Very important and valuable information on diabetic neuropathy,Including diabetic retinopathy as Diabetes mellitus is an epidemic disease these days .
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Useful information. Thanx.
Excellent information.Thanks for sharing.
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Nice update, Thanks for sharing.
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@Dr. Suvarchala Pratap Ji very nice information mem
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Friends today I am discussing about a very common disease now a days that is Diabetes mellitus. Diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired ability of the body to produce or respond to insulin and thereby maintain proper levels of sugar (glucose) in the blood. diabetes mellitus diabetes mellitus An overview of diabetes mellitus and advances in treatment. HudsonAlpha Institute for Biotechnology Diabetes is a major cause of morbidity and mortality, though these outcomes are not due to the immediate effects of the disorder. They are instead related to the diseases that develop as a result of chronic diabetes mellitus. These include diseases of large blood vessels (macrovascular disease, including coronary heart disease and peripheral arterial disease) and small blood vessels (microvascular disease, including retinal and renal vascular disease), as well as diseases of the nerves. READ MORE ON THIS TOPIC Prozac therapeutics: Diabetes mellitus Diet is the cornerstone of diabetic treatment whether or not insulin is prescribed. The goal is to regulate… Causes And Types Insulin is a hormone secreted by beta cells, which are located within clusters of cells in the pancreas called the islets of Langerhans. Insulin’s role in the body is to trigger cells to take up glucose so that the cells can use this energy-yielding sugar. Patients with diabetes may have dysfunctional beta cells, resulting in decreased insulin secretion, or their muscle and adipose cells may be resistant to the effects of insulin, resulting in a decreased ability of these cells to take up and metabolize glucose. In both cases, the levels of glucose in the blood increase, causing hyperglycemia (high blood sugar). As glucose accumulates in the blood, excess levels of this sugar are excreted in the urine. Because of greater amounts of glucose in the urine, more water is excreted with it, causing an increase in urinary volume and frequency of urination as well as thirst. (The name diabetes mellitus refers to these symptoms: diabetes, from the Greek diabainein, meaning “to pass through,” describes the copious urination, and mellitus, from the Latin meaning “sweetened with honey,” refers to sugar in the urine.) Other symptoms of diabetes include itching, hunger, weight loss, and weakness. The islets of Langerhans are responsible for the endocrine function of the pancreas. Each islet contains beta, alpha, and delta cells that are responsible for the secretion of pancreatic hormones. Beta cells secrete insulin, a well-characterized hormone that plays an important role in regulating glucose metabolism. The islets of Langerhans are responsible for the endocrine function of the pancreas. Each islet contains beta, alpha, and delta cells that are responsible for the secretion of pancreatic hormones. Beta cells secrete insulin, a well-characterized hormone that plays an important role in regulating glucose metabolism. Encyclopædia Britannica, Inc. There are two major forms of the disease. Type 1 diabetes, formerly referred to as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, usually arises in childhood. Type 2 diabetes, formerly called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, usually occurs after age 40 and becomes more common with increasing age. Type 1 diabetes mellitus Type 1 diabetes accounts for about 5 to 10 percent of cases of diabetes. Most cases of type 1 diabetes develop in children or adolescents, but about 20 percent of new patients are adults. The frequency of type 1 diabetes varies widely in different countries, from less than 1 case per 100,000 people per year in China and parts of South America to more than 20 cases per 100,000 people per year in places such as Canada, Finland, Norway, Sweden, and the United Kingdom. Most patients present with symptoms of hyperglycemia, but some patients present with diabetic ketoacidosis, a clear indication that insulin secretion has significantly deteriorated. diabetes mellitus diabetes mellitus A discussion of type I and type II diabetes mellitus. HudsonAlpha Institute for Biotechnology Type 1 diabetes is usually caused by autoimmune destruction of the islets of Langerhans of the pancreas. Patients with type 1 diabetes have serum antibodies to several components of the islets of Langerhans, including antibodies to insulin itself. The antibodies are often present for several years before the onset of diabetes, and their presence may be associated with a decrease in insulin secretion. Some patients with type 1 diabetes have genetic variations associated with the human leukocyte antigen (HLA) complex, which is involved in presenting antigens to immune cells and initiating the production of antibodies that attack the body’s own cells (autoantibodies). However, the actual destruction of the islets of Langerhans is thought to be caused by immune