the principles of diabetes medication are nuanced—starting with low doses and gradually increasing them. Doctors cannot prescribe the full dosage all at once, and since they cannot be with patients at all times, what if hypoglycemia occurs?

During hospitalization, doctors manage patients with daily rounds and medication adjustments. However, after discharge, doctors cannot provide the same level of daily follow-up on blood sugar levels and medication adjustments. Moreover, after leaving the hospital, dietary habits often change significantly. Without timely medication adjustments, blood sugar levels naturally fluctuate widely.

Another critical issue is that the diabetes treatment system includes both in-hospital care and out-of-hospital management. Currently, most patients receive in-hospital treatment, but very few undergo formal out-of-hospital management after discharge. Consequently, they often lack the knowledge to maintain a scientifically balanced diet or properly manage their blood sugar levels. This leads to repeated hospitalizations due to blood sugar issues, causing significant inconvenience to their lives and families.

Previously, when Dr. Wu worked with his mentor, he also wanted to provide out-of-hospital management for patients. However, working within the system did not allow for such practices due to environmental constraints, nor did he have the energy or time—given the daily tasks of writing and organizing medical records. Managing over a dozen patients daily kept him as busy as a spinning top, and he also had on-call duties. The attending physicians during hospitalization face similar challenges. Sometimes, they are so busy that they may be hard to reach, making it difficult to expect comprehensive, one-on-one follow-up management. This is one of the reasons for the issues currently faced by diabetes patients.

Out-of-hospital management is not just about helping patients lower their blood sugar; more importantly, it involves teaching them how to manage their blood sugar effectively in the long term. The goal is to achieve sustained blood sugar control, avoid rehospitalization due to blood sugar issues, and prevent further physical and financial strain. Out-of-hospital management plays a crucial role in the lives of diabetes patients, serving as a pivotal crossroads. Those who undergo such management often experience improved quality of life, enhanced health security, and greater overall well-being. At the very least, they avoid placing excessive burdens on their families due to diabetes or its complications, while also reducing the strain on the national healthcare system. I believe this is a worthwhile endeavor to pursue—one that benefits diabetes patients and society as a whole.