Type 2 diabetes and vitamin b deficiency usmle,medication administration errors in nursing 5th,alcohol and type 2 diabetes yahoo - 2016 Feature

If your toes are always cold, one reason could be poor blood flow — a circulatory problem sometimes linked to smoking, high blood pressure, or heart disease.
Raynaud’s disease can cause your toes to turn white, then bluish, and then redden again and return to their natural tone. The most common cause of heel pain is plantar fasciitis, inflammation where this long ligament attaches to the heel bone.
Sometimes the first sign of a problem is a change in the way you walk — a wider gait or slight foot dragging. This is usually a temporary nuisance caused by standing too long  or a long flight — especially if you are pregnant. Gout is a notorious cause of sudden pain in the big toe joint, along with redness and swelling (seen here).
If you feel like you’re walking on a marble, or if pain burns in the ball of your foot and radiates to the toes, you may have Morton’s neuroma, a thickening of tissue around a nerve, usually between the third and fourth toes. Itchy, scaly skin may be athlete’s foot, a fungal infection that’s common in men between the ages of 20 and 40. This foot deformity can be caused by shoes that are tight and pinch your toes or by a disease that damages nerves, such as diabetes, alcoholism, or other neurological disorder. A sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp, which can last many minutes. We associate skin cancer with the sun, so we’re not as likely to check our feet for unusual spots.
Sometimes an injury to the nail or frequent exposure to petroleum-based solvents can create a concave, spoon-like shape. Pitting, or punctured-looking depressions in the surface of the nail, is caused by a disruption in the growth of the nail at the nail plate. Compared to whole foods containing unrefined carbohydrates, refined carb foods tend to have a higher glycemic index, which is the ability of a food to raise your blood glucose level. Refined carbohydrates include white pasta, white rice, white all purpose flour, white bread, sucrose (white table sugar), high fructose corn syrup and any foods containing these ingredients such as soda pop, cereal, processed syrups, jellies, preserves, pastries and desserts. When whole-grain wheat is refined, the outer bran layers and germ is removed to produce flour with a finer texture and extended shelf life. Consuming too many processed, refined carbohydrate foods will not only cause nutrient deficiencies, but it can also lead to the development of chronic metabolic diseases such as diabetes and heart disease. Your total daily energy expenditure is determined by your metabolism at rest, or your basal metabolic rate.
Excessive consumption of refined carbohydrates will increase fat mass, body weight and the body mass index, or BMI, that measures body fat.

The cause may be the slow loss of normal sensation in your feet, brought on by peripheral nerve damage. It can also be caused by a vitamin B deficiency, athlete’s foot, chronic kidney disease, poor circulation in the legs and feet (peripheral arterial disease), or hypothyroidism. Diabetes can impair sensation in the feet, circulation, and normal wound healing, so even a blister can become a troublesome wound.
Your toes will be bent upward as they extend from the ball of the foot, then downward from the middle joint, resembling a claw. However, a melanoma, the most dangerous form of skin cancer, can develop even in areas that are not regularly exposed to the sun. If part or all of a nail separates from the nail bed (shown here), it can appear white — and may be due to an injury, nail infection, or psoriasis. Women with PCOS have higher rates of anxiety and depression than women without the syndrome.2.
In this regard, regular consumption of refined carbs will increase your risk for developing Type 2 diabetes an numerous other health issues.
In this process, most of the fiber, essential fatty acids, vitamin E, B vitamins and essential minerals are removed. Compared with whole, unprocessed carb foods, refined carbohydrate foods lower the thermic effect of your meals, which causes weight gain and decreases your basal metabolic rate. Metabolism increases when food is ingested, this is also called the "thermic effect". The thermic effect of food, or "thermogenesis" accounts for about 10% of your total daily energy expenditure.
Refined carb foods are rapidly digested and absorbed, and they tend to elevate your blood glucose levels very quickly, causing the pancreas to produce more insulin to prevent your blood glucose from getting too high, which then causes the liver to secrete triglyceride-rich lipoproteins and this increase in your fat mass will tend to lower your basal metabolic rate. But pain that’s not due to sky-high heels may come from a stress fracture, a small crack in a bone. Stress or changes in temperature can trigger vasospasms, which usually don’t lead to other health concerns.
Arthritis, excessive exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis. Lung disease is the most common underlying cause, but it also can be caused by heart disease, liver and digestive disorders, or certain infections.
If the joint is rigid, it may be hallux rigidus, a complication of arthritis where a bone spur develops. If the skin on your itchy feet is thick and pimple-like, it may be psoriasis, an over-reaction of the immune system. They may respond to stretching and exercises of the toes or you may need special shoes or even surgery.

Other causes include poor circulation, dehydration, or imbalances in potassium, magnesium, calcium, or vitamin D levels in the body.
Thick, yellow nails also can be a sign of an underlying disease, including lymphedema (swelling related to the lymphatic system), lung problems, or rheumatoid arthritis. If the nail is intact and most of it is white, it can sometimes be a sign of a more serious condition including liver disease, congestive heart failure, or diabetes. Worldwide, PCOS affects 6% to 10% of women, making it the most common endocrinopathy in women of childbearing age.3.
Foods that are more complex, require more work by the gastrointestinal tract and digestive organs, greater enzyme production and more secondary metabolism in the liver have a higher energetic cost than less complex foods.
A doctor can look for any underlying problems — or let you know that you simply have cold feet. One possible cause: Exercise that was too intense, particularly high-impact sports like basketball and distance running. Raynaud’s may also be related to rheumatoid arthritis, Sjogren’s disease, or thyroid problems.
Less common causes include a bone spur on the bottom of the heel, a bone infection,  tumor, or  fracture. Although a few of the major B vitamins and iron are added back to the flour (Enriched Flour), the nutritional quality of refined wheat flour is inferior to that of whole-wheat flour. Your energy expenditure due to a thermic effect after consuming a refined carbohydrate or processed food meal may be only about one-half of that after consuming a whole-food meal containing complex carbohydrates and dietary fiber. Slow-healing of sores also can be caused by poor circulation from conditions such as peripheral artery disease. The diagnotic criteria for PCOS states that a women has PCOS if she has at least 2 of the following 3 criteria: a. Women with PCOS have more testosterone and can build muscle easier than women without the syndrome.16. A number of studies demonstrate that modest weight loss of 5-10% of initial body weight improves metabolic, physiological and psychological aspects of PCOS.26. Women with PCOS have a higher incidence of gestational diabetes, miscarriages, preterm deliveries, and stillbirths.28. If left untreated, PCOS can lead to numerous chronic diseases such as type 2 diabetes and heart disease.

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