
Diabetes (mellitus, Type 1 And Type 2)
A A A Are There Home Remedies (Diet, Exercise, and Glucose Monitoring) for Diabetes? Diabetes is a condition characterized by the body's inability to regulate glucose (sugar) levels in blood. In type 1 diabetes, the body does not produce enough insulin. People with type 2 diabetes can produce insulin, but the body is not able to use the insulin effectively. The cause of type 1 diabetes is an autoimmune reaction. Combinations of genetic risk factors and unhealthy lifestyle choices cause type 2 diabetes. The main diagnostic test for diabetes is measurement of the blood glucose level. Changes in lifestyle and diet may be adequate to control some cases of type 2 diabetes. Others with type 2 diabetes require medications. Insulin is essential treatment for type 1 diabetes. No effective approach yet exists to prevent type 1 diabetes. Prevention of type 2 diabetes can be accomplished in some cases by maintaining a healthy weight, exercising, sustaining a healthy lifestyle. Prediabetes is a condition that can occur before development of type 2 diabetes. Complications of any type of diabetes include damage to blood vessels, leading to heart disease or kidney disease. Damage to blood vessels in the eye can result in vision problems including blindness. Nerve damage can occur, leading to diabetic neuropathy. Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (specifically, glucose) in the blood. The blood delivers glucose to provide the body with energy to perform all daily activities. The liver converts the food a person eats into glucose. The glucose is then released into the bloodstream from the liver between meals. In a healthy person, several hormones tightly regulate the blood glucose level, primarily insulin. Insulin is Continue reading >>
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Flu And Diabetes
Tweet People with diabetes are generally at a greater risk if they catch flu (influenza) as it can pose significant difficulties with diabetes management. Flu is a viral infection which is easily caught through inhaling small droplets released when someone with the flu virus nearby coughs or sneezes. A dangerous complication of the flu is pneumonia and people with diabetes are more at risk of developing this complication than people without diabetes. Flu, and other viral infections, can lead to higher blood sugar levels and increase the risk of serious short term complications risk, particularly short term complications such as ketoacidosis and Hyperosmolar Hyperglycaemic State (HHS). Read more on getting vacinated against the flu. What are the symptoms of flu? Symptoms of flu may occur rapidly and include: Severe aching and pain in joints Aching muscles Aching around the eyes Fever Warm, flushed skin Headache Dry cough Sore throat and discharge from the nose Complications of the flu Influenza can lead to chest infections which may develop into pneumonia. Rarer complications include tonsilitis, meningitis and encephalitis. The flu can be a killer and is responsible for around 600 deaths a year. During an epidemic, flu can kill thousands of people in a year. Diabetes and flu medication Some over-the-counter flu medication is suitable for people with diabetes. Some over-the-counter flu medication will be more suitable for people with diabetes than others. For instance, some flu medications contain non-steroidal anti-inflammatory drugs, such as ibuprofen, which are not usually recommended for people with diabetes because they may slightly increase the risk of heart problems and stroke. A number of flu medications may contain a relatively high level of sugar which could pre Continue reading >>

Can A Simple Fever Be That Bad For A Diabetes Patient?
No doubt you’ve heard the advice, “Drink plenty of fluids,” for a fever. This is because fever causes considerable fluid loss through the skin as perspiration. Your loss of fluid can be difficult to estimate, so your physician may want to assume that you’d require 1–2 more quarts of fluid daily than you’d normally need. Ordinarily, a mild fever helps to destroy the infectious agent (virus or bacteria) that caused the fever. The tendency to sleep out fever may also be beneficial. For a diabetic, however, the somnolence that you experience with fever may discourage you from checking your blood sugar, covering with insulin, drinking adequate fluid, and calling your physician every few hours. If you don’t have someone awaken you every 20 minutes, you should use aspirin, acetaminophen (Tylenol), or ibuprofen (Advil or Motrin), in accordance with your doctor’s instructions, to help fight the fever. Beware, however, that aspirin can cause false positive readings on tests for urinary ketones, so don’t even test for ketones if you are using aspirin. Never use aspirin or ibuprofen (or any of the nonsteroidal anti-inflammatory drugs, NSAIDs) for fever in children because of the risk of Reye’s syndrome. Excessive doses of aspirin or NSAIDs (naproxen, ibuprofen, and many others) can cause severe hypoglycemia. If at all possible, try not to use NSAIDs, as the combination of these drugs with dehydration can cause kidney failure. Acetaminophen can be highly toxic if used in doses greater than those indicated on the package label. If you have fever, the guidelines for blood sugar control and replacement of fluid are almost the same as indicated previously for vomiting. There is one difference, however. Since there is very little electrolyte loss in perspiration, it� Continue reading >>

