Monday, November 17, 2008

Diabetes

Diabetes
Diabetes mellitus is a long-term condition where the body is not able to control the amount of glucose in the blood. It develops when there is an insufficient amount of the natural hormone insulin. If untreated, the symptoms include excessive thirst, lots of trips to the toilet to pass urine and weight loss. Poorly controlled blood sugar can also be a major threat to health, including increased risk of heart disease and strokes, nerve damage and blindness.
Glucose and insulin
Glucose, a simple form of sugar, enters the blood from the intestines, where it is absorbed from food and sugary drink as a natural part of digestion. It is also produced by the liver, which acts as a store of energy.
One of the many functions of the blood is to carry glucose around the body. When it reaches the various body tissues, such as the muscle cells, it is converted into energy. The precise concentration of glucose in the blood is automatically regulated. Crucial to this is the hormone insulin, which is secreted into the blood by the pancreas – a gland found behind the stomach.
Insulin is required for the conversion of glucose into energy. With the digestive system and liver working normally, a shortage of insulin causes glucose to build up in the blood, leading to the symptoms of diabetes.
There are two main types of diabetes – Type 1 and Type 2.
Type 1 diabetes is also known as insulin- dependent diabetes mellitus (IDDM). It can develop at any age, although it usually develops in children and young adults and is also referred to as juvenile onset diabetes. The affected person does not produce any of their own insulin and needs to take it by injection every day. Once it has developed, it is a life-long disease.
Type 2 diabetes occurs later in life and is sometimes known as late-onset diabetes or non-insulin-dependent diabetes (NIDDM). Type 1 diabetes is less common than type 2.
Diabetes (type 1)
The cause
Type 1 diabetes is caused by the destruction of insulin-producing cells called the islets of Langerhans within the pancreas. The destruction of these cells is thought to be caused by the body’s own immune system. Consequently, diabetes is known as an autoimmune disorder.
Symptoms
Type 1 diabetes takes only a few weeks to develop. The initial symptoms are:
•increased production of urine (because the body tries to get rid of the excess glucose in the urine, diluting it with water), •excessive thirst, •fatigue (because the glucose is not being converted into energy), •loss of weight, •increased appetite, •feeling sick, •blurred vision, •infections such as thrush or irritation of the genitals. •If type 1 diabetes is not treated at this stage, the body begins to produce chemicals called ketones that build up in the blood. This condition – diabetic ketoacidosis – causes additional symptoms:
vomiting, stomach pain, rapid breathing, increased pulse rate,sleepiness.
Without treatment, diabetic ketoacidosis can lead to coma or death.
Diagnosis
Type 1 diabetes can be detected with a blood test to measure the level of glucose in the blood. It may be necessary to fast for eight hours before the blood sample is taken.
Treatment
Type 1 diabetes cannot be cured, but it can be controlled by insulin injections. Insulin cannot be taken in tablet form because it is destroyed by the acids in the stomach. Insulin injections are usually self-administered into the skin of the abdomen two or four times a day, using either a traditional hypodermic needle or a "pen" type syringe with refillable cartridges. There are different kinds of insulin that work at different rates and act for different lengths of time.
Controlling blood sugar
Carefully controlling blood sugar is the key to maintaining good health. Hypoglycaemia, blood glucose that is too low, and hyperglycaemia, blood sugar that is too high, are the result of poor control.
Hypoglycaemia
An inadequate amount of blood glucose – from either not eating enough or from taking too much insulin – results in hypoglycaemia. This can cause symptoms of faintness, sweating and a pounding heart, and if not treated by eating or drinking something sugary, can lead to collapse and coma. People with diabetes will probably experience a "hypo", or near-hypo, from time to time, and tend to make sure they always have some sugary food or glucose tablets at close hand to control it.
Hyperglycaemia
A high level of glucose in the blood is harmful. Even if the symptoms are not immediately severe (see symptoms, above), uncontrolled high blood sugar can over time lead to a number of complications including irreversible damage to the eyes, kidneys and nerves. Uncontrolled diabetes also increases the risk of cardiovascular diseases such as heart attack and stroke and, because it damages the circulation, it can lead to foot ulcers, gangrene and limb amputation.
Monitoring blood sugar
People with diabetes regularly use a blood sugar monitor. This involves taking a pin-prick of blood and analysing it with either colour-coded strips of paper (which give a blood sugar reading based on the colour they turn) or an electronic monitor. Diet and insulin can be adjusted to keep the level within the normal range.
A healthy lifestyle
In addition to controlling blood sugar, lifestyle is a key part of ensuring diabetes has the minimum impact on health.
A healthy diet is essential. This is the same as the normal, balanced diet recommended for good health – low in fat, sugar and salt; high in fibre, vegetables and fruit. Special diabetic foods are not necessary, but it’s important to eat regularly and keep weight under control.
Physical activity, which promotes a healthy circulation and helps to maintain a healthy weight, is recommended. Many successful sports people have diabetes: well-controlled diabetes need not prevent an active life.
Smoking damages the circulation and, like diabetes, increases the risk of cardiovascular disease. It is extremely important for smokers with diabetes to stop smoking.
Diabetes (type 2)
Diabetes mellitus is a long-term condition where the body is unable to regulate the amount of glucose in the blood properly. It results when the body no longer responds adequately to the natural hormone insulin, or when production of insulin is too low.
Type 2 diabetes usually has no symptoms, but in the long term it can lead to excessive thirst, frequent trips to the toilet to pass urine and weight loss.
Type 2 diabetes can usually be controlled with diet, exercise or medicines, but if poorly controlled, it increases the risk of heart disease and strokes, nerve damage and blindness.
Glucose and insulin
