Type 2 diabetes

Completet Solution of TYPE 2 DIABETES


This disease is mostly in adults
There are some reasons for having type 2 diabetes.

As if any member of your family has diabetes, then 80% of the chances are that you may also get this disease.

Apart from this, there is more Chance Type 2 diabetes if you are overweight or your routine is not okay or you are not eating properly or you consume too much of the outside things. 

Even then there is a lot of chances you have diabetes. Now it comes to how to prevent it and what is the right treatment for this disease?



Symptoms Of Type 2 Diabetes

  • Urination & ThirstIt is very easy to recognize that you are thirsty again and again and Having urination, again and again, you can imagine that you have type 2 diabetes.


  • Appetite - In type 2 diabetes you feel hungry more than normal.


  • Weight Loss - The weight starts to decline very fast in this disease.


  • Slow-Healing Sores - In type 2 diabetes, the wounds do not recover quickly and the infection gets accelerated and if it is not treated at the right time, then the patient starts to suffer a lot.

  • Blurred eyes - If type 2 diabetes is not treated at the right time and the amount of sugar in the patient's body increases significantly then the patient starts to appear blurred and after a long delay in treatment the eyesight also goes away.

Treatment & Diagnostics

Completet Solution of TYPE 2 DIABETES


Type 2 Diabetes 
  • Glycated hemoglobin (A1C) test - Glycated hemoglobin (A1C) test is used to measure the level of sugar in our blood. 
  • Through this investigation, we can find out the level of sugar in our blood during the last 3 to 4 months.
  • Which makes it easy to guess whether we have diabetes or not. The normal range of Glycated Hemoglobin (A1C) test should be below 5.7%.
  • And if you do not have the glycated hemoglobin (A1C) test method then you can get your doctor checked. Which is as follows.
  • Fasting Blood Sugar Test To check the Fasting Blood Sugar Test, work should be done after 8 hours of food at night, means that empty stomach in the morning, which has a minimum range of 70 to 125mg/dl, if it exceeds the blood test level 125, mg/dl, then you have type 2 diabetes.
  • Random Blood Sugar Test - In order to perform this test, the patient should check it at least 2 hours after eating it. By which food will dissolve completely in our body. Its normal range is 125 to 170 mg/dl. If the patient has a blood test more than 170 mg/dl then he has type 2 diabetes.
  • Oral glucose tolerance test- Oral glucose tolerance test. In order to do this test, the patient is first given the sugar and the test is done after 2 hours of sugar intake.
  • After testing, if the blood glucose level is more than the normal range, it means that the patient has type 2 diabetes. These tests are done when the blood test comes after normal 2 hours after eating empty stomach and food.

Treatment

management of Type 2 diabetes

Completet Solution of TYPE 2 DIABETES


Blood sugar monitoring regularly

  • The patient should check his blood glucose from time to time. As if the patient has a high blood glucose, then every week should be examined.
  • But if the patient's blood glucose is normal, then check blood glucose once in less than 15 days is very necessary.
Regular daily exercise

  • Exercising daily for sugar patients is very important.
  • The patient of type 2 diabetes should exercise 1 hour day at work.
  • Thereby, their glucose level remains fine and the health is also good.


Healthy Diet

Completet Solution of TYPE 2 DIABETES



  • Patients with Type 2 diabetes should pay a lot of attention to their food items. Because this disease is completely dependent on diet.
  • In this, green vegetables need a lot of story in green vegetables.
  • The doctor said that the fruit should be eaten. Not all fruits should eat.
Regular drug intake

  • Patients of type 2 diabetes should take regular medicines regularly, as suggested by the doctor.

Complication

  • Hypoglycemia
  • Ocular (Diabetic cataracts retinopathy)
  • Diabetic nephropathy
  • Skin & Mucous membranes
When to Admit

  • Altered mental status
  • Diabetic ketoacidosis
  • Marked volume disorders
  • Marked electrolyte disorder
  • Unstable comorbid condition
So this was the complete analysis of type 2 diabetes.
I hope that you will get a lot of work from the people. If you have enjoyed this article and have proved to be helpful, then please share this post as much as possible so that every person can get the benefit of it, who is suffering from type 2 diabetes.

