With the pursuit of good blood glucose control at its core, Fast Facts: Diabetes Mellitus is an invaluable resource for primary care physicians, specialist nurses and nurse educators, diabetes and endocrinology trainees, medical students and allied healthcare professionals such as dietitians and podiatrists.
It is also an ideal up-to-date overview of current practice for specialists from other disciplines who regularly see patients with diabetes. Author : R. Fast Facts: Obesity, written by leading experts in the field, provides a comprehensive overview of the causes and implications of obesity, and is packed with practical advice on the assessment and management of the obese patient.
It explains clearly how to achieve the seemingly simple objective of a negative energy balance, through caloric restriction and increased physical activity, and the importance of changing patients' habits and attitudes through behavioral therapy. The book provides the latest information on adjunctive pharmacotherapy and bariatric surgery, the latter being a vital and cost-effective means of improving health and quality of life in some individuals.
The authors also explore issues specific to the management of obesity in children, pregnant women and the elderly. As well as being a disease in its own right, obesity is a key risk factor for serious chronic conditions - type 2 diabetes, cardiovascular disease and many cancers - and also leads to a plethora of non-fatal but debilitating health problems, including musculoskeletal problems e.
This exciting new title in the Fast Facts library is complementary to the recently updated Fast Facts: Diabetes Mellitus as well as Fast Facts titles covering the numerous conditions associated with obesity e. It is an invaluable resource for any healthcare professional who wants to understand and manage this major threat to human health. Author : Carol A. An increase in pancreatic beta cell mass and insulin secretion in the fetus occurs by the 16 th week of gestation, in response to maternal hyperglycemia H Reiher, et.
The priming of the fetal beta cells may account for the persistence of fetal hyperinsulinemia throughout pregnancy and the risk of accelerated fetal growth Carpenter MW, et. This necessitates performing the test procedures to diagnose GDM in the first trimester itself.
Further, early detection and care results in a better fetal outcome V Seshiah, et. By following the usual recommendation for screening between 24 and 28 weeks of gestation, the chance of detecting unrecognized type 2 diabetes before pregnancy pre-GDM is likely to be missed Ben-Haroush, et. Bartha, et. Patient Education 2. Insulin 4. The implication of GDM for her baby and her self. Dietary recommendations. Self monitoring of blood glucose. Self administration of insulin and adjustment of these insulin doses.
Insulin Insulin is the pharmacological therapy that has most consistently been shown to reduce fetal morbidities when added to MNT.
INSULIN It is ideal to use human insulins as they are least immunogenic,though insulin doesnot cross the placenta, insulin antibodies due to animal source insulin can cross the placenta , and stress the fetal beta cell , increase insulin production and induce macrosomia.
Lispro appears to be safe in pregnancy if started after 14 weeks of gestation and it is the first analogue to get category B approval by USFDA Tracy L. A randomized unblinded clinical trial compared the use of insulin and glyburide in women with GDM who were not able to meet glycemic control goals on MNT.
Treatment with either agent resulted in similar perinatal outcomes. All patients were beyond the first trimester of pregnancy at the initiation of therapy Langer O, et. However ,further studies regarding use of glyburide are needed in a larger patient population to establish its safety TracyL. Rowan, et. Metfromin has been found to be useful in women with polycystic ovarian disease PCOD who failed to conceive Misra S, et. Jakubowicz et. Continuing this drug after conception is still a controversy, but there are few studies favouring continuation of metformin throughout pregnancy in these women Daniela J.
Jakubowicz, et. However , more studies are required before routinely recommending oral anti-diabetic agents during pregnancy.
Induction at 38 weeks gestation may be slow due to unfavourable conditions of the cervix but this also has to be balanced against the poorly defined and predictable risk of late intrauterine death , if pregnancy is allowed to continue more than 38 weeks.
Fetal health may deteriorate suddenly , hence obstetric management should not be rigid and each case needs individual care and attention. A neonatologist support at the time of delivery is advisable V Seshiah, et.
A BMI of 25 to A BMI of 30 or higher defines obesity. Prediabetes is a milder form of diabetes that's sometimes called impaired glucose tolerance.
