Diabetic Encephalopathy
Diabetic encephalopathy is damage to the brain caused by diabetes. A relatively unknown complication, encephalopathy is becoming more widely recognized as more people are diagnosed with type 1 and type 2 diabetes. Diabetic encephalopathy presents itself both mentally and physically. It can induce an altered mental state, cognitive decline, changes in personality, memory lapses, or severe impairment like dementia. The complication can also cause tremors, lack of coordination, and even seizures. Diabetic encephalopathy is largely due to acute hypoglycemia (blood sugar levels are too low) or severe hyperglycemia (blood sugar levels are too high). The condition manifests itself differently between the two major types of diabetes. Type 2 diabetes Encephalopathy in those with type 2 diabetes increases the risk of developing Alzheimer’s disease or other forms of dementia. According to a 2011 study, those with type 2 diabetes were twice as likely to develop Alzheimer’s and 1.75 times more likely to develop other forms of dementia than healthy participants. This increased risk could be due to many different factors brought about from type 2 diabetes. It could be caused by the body’s resistance to insulin, which makes it difficult for the brain to break down amyloid, a protein that forms brain plaques. Brain plaques are abnormal clusters of this protein that block cell-to-cell signaling at the synapses—a symptom infamous for contributing to the development of Alzheimer’s disease. Type 2 diabetic encephalopathy can also be generated from hyperglycemia or the conditions that commonly accompany type 2 diabetes like high blood pressure, obesity, or high cholesterol. Oxidative stress is another provoker of the complication. This stems from an imbalance between reactive oxyge Continue reading >>
Diabetic Neuropathy: Causes And Symptoms
Diabetic peripheral neuropathy—DPN for short—is diabetes-related damage to nerves that sit near the surface of your skin. DPN usually affects the feet and the hands, but can also harm nerves in arms and legs. Approximately 50 percent of people with type 2 diabetes and 20% of those with type 1 diabetes develop this kind of nerve damage.1 DPN can be extremely painful—or cause numbness so that you have little feeling, especially in your feet. DPN damages two different types of nerves close to the surface of your skin. DPN can affect small nerves that protect your body by sending signals about pain and temperature changes to your brain. This condition can also attack large nerves that detect touch, pressure and help you keep your balance. 2 Symptoms are different for each type. Most people with DPN have damage to both types of nerves. DPN usually affects extremities—feet, hands, legs and arms—where nerve fibers are the longest and most numerous. 3 Causes Experts are still investigating exactly how diabetes harms and kills these nerve cells. “The causes remain unknown,” the American Diabetes Association noted in a definitive 2017 review. One thing is certain: The conventional wisdom—that high blood sugar is the cause—is just part of the story. New research is revealing a bigger cast of culprits. These include high cholesterol, high triglycerides (another blood fat), high blood pressure, obesity and smoking, according to a British research report in a widely-cited 2005 study that tracked 1,172 people with diabetes for seven years. 4 The threats are major: Obesity and high triglycerides each doubled risk in people with diabetes in a 2013 University of Utah study of 218 people with type 2 diabetes. 5 Smoking increased risk by as much as 42% in a 2015 Harvard M Continue reading >>
Diabetic Ketoacidosis
Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>
Cranial Neuropathies
Nerves power your entire body, but those nerves can be damaged by injury or an illness such as diabetes. Neuropathy is a disorder that causes nerve damage and affects your ability to feel and move. Exactly how your body and your movement are affected depends on where in the body the damaged nerves are located. When nerves in the brain or brainstem are affected, it is called cranial neuropathy. The cranial nerves are those that arise directly from your brain or brainstem and often affect areas like the face and eyes. Some of the different types of cranial neuropathies include: Bell's palsy. This condition occurs when the facial nerve (seventh cranial nerve) is affected. Microvascular cranial nerve palsy. This condition affects the nerves in the eye. It is most common in people who have diabetes and in those who have high blood pressure. Third nerve palsy. This condition affects the third cranial nerve. This nerve helps manage a muscle that controls eye movement. Fourth nerve palsy. This is also called superior oblique palsy. It affects the superior oblique muscle, which helps you converge your eyes (to look at the tip of your nose). Sixth nerve palsy. This is also called cranial nerve VI or abducens palsy. It affects the sixth cranial nerve, which also helps control eye movement. If several different cranial nerves are affected, it is called multiple cranial neuropathies (MCN). Cranial neuropathy can develop for many different reasons. For example: Bell's palsy is often caused by a virus that causes swelling. This puts pressure on the facial nerve. Microvascular cranial nerve palsy can develop in people who have high blood pressure. Children are sometimes born with third nerve palsy. But it may also be caused by a head injury or an infection. A disorder affecting the br Continue reading >>
