The use of insulin in elderly patients with type 2 diabetes mellitus,diabetes mellitus treatment history verwijderen,how to relieve sciatic nerve pain pregnancy nhs - New On 2016

Type 2 Diabetes Mellitus is a condition in which the body fails to metabolise glucose (sugar) correctly. When a person does not have diabetes, a gland called the pancreas produces and secretes a hormone called insulin. Type 2 diabetes mellitus was previously called non-insulin dependent diabetes mellitus (NIDDM) and late onset diabetes mellitus. Almost one in 20 Australians, or one million people, were diagnosed with type 2 diabetes mellitus in 2008. Of those who have been diagnosed with type 2 diabetes, 56% are men and 92% are over 45 years of age.
It is by far the most common form of diabetes, accounting for 87% of all diabetes mellitus in Australia.
The proportion of Australians with type 2 diabetes has increased rapidly in the past decade. While there is no single cause for developing Type 2 diabetes, there are well-known risk factors. Family history of diabetes – people with close relatives that have type 2 diabetes are more likely to get the condition themselves.
Ethnic background – people from Aboriginal or Torres Strait Islanders, Pacific Islanders, Indian and Chinese ethnic background are more likely to develop type 2 diabetes mellitus.
Low birth weight is thought to predispose to diabetes due to poor beta-cell development and function. Type 2 diabetes mellitus may have an onset over several months, or be asymptomatic and be detected on a routine blood test. Without treatment patients may develop acute complications due to dehydration (HONKC, see below) and long-term complications will develop much more rapidly. The main acute complication is hyperosmolar nonketotic coma (HONKC), sometimes also known as hyperosmolar hyperglycaemic nonketotic coma (HHNC). Peripheral vascular disease – potentially causing gangrene and leading to need for leg or toe amputation.
Men are particularly susceptible to diabetic complications and often have higher rates of mortality than females. However, many patients with diabetes remain assymptomatic for many years but are still subject to the damaging effects of high blood sugars.
At the time of diagnosis of type 2 diabetes, you may already have several complications of the disease, such as heart or eye problems. Diabetes or impaired glucose tolerance may be detected on routine blood tests as part of a general health check-up or investigation for other symptoms or diseases.
Your doctor will perform a careful examination mainly looking for the various complications of diabetes. Your doctor will use a special device (called an opthalmoscope) to look at the back of your eye (retina). Leg examination may reveal diabetic ulcers (on pressure points in the feet) and peripheral vascular disease (poor peripheral pulses and circualtion), diabetic foot disease and trophic skin changes and skin infections. Your sensations of vibration (tested with a tuning fork placed on the bone) and propioception (recognition of joint space position, tested by wiggling your toe or finger with your eyes closed) tend to be affected first.
Patients who do not reach these criteria may still be classified as having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on the basis of fasting blood glucose or oral glucose tolerance test results. Glycosylated haemoglobin (HbA1c): this test is not used as a diagnostic or screening test for diabetes but may be used in the ongoing monitoring of diabetes. When a diagnosis of diabetes mellitus is first made, several tests are often ordered to check for organ function and exclude complications of diabetes. The acute complication of hyperosmolar non-ketotic coma has a mortality approaching 50% due to the fact that it affects elderly patients with extensive medical problems. The first goals of treatment are to eliminate symptoms of hyperglycemia (high blood sugar), stabilise blood glucose, and restore normal body weight. BSL monitoring is now a simple and quick task, which can be accomplished by the use of a blood sugar monitor (pictured right).
It is recommended that you consume foods that have a low Glycaemic Index (GI) as these raise your blood sugar by much lower amounts. If you are significantly overweight or obese you may require additional treatments to help you lose weight.
If lifestyle modifications are inadequate to control diabetes, tablets are usually the next step.
You should be aware of warning signs of a hypoglycaemic attack including weakness, pallor, hunger, sweating, shaking, confusion, loss of concentration and blurred vision, and carry suitable sugar remedies. Dunstan, Zimmet, Welborn, Sicree, Armstrong, Atkins, Cameron, Shaw, Chadban on behalf of the AusDiab Steering Committee, Diabesity & Associated Disorders in Australia- 2000. Huang ES, Brown SES, Ewigman BG, Patients perceptions of Quality of life with diabetes related complications and treatments.