It can be diagnosed with a www. World Journal of Pharmacy and Pharmaceutical Sciences simple blood test. Prediabetes is a major risk factor for developing type 2 diabetes. The CDC estimates that as many as 79 million children and adults in the U. Type 2 diabetes often starts with cells that are resistant to insulin. That means they are unable to take in insulin as it moves glucose from the blood into cells.
With insulin resistance, the pancreas has to work overly hard to produce enough insulin so cells can get the energy they need. This involves a complex process that eventually leads to type 2 diabetes. Hypertension, or high blood pressure, is a major risk factor for diabetes. Low levels of HDL "good" cholesterol and high triglyceride levels also put you at risk. If you developed diabetes while you were pregnant, you've had what is called gestational diabetes.
Having had gestational diabetes puts you at higher risk of developing type 2 diabetes later in life. Being inactive, exercising fewer than three times a week makes you more likely to develop diabetes. Having a family history of diabetes, a parent or sibling who's been diagnosed with this condition, increases your risk of developing type 2 diabetes.
Women with polycystic ovary syndrome PCOS are at higher risk of type 2 diabetes. Some doctors advise anyone over age 45 to be screened for diabetes. That's because increasing age puts you at higher risk of developing type 2 diabetes. It's important to remember, though, that people at any age can develop diabetes. If you're over 45 and overweight or if you have symptoms of diabetes, talk to your doctor about a simple screening test. Blood Sugar and Measuring Levels [15] There are many different chemical compounds that are sugars, but in diabetes, the sugar molecule of interest is glucose.
The terms blood sugar and blood glucose mean the same thing. World Journal of Pharmacy and Pharmaceutical Sciences Another way of measuring blood glucose is to check the glycosylated hemoglobin A1C level, which is measured as a percentage. This measurement, often called just A1C, is a way of telling what the average blood glucose has been for the last one to three months.
Glycosylated hemoglobin is hemoglobin the oxygen-carrying molecule that has gradually become coated with sugar like substances from too much sugar in the blood.
Antidiabetic drugs, along with diet and exercise, help achieve this goal. Complications of diabetes [13, 14, 15] Diabetes is a complex condition which can result in long term complications.
High blood glucose levels over a period of time can damage the small and large blood vessels and nerves. People with uncontrolled diabetes are at risk of stroke, heart disease, blindness, kidney disease, nerve damage, and coma. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain angina , heart attack, stroke, narrowing of arteries atherosclerosis and high blood pressure.
The risk of stroke is two to four times higher for people with diabetes, and the death rate from heart disease is two to four times higher for people with diabetes than for people without the disease, according to the American Heart Association. Excess sugar can injure the walls of the tiny blood vessels capillaries that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue. The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant.
Diabetes can damage the blood vessels of the retina diabetic retinopathy , potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. Severe damage might require toe, foot or even leg amputation. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Gum infections also may be a concern, especially if you have a history of poor dental hygiene. Diabetes may lead to lower than normal bone mineral density, increasing your risk of osteoporosis. Type 2 diabetes may increase the risk of Alzheimer's disease and vascular dementia. The poorer your blood sugar control, the greater the risk appears to be. So what connects the two conditions? One theory is that cardiovascular problems caused by www. World Journal of Pharmacy and Pharmaceutical Sciences diabetes could contribute to dementia by blocking blood flow to the brain or causing strokes.
Other possibilities are that too much insulin in the blood leads to brain-damaging inflammation, or lack of insulin in the brain deprives brain cells of glucose. Diabetes can also lead to hearing impairment. It is a chronic inflammatory condition characterized by destruction of the periodontal tissues and resulting in loss of connective tissue attachment, loss of alveolar bone, and the formation of pathological pockets around the diseased teeth.
Some level of periodontal disease has been found in most populations studied and is responsible for a substantial portion of the tooth loss in adulthood. Antidiabetic drugs [16] Antidiabetic drugs are medications that work to lower blood glucose concentrations, or the amount of sugar in the blood. They are an important way of treating gestational, type 1 and type 2 diabetes mellitus. There are many types of antidiabetic drugs. Herbal remedies and other forms of alternative medicine are also used for diabetes treatment, especially in areas where modern drugs are not easily available.
Authors: United States. Public Health Service. Division of Chronic Diseases. Authors: Dr.
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