How Type 2 Diabetes Affects The Brain
Reductions in both insulin production and an impaired physiological response to insulin release, which lead to elevated blood sugar, are hallmarks of type 2 diabetes. Less well-known are the cognitive effects of the metabolic disorder. “Diabetes does affect a number of cognitive domains, the main being executive functions, memory, learning, and concentration,” said Rodrigo Mansur, a psychiatry clinical and research fellow at the University of Toronto. These effects aren’t always dramatic, explained Yong-Wook Shin, an associate professor of psychiatry at the University of Ulsan College of Medicine in South Korea. When it comes to the brain, he said, type 2 diabetes has “a subtle effect, but it can be detected.” That type 2 diabetes can affect memory, learning, and concentration makes sense, according to computational cognitive neuroscientist Dae-Jin Kim of the Indiana University Bloomington. “Our brain consumes about 25 percent of the blood in our body,” he noted. “So, the glucose in our blood should affect our brain the most.” Two recent studies have approached this diabetes-brain connection from different angles. The first, published last month (June 23) in PLOS ONE, examined brain communication in patients with poorly controlled type 2 diabetes. “In terms of the brain architecture,” said Indiana University’s Kim, an author of the study, “it can be assumed that specific functions are happening in single brain regions. For example, our vision is located in the visual cortex of the brain and our auditory function is located in temporal regions of brain. These functions should be integrated optimally for global brain activity.” This first idea is known as segregation—the way the brain divides itself into separate, specialized areas. Integrati Continue reading >>
How Does Gestational Diabetes Affect My Baby?
If you have gestational diabetes (GDM) during your pregnancy, it puts the fetus at risk for a variety of conditions, including excessive weight (macrosomia or large for gestational age), hypoglycemia (low blood sugar), hyperbilirubinemia (high bilirubin, which can lead to brain damage if not controlled), the need for an operative delivery or primary Caesarean section and shoulder dystocia (when the fetus's shoulder is trapped in the pelvis at the time of delivery -- a very serious complication that can result in lifelong injury). The main concern with gestational diabetes is that the baby may develop a fetal macrosomia, a condition in which it grows more than nine pounds, four ounces before birth, regardless of gestational age. This occurs because the baby is getting large amounts of glucose from the mother, which triggers the baby's pancreas to produce more insulin. The extra glucose, then, is converted to fat. In some cases, the baby becomes too large to be delivered through the birth canal, requiring a cesarean delivery. Gestational diabetes also increases the risk of hypoglycemia, or low blood sugar, in the baby right after delivery. This medical problem typically occurs if the mother's blood sugar levels have been consistently high, leading to high blood levels of insulin in the baby. After birth, the baby continues to have a high insulin level but no longer has the high levels of glucose from the mother. So the newborn's blood sugar levels drop sharply and suddenly. Your baby's blood sugar levels will be checked in the newborn nursery, and if they're too low, the baby may receive oral or intravenous glucose. Babies whose mothers have gestational diabetes or whose mothers had insulin-dependent diabetes before they became pregnant are also at higher risk for respira Continue reading >>
Diabetes Ages Your Brain Five Years Faster Than Normal
