Diabetes Mellitus
Thursday, June 18, 2009
What is Diabetes Mellitus
Diabetes Mellitus is one of the disease that caused high number of mortality. What is diabetes mellitus? According to WHO, Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, or alternatively, when the body can not effectively use the insulin it produces. In 2005 alone, an estimated 1.1 million people in the world died from diabetes. This number projected will be increase by more than 50% in the next 10 years without urgent action.
Diabetes can occur to anybody in any age and any country, not only in the rich and modern country but also in poor and low income country. Based on WHO's data, mortality rate related to diabetes in low and middle-income countries is higher than upper-middle income countries.
What causes Diabetes?
Every human being need sugar in their body to use it as energy. But, the blood sugar level should be controlled in the normal range. That is main role of insulin hormone that produced by pancreas. In some condition, pancreas totally cannot produce insulin or it not enough to comply with body requirement. The other cause of diabetes is inability of the cells to use insulin properly and efficiently. These are two main cause that lead to hyperglycemia or high level sugar in the blood stream develops.
Types of Diabetes
There are two types of diabetes.
Type 1 diabetes formerly known as IDDM (insuline Dependent Diabetes Mellitus) or juvenile-onset diabetes. This type of diabetes usually develop in the early age, because of large part or totally from insuline producing cell of pancreas destroyed. The insuline production very little or totally stop. Patient need daily administration of insulin, otherwise will rapidly fatal. Type 1 diabetes has only about 10% from total diabetes patient.
Type 2 diabetes formerly known as NIDDM (Non Insulin Dependent Diabetes Mellitus) or adult-onset diabetes. Different with type 1, this diabetes causes by ineffective use of insulin. The pancreas still produces enough of insulin. Largerly the result of obesity or excess body weight and physical inactivity. Continuing corticosteroid therapy can also leads to type 2 diabetes. Some people with excess growth hormone or with tumor may also develop diabetes.
Gestational diabetes is hyperglaecimia that first detected during pregnancy period.
Symptoms and Diagnosis
Symptoms include polyuria or excessive excretion of urine, weight loss, polydipsia or thirst, constant hunger, vision change, blur, fatigue. In the type 1 diabetes, these symptom may occur suddenly. In the type 2 diabetes, people usually did not realize that they have diabetes. It may be diagnosed several years after onset with many complication already present.
Diabetes usually diagnosed with blood sugar level test.
The normal blood sugar level range from 70 to 100 milligrams of sugar per deciliter of blood (mg/dl) or 3.9 to 5.6 millimoles of sugar per liter of blood (mmol/L) after at least eight hours fasting. If you check your blood sugar level at any time after meal, snack or beverage, your blood sugar level should not more than 200 mg/dL or 11.1 mmol/L. The last methode to test the blood sugar is an oral glucose tolerance test, in which your fasting blood sugar will be measure. Then you drink a sugary solution, only after two hours your blood sugar level will be check again. The normal level is lower than 140 mg/dL or 7.8 mmol/L.
Pre Diabetes
Fasting blood sugar : 100 - 125 mg/dL (5.6 - 6.9 mmol/L)
Random blood sugar : 140 -199 mg/dL (7.8- 11 mmol/L)
Oral glucose tolerance : 140 - 199 mg/dL (7.8 - 11 mg/dL)
Type 1 and type 2 diabetes
Fasting blood sugar : 100 - 125 mg/dL (5.6 - 6.9 mmol/L)
Random blood sugar : 200 mg/dL (11.1 mg/dL) or higher
Oral glucose tolerance : 200 mg/dL (11.1 mg/dL) or higher
Further test may required to differentiate between type 1 and type 2 diabetes.
Risk Factors
Obesity or excess body weight is the main risk factor for diabetes. Obese people need very big amount of insulin to maintains their blood sugar level in the normal range. Approximately 80 - 90% people with diabetes are obese.
Prolonged hydrocortisone treatment, pancreas diseases, pregnancy, tumors, and agromegaly ( excess of growth hormone) also can lead to diabetes.
Complications
Prolonged high blood sugar level or diabetes mostly will cause other diseases in connection with blood vessels. Hyperglaecimia over a long time cause narrowing either big or small blood vessels. As the result is decreasing blood flow in the big or small blood vessels and atherosclerosis. Over time, poor circulation and high level of blood sugar can harm the brain, eyes, arms, heart, kidneys, legs, skin and nerves.