Completet Solution of TYPE 2 DIABETES


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Type 1 Diabetes 

What is Type 1 Diabetes ?


The pancreas present in our body produces a hormone called insulin that controls our body's sugar level.

When our body becomes insulin or it is finished, then our body cannot digest sugar.

Which increases the sugar level of our body. This action is called diabetes.

And diabetes that happens to young people like below 30 years old people are called type 1 diabetes.


Symptoms Of Type 1 Diabetes

There are many types of Type 1 diabetes that I have written below.....
  • Unwanted weight loss
  • Nausea or vomiting
  • Stomach pain
  • Unexplained bedwetting
  • Fruity smelling breath
  • Unquenchable thirst
  • Rapid, heavy breathing
  • Less energy
  • Frequent urination
  • Loss of consciousness
  • Blurry vision
  • A headache
  • Feeling Dizzy
  • Itching, Skin Infection
  • Feeling Hungry

When to call a doctor?


When you know that you have diabetes, you should contact your doctor immediately without any delay.



And just as your doctor advises you go according to what they say.

Causes


It is very difficult to know the exact cause of type 1 diabetes, but usually the digestive system of our body.

Which battles many types of pests and prevents our body from making insulin. By this, we find out what type 1 diabetes is.

I have also mentioned some other reasons by which we have diabetes.

  • Exposure to viruses and other environmental factors
  • Genetics.

What is the role of Insulin in type 1 Diabetes?

What is Type 1 Diabetes ?


About insulin, I have told you the rows above how insulin is formed.

When the amount of insulin is done in our body or it ends, then our body is not able to control the sugar in that situation.

Insulin is a type of hormone that is formed through the pancreas.
Insulin goes into our body and leads the sugar to our cells, which in turn leads to the amount of sugar in our bloodstream.

And when the level of sugar in our blood falls, then the pancreas produces insulin.

What is the role of Glucose in type 1 Diabetes?

As you all know that sugar is the main source of energy in our body, and tissues are formed in our body only through sugar and sugar.

Glucose comes from the main sources in our body

1. By our liver and
2. Food

Sugar is absorbed in the bloodstream and enters our cells through insulin. 

And our liver collects glycogen to glucose.
When our body's glucose levels begin to decline, then when we do not take it for a long time.

The liver breaks the stored glycogen in glucose to keep our glucose levels in the normal range.


In type 1 diabetes, there is no insulin to give glucose to our cells, so sugar is formed in our bloodstream. This can cause dangerous complications in our lives.

Diet of Type 1 Diabetes Patients 

What is Type 1 Diabetes ?


What to do.
  • Patients of type 1 diabetes should consume plenty of green vegetables.
  • Fish and chicken should be eaten but meat should not be eaten.
  • Do not eat any kind of sweet things.
  • Do not take the yellow part (YOLK) of the egg at all
  • Can eat white part of the egg
  • Eat medicines from time to time
  • Low-Calorie meal
  • Take 30 to 45 minutes walk per day.
  • Regular exercises.
  • Stay in touch with your doctor.
Do not do
  • Do not eat sweet things
  • Do not add to any kind of addiction
  • Do not eat meat
  • Do not eat smooth things
  • Avoid Junk Food
Also Read

Normal Range of diabetes

What is Type 1 Diabetes ?


In 2 ways we test our blood glucose, 1 by the veins and one by the fingers.

The test in which veins are considered accurate and which is tested by fingers is also almost perfect, only a slight difference occurs.

Fasting Blood test Range (FBS) 70 - 125 mg/dl
Postprandial blood test range (PPBS) 120-170 mg/dl

Type 1 Diabetes Risk Factors?

What is Type 1 Diabetes ?


Family History-If someone in your family has diabetes then it is possible that you may have diabetes.

Age- Type 1 diabetes can be seen in people of any age. But usually, it is more in young people.

Like it appears to be in children of 3-4 years or children in 10-15 years of age.

Genetics-Due to the presence of genes present in our body, there is the possibility of type 1 diabetes.

Geographic-When we travel longer than our scheduled condition, the risk of type 1 diabetes.

