Glycosylated hemoglobin as a diagnostic test for type 2 diabetes mellitus,home remedy for diabetic foot pain running,injectable medication for diabetes type 2 apartments - Videos Download


Gestational DiabetesGestational diabetes is a form of type 2 diabetes, usually temporary, that appears during pregnancy.
Genetic FactorsResearchers have found at least 18 genetic locations, labeled IDDM1 - IDDM18, which are related to type 1 diabetes.
Hyperglycemic Hyperosmolar Nonketonic Syndrome (HHNS)Hyperglycemic hyperosmolar nonketonic syndrome (HHNS) is a serious complication of diabetes that involves a cycle of increasing blood sugar levels and dehydration, without ketones. Kidney Damage (Nephropathy)Kidney disease (nephropathy) is a very serious complication of diabetes. The early and more common type of this disorder is called nonproliferative or background retinopathy. To achieve good blood sugar control, patients and parents of children must undergo some training. Insulin is a hormone that is involved in regulating how the body converts sugar (glucose) into energy. The IDDM1 region contains the HLA genes that encode proteins called major histocompatibility complex.
With this condition, the tiny filters in the kidney (called glomeruli) become damaged and leak protein into the urine.
People with diabetes face a higher risk for influenza and its complications, including pneumonia.
The results are given in percentages and indicate a person’s average blood glucose levels over the past 2 - 3 months.
The earliest manifestation of kidney disease is microalbuminuria, in which tiny amounts of a protein called albumin are found in the urine. The patient and doctor must determine the amount of insulin used -- it is not automatically calculated. People with type 1 diabetes need to take daily insulin shots and carefully monitor their blood glucose levels.Type 1 diabetes is much less common than type 2 diabetes. Type 1 diabetes is considered an autoimmune disorder that involves:Beta cells in the pancreas that produce insulin are gradually destroyed.
It is often triggered by a serious infection or another severe illness, or by medications that lower glucose tolerance or increase fluid loss (especially in people who are not drinking enough fluids).Symptoms of HHNS include high blood sugar levels, dry mouth, extreme thirst, dry skin, and high fever.
Everyone with diabetes should have annual influenza vaccinations and a vaccination against pneumococcal pneumonia.Urinary Tract Infections. Microalbuminuria is also a marker for other complications involving blood vessel abnormalities, including heart attack and stroke.People with diabetes should have an annual microalbuminuria urine test. This requires an initial learning period, including understanding insulin needs over the course of the day and in different situations and knowledge of carbohydrate counting.
Other chromosomes and genes continue to be identified.Most people who develop type 1 diabetes do not have a family history of the disease.
HHNS can lead to loss of consciousness, seizures, coma, and death.HypoglycemiaTight blood sugar (glucose) control increases the risk of low blood sugar (hypoglycemia). Urine tests showing microalbuminuria (small amounts of protein in the urine) are important markers for kidney damage.Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD). If these processes affect the central portion of the retina, swelling may occur, causing reduced or blurred vision.If the capillaries become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer.
Women with diabetes face a significantly higher risk for urinary tract infections, which are likely to be more complicated and difficult to treat than in the general population.Hepatitis.
Frequent blood testing is very important, particularly during the training period.Insulin pumps are more expensive than insulin shots and occasionally have some complications, such as blockage in the device or skin irritation at the infusion site. Type 1 diabetes can occur at any age, but it usually first develops in childhood or adolescence.
In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. Evidence suggests that both a genetic predisposition and environmental factors, such as a viral infection, are involved.
The odds of inheriting the disease are only 10% if a first-degree relative has diabetes and, even in identical twins, one twin has only a 33% chance of having type 1 diabetes if the other twin has it. Patients with ESRD have 13 times the risk of death compared to other patients with type 1 diabetes. Patients with diabetes are at increased risk for contracting the hepatitis B virus, which is transmitted through blood and other bodily fluids. In spite of early reports of a higher risk for ketoacidosis with pumps, more recent studies have found no higher risk.Supplementary Drugs for HyperglycemiaPramlintide (Symlin) is an injectable drug that is used to help control postprandial hyperglycemia, the sudden increase in blood sugar after a meal. Children are more likely to inherit the disease from a father with type 1 diabetes than from a mother with the disorder.Genetic factors cannot fully explain the development of diabetes. In this more severe condition, new abnormal blood vessels form and grow on the surface of the retina. Exposure to the virus can occur through sharing finger-stick devices or blood glucose monitors. Pramlintide is injected before meals and can help lower blood sugar levels in the 3 hours after meals. For the past several decades, the number of new cases of type 1 diabetes has been increasing each year worldwide. Symptoms of kidney failure may include swelling in the feet and ankles, itching, fatigue, and pale skin color.
