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Severe Diabetes

Diabetes Symptoms, (type 1 And Type 2)

Diabetes Symptoms, (type 1 And Type 2)

Diabetes type 1 and type 2 definition and facts Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. Insulin produced by the pancreas lowers blood glucose. Absence or insufficient production of insulin, or an inability of the body to properly use insulin causes diabetes. The two types of diabetes are referred to as type 1 and type 2. Former names for these conditions were insulin-dependent and non-insulin-dependent diabetes, or juvenile onset and adult onset diabetes. Symptoms of type 1 and type 2 diabetes include increased urine output, excessive thirst, weight loss, hunger, fatigue, skin problems slow healing wounds, yeast infections, and tingling or numbness in the feet or toes. Some of the risk factors for getting diabetes include being overweight or obese, leading a sedentary lifestyle, a family history of diabetes, hypertension (high blood pressure), and low levels of the "good" cholesterol (HDL) and elevated levels of triglycerides in the blood. If you think you may have prediabetes or diabetes contact a health-care professional. Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels that result from defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food Continue reading >>

Treatment Approach To Patients With Severe Insulin Resistance

Treatment Approach To Patients With Severe Insulin Resistance

In Brief Patients with severe insulin resistance require >2 units/kg of body weight or 200 units/day of insulin. Yet, many patients do not achieve glycemic targets despite using very high doses of insulin. Insulin can cause weight gain, which further contributes to worsening insulin resistance. This article describes the pharmacological options for managing patients with severe insulin resistance, including the use of U-500 insulin and newer agents in combination with insulin. An increasing number of patients have severe insulin resistance and require large doses of insulin. Managing patients with severe insulin resistance is challenging because it is difficult to achieve good glycemic control using conventional treatment approaches (1). Moreover, weight gain, hypoglycemia, regimen complexity, and cost are frequent concerns as insulin doses escalate. Insulin resistance is characterized by an impaired response to either endogenous or exogenous insulin (2). Although insulin resistance is a common feature of type 2 diabetes, cases of severe insulin resistance remain relatively uncommon but are likely increasing as the prevalence of diabetes and obesity surges. The degree of insulin resistance can be measured using the euglyemic insulin clamp technique, but this is not a clinically useful method of determining whether a patient has severe insulin resistance in practice (3). The most widely reported and clinically useful definitions of severe insulin resistance are based on exogenous insulin requirements using either the number of units per kilogram of body weight per day or the total daily dose (1). Patients who require >1 unit/kg/day are considered to have insulin resistance, and those requiring >2 units/kg/day have severe resistance (3). Alternatively, a total daily insul Continue reading >>

12 Signs Of Uncontrolled Diabetes

12 Signs Of Uncontrolled Diabetes

12 Signs of Uncontrolled Diabetes Blood tests tell you and your doctor when your glucose levels are too high. But signs of uncontrolled diabetes can appear all over your body. High blood glucose can damage nerves, blood vessels, and organs, resulting in a wide array of symptoms. Talk with your doctor if you spot any of them, so you can stay in control of your diabetes and improve your quality of life. © 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. You Might Also Like Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Throughout treatment blood sugar and potassium levels should be regularly checked.[1] Antibiotics may be required in those with an underlying infection.[6] In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended.[1][6] Rates of DKA vary around the world.[5] In the United Kingdom, about 4% of people with type 1 diabetes develop DKA each year, while in Malaysia the condition affects about 25% a year.[1][5] DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost univ Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

"Diabetes" redirects here. For other uses, see Diabetes (disambiguation). Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.[7] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2] Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.[8] There are three main types of diabetes mellitus:[2] Type 1 DM results from the pancreas's failure to produce enough insulin.[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".[2] The cause is unknown.[2] Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses a lack of insulin may also develop.[9] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2] Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[2] Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.[2] Control of blood pressure and maintaining proper foot care are important for people with t Continue reading >>

Symptoms

Symptoms

Print Overview Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the signs and symptoms of type 1 and type 2 diabetes are: Increased thirst Frequent urination Extreme hunger Unexplained weight loss Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin) Fatigue Irritability Blurred vision Slow-healing sores Frequent infections, such as gums or skin infections and vaginal infections Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. When to see a doctor If you suspect you or your child may have diabetes. If you notice any poss Continue reading >>