People who are diagnosed with diabetes in their 50s are at a significantly heightened risk for mental decline by the time they’re 70 To prevent cognitive decline in your senior years, it’s important to eat a healthy diet and exercise, especially when you hit middle age By Dr. Mercola In the United States, nearly 80 million people, or one in four, have diabetes or pre-diabetes. What’s worse, diabetes among children and teens has also skyrocketed. The most recent data1,2 reveals that incidence of type 2 diabetes among children aged 10-19 rose by 30 percent between 2001 and 2009. The same situation exists in other developed nations. In the UK, more than one-third of adults are now pre-diabetic,3 and British researchers warn that this will lead to a massive avalanche of type 2 diabetics in upcoming years, which will have serious consequences for health care and life expectancy. Diabetes Linked to Faster Decline in Memory One of many debilitating health problems associated with type 2 diabetes is a higher risk for dementia. According to one recent study,4,5,6 diabetes ages your brain about five years faster than normal. People who are diagnosed with diabetes in their 50s are at a significantly heightened risk for mental decline by the time they’re 70. Previous research7 has also shown that type 2 diabetics lose more brain volume with age than expected—particularly gray matter. This kind of brain atrophy is yet another contributing factor for dementia. According to lead author Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health:8 “The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50. There is a substantial cognitive decline associated w Continue reading >>
Effects Of Glucose On The Brain
Though there is a great amount of attention given to the effects of diabetes on the peripheral nervous system, it is important not to overlook the disease’s effects on our brains. While other organs in the body may rely on alternative sources of energy, such as fatty acids, the brain relies almost solely on glucose, using ketones as a last resort. For this reason, the blood brain barrier is rich in Glut1 active glucose transporters, and over 99% of the glucose that passes it is used by neurons and glia. Thus, the metabolic efficiency and continuous demands of the brain render it uniquely susceptible to fluctuations in glucose concentration in the body. As we discuss in this chapter, hyperglycemia and hypoglycemia both can have detrimental effects on cognition as well as mood. These effects are evident in people with Type 1 and Type 2 diabetes. The most common manifestations of cognitive deficit are neural slowing, attention deficit, and executive functioning. Patients with type 2 diabetes in particular do more poorly in measures of learning and memory [1]. It is important to note that in a hospital setting patients without diabetes can become hyperglycemic, and these patients have an increased mortality risk [2]. Stress induced hyperglycemia in patients without diabetes can occur during periods of acute illness and may be due to hormonal cascades, particularly increases in epinephrine, cortisol, growth hormone and glucagon [3]. Patients may have “pre-diabetes”, or may have frank diabetes that is undiagnosed. Among hyperglycemic patients in general medicine wards, one study found that 12% were undiagnosed, and that they had 18.3 times the mortality rate of their normoglycemic peers. These patients also had longer hospital stays, were admitted to the ICU more often, Continue reading >>
Embargoed For Release Until 4 Pm Et, August 01, 2011
EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, AUGUST 1, 2011 ST. PAUL, Minn. – A new study suggests smoking, high blood pressure, diabetes and being overweight in middle age may cause brain shrinkage and lead to cognitive problems up to a decade later. The study is published in the August 2, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. “These factors appeared to cause the brain to lose volume, to develop lesions secondary to presumed vascular injury, and also appeared to affect its ability to plan and make decisions as quickly as 10 years later. A different pattern of association was observed for each of the factors,” said study author Charles DeCarli, MD, with the University of California at Davis in Sacramento and a Fellow of the American Academy of Neurology. “Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it’s too late.” The study involved 1,352 people without dementia from the Framingham Offspring Study with an average age of 54. Participants had body mass and waist circumference measures taken and were given blood pressure, cholesterol and diabetes tests. They also underwent brain MRI scans over the span of a decade, the first starting about seven years after the initial risk factor exam. Participants with stroke and dementia at baseline were excluded, and between the first and last MRI exams, 19 people had a stroke and two developed dementia. The study found that people with high blood pressure developed white matter hyperintensities, or small areas of vascular brain damage, at a faster rate than those with normal blood pressure reading Continue reading >>
Diabetic Encephalopathy