Adults newly diagnosed with type 1 or type 2 diabetes should get hepatitis B vaccinations.DepressionDiabetes doubles the risk for depression. For patients with diabetes, A1C is measured periodically every 2 - 3 months, or at least twice a year.
A doctor uses the results from a creatinine blood test to calculate the glomerular filtration rate (GFR). Pramlintide is used in addition to insulin for patients who take insulin regularly but still need better blood sugar control. Patients who are at risk for hypoglycemia should carry some sugar product, or an emergency glucagon injection kit, in case an attack occurs.
VirusesSome research suggests that viral infections may trigger the disease in genetically susceptible individuals.Among the viruses under scrutiny are enteric viruses, which attack the intestinal tract. Usually the condition is manageable, but, occasionally, it can be severe or even life threatening, particularly if the patient fails to recognize the symptoms, especially while continuing to take insulin or other hypoglycemic drugs. The outlook of end-stage renal disease has greatly improved during the last four decades for patients with type 1 diabetes, and fewer people with type 1 diabetes are developing ESRD.NeuropathyDiabetes reduces or distorts nerve function, causing a condition called neuropathy.
Major hemorrhage or retinal detachment can result, causing severe visual loss or blindness. While finger prick self-testing provides information on blood glucose for that day, the A1C test shows how well blood sugar has been controlled over the past several months.In general, most adult patients with diabetes should aim for A1C levels below or around 7%. Pramlintide and insulin are the only two drugs approved for treatment of type 1 diabetes.Pramlintide is a synthetic form of amylin, a hormone that is related to insulin.
Beta-blocking medications, which are often prescribed for high blood pressure and heart disease, can mask symptoms of hypoglycemia.Risk Factors for Severe Hypoglycemia. The American Diabetes Association recommends that patients with type 1 diabetes have an annual comprehensive eye exam, with dilation, to check for signs of retina disease (retinopathy). Side effects may include nausea, vomiting, abdominal pain, headache, fatigue, and dizziness. Epidemics of Coxsackie virus, as well as mumps and congenital rubella, have been associated with type 1 diabetes.Risk FactorsType 1 diabetes is much less common than type 2 diabetes, consisting of only 5 - 10% of all cases of diabetes.
In terms of sexual health, diabetes may cause decreased vaginal lubrication, which can lead to pain or discomfort during intercourse.Women with diabetes should also be aware that certain types of medication can affect their blood glucose levels.
Patients with type 1 diabetes have an increased risk of severe low blood sugar (hypoglycemia) that may occur within 3 hours following a pramlintide injection.


Patients are also encouraged to wear a medical alert ID bracelet or necklace that states they have diabetes and that they take insulin.Patients with Type 1 Diabetes Living Longer and Healthier LivesRates of serious complications among people with type 1 diabetes have decreased over the past several decades. Nevertheless, like type 2 diabetes, new cases of type 1 diabetes have been rising over the past few decades. Hypoglycemia unawareness is a condition in which people become accustomed to hypoglycemic symptoms. It is a common complication for nearly half of people who have lived with type 1 or type 2 diabetes for more than 25 years. In addition to a comprehensive eye exam, fundus photography may be used as a screening tool. This drug should not be used if patients have trouble knowing when their blood sugar is low or have slow stomach emptying (gastroparesis).Treatment of ComplicationsHigh Blood Pressure and Heart DiseaseAll patients with diabetes and high blood pressure should adopt lifestyle changes. While type 2 diabetes has been increasing among African-American and Hispanic adolescents, the highest rates of type 1 diabetes are found among Caucasian youth.Type 1 diabetes can occur at any age but usually appears between infancy and the late 30s, most typically in childhood or adolescence. The most serious consequences of neuropathy occur in the legs and feet and pose a risk for ulcers and, in unusually severe cases, amputation.