cells sensitized in some way to components of islet tissue rather than to the production of autoantibodies. In general, 2 to 5 percent of children whose mother or father has type 1 diabetes will also develop type 1 diabetes. Type 2 diabetes mellitus Type 2 diabetes is far more common than type 1 diabetes, accounting for about 90 percent of all cases. The frequency of type 2 diabetes varies greatly within and between countries and is increasing throughout the world. Most patients with type 2 diabetes are adults, often older adults, but it can also occur in children and adolescents. There is a stronger genetic component to type 2 diabetes than to type 1 diabetes. For example, identical twins are much more likely to both develop type 2 diabetes than to both develop type 1 diabetes, and 7 to 14 percent of people whose mother or father has type 2 diabetes will also develop type 2 diabetes; this estimate increases to 45 percent if both parents are affected. In addition, it is estimated that about half of the adult Pima Indian population in Arizona has type 2 diabetes, whereas in the entire United States it is estimated that about 10 percent of the population has type 2 diabetes Many patients with type 2 diabetes are asymptomatic, and they are often diagnosed with type 2 diabetes when routine measurements reveal high blood glucose concentrations. In some patients the presence of one or more symptoms associated with the long-term complications of diabetes leads to a diagnosis of type 2 diabetes. Other patients present with symptoms of hyperglycemia that have been present for months or with the sudden onset of symptoms of very severe hyperglycemia and vascular collapse. Type 2 diabetes is strongly associated with obesity and is a result of insulin resistance and insulin deficiency. Insulin resistance is a very common characteristic of type 2 diabetes in patients who are obese, and thus patients often have serum insulin concentrations that are higher than normal. However, some obese persons are unable to produce sufficient amounts of insulin, and thus the compensatory increase in response to increased blood glucose concentrations is inadequate, resulting in hyperglycemia. If blood glucose concentration is increased to a similar level in a healthy person and in an obese person, the healthy person will secrete more insulin than the obese person. leptin leptin The discovery of the leptin protein in mice and its connection to diabetes and obesity. HudsonAlpha Institute for Biotechnology People with type 2 diabetes can control blood glucose levels through diet and exercise and, if necessary, by taking insulin injections or oral medications. Despite their former classifications as juvenile or adult, either type of diabetes can occur at any age. Gestational diabetes Diabetes mellitus also may develop as a secondary condition linked to another disease, such as pancreatic disease; a genetic syndrome, such as myotonic dystrophy; or drugs, such as glucocorticoids. Gestational diabetes is a temporary condition associated with pregnancy. In this situation, blood glucose levels increase during pregnancy but usually return to normal after delivery. However, gestational diabetes is recognized as a risk for type 2 diabetes later in life. Gestational diabetes is diagnosed when blood glucose concentrations measure between 92 and 125 mg per 100 ml (5.1 and 6.9 millimoles [mmol] per litre) after fasting or when blood glucose concentrations equal or exceed 180 mg per 100 ml (10 mmol per litre) one hour after ingesting a glucose-rich solution. Acute Clinical Manifestation Hyperglycemia itself can cause symptoms but usually only when blood glucose concentrations are approximately 180 mg per 100 ml (10 mmol per litre) or higher. When blood glucose concentrations increase, more glucose is filtered by the glomeruli of the kidneys than can be reabsorbed by the kidney tubules, resulting in glucose excretion in the urine. High glucose concentrations in the urine create an osmotic effect that reduces the reabsorption of water by the kidneys, causing polyuria (excretion of large volumes of urine). The loss of water from the circulation stimulates thirst. Therefore, patients with moderate or severe hyperglycemia typically have polyuria and polydipsia (excessive thirst). The loss of glucose in the urine results in weakness, fatigue, weight loss, and increased appetite (polyphagia). Patients with hyperglycemia are prone to infections, particularly vaginal and urinary tract infections, and an infection may be the presenting manifestation of diabetes. There are two acute life-threatening complications of diabetes: hyperglycemia and acidosis (increased acidity of the blood), either of which may be the presenting manifestation of diabetes. In patients with type 1 diabetes, insulin deficiency, if not recognized and treated properly, leads to severe hyperglycemia and to a marked increase in lipolysis (the breakdown of lipids), with a greatly increased rate of release of fatty acids from adipose tissue. In the liver, much of the excess fatty acid is converted to the keto acids beta-hydroxybutyric acid and acetoacetic acid. The increased release of fatty acids and keto acids from adipose, liver, and muscle tissues raises the acid content of the blood, thereby lowering the pH of the blood. The combination of hyperglycemia and