Role of the laboratory in surveillance Sources: WHO Laboratory Training for Field Epidemiologists ECDC -EUPHEM Robert Koch Institute National Reference. Role of the laboratory in surveillance Sources: WHO Laboratory Training for Field Epidemiologists ECDC -EUPHEM Robert Koch Institute National Reference Center for Listeriosis, Paris Laboratory for Urgent Response to Biological Threats, Paris Ph. I - Early warning signals Detection of pathogens that have potential to spread Sentinel events requiring early control measures Isolation of a single epidemic prone isolate (e.g. How to identify a new resistance to antibiotics Look for genetic material : broad range of genetic probes and methods for identification of resistance genes. Diabetes mellitus, commonly referred to as sugar diabetes, is a growing problem globally largely associated with a more sedentary lifestyle and obesity. Ask a Doctor Online Now!Diabetes mellitus can drastically reduce the quality of life if left untreated and eventually lead to life-threatening complications. Stimulating organs like the liver to convert glucose into its storage form known as glycogen.
It is therefore the responsibility of organs like the pancreas to maintain the balance of glucose available in the bloodstream.
Complications are the consequences of a disease that is either progressive, left untreated or poorly managed or has existed for a very long period of time. The complications of diabetes mellitus does not occur overnight – it develops gradually over years and decades. Diabetes mellitus can lead to nerve dysfunction and damage which is known as diabetic neuropathy.. Diabetes mellitus contributes to high blood pressure and hyperlipidemia (increased blood fats) which damages the walls of the blood vessels. Kidney dysfunction arises as the tiny blood vessels which carries blood to be filtered is damaged and parts of the filtration membranes thicken. The impaired blood flow and nerve damage associated with diabetes mellitus, as discussed above, impacts the most on the lower limbs.
Most cases of gestational diabetes (pregnancy diabetes) are mild and medication is not necessary.
The signs and symptoms of untreated diabetes mellitus or poorly managed diabetes mellitus depends on the conditions that arise. Some of the symptoms can be attributed to diabetic complications but cannot be easily differentiated from the clinical presentation of diabetes mellitus itself.

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Shigella dysenteriae type I) Reference centres may capture outbreaks disseminated over a large area, or correlate events (food control- cluster of human cases).
Despite it being one of the more common chronic conditions in most populations, there is still widespread ignorance about the serious nature of this disease and the consequences if the condition is left untreated. The presence of diabetes mellitus even when well managed increases the risk of many other serious diseases. The body has several ways of regulating the different levels of various substances in the body.
The bloodstream is being constantly monitored throughout the day and should the glucose levels rise too high, the pancreas releases insulin into the bloodstream. The body is in a constant need of energy to fuel all the different process that is constantly occurring including basic life processes like breathing and pumping of blood by the heart. Therefore the effects of untreated diabetes mellitus is actually the complications that arise, usually in the long term.
However, severe hyperglycemia (high blood glucose levels) or hypoglycemia (low blood glucose levels) has immediate effects known as diabetic emergencies. The onset of these conditions is largely individualistic meaning that one diabetic may experience certain complications sooner compared to another diabetic.
This may be caused by the narrowing of blood vessels supplying the nerve cells with oxygen and nutrient rich blood. It leads to plaques forming in the blood vessel wall (atherosclerosis) and increases the risk of clots forming in the vessels.
This causes a host of problems in the foot in particular and is therefore known as diabetic foot.
Dietary changes and moderate exercise may be sufficient to manage the diabetes which often resolves after childbirth. Firstly the symptoms of diabetes mellitus itself worsens so it is important to be familiar with these signs and symptoms. Since diabetes is largely asymptomatic in the early stages and eventually presents with several mild symptoms, there is a misconception that it is not a dangerous condition. The most severe complications in diabetes is seen in long term cases that are poorly controlled but there are several diabetic emergencies that can suddenly arise which can be equally as dangerous even in a person who has been diabetic for just a short period of time.

This is largely controlled by the endocrine system – hormones that are secreted from different glands. This means that pancreas is either not producing enough insulin (insulin deficiency) or that all the cells in the body are not responding as it normally should to insulin (insulin resistance). Even a person who has well managed diabetes mellitus is at risk of developing these complications. The main organs and structures that are affected are the eyes, nerves, kidneys, blood vessels and heart. High quantities of glucose within the nerve cells affects the normal processes responsible for nerve function. This can progress to a stroke or heart attack (myocardial infarction) as the blood supply to the brain and heart is compromised respectively. Injury to the foot is often the trigger event that then progresses to more severe complications as a result of poor wound healing and weakened immune activity.
It damages cells in the body in various ways and by doing so it leads to several other diseases in the long term or increases the risk of developing certain diseases. Eventually the blood glucose levels are at a higher level than is the norm (hyperglycemia) and damages different parts of the body over months and years. Should medication not be commenced in diabetes mellitus or used as prescribed, and if a person does not undertake dietary changes and start exercising, the blood glucose levels are out of control. However, these emergencies are more likely to arise in a person with poorly managed diabetes mellitus or with incorrect use of diabetes medication. The narrowed arteries and weakened veins especially to the legs leads to sluggish circulation with a host of problems that subsequently develops in the legs and feet. While the pancreas produces and secretes digestive enzymes into the gut, it also has a crucial role to play in producing and secreting the hormones that control the blood sugar levels.
It tends to remain high most of the time with episodes of very low blood glucose levels (hypoglycemia).
Both hyperglycemia and hypoglycemia have serious consequences and can lead to life-threatening complications in the short and long term.

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