Long-term use (more than 2 years) of birth control pills may increase the risk of health complications.Diabetes and Pregnancy. Fundus photography uses a special type of camera to take images of the back of the eye.Screening for Neuropathy. These include weight reduction (when needed), following the Dietary Approaches to Stop Hypertension (DASH) diet, smoking cessation, limiting alcohol intake, and limiting salt intake to no more than 1,500 mg of sodium per day.High Blood Pressure Control. It affects about 25% of patients who use insulin, nearly always people with type 1 diabetes. Peripheral neuropathy usually starts in the fingers and toes and moves up to the arms and legs (called a stocking-glove distribution).
All patients should be screened for nerve damage (neuropathy), including a comprehensive foot exam.
In such cases, hypoglycemia appears suddenly, without warning, and can escalate to a severe level. Studies indicate that high blood sugar levels (hyperglycemia) can affect the developing fetus during the critical first 6 weeks of organ development. These antibodies are referred to as autoantibodies because they attack the body's own cells -- not a foreign invader. Patients who lose sensation in their feet should have a foot exam every 3 - 6 months to check for ulcers or infections.Screening for Thyroid Abnormalities.
At the point when insulin production bottoms out, however, type 1 diabetes usually appears suddenly and progresses quickly. Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode. Therefore, it is important that women with pre-existing diabetes (both type 1 and type 2) who are planning on becoming pregnant strive to maintain good glucose control for 3 - 6 months before pregnancy.It is also important for women to closely monitor their blood sugar levels during pregnancy. Blood tests for these autoantibodies can help differentiate between type 1 and type 2 diabetes.Screening Tests for ComplicationsScreening Tests for Heart Disease.
The most beneficial fall into the following categoriesDiuretics rid the body of extra sodium (salt) and water.
Within 20 minutes after a meal insulin rises to its peak level.Insulin enables glucose to enter cells in the body, particularly muscle and liver cells.
With vigilant monitoring and by rigorously avoiding low blood glucose levels, patients can often regain the ability to sense the symptoms. Patients with diabetes should be aware of other warning signs of a heart attack, including sudden fatigue, sweating, shortness of breath, nausea, and vomiting.Rapid heart ratesLightheadedness when standing up (orthostatic hypotension)Diabetic gastroparesis is a type of neuropathy that affects the digestive track. All patients with diabetes should be tested for high blood pressure (hypertension) and unhealthy cholesterol and lipid levels and given an electrocardiogram. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs.Healthy eating habits, along with good control of blood glucose, are the basic goals, and several good dietary methods are available to meet them. However, even very careful testing may fail to detect a problem, particularly one that occurs during sleep.Symptoms. General dietary guidelines for diabetes recommend:Carbohydrates should provide 45 - 65% of total daily calories. Like ACE inhibitors and ARBs, certain calcium channel blockers (diltiazem and verapamil) can reduce urine protein loss caused by diabetic kidneys.Nearly all patients who have diabetes and high blood pressure should take an ACE inhibitor (or ARB) as part of their regimen for treating their hypertension.
However, during the past several decades, the rate of serious complications among people with diabetes has been decreasing, and more patients are living longer and healthier lives. Mild symptoms usually occur at moderately low and easily correctable levels of blood glucose. The result of this damage is that the digestive system takes too long at time to move and empty food. There are two important approaches to preventing complications from type 1 diabetes:Good control of blood glucose and keeping glycosylated hemoglobin (A1C) levels below or around 7%. Undigested food and the delay in stomach emptying can cause blood glucose levels to rise, and make diabetes more difficult to control.
The changes in estrogen and other hormonal levels that occur during perimenopause can cause major fluctuations in blood glucose levels. In addition to secreting digestive enzymes, the pancreas secretes the hormones insulin and glucagon into the bloodstream.
This approach can help prevent complications due to vascular (blood vessel) abnormalities and nerve damage (neuropathy) that can cause major damage to organs, including the eyes, kidneys, and heart.Managing risk factors for heart disease.
Heart attacks account for 60% of deaths in patients with diabetes, while strokes account for 25% of such deaths.