acidosis is called diabetic ketoacidosis and leads to hyperventilation and to impaired central nervous system function, culminating in coma and death. Patients with diabetic ketoacidosis must be treated immediately with insulin and intravenous fluids. In patients with type 2 diabetes, high blood glucose concentrations can lead to very severe and prolonged hyperglycemia and to marked polyuria, with the loss of a large volume of fluid and a very high serum osmolality. These factors place patients with type 2 diabetes at a high risk of developing central nervous system dysfunction and vascular collapse (hyperglycemia coma). Ketoacidosis is usually not a problem in patients with type 2 diabetes because they secrete enough insulin to restrain lipolysis. Patients with hyperglycemic coma should be treated aggressively with intravenous fluids and insulin. Diagnosis And Treatment Many people are unaware that they have diabetes. In 2012, for example, it was estimated that 8.1 million of 29.1 million American cases were undiagnosed. The disease is usually discovered when there are typical symptoms of increased thirst and urination and a clearly elevated blood sugar level. The diagnosis of diabetes is based on the presence of blood glucose concentrations equal to or greater than 126 mg per 100 ml (7.0 mmol per litre) after an overnight fast or on the presence of blood glucose concentrations greater than 200 mg per 100 ml (11.1 mmol per litre) in general. People with fasting blood glucose values between 100 and 125 mg per 100 ml (6.1 to 6.9 mmol per litre) are diagnosed with a condition called impaired fasting glucose (prediabetes). Normal fasting blood glucose concentrations are less than 100 mg per 100 ml (6.1 mmol per litre). While the blood glucose concentrations used to define diabetes and impaired fasting glucose are somewhat arbitrary, they do correlate with the risk of macrovascular and microvascular disease. Patients with impaired fasting glucose are likely to have diabetes later in life. Oral glucose tolerance tests, in which blood glucose is measured hourly for several hours after ingestion of a large quantity of glucose (usually 75 or 100 grams), are used in pregnant women to test for gestational diabetes. The criteria for diagnosing gestational diabetes are more stringent than the criteria for diagnosing other types of diabetes, which is a reflection of the presence of decreased blood glucose concentrations in healthy pregnant women as compared with nonpregnant women and with men. The duration and severity of hyperglycemia can be assessed by measuring levels of advanced glycosylation end products (AGEs). AGEs are formed when hemoglobin molecules in red blood cells undergo glycosylation (binding to glucose), and the bound substances remain together until the red blood cell dies (red blood cells live approximately 120 days). AGEs are believed to inflict the majority of vascular damage that occurs in people with diabetes. A glycosylated hemoglobin called hemoglobin subtype A1c (HbA1c) is particularly useful in monitoring hyperglycemia and the efficacy of diabetes treatments. Treatment Before the isolation of insulin in the 1920s, most patients died within a short time after onset. Untreated diabetes leads to ketoacidosis, the accumulation of ketones (products of fat breakdown) and acid in the blood. Continued buildup of these products of disordered carbohydrate and fat metabolism result in nausea and vomiting, and eventually the patient goes into a diabetic coma. Treatment for diabetes mellitus is aimed at reducing blood glucose concentrations to normal levels. Achieving this is important in promoting well-being and in minimizing the development and progression of the long-term complications of diabetes. Measurements of HbA1c can be used to assess whether an individual’s treatment for diabetes is effective. Target values of HbA1c levels should be close to normal. Diet and exercise All diabetes patients are put on diets designed to help them reach and maintain normal body weight, and they often are encouraged to exercise regularly, which enhances the movement of glucose into muscle cells and blunts the rise in blood glucose that follows carbohydrate ingestion. Patients are encouraged to follow a diet that is relatively low in fat and contains adequate amounts of protein. In practice about 30 percent of calories should come from fat, 20 percent from protein, and the remainder from carbohydrates, preferably from complex carbohydrates rather than simple sugars. The total caloric content should be based on the patient’s nutritional requirements for growth or for weight loss if the patient is obese. In overweight or obese patients with type 2 diabetes, caloric restriction for even just a few days may result in considerable improvement in hyperglycemia. In addition, weight loss, preferably combined with exercise, can lead to improved insulin sensitivity and even restoration of normal glucose metabolism. Insulin therapies Diabetics who are unable to produce insulin in their bodies require insulin therapy. Traditional insulin therapy entails regular injections of the hormone, which are often customized according to individual and variable requirements. Beef or pork insulin, made from the pancreatic extracts of cattle or pigs, can be used to treat humans with diabetes. However, in the United