Diabetes Treatments And Risk Of Amputation, Blindness, Severe Kidney Failure, Hyperglycaemia, And Hypoglycaemia: Open Cohort Study In Primary Care

Diabetes Treatments And Risk Of Amputation, Blindness, Severe Kidney Failure, Hyperglycaemia, And Hypoglycaemia: Open Cohort Study In Primary Care

Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia: open cohort study in primary care Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia: open cohort study in primary care BMJ 2016; 352 doi: (Published 30 March 2016) Cite this as: BMJ 2016;352:i1450 Julia Hippisley-Cox, professor of clinical epidemiology and general practice 1 , Carol Coupland, professor of medical statistics in primary care 1 1Division of Primary Care, University Park, Nottingham, NG2 7RD, UK Correspondence to: J Hippisley-Cox Julia.hippisley-cox{at}nottingham.ac.uk ObjectiveTo assess the risks of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia in patients with type 2 diabetes associated with prescribed diabetes drugs, particularly newer agents including gliptins or glitazones (thiazolidinediones). DesignOpen cohort study in primary care. Setting1243 practices contributing data to the QResearch database in England. Participants469 688 patients with type 2 diabetes aged 25-84 years between 1 April 2007 and 31 January 2015. ExposuresHypoglycaemic agents (glitazones, gliptins, metformin, sulphonylureas, insulin, and other) alone and in combination. Main outcome measuresFirst recorded diagnoses of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia recorded on patients primary care, mortality, or hospital records. Cox models estimated hazard ratios for diabetes treatments adjusting for potential confounders. Results21 308 (4.5%) and 32 533 (6.9%) patients received prescriptions for glitazones and gliptins during follow-up, respectively. Compared with non-use, glitazones were associated with a decreased risk of blindness (adjus Continue reading >>

Diabetes Complications - Topic Overview

Diabetes Complications - Topic Overview

Sometimes complications develop even when risk factors such as blood sugar level and blood pressure have been controlled. But following your treatment to control your blood sugar levels is still an important part of your treatment. The most common serious complications from diabetes are coronary artery disease (CAD) and stroke, kidney failure, blindness, and foot disease. All diabetes complications can require specialized medical treatment depending on their severity. Some of these conditions, such as CAD, may be adequately managed by your primary care doctor. If the disease progresses, you may need to see a specialist. Symptoms of diabetes complications can develop when you have prediabetes, diabetes that has not been diagnosed early, and even diabetes that has been treated. Complications of diabetes and symptoms of serious problems Complication of diabetes Consequences Symptoms Small blood vessel (microvascular) diseases Weakening of small blood vessels called capillaries causes blood to leak from the vessel. Eyes: Damage to the retina, the part of the eye that captures images Impaired vision and, in severe cases, blindness Kidneys: Impaired functioning of the kidneys, and, in severe cases, kidney failure Fatigue Muscle cramping Inability to think clearly Swelling from retention of body fluids Nerves: Decreased sensation, especially common in the feet and hands; weakness; abnormal functioning of some organ systems Numbness, tingling, weakness in the feet and hands Swings in heart rate and blood pressure Nausea and vomiting from abnormal functioning of the digestive tract Impotence in men Double vision Large blood vessel (macrovascular) disease Increased plaque in large blood vessels throughout the body can cause heart attacks, strokes, and compromised circulation. Hea Continue reading >>

The Treatment Of Severely Uncontrolled Diabetes Mellitus.

The Treatment Of Severely Uncontrolled Diabetes Mellitus.