Complications

  • Diabetic Ketoacidosis.
  • Hypoglycemia and altered awareness of hypoglycemia.
  • Diabetic Retinopathy, Cataract.
  • Nephropathy
  • Neuropathy.
  • Coronary Artery Disease, Peripheral Vascular Disease.
  • Lipodystrophy at injection Sites.

Treatments

What is Type 1 Diabetes ?


  • Use Of Insulin -
Preprandial rapid-acting insulin plus basal insulin replacement with intermediate or long-acting insulin.

  • Rapid Acting Insulin-
Insulin Lispro,Insulin aspart,Insulin glulisin.

  • Short Acting Insulins-
Regular,Regular Humulin,Regular IIetin II.

  • Intermediate Acting Insulin-
Lente Humulin,Lente IIetin II ,Lente Novolin,Neutral Pratamine Hagedorn (NPH) Humulin,NPH IIetin II,NPH Novolin.

  • Premixed Insulin-
Novolin 70/30,Humulin 70/30 ,Novolog Mix 70/30.

  • Long Acting Insulins-
Ultra Lente Humulin,Insulin glargine.

When to Admit ?

  • Altered Mental Status.
  • Diabetic Ketoacidosis.
  • Marked Volume Disorder.
  • Marked Electrolyte Disorder.
  • Unstable Comorbid Condition.

When To Refer ?

  • Team Educational Approaches critical.Enlist Nutritionist.
  • Poorly Controlled Diabetes.
Now you must have understood what type 1 diabetes is and what is the solution.

I hope these posts will helpful for to you.

Thank you very much for reading this post.









Key Feature


Abdominal Aortic Aneurysm


Essentials Of Diagnosis

  • Defined as an aortic diameter > 3 cm.
  • Most are asymptomatic,detected during a routine physical examination or imaging performed for anoother reason 
  • Sever back and abdominal pain and hypotension indicate rupture
  • Concomitant atherosclerotic occlusive disease of lower extremities in 25 %
General Considerations

  • More then 90% of abdominal aneurysms originate below the renal arteries many extend into the common iliac arteries.
  • Half are <5 Cm in diameter.
  • On routine ultrasound surveillance,two third will increase in size to require repair.
  • Yearly rupture risk is 2% for 4 to 5.4 cm aneurysms ,7% for 6 to 6.9 cm aneurysms,25% for 7 cm aneurysms
  • Patients with chronic obstructive pulmonary disease are more likely to experience rupture are small aneurysms.
  • More then one third of patients with popliteal aneurysms have abdominal aortic aneurysms. 
Demographic
  • Aortic aneurysms is present in 5-8% of the population older than 65.
  • Incidence has tripled over the last 30 years. 
Clinical Finding

Symptoms & Signs
  • Asymptomatic aneurysms prominent aortic pulsation on routine physical examination and incidental finding on abdominal ultrasonogram or CT scan,coexisting renal or lower extremity arterial occlusive disease present in 25% ,popliteal artery aneurysms in 15%.
  • Symptomatic aneurysms : midabdominal or lower back pain (or both).
  • Inflammatory aortic aneurysms : Low grade fever,elevated sedimentation rate and recent upper respiratory tract infection.
  • Infected aneurysms (rare) : Fever of unknown origin.peripheral emboli,positive blood cultures,caused by septic emboli to a normal aorta or bacterial colonization of an exisiting aneurysms.
  • Ruptured aneurysms : Severe back,abdominal or flank pain and hypotension ; 90% patients die before reaching the hospital are in the perioperative period.
Differential Diagnosis 
  • Asymptomatic abdominal aortic aneurysms: intraabdominal tumor,iliac aneurysms,Or mesenteric artery aneurysms.
  • Symptomatic/Ruture abdominal aortic aneurysms: acute myocardial infarction,Aortic dissection,Renal stones,Gastrointeritis,Bowel obstruction,and bowel infarction.
Diagnosis
Laboratory Tests
preoperative evaluation : Electrocardiogram,Serum Creatinine,Hematocrit and Hemoglobin and type and acrsross match.

