Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! BodyLove is an Alabama-based radio soap opera that uses drama to reach African American listeners with messages that promote diabetes awareness and healthy lifestyles? ADMA, a chemical found in human blood, produces adverse effects that may lead to cardiovascular disease, diabetes and erectile dysfunction? Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
All forms of diabetes have been treatable since insulin became medically available in 1921, and type 2 diabetes can be controlled with tablets, but it is chronic condition that usually cannot be cured. The term diabetes, without qualification, usually refers to diabetes mellitus, which roughly translates to excessive sweet urine (known as "glycosuria"). The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM).
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency. Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity.
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Pre-diabetes indicates a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.
Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more common in type 2 diabetes and is mainly the result of dehydration due to loss of body water. A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes. A number of lifestyle factors are known to be important to the development of type 2 diabetes. Environmental toxins may contribute to recent increases in the rate of type 2 diabetes.
Hypogonadism is often associated with cortisol excess, and testosterone deficiency is also associated with diabetes mellitus type 2, even if the exact mechanism by which testosterone improve insulin sensitivity is still not known.
Various hereditary conditions may feature diabetes, for example myotonic dystrophy and Friedreich's ataxia. The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals. Insulin is the principal hormone that regulates uptake of glucose from the blood into most cells (primarily muscle and fat cells, but not central nervous system cells). Humans are capable of digesting some carbohydrates, in particular those most common in food; starch, and some disaccharides such as sucrose, are converted within a few hours to simpler forms most notably the monosaccharide glucose, the principal carbohydrate energy source used by the body. Insulin is also the principal control signal for conversion of glucose to glycogen for internal storage in liver and muscle cells. Higher insulin levels increase some anabolic ("building up") processes such as cell growth and duplication, protein synthesis, and fat storage. If the amount of insulin available is insufficient, if cells respond poorly to the effects of insulin (insulin insensitivity or resistance), or if the insulin itself is defective, then glucose will not have its usual effect so that glucose will not be absorbed properly by those body cells that require it nor will it be stored appropriately in the liver and muscles. About a quarter of people with new type 1 diabetes have developed some degree of diabetic ketoacidosis (a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids) by the time the diabetes is recognized. A positive result, in the absence of unequivocal hyperglycemia, should be confirmed by a repeat of any of the above-listed methods on a different day. Diabetes screening is recommended for many people at various stages of life, and for those with any of several risk factors.
There are numerous studies which suggest connections between some aspects of Type II diabetes with ingestion of certain foods or with some drugs. There are roles for patient education, dietetic support, sensible exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. Patient education, understanding, and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels. Wider health problems may accelerate the deleterious effects of diabetes. Except in the case of type 1 diabetes, which always requires insulin replacement, the way type 2 diabetes is managed may change with age. The day of the dead tradition is so much into the being of every person in Oaxaca that it should no keep amazing me but I can’t help it.
There is an enclosed market which extends out to all the streets surrounding the market and even beyond them to the areas around the cathedral and the convent. We got there early morning and all farmers were already there with their animals or unloading them. Ostlund, a Wyoming state senator and 1978 gubernatorial nominee, lost his eyesight to diabetes and penned his autobiography to benefit the training of seeing-eye dogs? Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose, to turn into energy. Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes mellitus (NIDDM).
The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor.
At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Many people destined to develop type 2 diabetes spend many years in a state of pre-diabetes which has been termed "America's largest healthcare epidemic,":10–11.
However, in type 2 diabetes symptoms usually develop much more slowly and may be subtle or completely absent. This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.
In one study, those who had high levels of physical activity, a healthy diet, did not smoke, and consumed alcohol in moderation had an 82% lower rate of diabetes. Type 1 diabetes may be triggered by certain infections, with some evidence pointing at Coxsackie B4 virus.
Wolfram's syndrome is an autosomal recessive neurodegenerative disorder that first becomes evident in childhood. Insulin production is more or less constant within the beta cells, irrespective of blood glucose levels. Therefore deficiency of insulin or the insensitivity of its receptors plays a central role in all forms of diabetes mellitus. The most significant exceptions are fructose, most disaccharides (except sucrose and in some people lactose), and all more complex polysaccharides, with the outstanding exception of starch.