Stroke, blur vision, diabetic retinopathy, blind, many cases of heart diseases such as angina, heart failure, kidney failure, skin infections, prolonged time of healing, and even amputation of the foot or part of the leg. The arm or leg become weak, as the result of single nerve malfunction. Loss of sensation that lead to repeated injuries to the hands, legs and feet because people cannot feel pain, hot, cold and even pressure.
Very high blood sugar sometimes cause excessive urination that lead to diabetic ketoacidosis. It is a medical emergency because it can cause coma and death. Rehydration with large amount of fluids must given intravenously along with electrolytes to replace loss fluids. Level of blood sugar, electrolytes and ketones are measuring periodically until goal's level achieved.
Treatment and prevention
The main goal in diabetes treatment is to maintain blood sugar level in the normal range. It include combination of education, exercise, diet and use of drugs for most people.
With learning and aware about diabetes and it's complication, people will get enough knowledge about diabetes management. They will understand what should do and not to do in order to maintain normal blood sugar level, and avoid complications. Actively life with exercise, balanced diet and efforts to maintain a healthy weight. Bassically, people should not eat excess sweet in their daily diet. Dietitian advice may needed to develop an optimal eating plan.
Drugs treatment for type 1 diabetes is a must. But with maintaining healthy weight and healthy active lifestyle, they may be able to avoid the need of larger doses of insulin. And for type 2 diabetes, they may no need to take an insulin or any diabetes pills if they can maintain healthy weight and lifestyle.
Physician will prescribe you the insuline type that you should take once, twice or even three times daily. There are four major types of insuline : rapid-acting, short-acting, intermediate-acting and long acting insuline. Differentiate between that four type of insuline is only based on it's acting time. There are so many oral medication for diabetes. These oral medication are taken as a single treatment or sometimes combined with insuline. The medications work in several different ways include : increase insulin production, reduce blood sugar production, inhibit blood sugar absorption and improve effectiveness of body's natural insuline.
At the end, preventive action is better to keep people from diabetes. Eating healthy diet, be physically active, control your body weight, and relax your mind seems helpful to prevent diabetes.
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posted by faku @ 1:30 PM,
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Hypertension
Tuesday, June 9, 2009
Hypertension, also known as high blood pressure is a medical condition in which the blood pressure is chronically elevated because of blood presses against the walls of the blood vessels with to much force. Hypertension is already a highly prevalent cardiovascular risk factor worldwide because of increasing longevity and prevalence of contributing factors such as obesity. Hypertension or high blood pressure for a long period is a serious condition that can lead coronary heart diseases, stroke, kidney failure, heart failure.Risk Factors
Are you at risk? Take a look who is at risk of getting hypertension and risk factors that can cause hypertension. The risk of high blood pressure increases as your age, hypertension is particularly common among black people often developing in early age than it does in white, obesity or overweight people and tends to run in families. No medical science understand why most cases of hypertension occur. But we can prevent with controlled unhealthy lifestyle such as :
- Eating too much salt
- Drinking too much alcohol
- Lack of physical activity
- Smoking
- Stress
According to update statistic, about one in three adult in USA has high blood pressure. But most of them don't know that they have hypertension. Many people have hypertension or high blood pressure for years without realising that. There are no specific signs and symptom of hypertension. In some cases, rarely dull headaches may occur, dull headaches, dizzy spells or a few more nosebleeds than normal.
Diagnosis and Classification
A doctor will diagnose hypertension or high blood pressure with sphygmomanometer blood pressure cuff). It measures tw0 kind of number : high number as the pressure while the heart is beating, known as systolic, the lower number as the pressure when the heart is resting between beats (Diastolic).
The US's National Heart, Lung and Blood Institute divide blood pressure measurements into four categories :
- Normal Blood Pressure. You have a normal blood pressure if it is below 120/80 mmHg.
- Prehypertension. If your systolic blood pressure ranging from 120 - 139 mmHg, or your diastolic blood pressure ranging from 80 - 89 mmHg.
- Stage 1 Hypertension. stage 1 hypertension is systolic pressure ranging from 140 - 159 mmHg, or diastolic blood pressure ranging from 90 - 99 mmHg.