About myVMCVirtual Medical Centre is Australia’s leading source for trustworthy medical information written by health professionals based on Australian guidelines. Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician.
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You are located on a secure website.Customer data is for our internal use only and will be treated as confidential. When checked, Shutterstock's safe search screens restricted content and excludes it from your search results. Here we discuss gestational diabetes blood sugar levels as well as normal blood sugar levels.
First, a few things you need to know about gestational diabetes so that you can understand what gestational diabetes blood sugar levels mean.
Gestational diabetes is diabetes that is found for the first time when a woman is pregnant. There is also evidence that women that have gestational diabetes are at higher risk for developing pre-diabetes and type 2 diabetes later in life. The changing hormones and weight gain you experience in pregnancy can make it hard for your body to keep up with its need for insulin. Gestational Diabetes Diagnosis to find out more about the dangerous complications you want to avoid. If it turns out you have gestational diabetes blood sugar levels, you will need to regularly test your blood.
Do have very specific or personal questions you don't feel comfortable discussing in public  forums? Get a glucose monitoring system that has no coding required (it will say so on the box) and includes a lancing device as well as a few test strips. Typically this means using the lancing device on the inside of one of your finger tips to get a drop of blood which you apply to the test strip that you have already inserted into your blood glucose monitor. Blood sugar levels between the two scenarios above indicate grey areas that are less than optimal but may not mean you have diabetes.
If you test positive for gestational diabetes, you will no longer be considered a a€?low-risk pregnancya€?.
In short, if you plan to deliver naturally, without pain relief medications or interventions, your ability to do so will be drastically reduced. You may want to take steps to prevent being diagnosed with gestational diabetes, especially if you know your blood sugar levels are within a normal range and but the testing parameters will likely identify you as having gestational diabetes.
An example of this is knowing that eating a bowl of ice cream will raise your blood sugar level to 160 where it will remain for over 45 minutes so likely the Glucola test will result in a similarly high reading. We are not suggesting that you avoid being diagnosed with gestational diabetes when you really have it.
As a natural childbirth advocate, you already know that maintaining your blood sugar levels thru diet and lifestyle modifications is better than taking simply taking insulin. Because we knew that our blood sugar levels were stable and we liked our birth center or midwife, we did not want to be erroneously diagnosed with gestational diabetes. Read Pregnancy Gestational Diabetes Diet for more information about how you can keep your blood sugar levels low by following a good pregnancy diet. Gestational Diabetes Testing for more information about how Gestational Diabetes is diagnosed as well as problems with the current testing. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. Normally the insulin would be used by the body to draw glucose into the cells, where it could be stored as energy which could be used by the body later (e.g. The actual proportion of Australians with the condition may be higher as many people are not diagnosed until they develop complications, for example diabetic retinopathy. Estimates suggest that if the increase continues three million Australians will be living with diabetes by 2025.
Each year, 3 children in every 100,000 aged 10-14 years and 8 in every 100,000 aged 15-19 year are diagnosed with type 2 diabetes. People whose parents had diabetes have a genetic predisposition, meaning they are more likely to get type 2 diabetes themselves. One in ten of those with a sibling that has type 2 diabetes will develop the condition, as will half of those with an identical twin who is affected by type 2 diabetes. It is generally not recognised and diagnosed until the patient seeks health care for another problem. This is a condition that develops over several days in poorly controlled diabetes involving high blood glucose and potentially lethal secondary dehydration and electrolyte disturbances.
Unlike type 1 diabetes which tends to present acutely, type 2 diabetes presents gradually over several years. You may have noticed blurring of your vision, pins and needles in the feet (due to damage to the nerves) and recurrent infections. If you are obese, suffer from high blood pressure, have a family history of diabetes, have high cholesterol or come from a high risk population (e.g. Here the doctor may see various degrees of diabetic retinopathy which basically represents damage to and leaking from the small vessels at the back of your eyes.