Abstract Patients with severely uncontrolled diabetes mellitus must be cared for by physicians and nurses who understand the pathophysiology of ketoacidosis and nonketotic hyperglycemia, who carefully seek and treat precipitating or underlying illnesses, and who can provide the patients with continuous clinical attention and laboratory monitoring. Most patients with diabetic ketoacidosis survive the acute metabolic disorder; the infrequent deaths are usually due to serious underlying illnesses. The latter are more common in patients with nonketotic hyperglycemia, who are usually older than those with ketoacidosis and who usually also have serious underlying chronic diseases. The essential features of treatment for either of the foregoing acute metabolic disorders are administration of insulin (especially gingerly in the older patients with nonketotic hyperglycemia, despite their commonly remarkable hyperglycemia); rehydration with NaCl solutions; and IV administration of K+, usually not until after a few hours of treatment with insulin and NaCl solutions. Administration of NaHCO3 is usually not necessary except in patients with a blood pH less than 7.1. Administration of phosphate has been recommended as part of the treatment for ketoacidosis, but its need is uncertain. Although patients with nonketotic hyperglycemia are often more severely dehydrated and hyperglycemic than those with ketoacidosis, they usually should be given smaller amounts of insulin, NaCl solutions, and K+, and less rapidly. Continue reading >>

Complications

Complications

The two main complications of diabetes insipidus are dehydration and an electrolyte imbalance. Complications are more likely if the condition goes undiagnosed or is poorly controlled. Dehydration If you have diabetes insipidus, your body will find it difficult to retain enough water, even if you drink fluid constantly. This can lead to dehydration (a severe lack of water in the body). If you or someone you know has diabetes insipidus, it's important to look out for the signs and symptoms of dehydration. These may include: dizziness or light-headedness sunken features (particularly the eyes) confusion and irritability Dehydration can be treated by rebalancing the level of water in your body. If you're severely dehydrated, you may need intravenous fluid replacement in hospital. This is where fluids are given directly through a drip into your vein. Read more about treating dehydration. Electrolyte imbalance Diabetes insipidus can also cause an electrolyte imbalance. Electrolytes are minerals in your blood that have a tiny electric charge, such as sodium, calcium, potassium, chlorine, magnesium and bicarbonate. If the body loses too much water, the concentration of these electrolytes can go up simply because the amount of water they're contained in has gone down. This dehydration disrupts other functions of the body, such as the way muscles work. It can also lead to: headache fatigue (feeling tired all the time) irritability muscle pain Next review due: 01/04/2019 Continue reading >>

What's The Difference Between Type 1 And Type 2 Diabetes?

What's The Difference Between Type 1 And Type 2 Diabetes?

First, the formal name for what we commonly call diabetes is diabetes mellitus, which translates from the Greek as making lots of urine with sugar in it or making lots of sweet urine. Type 1 and type 2 diabetes mellitus are diseases that have in common, sugar in the urine and the increased urination. When there are high amounts of sugar in the blood, the kidneys filter sugar into the urine. Sugar can be measured in the urine through a lab test commonly called a urinalysis. Urine dipsticks are also used to show sugar in the urine. Patients who develop diabetes mellitus most commonly have initial symptoms of increased thirst, increased urination and blurred vision due to high amounts of sugar in the fluids of the eye. Type 1 diabetes results from a rheumatoid-like autoimmune reaction in which one's own body attacks and destroys the beta cells of the pancreas. These are the cells that normally produce insulin. Type 1 is a disease in which the patient in a relatively short time has no insulin production. All patients with type 1 diabetes can also develop a serious metabolic disorder called ketoacidosis when their blood sugars are high and there is not enough insulin in their body. Ketoacidosis can be fatal unless treated as an emergency with hydration and insulin. Type 1 was once commonly called juvenile diabetes mellitus because it is most commonly diagnosed in children. It should be noted that even older adults in their 60s have occasionally been diagnosed with type 1 diabetes mellitus. One should think of it as a disease of high blood sugars due to a deficiency of insulin production. It must be treated by administration of insulin. Insulin is given at least twice a day and is often given four times a day in type 1 diabetes. Type 2 diabetes rates are growing dramatically Continue reading >>