Symptoms of gastroparesis include heartburn, nausea, abdominal bloating, feeling full after eating only a small amount of food, and vomiting of undigested food several hours after a meal.Blood sugar control is an essential component in the treatment for neuropathy. Women with diabetes also face an increased risk of premature menopause, which can lead to higher risk of heart disease.Specific Problems for Adolescents with Type 1 DiabetesLack of Blood Glucose Control.
The release of insulin into the blood lowers the level of blood glucose (simple sugars from food) by enhancing glucose to enter the body cells, where it is metabolized.
Blood glucose control helps the heart, but it is also very important that people with diabetes control blood pressure, cholesterol levels, and other factors associated with heart disease.Diabetic KetoacidosisDiabetic ketoacidosis (DKA) is a life-threatening complication caused by a complete (or almost complete) lack of insulin. Diabetes affects the heart in many ways:Both type 1 and 2 diabetes accelerate the progression of atherosclerosis (hardening of the arteries). Studies show that tight control of blood glucose levels delays the onset and slows progression of neuropathy.
Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists.Fats should provide 25 - 35% of daily calories. If blood glucose levels get too low, the pancreas secretes glucagon to stimulate the release of glucose from the liver.
Adolescents with diabetes are at higher risk than adults for ketoacidosis resulting from noncompliance. Ketones are byproducts of fat breakdown that build up in the blood and appear in the urine.
This can lead to coronary artery disease, heart attack, or stroke.In type 1 diabetes, high blood pressure (hypertension) usually develops if the kidneys become damaged.
Lowering triglycerides, losing weight, reducing blood pressure, and quitting smoking may help prevent the onset of neuropathy.Foot Ulcers and AmputationsAbout 15% of patients with diabetes have serious foot problems. Young people who do not control glucose are also at high risk for permanent damage in small vessels, such as those in the eyes.Eating Disorders.
Up to a third of young women with type 1 diabetes have eating disorders and under-use insulin to lose weight.
Children with diabetes are also at risk for hypertension.Impaired nerve function (neuropathy) associated with diabetes also causes heart abnormalities.


The consequences of both poor circulation and peripheral neuropathy make this a common and serious problem for all patients with diabetes.
Limit trans-fats (hydrogenated fat found in snack foods, fried foods, and commercially baked goods) to less than 1% of total calories.Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements. Extreme stages of diabetic ketoacidosis can lead to coma and death.For some people, DKA may be the first sign that someone has diabetes. Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Diabetes is responsible for more than half of all lower limb amputations performed in the U.S.
In type 1 diabetes, it usually occurs when a patient is not compliant with insulin therapy or intentionally reduces insulin doses in order to lose weight. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Most amputations start with foot ulcers.People with diabetes who are overweight, smokers, and have a long history of diabetes tend to be at most risk.
People who have the disease for more than 20 years and are insulin-dependent are at the highest risk. Reducing sodium can help lower blood pressure and decrease the risk of heart disease.Healthy Weight ControlWeight gain is a potential side effect of intense diabetic control with insulin. Related conditions that put people at risk include peripheral neuropathy, peripheral artery disease, foot deformities, and a history of ulcers. Foot ulcers usually develop from infections, such as those resulting from blood vessel injury. Widespread screening of patients to identify those at higher risk for diabetes type 1 is not recommended.Oral Glucose Tolerance TestThe oral glucose tolerance test (OGTT) is more complex than the FPG and may overdiagnose diabetes in people who do not have it.
On the other hand, studies suggest that more than one-third of women with diabetes omit or underuse insulin in order to lose weight.
Numbness from nerve damage, which is common in diabetes, compounds the danger since the patient may not be aware of injuries.
Some doctors recommend it as a follow-up after FPG, if the latter test results are normal but the patient has symptoms or risk factors of diabetes. Eating disorders are especially dangerous in patients with diabetes and can increase the risk for diabetic ketoacidosis.
Ketoacidosis is a significant complication of insulin depletion and can be life threatening.ExerciseAerobic exercise has significant and particular benefits for people with type 1 diabetes.
Charcot foot or Charcot joint (medically referred to as neuropathic arthropathy) is a degenerative condition that affects the bones and joints in the feet.