States, beef and pork forms of insulin are no longer manufactured, having been discontinued in favour of human insulin production. Modern human insulin treatments are based on recombinant DNA technology. Human insulin may be given as a form that is identical to the natural form found in the body, which acts quickly but transiently (short-acting insulin), or as a form that has been biochemically modified so as to prolong its action for up to 24 hours (long-acting insulin). Another type of insulin acts rapidly, with the hormone beginning to lower blood glucose within 10 to 30 minutes of administration; such rapid-acting insulin was made available in an inhalable form in 2014. The optimal regimen is one that most closely mimics the normal pattern of insulin secretion, which is a constant low level of insulin secretion plus a pulse of secretion after each meal. This can be achieved by administration of a long-acting insulin preparation once daily plus administration of a rapid-acting insulin preparation with or just before each meal. Patients also have the option of using an insulin pump, which allows them to control variations in the rate of insulin administration. A satisfactory compromise for some patients is twice-daily administration of mixtures of intermediate-acting and short-acting insulin. Patients taking insulin also may need to vary food intake from meal to meal, according to their level of activity; as exercise frequency and intensity increase, less insulin and more food intake may be necessary. Research into other areas of insulin therapy include pancreas transplantation, beta cell transplantation, implantable mechanical insulin infusion systems, and the generation of beta cells from existing exocrine cells in the pancreas. Patients with type 1 diabetes have been treated by transplantation of the pancreas or of the islets of Langerhans. However, limited quantities of pancreatic tissue are available for transplantation, prolonged immunosuppressive therapy is needed, and there is a high likelihood that the transplanted tissue will be rejected even when the patient is receiving immunosuppressive therapy. Attempts to improve the outcome of transplantation and to develop mechanical islets are ongoing. Drugs used to control blood glucose levels There are several classes of oral drugs used to control blood glucose levels, including sulfonylureas, biguanides, and thiazolidinediones. Sulfonylureas, such as glipizide and glimepiride, are considered hypoglycemic agents because they stimulate the release of insulin from beta cells in the pancreas, thus reducing blood glucose levels. The most common side effect associated with sulfonylureas is hypoglycemia (abnormally low blood glucose levels), which occurs most often in elderly patients who have impaired liver or kidney function. Biguanides, of which metformin is the primary member, are considered antihyperglycemic agents because they work by decreasing the production of glucose in the liver and by increasing the action of insulin on muscle and adipose tissues. A potentially fatal side effect of metformin is the accumulation of lactic acid in blood and tissues, often causing vague symptoms such as nausea and weakness. Thiazolidinediones, such as rosiglitazone and pioglitazone, act by reducing insulin resistance of muscle and adipose cells and by increasing glucose transport into these tissues. These agents can cause edema (fluid accumulation in tissues), liver toxicity, and adverse cardiovascular events in certain patients. Furthermore, oral hypoglycemic agents lower mean blood glucose concentrations by only about 50–80 mg per 100 ml (2.8–4.4 mmol per litre), and sensitivity to these drugs tends to decrease with time. There are several other agents that can be highly effective in the treatment of diabetes. Pramlintide is an injectable synthetic hormone (based on the human hormone amylin) that regulates blood glucose levels by slowing the absorption of food in the stomach and by inhibiting glucagon, which normally stimulates liver glucose production. Exenatide is an injectable antihyperglycemic drug that works similarly to incretins, or gastrointestinal hormones, such as gastric inhibitory polypeptide, that stimulate insulin release from the pancreas. Exenatide has a longer duration of action than incretins produced by the body because it is less susceptible to degradation by an enzyme called dipeptidyl peptidase-4 (DPP-4). A drug called sitagliptin specifically inhibits DPP-4, thereby increasing levels of naturally produced incretins. Side effects associated with these drugs are often mild, although pramlintide can cause profound hypoglycemia in patients with type 1 diabetes. Glucometer monitoring All patients with diabetes mellitus, particularly those taking insulin, should measure blood glucose concentrations periodically at home, especially when they have symptoms of hypoglycemia. This is done by pricking a finger, obtaining a drop of blood, and using an instrument called a glucometer to measure the blood glucose concentration. Using this technology, many patients become skilled at evaluating their diabetes and making appropriate adjustments in therapy on their own initiative. Long-Term Complications Of Diabetes Mellitus The prolonged survival of patients with diabetes mellitus has led to an increasing incidence of long-term