6 Emergency Complications Of Type 2 Diabetes
People with type 2 diabetes are at increased risk of many serious health problems, including heart attack, stroke, vision loss, and amputation. But by keeping your diabetes in check — that means maintaining good blood sugar control — and knowing how to recognize a problem and what to do about it should one occur, you can prevent many of these serious complications of diabetes. Heart Attack Heart disease and stroke are the top causes of death and disability in people with diabetes. Heart attack symptoms may appear suddenly or be subtle, with only mild pain and discomfort. If you experience any of the following heart attack warning signs, call 911 immediately: Chest discomfort that feels like pressure, squeezing, fullness, or pain in the center of your chest, lasting for a short time or going away and returning Pain elsewhere, including the back, jaw, stomach, or neck; or pain in one or both arms Shortness of breath Nausea or lightheadedness Stroke If you suddenly experience any of the following stroke symptoms, call 911 immediately. As with a heart attack, immediate treatment can be the difference between life and death. Stroke warning signs may include: Sudden numbness or weakness in the face, arm, or leg, especially if it occurs on one side of the body Feeling confused Difficulty walking and talking and lacking coordination Developing a severe headache for no apparent reason Nerve Damage People with diabetes are at increased risk of nerve damage, or diabetic neuropathy, due to uncontrolled high blood sugar. Nerve damage associated with type 2 diabetes can cause a loss of feeling in your feet, which makes you more vulnerable to injury and infection. You may get a blister or cut on your foot that you don't feel and, unless you check your feet regularly, an infection Continue reading >>

Diabetes And Infection: How To Spot The Signs
Diabetes can slow down your body's ability to fight infection. The high sugar levels in your blood and tissues allow bacteria to grow and help infections develop more quickly. Common sites for these problems are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment can prevent more serious issues later on. What to Look For Most infections in people with diabetes can be treated. But you have to be able to spot the symptoms. Tell your doctor immediately if you have any of the following: Fever over 101 F Pain, tenderness, redness, or swelling Wound or cut that won't heal Red, warm, or draining sore Sore throat, scratchy throat, or pain when you swallow Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones White patches in your mouth or on your tongue Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy" Painful or frequent peeing or a constant urge to go Bloody, cloudy, or foul-smelling pee *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not performed, may result in hypoglycemia. Please see important risk and safety information. Continue reading >>

Handling Diabetes When You're Sick
Whether your head feels like it's stuffed with cotton because you have a cold or you're spending a lot of time on the toilet because of a stomach bug, being sick is no fun for anyone. For people with diabetes, being sick can also affect blood sugar levels. The good news is that taking a few extra precautions can help you keep your blood sugar levels under control. When you get sick whether it's a minor illness like a sore throat or cold or a bigger problem like dehydration or surgery the body perceives the illness as stress. To relieve the stress, the body fights the illness. This process requires more energy than the body normally uses. On one hand, this is good because it helps supply the extra fuel the body needs. On the other hand, in a person with diabetes, this can lead to high blood sugar levels. Some illnesses cause the opposite problem, though. If you don't feel like eating or have nausea or vomiting, and you're taking the same amount of insulin you normally do, you can develop blood sugar levels that are too low. Blood sugar levels can be very unpredictable when you're sick. Because you can't be sure how the illness will affect your blood sugar levels, it's important to check blood sugar levels often on sick days and adjust your insulin doses as needed. Your diabetes management plan will help you know what to do when you're sick. The plan might tell you: how to monitor your blood glucose levels and ketones when you're sick what changes you might make to your food and drink and diabetes medications In addition, people with diabetes should get the pneumococcal vaccine, which protects against some serious infections. You should also get a flu shot every year. These vaccines may help you keep your diabetes under better control and cut down on the number of sick d Continue reading >>