Imaging Studies


  • Abdominal Ultrasonography : Indicated for screening and for monitoring aneurysm growth (annually for aneurysms > 3.5 cm in diameter)
  • Abdominal Radiograph : Curvilinear calcification are much less accurate
  • Contrast - enhanced CT scanning : precisely sizes the aneurysm,define it`s relationship to the renal arteries.
  • MRI : as sensitive and specific as CT and useful is renal insufficiency precludes contrast-enhanced CT.
  • Aortography/CT angiogram : indicated before elective aneurysmrepair when arterial occlusive disease of the visceral or lower extremity arteries is suspected or when endograft repair is being considerd .
  • Preoperative Evaluation : Assessment of cardiac risk and ultrasound examination of the carotid arteries.

Medication

  • Beta-Blocker and oral Roxithromycin ,300 mg daily for 30 days,Decrease the expansion rate of small  aneurysm.

Surgery

  • In asymptomatic good risk patients,surgery advised when  aneurysm diameter > 5 cm.
  • In poor risk patients,surgery advised when  aneurysm diameter > 6 cm.
  • Urgent repair advised for symptomatic  aneurysms irrespective diameter.
  • Ruptured  aneurysms require emergent surgery.
  • Open repair : Surgical reaction and synthetic graft replacement for most thoracic,abdominal,juxtarenal,and infrarenal aortic  aneurysms with diameter > 5 cm.
  • Endovascular Repair : Uniiliac or bifurcated endovascular stent grafts,deployed via the common femoral arteries,can be considered for infrarenal  aneurysms with favorable anatomy.
  • Endovascular repair can be done by a percutaneous route or by bilateral inguinal incisions under epidural anesthesia,and thus has made repair of aortic  aneurysms feasible in elderly high risk patients.
  • Long-Term durability of endovascular grafts needs to be established.

Therapeutic procedure 

  • Physical examination.
  • Ultrasonogram of abdominal aorta every 6 month.

Follow Up

  • Open repair : Yearly physical examination.
  • Endovascular repair : Routine surveillance,CT abdomen,and physical examination.

Complication

  • Open repair : Acute myocardial infraction,Arrhythmia,Bleeding,Respiratory failure,Limb ischemia,Renal failure,stroke,Ischemic colitis,Bowel infraction,Liver dysfunction,acalculous cholecystitis,Grafts infaction,Graft enteric fistula.
  • Endovascular Repair : Persistent filling of the  aneurysm(Endoleak),Graft Migration,Graft Thrombosis,Graft Infaction (Rare),Renal failure,conversion to open repair.

Prognosis

  • Mortality following elective open or endovascular repair is 1-5 %
  • A patient with >5 cm aortic aneurysmand life expectancy of > 1 year has a 3 fold greater chance of dying of rupture than of dying from surgical reaction .
  • 5 year survival after surgical repair is 60-80 %.
  • 5-10 will develop another aortic aneurysm adjacent to the graft or in the thoracic aorta.

When to Refer

  • Any patient with an aneurysm_> 4.0 cm .
  • Any patient with a symptomatic or suspected ruptured abdominal aortic aneurysm.

When to Admit

  • All patients with symptomatic or suspected ruptured abdominal aortic aneurysms or suspected infected aneurysms.

Prevention

  • Blood pressure Control.
  • Cardiovascular risk assessment and treatment.
  • Smoking cessation .
  • Screening of family members older than 65.

Evidence

Practice Guidelines

  • Brewster DC et al : Guideline for the treatment of abdominal aortic aneurysms.Report of a subcommittee of the joint Council of the American association for the vascular surgery and Society for Vascular surgery.