You may have an abnormal heart rhythm or crackles at the base of your lungs from accumulated fluid.
Heart disease (heart attacks 3-5 times more likely), peripheral vascular disease (amputation 50 times more likely), and stroke (twice as likely) are the major causes of death in patients over the age of 50. Hypoglycaemia due to inappropriate use of insulin or as a side-effect of medications is also potentially fatal. The ongoing goals of treatment are to prevent or reduce long-term complications, and to allow the patient to live as normal a life as possible. Team members may include a GP, diabetic specialist, diabetic educator, ophthalmologist, podiatrist, dietician and the patient themselves. BSL monitors assess levels by analysing a drop of blood that has usually been obtained by a very quick finger prick and take only moment to give a result. Tests include glycosylated Hb (also known as HbA1c, a reflection of long-term blood glucose control), blood pressure, weight, plasma lipids, proteinuria (protein in the urine), kidney function, condition of feet and cardiovascular exam. In fact, most patients will notice an improvement in symptoms after just one month of lifestyle changes. A variety of obesity treatments are now available including meal replacement programs, lifestyle changes, weight loss drugs and surgery (for the morbidly obese). Metformin is usually the first line agent if you are overweight as it does not have the side effect of weight gain.
Metformin can have a serious side effect called lactic acidosis if you have impaired renal, liver or cardiac function. The ever-optimistic Bob Harrington interviews Karen Joynt; both see an opportunity for cardiologists to take the lead in developing good-value care. Take an overall attention to statistic below then consider again whether you should be even more careful than you thought you have already been or not.
What you may not realize is that you can go to your local pharmacy and purchase a blood glucose monitoring system without being diagnosed with gestational diabetes. We all used the information we received from testing and knowing our own blood sugar levels to ensure we did not test positive for pregnancy diabetes. Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content. Usually the amount of insulin secreted increases in relation to the amount of carbohydrate (sugar) a person consumes.


However characteristics of a person’s lifestyle, especially what they eat and how much exercise they do, also influence the risk of type 2 diabetes. In the early stages of disease your examination may be completely normal, however as the duration and severity of disease progressed it is likely you will have some end-organ damage. In addition, your blood pressure will be checked and your doctor may perform an ECG to detect any obvious ischaemic changes.
Results >7% suggest poor blood glucose control and correlate with poor clinical outcomes. In addition, diabetic eye disease and renal failure due to diabetic nephropathy are important causes of morbidity. Dietary changes focus on the ideas of weight loss and blood sugar regulation (that is, keeping the blood sugar levels relatively stable throughout the day, avoiding big peaks or troughs). If you are not used to exercise, always take care when beginning a new exercise program, and see your health professional before you begin. Your doctor will decide whether this medication is suitable for you and explain situations where metformin treatment may be dangerous. Insulin may eventually be needed in poorly controlled diabetes, or when other treatments fail. This drug is oral blood sugar-lowering and belongs to the sulfonylurea class of medications which are used for managing diabetes. There is no prescription required, although your insurance company will not reimburse you for the testing strips unless you have an official diagnosis. People with a genetic predisposition may not develop the condition if they lead a healthy lifestyle. Diabetic educators in particular are invaluable, providing you with information about nutrition, exercise, the management of diabetes during illness, and medication.
Lowering of blood sugar is due to the release of insulin through pancreatic beta cells drug stimulation and by drug induced increase in activity of intracellular insulin receptors. The neuropathy starts distally and progresses further up the limb as the condition worsens.