Glucose, a simple form of sugar, enters the blood from the intestines, where it is absorbed from food and sugary drink as a natural part of digestion. It is also produced by the liver, which acts as a store of energy.
One of the many functions of the blood is to carry glucose around the body. When it reaches the various body tissues, such as the muscle cells, it is converted into energy. The precise concentration of glucose in the blood is automatically regulated. Crucial to this is the hormone insulin, which is secreted into the blood by the pancreas - a gland found behind the stomach.
Insulin is required for the conversion of glucose into energy. With the digestive system and liver working normally, a shortage of insulin causes glucose to build up in the blood, leading to the symptoms of diabetes.
Type 2 diabetes
Type 2 diabetes occurs later in life and is sometimes known as late-onset diabetes or non-insulin-dependent diabetes mellitus (NIDDM), because insulin treatment is not always needed.
The cause
Type 2 diabetes develops when the body becomes resistent to insulin. This happens when the body's tissues, such as muscle, do not respond fully to the actions of insulin, so cannot make use of glucose in the blood. The pancreas responds by producing more insulin. In addition the liver, where glucose is stored, releases more glucose to try to increase the amount of glucose available.
Eventually the pancreas becomes less able to produce enough insulin and the tissues become more resistent to insulin. As a result, blood glucose levels slowly start to rise.It can take several years for the blood sugar to reach a level that causes symptoms.
Who is at risk of type 2 diabetes?
Type 2 diabetes usually develops in men or women over 40 years of age. The average age for developing the disease is 52, but this is now falling and some very overweight children are affected.People who are overweight (with a BMI over 25) and not physically active are more at risk of type 2 diabetes. In particular, people who are an "apple-shape" - with lots of fat around the abdomen - are at greater risk of developing diabetes.
Type 2 diabetes runs in families, and is particularly common among people of African-Caribbean or Asian origin.
Having high blood pressure or high cholesterol increases the risk of getting type 2 diabetes.
Symptoms
Up to two-thirds of people with type 2 diabetes have no symptoms. If present, the most common ones are:
•increased production of urine (the body is trying to get rid of the excess glucose in the urine) •unusual thirst •tiredness (because the glucose is "going to waste" and not being converted into energy) •loss of weight •increased appetite •feeling sick •blurred vision •infections such as thrush or irritation of the genitals
Some people simply feel a bit unwell or assume they are just ageing.
High blood glucose
A high level of glucose in the blood is harmful. Even though the symptoms are not immediately severe (see symptoms, above), over time, uncontrolled high blood sugar can damage the smaller blood vessels, leading to complications including irreversible damage to the eyes and kidneys. Nerves can also be damaged, which can affect internal organs as well as the ability to feel sensations and pain. Uncontrolled diabetes increases the risk of cardiovascular diseases such as heart attack and stroke.
Diagnosis
Doctors diagnose type 2 diabetes after listening to a description of any symptoms, doing a physical examination and doing a blood test to measure the level of blood glucose. Most people are asked to fast for eight hours before the blood sample is taken.A glucose tolerance test may be done to assess the body's ability to handle glucose. For this test, the person drinks a specific amount of glucose and the levels are measured in blood samples over a period of several hours.
Type 2 diabetes may be diagnosed during a routine medical check-up.
Treatment
In many cases, type 2 diabetes can be controlled by lifestyle changes alone.Diet
A healthy diet is essential for people with type 2 diabetes. This is the same as the normal, balanced diet that's recommended for good health - low in saturated fat, sugar and salt; high in fibre, vegetables and fruit.
Carbohydrates should be spread throughout the day to prevent high blood sugar levels after a meal. Carbohydrates include starchy food such as pasta, potatoes, bread and cereals and sugary foods including fruit, sweets and biscuits.
Exercise
Regular physical activity helps the body use insulin more efficiently. Half an hour of activity on most days of the week is recommended.
Medicines
If lifestyle changes do not reduce glucose levels, antidiabetic tablets may be prescribed to increase the production of insulin and strengthen its effect. The standard treatments include:
•Drugs called sulphonylureas, which encourage the production of insulin from the pancreas. •A drug that improves the effectiveness of insulin by reducing the amount of glucose released from the liver and improving the way glucose is used by the muscles. This drug is called metformin and is the routine treatment for people who are overweight. It is sometimes combined with other antidiabetic medicines or insulin. •Other drugs are available and can be used in addition to the standard antidiabetic tablets, if these, plus a healthy diet and physical activity, are not controlling blood sugar levels.
Insulin injections
If lifestyle changes and medicines still do not adequately control blood glucose levels, insulin injections may have to be started in addition to, or instead of, oral treatments. Insulin injections may be temporary or for the rest of the person's life.
Insulin injections are usually self-administered two or four times a day, using either a traditional needle or a "pen" type syringe with refillable cartridges. There are different kinds of insulin that work at different rates and for different lengths of time.
Monitoring blood glucose
People with diabetes regularly monitor their blood sugar. This involves taking a pin-prick of blood and getting a blood glucose reading from colour-coded paper strips or an electric monitor.
In addition to controlling blood sugar, lifestyle is a key part of ensuring that diabetes has the minimum impact on health.
It's important to keep weight under control. Healthy diet and physical activity will help with this. Alcohol should only be consumed in moderation and with food.Smoking damages the circulation and, like diabetes, increases the risk of cardiovascular disease. It is extremely important for smokers with diabetes to stop smoking.
நன்றி:bupa middle east

3 comments:

அதிரை ஜமால் said...

Why don't you try to give these articles in a simple way that too in Tamil.

Try brother.

பார்சா குமார‌ன் said...

thnks for visit

sakthi said...

nice post