Encephalopathy is defined as brain disease, damage or malfunction. It characteristically results in an altered mental state, sometimes accompanied by such physical manifestations as tremors or lack of coordination of limb movements. Oftentimes there are changes in personality as well. There are many, many causes for encephalopathy, and the cause is usually one of the more than 150 descriptors attached to the diagnosis. For instance, hepatic encephalopathy is damage to the brain caused by liver disease. Lyme encephalopathy is the result of advanced Lyme disease. Diabetic encephalopathy is the result of damage to the brain caused by diabetes. It can cause symptoms that range from mild memory issues to severe impairment, including dementia, seizures and coma. While diabetic encephalopathy may occur in patients with either type 1 diabetes or type 2 diabetes, the nature of the cognitive deficits tends to be different in each. Type 2 Diabetes and Encephalopathy The primary symptom of encephalopathy is diminished brain function. This can take many forms. Type 2 diabetes tends to be associated with an increased risk of Alzheimer's disease or other forms of dementia. A 2011 study of more than 1000 men and women over age 60, published in the journal Neurology, found that people with diabetes were twice as likely to develop Alzheimer's disease over fifteen years as those participants who did not have diabetes. They were also 1.75 times more likely to develop other forms of dementia than non-diabetics in the study. There is no specific answer as to why this is, but a lot of research is going on to determine the exact mechanisms. Some researchers say that insulin resistance may interfere with the body's ability to break down amyloid, a protein that contributes to the formation of br Continue reading >>
Conversations
A growing body of research is finding that diabetes can take as devastating a toll on the brain as it takes on the body. A new study published this week in the journal Neurology shows that people with Type 2 diabetes demonstrate a decline in cognitive skills and ability to perform daily activities over the course of only two years. These changes are linked with an impaired ability to regulate blood flow in the brain, due in part to inflammation, which is a common component of Type 2 diabetes. Normally, the brain distributes blood as needed to areas of increased neural activity. In diabetic individuals, however, this process becomes impaired. “We have shown that people with diabetes have abnormal blood flow regulation in the brain, namely impaired ability to increase blood flow and deliver sugar and oxygen to the brain during episodes of increased mental activity,” the study’s lead author, Dr. Vera Novak of the Harvard Medical School, told The Huffington Post in an email. “Inflammation further alters blood flow regulation in diabetic people and contributes to mental and functional decline.” For the study, the researchers recruited 65 men and women with an average age of 66, half of whom had Type 2 diabetes and half of whom did not. The participants were given a series of memory and cognition tests at the outset of the study and again two years later. They also received brain scans to measure brain volume and blood flow and blood tests to measure inflammation and blood sugar control. Here are some of the key findings: After two years, the people with diabetes showed greater declines in gray matter as well as impairments in their ability to regulate blood flow in the brain than the people without. Blood flow regulation decreased by an average of 65 percent in the Continue reading >>
Failure To Diagnose Gestational Diabetes
Gestational diabetes is unfortunately a common occurrence in pregnancy, affecting thousands of pregnant women in the United States each year. If left undiagnosed and untreated, it can lead to a myriad of medical issues for bother mother and baby. Gestational Diabetes Statistics and Facts According to the American Diabetes Association,gestational diabetes has increased significantly over the past 20 years. The increase has happened for several reasons, including: Increase in maternal obesity Decrease in physical activity Being 25 and older when pregnant Family history of diabetes Excessive amniotic fluid Gestational Diabetes Symptoms In many cases, there are no symptoms at all. Some women may go back to a normal blood sugar within a few weeks after delivery. However, other pregnant women may experience: Frequent infections Fatigue Blurred vision Nausea and/or vomiting Weight loss Increased thirst and urination How Does Gestational Diabetes Affect Infants? If gestational diabetes is untreated or even treated poorly, infants are at risk for several health issues. When gestational diabetes develops, the pancreas must work overtime in order to produce the insulin needed for your body. When this occurs, it not only gives an infant high blood glucose levels, but the infant’s pancreas also creates extra insulin in an attempt to rid the additional blood glucose passed down from the mother. Extra insulin and high blood glucose levels can cause infants to develop fetal macrosomia, also known as “fat baby” syndrome, a condition marked by excessive fetal weight and size. An unusually large infant is at risk for a plethora of birth injuries, including brachial plexus injuries, shoulder dystocia, and more. Additionally, infants are at risk for excessive weight gain later in life Continue reading >>
Diabetes And Seizures: What Are They? What Are The Symptoms?
