Wednesday, May 28, 2008

How do diabetes mellitus contribute to diabetic nephropathy

How do diabetes mellitus contribute to diabetic nephropathy?

Diabetes - 6 Answers
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1 :
Diabetes can cause NEUROPATHY in the feet, meaning that people who suffer from diabetes can loose feeling in their feet. This is caused by poor circulation to the limbs, especially the lower extremities.
2 :
When the blood sugar is high, it damages the tiny blood vessels in the kidneys. Those blood vessels filter waste from the blood. When they get damaged from high blood sugar, the kidneys aren't able to do their job as well. Note to others: The question is about NEPHROpathy, not NEUROpathy
3 :
Neuropathy is a common name for complications affecting the nervous system. Diabetic neuropathy is long-term damage to the nerve fibres. It happens when high blood glucose levels are present over several years. In diabetes, the form it usually first takes is reduced sensation in the feet. The nerve damage affects each foot equally and eventually spreads up the legs. Poor sensation in your feet makes them more prone to injury. Combined with poor circulation this can easily lead to ulcers and infections. The nerve damage can be short term (acute) or long term (chronic): * acute neuropathy usually disappears once the diabetes is under control. It often presents as a burning sensation in the feet and is especially bad at night * chronic neuropathy has more serious implications. Because this complication is caused by poor blood sugar control, people who don't take enough care in controlling their diabetes stand a higher risk of developing nerve damage. An early sign of diabetic neuropathy is a lack of ability to feel vibrations, for example from a tuning fork. This test can be carried out during your annual diabetes check-up. The same sort of nerve damage can occur in the hands. This is uncommon, and is always accompanied by problems in the feet and legs. Unfortunately, this type of nerve damage is permanent. Once it's happened, it isn't improved by better control of diabetes.
4 :
High blood glucose (sugar) levels cause damage to the microcirculation, especially in the extremities. This in turn causes nerve damage and results in neuropathic pain.
5 :
Type 2 diabetics usually take Metformin. In many of us it causes a deficiency in B12. Which in turn contributes to diabetic neuropathy. Healthy Nerves Vitamin B12 is an especially important vitamin for maintaining healthy nerve cells and it aids in the production of DNA and RNA, the body's genetic material. Vitamin B12 also works closely together with folic acid to regulate formation of red blood cells
6 :

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Saturday, May 24, 2008

How is diabetes mellitus type 2 associated with obescity

how is diabetes mellitus type 2 associated with obescity?
i would like to know the effect that extra fat has on the metabolism of glucose.
Diabetes - 2 Answers
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1 :
http://www.phlaunt.com/diabetes/ Read the above site for some insight on this. Obesity is not that much a factor in who gets type 2, but it does make a difference to those who get type 2 in how their medications work to aid them in maintaining low glucose numbers.
2 :
Because the extra fat is pushing on the pancreas making it hard to work, so you become resistant to the insulin. Then the insulin isn't there to lower your sugar so it gets all outa whack.

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Tuesday, May 20, 2008

Is the incidence of Diabetes Mellitus increasing, decreasing or staying the same

Is the incidence of Diabetes Mellitus increasing, decreasing or staying the same?
Is it increasing or decreasing in the world? Is it increasing or decreasing in developed countries?
Medicine - 6 Answers
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1 :
type 2 increasing in leaps in bounds all over the world, and in younger and younger people. Type 1 increasing too, but likely not as dramatic an increase, but proportionate to the growth of the general population.
2 :
The incidence is increasing, but the criteria for the diagnosis is also being lowered. Even corrected for the diagnosis, I believe the incidence is still increasing. Diabetes.org and the CDC will probably have good info on this.
3 :
Diabetes incidence is increasing globally, and that is based on reliable epidemiological studies. One reason is because diabetes, type 2 diabetes in particular, is very difficult to detect at the onset due to lack of signs and symptoms. Majority of patients are diagnosed with diabetes when the disease has already fully progressed because this is the only time when signs and symptoms arise. Also, many people observe poor lifestyle (such as lack of exercise and a poor diet) which is one major factor contributing to the increasing incidence of diabetes around the world.
4 :
Diabetes Mellitus will continue to increase in the world over. India will rank No.1 position with regard to the total number of diabetic patients.
5 :
Over eating and obesity is increasing and so diabetes also.
6 :
Diabetes mellitus is increasing all over the world,type 2 more as the cause of it is generally idiopathic and more so in the developed countries.one cause for this is thought the lack of nutritional stress in the lives of most people due to the change in lifestyle. the incidence is also higher nowadays as the longetivity is increased and DM is incurable(only palliative medicine is available). a particular group of factors in the body,proteins and transcription factors(ppr gamma) are thought to be responsible for managing nutritional stress in the organisms. this in,our case has been rendered redundant too fast and has consequentially created havoc in the body as the body is not evolutionarily ready to accept the sudden change of lifestyle. this is considered as one of the major causes for the widespread dying out of the native red indians in US,one of the major causes has been found to be DM. But in terms of cause the reasosns cannot be narrowed thus.DM is precipitated by many factors one of which maybe as stated above,