complications. The most common complications are vascular complications, which may involve large arteries, small arteries, or capillaries. Large-vessel disease generally presents as atherosclerotic vascular disease (atherosclerosis). Atherosclerosis in diabetic patients does not differ from that which occurs in nondiabetic patients, although it may occur sooner and progress more rapidly in diabetic than nondiabetic patients. It involves the coronary arteries, the cerebral arteries, and the large arteries (iliac and femoral arteries) that supply blood to the legs. Thus, nonfatal and fatal myocardial infarction (heart attack), stroke, and ulceration and gangrene of the feet, often necessitating amputation, are common in patients with diabetes. Small-artery disease (microangiopathy) consists of thickening of the walls of small arteries and capillaries, which initially renders them permeable (leaky) to fluids and subsequently renders them prone to obstruction (thrombosis or embolism). These changes occur primarily in the retina (diabetic retinopathy) and kidneys (diabetic nephropathy), and as a result diabetes is the most common cause of blindness and end-stage kidney disease. Vascular complications are aggravated by hypertension and hyperlipidemia (high serum levels of lipids), both of which are common in patients with diabetes. Cataract formation can occur as a complication of diabetes (shown here in a person affected by type I diabetes). Cataract formation can occur as a complication of diabetes (shown here in a person affected by type I diabetes). There are other, nonvascular complications of diabetes, including cataract formation and neuropathy (diabetic neuropathy). The most common type of neuropathy is symmetric polyneuropathy. This causes abnormal sensation (numbness or tingling) or loss of sensation, loss of position sense and vibratory sense, and weakness of the muscles of the feet, lower legs, and hands. Other patients have single-nerve neuropathy, such as loss of function of a nerve to the muscles of one eye, causing visual disturbances, or of a nerve to the muscles of the forearm, causing wrist drop. They may also have autonomic neuropathy, which may result in postural hypotension (fainting upon sitting up or standing), gastric retention, erectile dysfunction, or urinary bladder dysfunction. These complications may be caused by glycosylation of ocular tissue or nervous tissue, accumulation of osmotically active glucose metabolites in these tissues, or disease of the small vessels in these tissues. The development or progression of the small-vessel complications of diabetes, such as diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy, can be slowed or prevented by control of hyperglycemia. It is less clear whether the control of hyperglycemia has a similar effect in controlling large-vessel complications. The onset and progression of the vascular complications of diabetes can be delayed by controlling high blood pressure (hypertension). Many antihypertensive treatments are aimed specifically at preventing the actions of angiotensin II, a peptide that stimulates blood vessel constriction to increase blood pressure. The increase in blood pressure can be prevented by drugs that inhibit angiotensin-converting enzyme (drugs known as ACE inhibitors), which converts inactive angiotensin I to active angiotensin II, or by drugs that block the angiotensin receptor, which prevents angiotensin II from stimulating blood vessels to constrict. Cessation of smoking and lowering serum lipid concentrations are also helpful in slowing progression of vascular disease in patients with diabetes. Prevention Attempts to prevent type 1 diabetes have been unsuccessful. On the other hand, in people with impaired fasting glucose, progression to type 2 diabetes can be prevented by weight loss and exercise and by treatment with metformin, an ACE inhibitor, or a statin (a type of cholesterol-lowering drug). Homeopathic remedies marketed to treat the symptoms of diabetes or prevent complications include: Syzygium jambolanum or S. cumini (black plum) is said to help treat thirst, weakness, skin ulcers, and excessive urination. Uranium nitricum is marketed to treat excessive urination, nausea, swelling, and burning with urination. Conium (hemlock) is purported to treat numbness in the feet and hands as well as diabetic neuropathy (nerve damage). Plumbum (lead) is said to help with numbness in the hands and feet, nerve pain, and tinnitus. Calendula (marigold) is said to treat infected ulcers. Phosphoric acid is promoted to treat impaired memory, confusion or heavy head, frequent urination at night, hair loss, and difficulty maintaining an erection.Dr. Rajesh Gupta6 Likes5 Answers
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A 50 YEAR OLD FEMALE CAME ON ED C/O NUMBNESS OF BOTH LOWER LIMB, SOB+ DURING SLEEPING, JOINT PAIN, INTERMITANT ON AND OFF FEVER, PMH - HTN,CKD,T2DM Taking tab. Janumet 50/500 BBF, RBS - 498 mg/dl, BP - 140/80 MM/HG, R/R - 24 BRTH/MIN, TEMP. AFEBRILE, SPO2 - 96%, CVS -S1S2, CNS - COUNCIOUS, R/S - BL CLEAR, OTHER - NAD, Following report are attached SUGGEST YOUR VALUABLE OPINIONDr. Rajendra Rai2 Likes13 Answers