- Stage 2 hypertension. Stage 2 hypertension is a systolic blood pressure of 160 mmHg and higher, or a diastolic blood pressure of 100 mmHg and higher.
If the patient has borderline hypertension, the physician may not prescribe a medication but may ask the patient to do one or more of the following to prevent or control their blood pressure :
- Quit smoking
- Eat a healthy, well balance diet
- Maintain a healthy body weight
- Reduce the amount of fatty foods
- Lower the intake of salt and salty food
- Limit or stop alcohol intake
- Begin a regular exercise program
- Have the blood pressure checked regularly
- Take time to relax and reduce the stress in your life
- Faithfully take the hypertension medication
Obey and don't disrupt your hypertension medication that your physician prescribed to you.
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posted by faku @ 12:29 PM,
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Healthy Travel Tip
Wednesday, June 3, 2009
For some people, traveling is very exiting experience. But the stress and excitement can make you more likely to get sick. To stay healthy and safe during and after your journey is more important. Here are some tips for safe and healthy travel.
- Prepare and keep your medicine for your entire journey as our doctor prescribed for you if you have any illness. Bring some extra stock in case your return trip delayed.
- Don't forget to bring your identification card if you are diabetes or epilepsy.
- Keep "your comfort items" with you, such as warm pair of socks, headphones, wear comfortable loose clothing.
- Get plenty of sleep before your journey.
- Don't drink alcoholic drink and over eating.
- Drink plenty of water.
- Do exercise as much as you can during the trip, especially your lower leg to prevent deep vein thrombosis (move your legs and flex and stretch your feet to encourage blood flow in your calves).
- Adjust your sleep and meal schedule according your local time of journey.
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posted by faku @ 12:06 PM,
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Deep Vein Thrombosis
Deep vein thrombosis or usually abbreviated as DVT is a formation of blood cloth in a deep vein in the body.Deep vein thrombosis very often occurs in the lower leg or thigh vein, but DVT may also occasionally develop in the arms or other parts of the body.
Complications
As a clot, deep vein thrombosis some times can loose or break off and becoming that what we called an embolus. It will travel along with blood stream through all parts of the body. When the clot travel to the lungs and get stuck there, it will blocks blood flow. That can be fatal,leads to death, this blockage is called pulmonary embolism.
Causes
There are three major factors that contribute to deep vein thrombosis:
- Injury or damage that occurs to the vein's inner lining. It can happen because of injury during surgery, injection, inflammation, serious injury.
- Slowing of blood flow can caused deep vein thrombosis. Usually occur after surgery or illness that need prolonged bed rest. A long distance travel in some cases may contribute to deep vein thrombosis.
- Some disorder that make blood thicker. Some oral contraceptives drug, estrogen therapy, cancer, smoking can contribute to deep vein thrombosis.
Most of people with deep vein thrombosis are not feeling any symptom at all. Common symptoms in deep vein thrombosis are swelling and pain of the leg : calf, ankle, tight or foot, increase warmth and discolored swelling skin. For the pulmonary embolism, pain with deep breathing, shortness of breath, and coughing up blood.
How to Diagnose
The doctor usually will assess your medical history include surgery, any medication that you have taken, your physical appearance ( especially your leg) and may refer you to do : blood test that called D-Dimmer (negative for unlikely DVT), venogram to show clots below the knee, and doppler ultrasound to show clots above the knee.
Treatment
Your doctor will prescribed you with anticoagulant, known as blood thinner medicines such as heparin and warfarin for the common treatments for DVT. It will easily decrease your blood ability to clot. Another medicine for treating DVT is thrombolytic, rarely use only to treating severe DVT because of it's high risk of causing bleeding.
Other type of deep vein treatment is inserting filter in the large vein between the heart and DVT affected area. It will prevent blood clots's debris in vein before they move in to the lungs.
Compression stockings, known as graduated compression stocking can relieve pain and reduce swelling, and prevent post thrombotic syndrome. The stocking must be use for at least a year after diagnosed with DVT.
Prevention
Visit your doctor fo routine medical check up, consult with your doctor before surgery, immediately ambulation after surgery, exercising your lower leg muscle during long trip (see travel tips to prevent DVT).
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posted by faku @ 9:37 AM,
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