It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat. Early changes appear similar to an infection, with the foot becoming swollen, red, and warm. The bones may crack, splinter, and erode, and the joints may shift, change shape, and become unstable. It typically develops in people who have neuropathy to the extent that they cannot feel sensation in the foot and are not aware of an existing injury. Instead of resting an injured foot or seeking medical help, the patient often continues normal activity, causing further damage.Retinopathy and Eye ComplicationsDiabetes accounts for thousands of new cases of blindness annually and is the leading cause of new cases of blindness in adults ages 20 - 74. Because patients with diabetes may have silent heart disease, they should always check with their doctors before undertaking vigorous exercise.Warning on Dietary SupplementsVarious fraudulent products are often sold on the Internet as “cures” or treatments for diabetes. People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma. The US Food and Drug Administration (FDA) and Federal Trade Commission (FTC) warn patients with diabetes not to be duped by bogus and unproven remedies.TreatmentInsulin is essential for control of blood glucose levels in type 1 diabetes.
Good blood glucose control is the best way to prevent major complications in type 1 diabetes, including those that affect the kidneys, eyes, nerve pathways, and blood vessels. It is important to manage heart disease risk factors that might develop as a result of insulin treatment.A diet plan that compensates for insulin administration and supplies healthy foods is extremely important. The basal component of the treatment attempts to provide a steady amount of background insulin throughout the day. Insulin glargine offers the most consistent insulin activity level, but other intermediate and long-acting forms may be beneficial when administered twice a day. Short-acting insulin delivered continuously using a pump is proving to a very good way to provide basal rates of insulin.Mealtime insulin administration. Snacks are often necessary.Insulin requirements vary depending on many non-nutritional situations during the day, including exercise and sleep. Injections of insulin under the skin ensure that it is absorbed slowly by the body for a long-lasting effect. The timing and frequency of insulin injections depend upon a number of factors:The duration of insulin action. Insulin lispro (Humalog) and insulin aspart (Novo Rapid, Novolog) lower blood sugar very quickly, usually within 5 minutes after injection. This rapid action reduces the risk for hypoglycemic events after eating (postprandial hypoglycemia). Optimal timing for administering this insulin is about 15 minutes before a meal, but it can also be taken immediately after a meal (but within 30 minutes).
Fast-acting insulins may be especially useful for meals with high carbohydrates.Regular Insulin.
Regular insulin begins to act 30 minutes after injection, reaches its peak at 2 - 4 hours, and lasts about 6 hours.
Regular insulin may be administered before a meal and may be better for high-fat meals.Intermediate Insulin.
Lente (insulin zinc) is another intermediate insulin that peaks 4 - 12 hours and lasts up to 18 hours.Long-Acting (Ultralente) Insulin. Regimens generally include combinations of short and longer-acting insulins to help match the natural cycle. For example, one approach in patients who are intensively controlling their glucose levels uses 3 injections of insulin, which includes a mixture of regular insulin and NPH at dinner. Another approach uses 4 injections, including a separate short-acting form at dinner and NPH at bedtime, which may pose a lower risk for nighttime hypoglycemia than the 3-injection regimen.Insulin Pens. Newer, prefilled pens (Humulin Pen, Humalog) are disposable and allow the patient to dial in the correct amount.Insulin PumpsAn insulin pump can improve blood glucose control and quality of life with fewer hypoglycemic episodes than multiple injections. The pumps correct for the “dawn phenomenon” (sudden rise of blood glucose in the morning) and allow quick reductions for specific situations, such as exercise.
Many different brands are available.The typical pump is about the size of a beeper and has a digital display.
Some are worn externally and are programmed to deliver insulin through a catheter in the skin or the abdomen. They work by administering a small amount of insulin continuously (the basal rate) and a higher dose (a bolus dose) when food is eaten.Although learning to use the pump can be complicated at first, most patients find over time that the devices are fairly easy to use. Adults, adolescents, and school children use insulin pumps and even very young children (ages 2 - 7 years) may be able to successfully use them.
The catheter at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes. Dosage instructions are entered into the pump's small computer, and the appropriate amount of insulin is then injected into the body in a calculated, controlled manner.



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