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Friends today I am discussing about Hyperglycemia, Diabetes. TYPE 2 DIABETES SYMPTOMS According to the American Diabetes Association, in patients with type 2 diabetes, hyperglycemia (high blood glucose) typically develops gradually and, at earlier stages, is often not severe enough for you to notice any classic symptoms. This may be why many people are undiagnosed for many years, but being able to recognize the symptoms of high blood sugar can help you to diagnose diabetes, manage it better, and prevent an emergency. For those people already diagnosed with diabetes, having a blood sugar that is sporadically higher than usual doesn't necessarily put you in immediate danger. However, chronically elevated blood sugar may be problematic. Over time, blood sugar levels that are too high can affect the small and big vessels of the body, leading to complications of the eyes, heart, kidneys, and feet. hyperglycemia symptoms Frequent Symptoms Experiencing common hyperglycemia symptoms may be a diabetes warning sign for those who have not yet been diagnosed. If you know you have diabetes, noting these symptoms may be an indication that a tweak in your treatment plan is needed. Excessive Thirst (Polydipsia) In an effort to restore blood sugar balance, your body tries to get rid of excess sugar through urine. As a result, the kidneys are forced to work overtime absorbing excess sugar. But, because they are unable to keep up with the glucose load, they pull fluids from your tissues along with the excess sugar. The more fluid you lose, the stronger your urge is to drink. If you find that you can continuously drink and not feel as though your thirst is quenched, or that you have a severely dry mouth, this may be a sign of hyperglycemia. Increased Hunger (Polyphagia) Excess sugar in your bloodstream means that your body is unable to utilize it for fuel. Hence, your cells become starved for energy and you feel extra hungry and, in extreme cases, unsatiable. But the more carbohydrates you consume, the higher the blood sugars rise. Increased Urination (Polyuria) More frequent trips to the bathroom, especially at night, can be a sign of high blood sugar. This is a result of the kidneys drawing extra water out of your tissues to dilute the extra sugar in your blood and get rid of it through the urine. Blurry Vision High sugar levels force the body to pull fluid from your tissues, including the lenses of your eyes, which can affect your ability to focus and result in blurry vision. Fatigue When sugar remains in the blood as opposed to being taken to the cells for energy, your cells become starved of food, leaving you to feel sluggish or fatigued. This can commonly happen after you've eaten a meal, particularly one that is rich in carbohydrates. Severe Symptoms These particular symptoms tend to occur when someone has had hyperglycemia for a long time, or when the blood sugar is extremely elevated. They usually indicate an emergency. Stomach Pain Chronic hyperglycemia can result in nerve damage to the stomach (gastroparesis). Stomach pain can also be a sign of diabetic ketoacidosis, a medical emergency that needs to be treated right away. Weight Loss Unintentional weight loss is an important sign, particularly in kids who are drinking and urinating often, that the blood sugars are elevated. Many children who are diagnosed with type 1 diabetes lose weight prior to diagnosis. This usually occurs because the body is not able to use the sugar in the bloodstream for fuel. Mouth and Breathing Changes Nausea, vomiting, fruity breath, deep and rapid breathing, and loss of consciousness are indications that you need to seek emergency help. These symptoms can be warning signs of other diabetes-related conditions that can result in death if not treated immediately. Rare Symptoms Some more rare symptoms can occur in people with hyperglycemia, too. Numbness Nerve damage in the extremities (known as peripheral neuropathy) occurs over time and can present as numbness, tingling, or pain in the hands, feet, or legs. Skin Conditions Dry/itchy skin, wounds or cuts that are slow to heal, and acanthosis nigricans (thick, velvety patches found in the folds or creases of areas like the neck, indicative of insulin resistance) can be an indication of hyperglycemia. Frequent Yeast Infections and Erectile Dysfunction These are manifestations that affect women and men, respectively. Hyperglycemic Hyperosmolar Nonketotic Syndrome Hyperglycemic hyperosmolar nonketotic coma (HHNKC) is an extremely serious complication which can happen in those with type 1 or type 2 diabetes, but most often occurs in those who are non-insulin dependent (type 2 diabetes). HHNKC is characterized by a dangerously high blood sugar that is over 600 mg/dL and is typically brought on either by an infection such as pneumonia, a urinary tract infection, or inability to effectively manage your blood sugar. If left untreated, it can result in coma and even death. Signs and symptoms include: extreme thirst confusion fever (usually over 101 degrees Fahrenheit) weakness or paralysis on one side of the body The best way to prevent HHNKC is to take your medications as directed and to keep in contact with your healthcare team when your blood sugar is consistently over 300 mg/dL. Diabetic Ketoacidosis Hyperglycemia can lead to another very dangerous condition referred to as diabetic ketoacidosis (DKA), which occurs most commonly in people who have type 1 diabetes and is often