Hyperglycemia In Diabetes
Print Overview High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication. It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart. Symptoms Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars. Early signs and symptoms Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for: Frequent urination Increased thirst Blurred vision Fatigue Headache Later signs and symptoms If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include: Fruity-smelling breath Nausea and vomiting Shortness of breath Dry mouth Weakness Confusion Coma Abdominal pain When to see a doctor Call 911 or emergency medical assistance if: You're sick and can't keep any food or fluids down, and Your blood glucose levels are persistently above 240 mg/dL (13 mmol/L) and you have ketones in your urine Make an appointment with your Continue reading >>

Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>

Diabetes And Sick Days: What Meds Are Ok
In the midst of cold and flu season, you may wonder what medications are safe to take without greatly impacting blood glucose levels when you have diabetes. Overall, it's the sickness that increases blood glucose in people with diabetes, not the medication used to treat it. However, some medications should be used with caution. Stacey O'Donnell, R.N., B.S., C.D.E., nurse manager, at Joslin Diabetes Center, goes over different types of medications and how they could impact your diabetes. Examples: Tylenol, Aspirin Effect on diabetes: No effect. Use cautiously if you have renal disease. Anti-inflammatory Examples: Ibuprofen, such as Advil, Motrin, Nuprin Effect on diabetes: No effect. Also should be used carefully if you have renal disease. Examples: Allegra, Bumex Effect on diabetes: Caution should be used in patients who have diabetes with renal disease, cardiac disease and high blood pressure. General guidelines for taking medications for people with diabetes are to avoid products containing sugar, such as sucrose, dextrose, fructose, lactose and honey, O'Donnell says. Also, choose products with little or no alcohol. A suggested list of sugar-free cough and cold medicines includes: Chlor-Trometon tablets Dimetapp Elixir Scot-Tussin DM Liquid Cerose-DM Liquid Continue reading >>

Early Symptoms Of Diabetes
What are the symptoms of diabetes? Although the signs of diabetes can begin to show early, sometimes it takes a person a while to recognize the symptoms. This often makes it seem like signs and symptoms of diabetes appear suddenly. That’s why it’s important to pay attention to your body, rather than simply brushing them off. To that end, here are some type 1 and type 2 diabetes symptoms that you may want to watch out for: If you’re experiencing frequent urination your body might be telling you that your kidneys are trying to expel excess sugar in your blood. The resulting dehydration may then cause extreme thirst. Along the same lines, the lack of available fluids may also give you dry mouth and itchy skin. If you experience increased hunger or unexpected weight loss it could be because your body isn’t able to get adequate energy from the food you eat. High blood sugar levels can affect blood flow and cause nerve damage, which makes healing difficult. So having slow-healing cuts/sores is also a potential sign of diabetes. Yeast infections may occur in men and women who have diabetes as a result of yeast feeding on glucose. Other signs of diabetes Pay attention if you find yourself feeling drowsy or lethargic; pain or numbness in your extremities; vision changes; fruity or sweet-smelling breath which is one of the symptoms of high ketones; and experiencing nausea or vomiting—as these are additional signs that something is not right. If there’s any question, see your doctor immediately to ensure that your blood sugar levels are safe and rule out diabetes. So what are the low blood sugar symptoms you should look out for? It’s important to realize that the signs of… Polyuria occurs when your body urinates more frequently—and often in larger amounts—than Continue reading >>

