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Treatment of Diabetes in Type II Diabetes Mellitus
Treatment of Diabetes in Type II Diabetes Mellitus
Treatment of diabetes starts with educating patient about this disease. He is also educated about symptoms related to low and high sugar levels so that he can recognise these. He is encouraged to carry a diabetes card with his medication, and the name of his doctor written on it. He is also encouraged to carry with him sugar candies etc near him to treat hypoglycemia. Home blood glucose monitoring can be taught to nearly all patients.
The various risk factors are noted and the complications if any are studied. The goal of treatment is to reduce the sugar to near normal levels to ward off complications of diabetes and reduce risk to life, vital organs while permitting a good quality of life.
To reduce risk of heart disease and stroke, weight should be reduced to normal levels. If a person is overweight (BMI ie Wt in kgs/ ht in meters squared) and BMI is between 25 to 29.9 wt can be reduced gradually to with in limits. If a person is obese BMI >30 then more urgent weight reduction is required.
A weight reduction of about 10 kgs will make a substantial difference in diabetic control
If overweight or obese calories are cut down. About 15% calories should come from proteins and < 30 % from fats. The rest of calories may be from complex carbohydrates. Simple sugars are not advisable. Sugar substitutes can be taken.
If weight does not reduce after 6 months of trial, weight reduction tablets (Orlistat) etc may be considered. In severe obesity cases bariatric surgery may be the only alternative if all else fails.
About 150 mins of exercise in a week is recommended. Aerobic exercises are preferred though in younger patients who do not have heart disease or advanced diabetic retinopathy weight lifting twice a week is encouraged.
The exercise should be done on most days of the week and be sufficiently vigorous to be of cardiac benefit.
Smoking is a huge risk factor for heart disease. Since diabetes itself is a high-risk state for angina and myocardial infarction continued smoking increased the risk manifold. Smoking should be stopped totally to reduce this risk.
Drugs are required in nearly all cases for sugar control. More about drugs later.
For patients suffering from type II /adult onset diabetes :In type II diabetes, diagnosis is often late (after the disease has already been present for some time). In early days T2DM (short for the adult type of diabetes) are often without symptoms. Hence the delay in diagnosis. This means complications will be seen early after diagnosis. Foot Care :
Foot disease in diabetes may lead to difficulty in walking, pain and may lead to infections. If neglected amputation may be required.
Inspect feet with a mirror before going to sleep every night.
Use well fitting shoewear.
Do not walk bare feet even in the house.
Socks should be clean and correct size.
In case of deformities of feet, special shoes can be worn. Eye Care :
It is nowadays the commonest cause of blindness throughout the world. Continue Reading ~ Second Medical Opinion / Advice
Nephrotic Syndrome Kidneys receive approximately 1 liter of blood every minute. Of this, about 100 ml gets filtered in the kidney. This contains, small molecules and few large molecules. This is due to the intricate cellular structure that prevents proteins from getting filtered into the urinary space. A derangement of this filter results in passage of heavy amounts of proteins in urine. This condition is called HeavyProteinuria or Nephrotic syndrome or Nephrosis. Definition:
In the urine, the protein excretion is > 3.5 gm/day or in children, it is >50mg/kg of body weight. In most cases, the serum albumin is <3gm/dl (normal>4), and passage of lipids in the urine. The lipids in the blood increase and swelling of face and feet also occur. Causes of Nephrotic Syndrome:
In children, most cases are due to Minimal Change Disease, FSGS, MPGN etc. In adults, most cases are due to primary illness while upto 30% may be due to secondary illness. Clinical Features:
Apart from Edema, ther…
Asthma or Bronchial Asthma is a common disease. About 75 % cases start in childhood before 10 years of age. A large no of patients stop having symptoms at the time of puberty and some may again have the disease in the later years. It is uncommon after 50 years of age. It can be troublesome, disabling and if not treated properly may be dangerous.
The disease results from heightened reactivity of the airways in response to irritants, allergens, fumes and at times exercise. It is typically intermittent and a person feels well when there is no ongoing attack of asthma. Symptoms:
Symptoms of asthma are shortness of breath, difficulty in breathing, cough and whistling sounds during breathing. These symptoms may also be seen in a no of heart, lung or infective conditions. Hence the diagnosis is usually made by experienced doctors after a few episodes have occurred!
The important markers of the disease are rapid reversibility of the signs and symptoms with appropriate treatment or spontaneousl…