the condition that leads to the diagnosis of type 1 diabetes. DKA is caused when the body has little or no insulin to use and, as a result, blood sugars rise to dangerous levels and the blood becomes acidic. Cell damage can occur and if it continues to progress, it can cause coma or death. DKA needs immediate medical intervention—patients with DKA will need to be monitored by a medical professional and given intravenous fluids, electrolytes, and insulin. Complications Frequent and long-standing hyperglycemia can lead to a host of complications known as micro (small) and macro (large) vascular issues. They include damage to the: eye (retinopathy) kidney (nephropathy) peripheral and autonomic neuropathy (nerve loss in the feet and other areas of the body such as the intestine) Additionally, chronically elevated blood sugars can cause or exacerbate heart disease and peripheral arterial disease. During Pregnancy Hyperglycemia in pregnancy can be particularly damaging to the fetus and the mother. According to the American Diabetes Association, uncontrolled diabetes in pregnancy can pose risks such as spontaneous abortion, fetal anomalies, preeclampsia (uncontrolled blood pressure in mother), fetal demise, macrosomia (large baby), hypoglycemia in babies at birth, and neonatal hyperbilirubinemia, among others. In addition, diabetes in pregnancy may increase the risk of obesity and type 2 diabetes in offspring later in life. In Children Hyperglycemia in children, especially when undiagnosed, can lead to the development of type 2 diabetes or ketoacidosis in those children who have type 1 diabetes. Those children with diabetes who have chronically elevated glucose levels are at increased risk for developing diabetes complications. When to See a Doctor If you don't feel like your usual self and think your blood sugar is elevated, test it to confirm. If your blood sugar happens to be elevated and it's an isolated event, odds are that you can probably get it back to normal on your own. Go for a walk or do some light exercise, drink extra water, and take your medicine as prescribed. On the other hand, if you are experiencing elevated blood sugars for several consecutive days, give your medical team a call, as you may need to tweak your treatment plan. If you don't have diabetes and notice any of these signs or symptoms, and are overweight or obese or have a family history of diabetes, you should schedule an appointment with your doctor to be screened. Microvascular complications of diabetes can occur prior to diagnosis, so the sooner you receive treatment, the better. For Parents of Children Without Diabetes If you've noticed that your child is drinking, eating, and urinating more often than usual, a trip to the doctor is a good idea, especially if you've seen a quick change in weight. If the symptoms appear to be more severe and resemble those of DKA (refer above), go to the emergency room right away. For Parents of Children With Diabetes If your child is presenting with hyperglycemia symptoms and their blood sugar is greater than 240 mg/dL, you should test them for ketones. Upon a positive test, call your medical team for guidance on what to do next or refer to your sick day plan. Depending on the severity of the ketones, you may be advised to go to the emergency room. Homeopathic remedies marketed to treat the symptoms of diabetes or prevent complications include: Syzygium jambolanum or S. cumini (black plum) is said to help treat thirst, weakness, skin ulcers, and excessive urination. Uranium nitricum is marketed to treat excessive urination, nausea, swelling, and burning with urination. Conium (hemlock) is purported to treat numbness in the feet and hands as well as diabetic neuropathy (nerve damage). Plumbum (lead) is said to help with numbness in the hands and feet, nerve pain, and tinnitus. Calendula (marigold) is said to treat infected ulcers. Phosphoric acid is promoted to treat impaired memory, confusion or heavy head, frequent urination at night, hair loss, and difficulty maintaining an erection. Candida (yeast) is said to treat yeast infections.Dr. Rajesh Gupta8 Likes11 Answers
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Diabetes Supplements: Vitamins, Minerals, And Antioxidants 1mg TeamSeptember 11, 2018 Diabetes,Eat Well, Health A-Z, Supplements ￼ There is no doubt that diet plays a key role in the management and treatment of diabetes. In addition to taking medications, it is important to follow a nutritious diet to keep your blood glucose level in control. If your diet lacks adequate nutrition, adding dietary supplements might be recommended. Here is a quick guide on the use of vitamin, mineral and antioxidantsupplements for diabetes. Vitamin supplements for diabetes Vitamins play a key role in glucose metabolism and the lack of these nutrients could make supplementation necessary to manage and prevent diabetes-related complications. Due to abnormal glucose metabolism in diabetics, there is an excess production of free radicals. This, in turn, reduces the antioxidants in the blood, which causes a deficiency of vitamins such as A, C, and E, which are potent antioxidants. This may require you to load up on the vitamins to meet your body’s requirements. Certain medicines used to treat diabetes can lower the absorption of Vitamin B9 (folic acid) and Vitamin B12. So, if