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Friday, May 16, 2008

How does type 1 diabetes mellitus differ from type 2 diabetes mellitus

How does type 1 diabetes mellitus differ from type 2 diabetes mellitus?

Diabetes - 4 Answers
Random Answers, Critics, Comments, Opinions :
1 :
type 1 there is no insulin production so insulin therapy is required. Insuling Dependent type 2 there is little insulin production, insulin may or may not be needed. Can be fixed with diet and exercise.
2 :
Type 1 Diabetes is caused by the failure of an internal organ called the Pancreas. this organ produces insulin. When the organ fails, there is no insulin, and the patient is in danger of dying unless they take insulin injections every day for the rest of their life. Type 2 Diabetes is caused by being overweight. This comes from eating to much and not exercising enough. In Type 2 diabetes, the pancreas is probably still working, but it cannot produce ENOUGH insulin for all that fat! Treatment for Type 2 diabetes is controlling the diet, especially cutting out sugars and carbohydrates, get a LOT more exercise, and losing weight. Sometimes, some medicinal help is needed until the patient learns a better lifestyle. the GOAL of managing Type 2 Diabetes is to get the patient to lean how to eat properly, exercise more, and control their weight. if the patient is successful at this, then the medications can be eliminated.
3 :
Gary B said it nicely, but I would like to add and correct a few things: Type 1. The pancreas is working just fine for a diabetic (for the most part) and only the Beta cells are destroyed by ones own immune system. That can be from various causes (I for example got that as a chickenpox complication). The risk for immediate death isn't all that high and you will 100% notice the increase of BG levels in time to act on it due to excessive thirst and urination followed by puking, headache and sweating. Type 2 makes insulin like normal, but it's either not enough for fat or the organism becomes somewhat resistant to insulin and cannot use it effectively on it's own. That is treated by medicine that boosts the organisms insulin intake. You can get it from obesity and lack of exercise or sometimes in old age. This can also evolve into a insulin dependant type 2 diabetes.
4 :
Type I: Yes, insulin dependent... seems to often be due to an immune sequel reaction to Coxackie Virus B4. Plus, certain other HLA/MHC genes have been shown to confer increased risk of development of type I. Type II: Non Insulin Dependent... Yes being overweight is a very common cause of this form of diabetes but it IS NOT the only thing that matters although most people are lead to believe this one condition (obesity) invariably causes the other (diabetes). The fact is there are genetic defects and markers, about 20 genes identified so far and some 140 mutations, which lend people to develop type II diabetes. Most of these gene defects are in genes coding for GLUT channels 2 and 4. GLUT 2 is found mostly in your liver and pancreatic cells and doesn't require insulin to transport glucose into the cells, GLUT 4 which is commonly found in muscle and adipose cells DOES need insulin to function. Try to maintain proper diet and exercise, but never believe that living a healthy lifestyle is a 100% safeguard from all the different disorders humans develop because it just decreases risk... it never eliminates it all together.

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Monday, May 12, 2008

Where are PG courses in Diabetology available for doctors to train themselves in Diabetes Mellitus management

Where are PG courses in Diabetology available for doctors to train themselves in Diabetes Mellitus management?
Where are PG courses in Diabetology available for doctors to train themselves in Diabetes Mellitus management?
Diabetes - 3 Answers
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1 :
There is no such disclipline as "diabetology". Diabetes is taught to all medical students and any medical doctor can begin treatment for the disease. For expert management, one would be referred to an endocrinologist who would carefully evaluate the individual's needs, prescribe any required medications, and then further refer the individual to a certified nutritionist and a certified diabetes educator, who is usually an RN with added training in the management of the disease. Management of diabetes is a team effort, and the diabetic him/herself is just as important a member of that team as is the M.D.
2 :
I don't think are are post grad courses. My diabetes specialists have always been endocrinologists who focus specifically on the treatment of type I diabetes.
3 :
Some fellowship courses are available in Chennai, India exposing medical graduates to diabetology.Also, M.Sc (Diabetes Sciences) a 3 yr. course with eligibility B.Sc in any branch including B.Sc Nursing is offered by the Health Care Campus of Amrita Instt. of Medical Sciences, P.O:-Elamakkara, KOCHI- 682026(Kerala) India.You can write to the Principal, Medical College in the already mentioned address or E-mail to medicalcollege@aims.amrita.edu .You may specifically enquire regarding Fellowship in endocrinology and Diabetes, which is open only to medical degree holders. You may visit their website www.aimshospital.org