Managing Diabetes With A Cold Or Flu
The cold and flu season is on its way. And while sick days bring everyone down, people with type 2 diabetes have some special considerations when they're under the weather. In addition to choosing the right cold medications and checking in with your doctor about possible dosage changes, good diabetes care means being prepared for the days when you would rather not drag yourself out of bed for a glucose check or a snack. Pick the Right Cold Medicine “A lot of [cold and flu] medications, particularly cough syrup, are high in glucose,” says internist Danny Sam, MD, the program director of the residency program at Kaiser Permanente in Santa Clara, Calif. His practice specializes in adult diabetes. If you have diabetes, your best bet is a medicine that is clearly labeled sugar-free. Almost every major pharmacy has a store brand of sugar-free cold or cough medicine, says Dr. Sam. If you have questions, ask your pharmacist for help. Check Blood Sugar Often “Diabetes is not as well controlled when you are sick,” observes Sam. This is because when your body fights infection, it releases a chemical cascade that can alter your body’s glucose and insulin response. As a result, you may need to check your blood sugar more often than you usually do. People with type 2 diabetes may need to check their blood sugar four times a day, and should check their urine for ketones anytime their blood sugar level is higher than 300 mg/dL. Other medications you may need to take when you are sick can affect your blood sugar levels: Aspirin may lower blood sugar levels Certain antibiotics may decrease blood sugar levels in those taking some oral diabetes medications Decongestants may raise blood sugar levels Adjust Your Plan “You have to monitor your blood sugar more frequently and you m Continue reading >>