you are taking diabetes medication for a long time, you may also need to take supplements. -Vitamin A: The active form of Vitamin A is retinol, which is a potent antioxidant that not only helps deal with stress but also improves the functioning of the pancreatic cells. This is important as pancreatic cells produce insulin. -Vitamin C: According to a 2007 study in the Indian Journal of Medical Research, consumption of 1000 mg of Vitamin C supplements on a daily basis was found to lower levels of glucose and lipids in people with type 2 diabetes. Supplements can also help prevent Vitamin C deficiency and thereby reduce the risk of complications associated with diabetes. -Vitamin E: The use of Vitamin E supplements in people with diabetes mellitus for around 24 months was found to prevent the development of diabetic complications. This includes complications like diabetic retinopathy, foot ulcers, and cardiovascular problems. Moreover, vitamin E supplementation slows down the progression of complications in people with uncontrolled diabetes. -Vitamin B1: Many people with Type 1 and type 2 diabetes suffer from Vitamin B1 or thiamine deficiency. Studies have reported that the use of thiamine supplements for at least a month decreases blood glucose level in diabetics, also lowering the risk of diabetic nephropathy. -Vitamin B9: Studies have shown that folate supplementation can help improve glycemic control by reducing HbA1c levels. Additionally, it improves serum insulin and insulin resistance in type 2 diabetes patients. When used in combination with other vitamins like Vitamin B6 and Vitamin B12, it can also improve symptoms of diabetic retinopathy. -Vitamin B12: Supplementation of vitamin B12, along with folate (Vitamin B9) and pyridoxine (Vitamin B6), improves symptoms of diabetic retinopathy such as retinal edema (fluid accumulation in the eyes) and increased sensitivity to light. When supplemented along with lipoic acid, vitamin B12 also improves nerve function, protecting against diabetic neuropathy. Overall, numerous research studies have reported that vitamin supplementation not only improves glycemic control in diabetics but also prevents diabetes-related complications. Mineral supplements for diabetes Minerals play an equally important role in the management and treatment of diabetes. This is because lack of minerals can impair glucose metabolism, raising the risk of health complications. In fact, diabetes patients often suffer from low levels of magnesium and zinc. -Magnesium: Magnesium is needed for the breakdown of glucose by various enzymes. Moreover, low levels of this mineral can impair the secretion of insulin by the pancreas. For this reason, the use of magnesium supplements can improve glycemic control, helping in the management of diabetes. -Zinc: Zinc plays a significant role in the synthesis, storage, and secretion of insulin. Low levels of zinc not only increase the risk of diabetes and associated complications, but it also affects other cellular functions. Hence, to regulate glucose levels and prevent diabetic complications, zinc supplementation may be recommended. -Chromium: Research studies have shed light on the need for chromium, which is a trace mineral. This mineral is required for the metabolism of carbohydrates. Although low doses of this mineral are regarded as safe, there is not enough evidence on the appropriate dosage. Do talk to your doctor before you take any mineral supplements for diabetes. Antioxidants for diabetes Hyperglycemia or high blood glucose levels can lead to auto-oxidation of glucose to form free radicals. An excess of free radicals in the body can lead to vascular damage and dysfunction of the blood vessels and neurons, thus increasing the risk of diabetic neuropathy. Antioxidants help to scavenge free radicals, thereby lowering the risk of complications. Intake of antioxidants such as Vitamin C and alpha lipoic acid (ALA), either through natural food sources or through supplements, can help to prevent the risk of diabetic pathologies. This makes them helpful in the management of diabetes. ALA is a potent antioxidant that lowers fasting blood glucose levels, reduces oxidative stress, and decreases insulin resistance. However, this supplement should be used with caution as it can cause a drastic drop in your blood glucose levels. Before you start using any supplements, keep in mind that certain supplements might interfere with your diabetes medications. This is why it is important to first consult your doctor for the appropriate dosage and usage information, depending on your specific requirements. (The article is reviewed by Dr. Lalit Kanodia, General Physician)Saquib Nomani Microbiologist4 Likes4 Answers
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A 45 year old female presented with this non healing wound due to toe-ring over second toe anterior aspect of left foot for past 10days. She has been getting injection cefotaxim twice daily from another practitioner. She is a known case of T2DM. Weight - 55 kg Height - 165cm BMI - 20.22 Her present RBS is 260mg/DL I have asked her to get HBA1C, FBS AND PPBS, which I will update soon. Meanwhile sir what antibiotics, OHA and topical application would be best suitable for such patient. @Sepuri Krishna Mohan Sir, I need your valuable advise too.Dr. Ajeet Singh3 Likes26 Answers