However, several large trials have proven that the risks of long-term complications from diabetes can be reduced with good blood glucose (sugar) control. Glimepiride is related to other sulfonylureas such as glipizide (Glucotrol), glyburide (Micronase; Diabeta), tolazamide (Tolinase), and tolbutamide (Orinase). Some medicines cannot be given by mouth because chemical action of the enzymes and digestive fluids would change or reduce their effectiveness, or because they would be removed from the body too quickly to have any effect. Its contraindications include pregnancy and hypersensitivity sulfonylureas while side effects may include leukopenia, occasional allergic reactions, hemolytic anemia, gastrointestinal disturbance, and thrombocytopenia (rarely). In addition to the most common types of injections described below, injections are sometimes made into arteries, bone marrow, the spine, the sternum, the pleural space of the chest region, the peritoneal cavity, and joint spaces. In sudden heart failure, heart-stimulating drugs may be injected directly into the heart (intracardiac injection).Sites for injections. These injections are given in an area where the skin and hair are sparse, usually on the inner part of the forearm.
A 25-gauge needle, about 1 cm long, is usually used and is inserted at a 10- to 15-degree angle to the skin.intramuscular injection injection into the substance of a muscle, usually the muscle of the upper arm, thigh, or buttock.
They should be given with extreme care, especially in the buttock, because the sciatic nerve may be injured or a large blood vessel may be entered if the injection is not made correctly into the upper, outer quadrant of the buttock. The area permits multiple injections, is more accessible, and is easier to stabilize, particularly in pediatric patients or others who are restless and uncooperative. The vastus lateralis muscle is located by identifying the trochanter and the side of the knee cap and then drawing a visual line between the two. The distance is then divided into thirds and the needle inserted into the area identified as the middle third.The needle should be long enough to insure that the medication is injected deep into the muscle tissue.
The maximum for an infant is 0.5 ml, and the injection is made into the vastus lateralis muscle.
When the gluteus maximus muscle is the site chosen for the injection, the patient should be in a prone position with the toes turned in if possible.
This position relaxes the muscle and makes the injection less painful.intrathecal injection injection of a substance through the theca of the spinal cord into the subarachnoid space.
Patients receiving intrathecal chemotherapy for metastatic malignancy of the central nervous system should maintain a flat or Trendelenburg position for one hour after treatment to achieve optimum distribution of the drug.intravenous injection an injection made into a vein.
Intravenous injections are used when rapid absorption is called for, when fluid cannot be taken by mouth, or when the substance to be administered is too irritating to be injected into the skin or muscles.
In certain diagnostic tests and x-ray examinations a drug or dye may be administered intravenously. Although usually fluid medications are injected, occasionally solid materials such as steroid hormones may be injected in small, slowly absorbed pellets to prolong their effect. Subcutaneous injections may be given wherever there is subcutaneous tissue, usually in the upper outer arm or thigh. A 25-gauge needle about 2 cm long is usually used, held at a 45-degree angle to the skin, and the amount injected should not exceed 2 ml in an adult. Called also hypodermic injection.Angle of needle insertion for administering a subcutaneous injection. When a patient is unconscious, injection may be the only means of administering medication, and in some cases nourishment. Some medicines cannot be given by mouth because chemical action of the digestive juices or of hepatic enzymes would change or reduce their effectiveness, or because they would be removed from the body too quickly to have any effect. Certain potent medicines must be injected because they would irritate body tissues if administered any other way.
This method is used in diagnostic procedures and in administration of regional anesthetics, as well as in treatment procedures. These injections are given in an area where the skin and hair are sparse, usually on the inner part of the thigh in dogs or the caudal fold in cows. A small-gauge needle is recommended and it is inserted at a 10- to 15-degree angle to the skin.intramuscular injectioninjection into the substance of a muscle, usually the thigh or pectoral muscle, or the muscle of the neck or rump. The needle is introduced into the upper flank and the syringe plunger withdrawn to ensure that intestine has not been penetrated. In certain diagnostic tests and x-ray examinations, a drug or dye may be administered intravenously. Although usually fluid medications are injected, occasionally solid materials, such as steroid hormones, are administered subcutaneously in small, slowly absorbed pellets to prolong their effect.
Subcutaneous injections may be given wherever there is subcutaneous tissue, usually in the loose skin on the side of the chest or in the flank.
The amount injected should not exceed 2 ml for cats and small dogs, 5 ml for large dogs and 20 ml for horses.




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