6 Emergency Complications Of Type 2 Diabetes

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 >>

Severe Hypoglycemia

Severe Hypoglycemia

Tweet Severe hypoglycemia is defined as having low blood glucose levels that requires assistance from another person to treat. Severe hypoglycemia is classed as a diabetic emergency and is a complication that can occur in people with diabetes that take insulin and certain anti-diabetic tablets. Symptoms of severe hypoglycemia Signs of severe hypoglycemia may include: Confusion and disorientation Convulsions / fitting / seizures Intense nightmares whilst asleep Loss of consciousness Causes and risk factors of severe hypoglycemia Severe hypoglycemia in people with diabetes will usually only occur in people on blood glucose lowering medication such as insulin, sulfonylureas or prandial glucose regulators. Severe hypoglycemia may develop in people taking these medications as a result of: A regular meal being missed or delayed An overdose medication – read about insulin overdoses Exercise being taken without appropriate reduction in medication Alcohol being taken Alcohol, sport and severe hypoglycemia Because exercise and alcohol are both risk factors for severe hypoglycemia it is advisable not to have alcohol following a sustained period of exercise. Alcohol prevents the liver from releasing glycogen, which keeps our blood glucose levels from going too low, and so by blocking the release of glycogen, there is a greater chance of hypoglycemia. Exercise can significantly increase the body’s sensitivity to insulin and therefore the effect of any insulin you inject, or your pancreas produces, will be more powerful. The insulin sensitising effect of exercise can last for up to 48 hours. The safest option is to avoid alcohol after exercise. If you are dancing during a night out that includes drinking alcohol, be aware of the effects of both alcohol and exercise. You may need Continue reading >>

Diabetes Complications Severity Index And Risk Of Mortality, Hospitalization, And Healthcare Utilization

Diabetes Complications Severity Index And Risk Of Mortality, Hospitalization, And Healthcare Utilization

Go to: Abstract To determine whether the number and severity of diabetes complications are associated with increased risk of mortality and hospitalizations. The Diabetes Complications Severity Index (DCSI) was developed from automated clinical baseline data of a primary care diabetes cohort and compared with a simple count of complications to predict mortality and hospitalizations. Cox proportional hazard and Poisson regression models were used to predict mortality and hospitalizations, respectively. Results Of 4229 respondents, 356 deaths occurred during 4 years of follow-up. Those with 1 complication did not have an increased risk of mortality, whereas those with 2 complications (hazard ratio [HR] = 1.90, 95% confidence interval [CI] = 1.27, 2.83), 3 complications (HR = 2.66, 95% CI = 1.77, 4.01), 4 complications (HR = 3.41, 95% CI = 2.18, 5.33), and ≥5 complications (HR = 7.18, 95% CI = 4.39, 11.74) had greater risk of death. Replacing the complications count with the DCSI showed a similar mortality risk. Each level of the continuous DCSI was associated with a 1.34-fold (95% CI = 1.28, 1.41) greater risk of death. Similar results were obtained for the association of the DCSI with risk of hospitalization. Comparison of receiver operating characteristic curves verified that the DCSI was a slightly better predictor of mortality than a count of complications (P < .0001). Compared with the complications count, the DCSI performed slightly better and appears to be a useful tool for prediction of mortality and risk of hospitalization. Continue reading >>

Ten Signs Of Uncontrolled Diabetes

Ten Signs Of Uncontrolled Diabetes

Uncontrolled diabetes can be fatal. It can also lower quality of life. In 2010, diabetes and its complications were responsible for 12 percent of deaths worldwide. Many of these deaths were avoidable. Although diabetes is a chronic condition, it can be managed with lifestyle changes and the right medication. People who do not manage the condition well may develop uncontrolled diabetes, which causes dangerously high blood glucose. This can trigger a cascade of symptoms, ranging from mood changes to organ damage. People with type 1 diabetes, a disease that causes the body to attack insulin-producing cells in the pancreas, are diagnosed, typically, in childhood. However, as many as a third of adults with the most common type 2 diabetes variant of the disorder, do not know they have it. Without taking measures to treat it, these people can develop uncontrolled diabetes. The following 10 symptoms are signs of uncontrolled diabetes. Anyone experiencing them should consult a doctor promptly. Contents of this article: High blood glucose readings High blood glucose readings are the most obvious symptom of uncontrolled diabetes. As diabetes raises blood sugar levels, many people with diabetes think it is normal to have high blood glucose. Normally, however, diabetes medication and lifestyle changes should bring blood glucose within target ranges. If blood glucose is still uncontrolled, or if it is steadily rising, it may be time for an individual to review their management plan. Frequent infections Diabetes can harm the immune system, making people more prone to infections. A person with diabetes who suddenly gets more infections, or who takes longer to heal from an infection they have had before, should see a doctor. Some of the most common infections associated with diabetes in Continue reading >>

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