Lowered glucose levels result both in the reduced release of insulin from the beta cells and in the reverse conversion of glycogen to glucose when glucose levels fall.
Insulin (or its lack) is the principal signal in converting many of the bidirectional processes of metabolism from a catabolic to an anabolic direction, and vice versa. The net effect is persistent high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.
The screening test varies according to circumstances and local policy, and may be a random blood glucose test, a fasting blood glucose test, a blood glucose test two hours after 75 g of glucose, or an even more formal glucose tolerance test. A partial list includes: subclinical Cushing's syndrome, testosterone deficiency, high blood pressure, elevated cholesterol levels, coronary artery disease, past gestational diabetes, polycystic ovary syndrome, chronic pancreatitis, fatty liver, hemochromatosis, cystic fibrosis, several mitochondrial neuropathies and myopathies (such as MIDD), myotonic dystrophy, Friedreich's ataxia, some of the inherited forms of neonatal hyperinsulinism. This includes yearly urine testing for microalbuminuria and examination of the retina of the eye for retinopathy. Management concentrates on keeping blood sugar levels as close to normal ("euglycemia") as possible without presenting undue patient danger. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure in patients with hypertension, cholesterol in those with dyslipidmia, as well as exercising more, smoking less or ideally not at all, consuming a recommended diet. In other circumstances, general practitioners and specialists share care of a patient in a team approach. Within peer support, people with a common illness share knowledge and experience that others, including many health workers, do not have.
These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. The most common of these is diabetes insipidus in which large amounts of urine are produced (polyuria), which is not sweet (insipidus meaning "without taste" in Latin).
Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years. This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future. Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible mental fatigue.
Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst. Concordance among monozygotic twins is close to 100%, and about 25% of those with the disease have a family history of diabetes. It is stored within vacuoles pending release, via exocytosis, which is primarily triggered by food, chiefly food containing absorbable glucose. This is mainly controlled by the hormone glucagon which acts in the opposite manner to insulin. In particular, a low insulin level is the trigger for entering or leaving ketosis (the fat burning metabolic phase).
Many healthcare providers recommend universal screening for adults at age 40 or 50, and often periodically thereafter.
The risk of diabetes is higher with chronic use of several medications, including long term corticosteroids, some chemotherapy agents (especially L-asparaginase), as well as some of the antipsychotics and mood stabilizers (especially phenothiazines and some atypical antipsychotics). This can usually be with close dietary management, exercise, and use of appropriate medications (insulin only in the case of type 1 diabetes mellitus.
Patients with foot problems are also recommended to wear diabetic socks, and possibly diabetic shoes.
Peer support is frequent, ongoing, accessible and flexible and can take many forms—phone calls, text messaging, group meetings, home visits, and even grocery shopping.
Additionally, insulin resistance increases because of the loss of lean tissue and the accumulation of fat, particularly intra-abdominal fat, and the decreased tissue sensitivity to insulin. Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma.
Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). All of these symptoms except weight loss can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled, although unexplained weight loss may be experienced at the onset of the disease. However, even in those who have inherited the susceptibility, type 1 diabetes mellitus seems to require an environmental trigger. Insulin is released into the blood by beta cells (?-cells), found in the Islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Glucose thus forcibly produced from internal liver cell stores (as glycogen) re-enters the bloodstream; muscle cells lack the necessary export mechanism. Diabetes is often detected when a person suffers a problem that is frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia. It complements and enhances other health care services by creating the emotional, social and practical assistance necessary for managing disease and staying healthy. Serious long-term complications include cardiovascular disease, chronic renal failure, retinal damage. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages.
In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment.
Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed).
Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage.
Normally liver cells do this when the level of insulin is low (which normally correlates with low levels of blood glucose).
Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cesation and maintaining a healthy body weight. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children. A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.
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