Hypertension Chronic

Essentials Of Diagnosis

  • Usually asymptomatic
  • Severe Hypertension : Occipital headache at awakening,blurry vision
General Consideration
  • Mild to moderate hypertension nearly always asymptomatic.
  • Severe hypertension usually due to parenchymal renal disease,endocrine abnormalities.renal artery stenosis,drug use,or abrupt cessation anti hypertensive medications.
  • Table 42 provides classification based on blood pressure (BP) measurements.
  • Table 43 summarizes potential identificable causes of hypertension.
  • Resistant hypertension is defined as failure to reach BP control in patients.
  • Adherent to full doses of a 3 drug regimen (including a diuretic).
  • Table 44 summarizes reason for failure to reach BP control. 
Demographics
  • 70 % of aware of their condition.
  • 50 % of those aware are receiving treatment.
  • 25 % of all hypertensive patients have BP under control.
  • Incidence of hypertension increases with age.
  • More men than women in early life.
  • More Women than men later life.
Symptoms & Signs
  • Usually asymptomatic.
  • Occipital headaches characteristic but uncommon.
  • Elevated BP
  • Loud A2 on cardiac examination.
  • Retinal arteriolar narrowingwith "Silver wiring" arteriovenous nicking.
  • Plame-Shaped Hemorrhages.
  • Laboratory findings usually normal.
  • In severe hypertension,renal dysfunction and hemolysis. 
Hypertension Chronic

Differential Diagnosis
Primary (Essential)Hypertension
  • White Coat Hypertension.
  • BP cuff too small.
Secondary Hypertension

  • Adrenal

-Primary hyperaldosteronism.
-Cushing`s Syndrome.
-Pheochromocytoma.

  • Renal
-Chronic renal disease

-Renal artery stenosis(Atherosclerotic or fibromuscular dysplasia)

  • Other
-Oral Contraceptives
-Alcohol
-Non-Steroidal Anti-Inflammatory drugs.
-Pregnancy associated.
-Hypercalcemia
-Hyperthyroidism
-Obstructive Sleep apnea
-Obesity
-Coarctation of the aorta.
-Acromegaly
-Increased Intracranial Pressure.

Diagnosis 
Laboratory Test.
  • Heamoglobin
  • Urinalysis
  • Serum Creatinine,Blood Urea Nitrogen.
  • Serum Pottasium.
  • Fasting Blood glucose
  • Serum Uric acid 
  • ECG.
  • When a secondary cause is suspected,consider.
-Chest X-Ray.
-ECG
-Plasma metanephrine levels.
-Plasma aldosterone Concentration,Plasma renin activity
- Urine electrolytes.

Treatment
Medication
  • Initiation of drug therapy based on level of BP,Presence of target end-organ damage,and overall cardiovascular risk profile.
  • Mejor risk Factors include.
-Smoking
-Dyslipidemia
-Diabetes mellitus
-Age > 60 years.
-Family history of cardiovascular disease.
  • Specific choice of pharmacotherapeutic agent should be based on other risk factors,Compliance and cost.
  • Diuretics.
  • β-Adrenergic blocking agents.
  • Angiotensin-converting enzyme(ACE)inhinitors and angiotensin receptor blockers.
  • Calcium channel-blocking agents.
  • α-Adrenergic blockers,vasodilators,centrallyacting agents.
Hypertension Chronic



Therapeutic Procedure
  • Dietary changes(DASH diet):high in fruits and vegetables,low fat,low salt.
  • Weight reduction
  • Alcohol restriction 
  • Salt reduction
  • Adequate potassium intake.
  • Increase physical activity
  • Smoking cessation
  • Aggressive risk factor management should be consideredin all patient with hypertension
  • Anti Hypertensive medications should be indivisualized.
  • Diabetes and hypertension should be treated aggressively,aiming for target BP < 140/80 mm Hg,given hish risk of cardiovascular events and ACE inhibitors or angiotensin receptor blockers should be part of regiemen.
Follow Up
  • frequent visits until BP is controlled 
  • Once Controlled,Visits can be infrequent,Limited laboratory tests.
  • Lipid monitoring every year
  • ECG every 1-2 year,depending on initial ECG
Complication
  • Stoke 
  • Dementia
  • Myocardial Infarction
  • Congestive heart failure
  • Retinal Vasculopathy
  • Aortic dissection
  • Renal Disease.Including Proteinuria and nephrosclerosis
When to Refer
  • Refer if BP remains uncontrolled after three concurrent medications.
  • Refer if patient has uncontrolled BP and symptoms and signs of end organ damage 
When to Admit
Consider Hospitalization if symptoms and signs of of a hypertensive emergency(see Urgencies & emergencies)including,in the setting of very high BP ,Severe Headache ,Neurologic symptoms,Chest pain altered mental status,or acutely worsening renal failure.

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