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Thursday, May 8, 2008

Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus

Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus?
IS THIS TRUE OR FALSE?
Medicine - 3 Answers
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1 :
True. The word "diabetes" means "to pass" (as in "to pass urine," so we ue it to mean it causes you to pee alot). The first symptoms of diabetes mellitus is polydypsia (drink a lot), polyuria (pee a lot), and polyphagia (eat a lot). Of course doctors wouldn't be as highly paid if they said things like "patient eats, drink and pees a lot," so instead we say "patient presents with polydypsia, polyuria, and polyphagia." And anytime you have polydypsia (pee a lot), you have a higher chance of being dehydrated. Especially in Diabetes Insipidus. Now go do your homework! :) You should understand the difference between diabetes mellitus (what we mean when we say "he's diabetic") Type I (Juvenile Diabetes, autoimmune, insulin producing cells are destroyed) and Type II (adult-onset diabetes, insulin-independent, its mostly due to loss of insulin receptors, mostly due to overeating, obesity, bad diet, and lack of exercise), and Diabetes Insipidus (lots of pee, usually due to lack of ADH (the thing you release to not go pee), due to inherited disease). So know the different types of diabetes. And what does this insulin thing do? ;) Where is insulin released from, and when does the body release it? What is a receptor? And what happens when insulin meets (bind to) its receptor? When you start "getting" concepts in medicine like receptors, up and down regulation, and feedback mechanisms, understanding diseases and drugs becomes really easy.
2 :
True, though the mechanisms are completely different.
3 :
Both types of diabetes involve excessive fluid loss in urine which can result in dehydration.

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Sunday, May 4, 2008

What drugs should be given to a patient for bronchial asthma, with hypertention stage 2 and diabetes mellitus

what drugs should be given to a patient for bronchial asthma, with hypertention stage 2 and diabetes mellitus?
I thought of adding atrovent, its an exam question, glucocorticoids are contraindicated, can someone just mention the possible combinations of the various groups available, condition of pation is medium not severe.
Medicine - 4 Answers
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1 :
Ask your doctor or pharmacists.
2 :
Consult with your doctor. He/she will recommend the appropriate medications for those conditions and what is suitable for the patient's health.
3 :
Is this asthma due to COPD, allergies, URI?? Depends on the receptor sites and if you want to decrease the SNS or increase the PNS......... also you have to consider what other meds this parson is on, their renal function, age, ethnicity........call your MD
4 :
aminophylline could be taken safely and aerosol of salmetrol could be used

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Thursday, May 1, 2008

What is the relationship of pregnancy to diabetes mellitus

What is the relationship of pregnancy to diabetes mellitus?