Hyperglycemia: When Your Blood Glucose Level Goes Too High
Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes—when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin. You get glucose from the foods you eat. Carbohydrates, such as fruit, milk, potatoes, bread, and rice, are the biggest source of glucose in a typical diet. Your body breaks down carbohydrates into glucose, and then transports the glucose to the cells via the bloodstream. Body Needs Insulin However, in order to use the glucose, your body needs insulin. This is a hormone produced by the pancreas. Insulin helps transport glucose into the cells, particularly the muscle cells. People with type 1 diabetes no longer make insulin to help their bodies use glucose, so they have to take insulin, which is injected under the skin. People with type 2 diabetes may have enough insulin, but their body doesn't use it well; they're insulin resistant. Some people with type 2 diabetes may not produce enough insulin. People with diabetes may become hyperglycemic if they don't keep their blood glucose level under control (by using insulin, medications, and appropriate meal planning). For example, if someone with type 1 diabetes doesn't take enough insulin before eating, the glucose their body makes from that food can build up in their blood and lead to hyperglycemia. Your endocrinologist will tell you what your target blood glucose levels are. Your levels may be different from what is usually considered as normal because of age, pregnancy, and/or other factors. Fasting hyperglycemia is defined as when you don't eat for at least eight hours. Recommended range without diabet Continue reading >>
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Diabetic Hyperglycemic Hyperosmolar Syndrome
What is diabetic hyperglycemic hyperosmolar syndrome? Hyperglycemic hyperosmolar syndrome (HHS) is a potentially life-threatening condition involving extremely high blood sugar, or glucose, levels. Any illness that causes dehydration or reduced insulin activity can lead to HHS. It’s most commonly a result of uncontrolled or undiagnosed diabetes. An illness or infection can trigger HHS. Failure to monitor and control blood glucose levels can also lead to HHS. When your blood sugar gets too high, the kidneys try to compensate by removing some of the excess glucose through urination. If you don’t drink enough fluids to replace the fluid you’re losing, your blood sugar levels spike. Your blood also becomes more concentrated. This can also occur if you drink too many sugary beverages. This condition is called hyperosmolarity. Blood that’s too concentrated begins to draw water out of other organs, including the brain. Some possible symptoms are excessive thirst, increased urination, and fever. Symptoms may develop slowly and increase over a period of days or weeks. Treatment involves reversing or preventing dehydration and getting blood glucose levels under control. Prompt treatment can relieve symptoms within a few hours. Untreated HHS can lead to life-threatening complications, including dehydration, shock, or coma. Go to an emergency room or call 911 if you have symptoms of HHS. This is a medical emergency. HHS can happen to anyone. It’s more common in older people who have type 2 diabetes. Symptoms may begin gradually and worsen over a few days or weeks. A high blood sugar level is a warning sign of HHS. The symptoms include: excessive thirst high urine output dry mouth weakness sleepiness a fever warm skin that doesn’t perspire nausea vomiting weight loss leg Continue reading >>
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Fever With Abdominal Pain And Diabetes - Is It Emphysematous Pyelonephritis?
Go to: Case Report A 35-year-old female was hospitalised for high fever with chills and rigors and abdominal pain suggestive of urinary infection for the last one week. The pain was in the right upper abdomen and right upper back. Pain was aggravated by deep breathing and relieved on lying on the left lateral position. Patient was under treatment for type II diabetes and was taking met for min 500 mg twice a day (BD) supplemented by insulin 46 IU subcutaneously every day; though not regularly. Patient was treated for cystitis one month ago and had tubectomy 10 years ago. On examination the following was recorded: pulse 100/min, blood pressure (BP) 110/70 mm of Hg, temperature 102°F, respiration 24/min and patient appeared in distress. There was marked tenderness in right lumbar and hypochondriac area. Rest of the examination was normal. Investigations revealed haemoglobin of 9.8 g/dL, total white cell count 7.6 × 109/L; platelet count 50 × 109/L; red blood cells (RBC) were microcytic hypochromic, erythrocyte, sedimentation rate was 28 mm in 1 h, RBC indices were Mean Corpuscular Volume MCV 77.9 fL, Mean Corpuscular Haemoglobin (MCH) of 24.2 pgl, Mean Corpuscular Haemoglobin Concentration (MCHC of 31.0 g/dL, urine analysis revealed ketones of 15 mg/dL, albumin 3+, glucose 3+ and 2 to 3 pus cells/HP. Blood urea was 83 mg/dL and creatinine was 2.0 mg/dL. The HbA1C was 9%; random blood glucose was 456 mg/dL. Arterial blood gas analysis showed mild metabolic acidosis. Total serum bilirubin was 0.6 mg/dL (direct 0.3 mg/dL) .Hepatic transaminases were normal. Serum proteins were 6.3 g/dL with an albumin of 2.9 g/dl. Serum sodium, potassium, calcium, phosphorous, uric acid estimations were normal. Human immunodeficiency virus (HIV) and Hepaitis B surface antigen (HBsAg) test Continue reading >>
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Diabetes, Fever And Flank Pain: Is It Emphysematous Pyelonephritis?
Go to: Case Report A sixty-four–year-old male, obese, diabetic, and hypertensive for five years presented with pain in the abdomen localized to the right flank, vomiting, and burning micturition with increased frequency of a seven-day duration. On examination, he was febrile and blood pressure was 160/100. Abdominal examination revealed tenderness over the right renal angle. Examination of the central nervous system revealed the presence of sensory motor neuropathy. Rest of the systemic examination was normal. On investigation, hemoglobin was 12 g% and peripheral smear revealed neutrophilic leukocytosis. Random blood glucose was 255 mg% and glycated hemoglobin (HbA1c) was 7.8%. Serum urea was 77 mg% and creatinine was 1.7 mg%. Liver functions, serum electrolytes, and arterial blood gases were normal. Urine examination showed numerous pus cells, 1+ albumin, and positive ketones. Plain X-ray of the abdomen revealed gas distributed over the right kidney [Figure 1]. Ultrasound of the abdomen was suggestive of EPN of the right kidney [Figure 2]. Noncontrast CT of the abdomen was characteristic of EPN of right kidney which showed renal and perirenal fluid collections with gas in the collecting system, intraparenchymal gas, and extension of gas into the perinephric space [Figure 3]. The left kidney was normal. The patient was managed by a combined medical treatment and PCD. Urine culture showed a growth of Escherichia coli. The patient improved and was followed up with serial ultrasound. Contrast enhanced CT scan at discharge revealed complete disappearance of the gas. Continue reading >>
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