Having a seizure is a very serious thing. It is dangerous for the person experiencing it, and it is also scary for those nearby. Seizures can be caused for several reasons. Some people have epilepsy, which is a disorder where seizures happen often. For those without epilepsy, they are often called “provoked seizures” because they were provoked, or brought on, by something reversible. Individuals with diabetes can experience these “provoked seizures” when their blood sugar drops too low. The following article explains the difference in these, how to prevent them, and how to care for someone that is having a diabetic seizure. The difference between epilepsy and seizures Epilepsy is a seizure disorder that happens because there is an electrical storm in the brain. People have recurrent seizures that involve loss of consciousness, convulsions, abnormal behavior, disruption of senses, or all of the above. Some have an “aura” before having a seizure and know when it is going to happen. Most causes of epilepsy are unknown, however they can be triggered by flickering light, loud noises, or physical stimulation. Treatment for this condition includes medications and sometimes diet changes. A “provoked seizure” happens because something abnormal is happening in the body. This can include low sodium, fever, alcohol, drugs, trauma, or low blood sugar. The same thing happens as with epilepsy, and there is unusual activity in the brain causing abnormal movements and behaviors. Unlike epilepsy though, where a seizure can happen for no reason, there is an actual cause for each one that occurs for “provoked seizure”. It is important to understand the cause of these so that preventative measures can be taken. There is no relationship between epilepsy and diabetes. One Continue reading >>
Gestational Diabetes
Gestational diabetes is one of the most common health issues that can occur during pregnancy. It occurs when the mother is first diagnosed with diabetes partway through the pregnancy. The key to minimizing the effects of gestational diabetes is diagnosing it early through the use of an oral glucose tolerance test. If gestational diabetes is not diagnosed properly, it can lead to macrosomia in the baby (abnormally large fetal size), which puts the baby at risk for neonatal hypoglycemia, trauma, and other complications. It can also lead to jaundice, premature birth, birth asphyxia, and reduced uteroplacental perfusion (RUPP), which harms both mother and child by reducing blood flow between baby and mother. Gestational Diabetes and Birth Injury During pregnancy, hormonal changes can make an expectant mother’s cells less responsive to insulin. When a person’s body needs more insulin, the pancreas secretes more. However, pregnant women often experience increased insulin demand during pregnancy, and, as a result, their pancreases cannot keep up with the demand. Ultimately, these pregnant women experience heightened blood glucose levels with resultant gestational diabetes. Currently, the American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association recommend screening all pregnant women for gestational diabetes. Additionally, ACOG states that women who develop pregnancy-related diabetes should be re-tested 6 to 12 weeks after delivering their babies. However, according to a new study of one million patient records, only about two-thirds of pregnant women undergo screening tests for gestational diabetes. Among the 5% of women who tested positive for gestational diabetes, just 1 in 5 were screened again within 6 months of giving birth, expl Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
Symptoms Of Diabetic Shock
Diabetic shock is a medical emergency in patients suffering from diabetes mellitus. It occurs when body contains too much insulin decreasing the blood glucose levels (hypoglycemia). It is also called insulin shock, severe hypoglycemia or simply, low blood sugar. The insulin is a hormone produced by the pancreas. The insulin decreases the blood glucose by moving the glucose into the cells. The endogenous insulin secretion is tightly regulated according to the blood glucose levels so that glucose levels neither increase nor decrease disproportionately. In diabetic individuals, this mechanism is disturbed and blood glucose levels rise. To normalize the increased blood glucose levels, insulin and other oral anti-diabetic medicines are given. In diabetic person, the blood glucose may decrease dramatically and diabetic shock may develop if the person: Takes too much insulin or other anti-diabetic medicines by mistake Misses the meal completely after taking insulin Exercises excessively Drinks too much alcohol without eating Symptoms of Diabetic Shock: The glucose is the necessary energy fuel for our brain and nervous system. When blood glucose levels decrease in diabetic shock, energy supply to the brain is decreased causing most of the symptoms that may be divided into mild, moderate or severe depending upon the glucose levels. The mild symptoms are as follows: Excessive sweating The patients with low blood sugar sweat profusely, even in cold temperatures. They may develop the tremors and shakiness within their whole body. Pallor These patients also become pale and cold. These are due to the effects of some blood hormones, catecholamine, that are released in response to low blood sugar. Hunger The low blood glucose levels naturally stimulate the hunger center in the brain ca Continue reading >>