Women's Health - 2 Answers
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1 :
A pregnant woman who does not have diabetes can develop â€œgestational diabetesâ€ later in pregnancy. A woman with gestational diabetes will need to watch her blood sugar closely and balance food intake, exercise, and, if needed, insulin shots to keep her blood sugar in control. If a woman with gestational diabetes does not keep her blood sugar in good control, she could have several problems. She might have an extra large baby, have high blood pressure, deliver too early, or need to have a cesarean section (an operation to get the baby out of the mother through her abdomen). The extra large baby might cause the woman to feel uncomfortable during the last months of pregnancy. Also, it could lead to problems for both the woman and the baby during delivery. When the baby is delivered surgically by a cesarean section (C-section), it takes longer for the woman to recover from childbirth. High blood pressure when a woman is pregnant might lead to an early delivery and could cause seizures or a stroke in the woman. Sometimes gestational diabetes in women does not go away after delivery. These women have converted to Type 2 diabetes. A woman whose diabetes does not go away after delivery will need to manage her diabetes for the rest of her life.
2 :
Diabetes is often detected in women during their childbearing years and can affect the health of both the mother and her unborn child. Poor control of diabetes in a woman who is pregnant increases the chances for birth defects and other problems for the baby. It might cause serious complications for the woman, also. Proper health care before and during pregnancy will help prevent birth defects and other poor outcomes, such as miscarriage or stillbirth. What is diabetes? Diabetes is a condition in which the body cannot use the sugars and starches (carbohydrates) it takes in as food to make energy. The body either makes too little insulin in the pancreas or cannot use the insulin it makes to change those sugars and starches into energy. As a result, the body collects extra sugar in the blood and gets rid of some sugar in the urine. The extra sugar in the blood can damage organs of the body, such as the heart, eyes, and kidneys, if it is allowed to collect in the body too long. The 3 most common types of diabetes are Type 1, Type 2, and gestational. * Type 1 diabetes is a condition in which the pancreas makes so little insulin that the body canâ€™t use blood sugar for energy. Type 1 diabetes must be controlled with daily insulin shots. * Type 2 diabetes is a condition in which the body either makes too little insulin or canâ€™t use the insulin it makes to use blood sugar for energy. Often Type 2 diabetes can be controlled through eating a proper diet and exercising regularly. Some people with Type 2 diabetes have to take diabetes pills or insulin or both. * Gestational diabetes is a type of diabetes that occurs in a pregnant woman who did not have diabetes before she was pregnant. Often gestational diabetes can be controlled through eating a proper diet and exercising regularly, but sometimes a woman with gestational diabetes must also take insulin shots. Usually gestational diabetes goes away after pregnancy, but sometimes it doesnâ€™t. Also, many women who have had gestational diabetes develop Type 2 diabetes later in life. What are some common problems caused by diabetes? People with diabetes can get high blood pressure, kidney disease, nerve damage, heart disease, and blindness. Young women with diabetes might not have these problems yet. The damage caused by these problems often happen in people whose blood sugar has been out of control for years. Keeping blood sugar under control can help prevent the damage from happening. People with diabetes can go into â€œdiabetic comaâ€ if their blood sugar is too high. They can also develop blood sugar that is too low (hypoglycemia) if they donâ€™t get enough food, or they exercise too much without adjusting insulin or food. Both diabetic coma and hypoglycemia can be very serious, and even fatal, if not treated quickly. Closely watching blood sugar, being aware of the early signs and symptoms of blood sugar that is too high or too low, and treating those conditions early can prevent these problems from becoming too serious. How does a person get diabetes? We donâ€™t know exactly how people get diabetes. However, it appears that both genetics and personal lifestyle play a role in who gets diabetes. Some people have diabetes that â€œrunsâ€ in the family. Lack of exercise, poor eating habits, and obesity seem to increase the risk of developing Type 2 diabetes in other people. In some, but not all cases, Type 2 diabetes can be controlled if people lose weight, eat right, and exercise regularly. Can a person prevent problems from diabetes? A person with diabetes who keeps her blood sugar as close to normal as possible has fewer problems than a person who does not keep his blood sugar in â€œtight control.â€ A woman with diabetes who can get pregnant should watch her blood sugar closely to prevent problems if she should get pregnant. To keep blood sugar in tight control, a person can manage her diabetes with a strict plan: * Eat healthy foods from personal diabetes meal plan * Exercise regularly * Monitor blood sugar often * Take medications on time, including insulin if ordered by the doctor. * Know how to adjust food intake, exercise, and insulin depending on the results of blood sugar tests * Control or treat low blood sugar and high blood sugar * Follow up with health care provider regularly Return to top How does gestational diabetes differ from Type 1 or Type 2 diabetes? Gestational diabetes happens in a woman who develops diabetes during pregnancy. Some women have more than one pregnancy affected by diabetes that disappears after the pregnancy ends. About half of women with gestational diabetes will develop Type 2 diabetes later. If not controlled, gestational diabetes can cause the baby to grow extra large and lead to problems with delivery for the mother and the baby. Gestational diabetes might be controlled with diet and exercise, or it might take insulin as well as diet and exercise to get control. Type 1 and Type 2 diabetes often are present before a woman gets pregnant. If not controlled before and during pregnancy, Type 1 and Type 2 diabetes can cause the baby to have birth defects and cause the mother to have problems (or her problems to worsen if they are already present), such as high blood pressure, kidney disease, nerve damage, heart disease, or blindness. Type 1 diabetes must be controlled with a balance of diet, exercise, and insulin. Type 2 diabetes might be controlled with diet and exercise, or it might take diabetes pills or insulin or both as well as diet and exercise to get control.

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