DIABETIC NEUROPHATY INFORMATIONS CENTER COMUNICATIONS FORUM
editor and consultan
Dr Iwan suwandy,MHA
EDITOR NOTES
THIS SPOCIAL FOR GERIATRY DIABETIC NEUROPHATY DIABETIC TYPE 2 ONLY,NOT FOR YOUNG OR OTHER TYPE DIABETIC TYPE ONE . THIS FORUM DISCUSS ABOUT HOW THE SENIOR AFTER 65 YEAR WITH DIABETIC NEUROPATHY WILL STILL LFIFE HEALTHY AND HAPINESS WITH THE CONTROL OF THE BLOOD SUGAR WITH DIET CONRTROL,EXERCISE ETC
PLEASE ALL THE SENIOR PEOPLE AND THE RESEARCES JOIN THIS FORUM,THSI INFO AND COMMUNICATION FREE.
THANKS FOR YOUR ATTANTIONS
DIABETIC NEUROPATHY STILL CAN LIVE HEALTY UNTIL UPPER THAT 80 YESR OLD.
Diabetic Info
NATIONAL DIABETES EDUCATION educator INDONESIA
Jakarta, 21 April 2012
Minister of Health, represented by Director General of Disease Control and Environmental Health (PP and PL), Prof. dr. Tjandra Yoga Aditama, Sp.P (K), MARS, DTM & H, DTCE
officially opened the National Training Diabetes Educator Indonesia’s 10th organized by the Association of Diabetes Educators Indonesia (Pedi) in Jakarta (4/20/12).
Ministry of Health welcomes this training, because of 4 things, the first of Diabetes Mellitus (DM) is an important health problem in Indonesia, because DM is a leading cause of death to 6, the urban prevalence of DM 5.7%, and prevalence of Impaired Glucose Tolerance 10.2% .
The second reason for DM control should be the continum care, where education is one important factor.
Then those who were already trained will immediately be able to handle the DM patients and their families so they can stay healthy, fit and independent.
While the latter is a real form of training is active participation with the government’s public health to tackle health problems in Indonesia, in this Diabetes Mellitus.
The training lasted for 3 days and followed more than 200 participants, consisting of doctors, nurses, diietesien, and other officers. Training has been running 10 years and have three levels, namely basic, advanced and sustainable.
Training methods in the form: theory, workshops, and simulations.
This information is published by the Center for Public Communication, Secretariat General of the Ministry of Health.
PATHOGENESIS OF DIABET
welcome
Dear Dr iwan suwandy,MHA
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Type 2 diabetes
Definition
Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.
Alternative Names
Noninsulin-dependent diabetes; Diabetes – type 2;
Adult-onset diabetes
Causes, incidence, and risk factors
Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.
When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin.
This is called insulin resistance.
As a result, blood sugar does not get into these cells to be stored for energy.
When sugar cannot enter cells, high levels of sugar build up in the blood. This is called hyperglycemia.
Type 2 diabetes usually occurs slowly over time. Most people with the disease are overweight when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.
Type 2 diabetes can also develop in people who are thin. This is more common in the elderly.
Family history and genes play a large role in type 2 diabetes.
Low activity level, poor diet, and excess body weight around the waist increase your risk.
See also: Type 2 diabetes for a list of risk factors.
Symptoms
Often, people with type 2 diabetes have no symptoms at first. They may not have symptoms for many years.
The early symptoms of diabetes may include:
- Bladder, kidney, skin, or other infections that are more frequent or heal slowly
- Fatigue
- Hunger
- Increased thirst
- Increased urination
The first symptom may also be:
- Blurred vision
- Erectile dysfunction
- Pain or numbness in the feet or hands
Signs and tests
Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.
Diabetes blood tests:
- Fasting blood glucose level — diabetes is diagnosed if it is higher than 126 mg/dL two times
- Hemoglobin A1c test –
- Normal: Less than 5.7%
- Pre-diabetes: 5.7% – 6.4%
- Diabetes: 6.5% or higher
- Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours
Diabetes screening is recommended for:
- Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years
- Overweight adults (BMI greater than 25) who have other risk factors
- Adults over age 45 every 3 years
You should see your health care provider every 3 months. At these visits, you can expect your health care provider to:
- Check your blood pressure
- Check the skin and bones on your feet and legs
- Check to see if your feet are becoming numb
- Examine the back part of the eye with a special lighted instrument called an ophthalmoscope
The following tests will help you and your doctor monitor your diabetes and prevent problems:
- Have your blood pressure checked at least every year (blood pressure goals should be 130/80 mm/Hg or lower).
- Have your hemoglobin A1c test (HbA1c) every 6 months if your diabetes is well controlled; otherwise every 3 months.
- Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 70-100 mg/dL).
- Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
- Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
- See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.
Treatment
The goal of treatment at first is to lower high blood glucose levels. The long-term goals of treatment are to prevent problems from diabetes.
The main treatment for type 2 diabetes is exercise and diet.
LEARN THESE SKILLS
You should learn basic diabetes management skills. They will help prevent problems and the need for medical care. These skills include:
- How to test and record your blood glucose (See: Blood glucose monitoring)
- What to eat and when
- How to take medications, if needed
- How to recognize and treat low and high blood sugar
- How to handle sick days
- Where to buy diabetes supplies and how to store them
It may take several months to learn the basic skills. Always keep learning about diabetes, its complications, and how to control and live with the disease. Stay up-to-date on new research and treatments.
MANAGING YOUR BLOOD SUGAR
Self testing means that you check your blood sugar at home yourself. Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes.
A device called a glucometer can give you an exact blood sugar reading.
There are different types of devices. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are given in 30 – 45 seconds.
A health care provider or diabetes educator will help set up an at-home testing schedule for you. Your doctor will help you set your blood sugar goals.
- Most people with type 2 diabetes only need to check their blood sugar once or twice a day.
- If your blood sugar levels are under control, you may only need to check them a few times a week.
- You may test yourself when you wake up, before meals, and at bedtime.
- You may need to test more often when you are sick or under stress.
The results of the test can be used to change your meals, activity, or medications to keep your blood sugar levels in the right range. Testing can identify high and low blood sugar levels before you have serious problems.
Keep a record of your blood sugar for yourself and your health care provider. This will help if you are having trouble managing your diabetes.
DIET AND WEIGHT CONTROL
Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like.
Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop taking medications after losing weight (although they still have diabetes).
See also:
Very overweight patients whose diabetes is not well managed with diet and medicine may consider bariatric (weight loss) surgery.
See:
REGULAR PHYSICAL ACTIVITY
Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight.
Exercise can help your health by improving blood flow and blood pressure. Exercise also increases the body’s energy level, lowers tension, and improves your ability to handle stress.
Ask your health care provider before starting any exercise program. People with type 2 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise
MEDICATIONS TO TREAT DIABETES
If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug.
Some of the most common types of medication are listed below. They are taken by mouth or injection.
- Alpha-glucosidase inhibitors (such as acarbose)
- Biguanides (Metformin)
- Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin)
- Meglitinides (including repaglinide and nateglinide)
- Sulfonylureas (like glimepiride, glyburide, and tolazamide)
- Thiazolidinediones (such as rosiglitazone and pioglitazone). (Rosiglitazone may increase the risk of heart problems. Talk to your doctor.)
These drugs may be given with insulin, or insulin may be used alone. You may need insulin if you continue to have poor blood glucose control. It must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth. See also: Type 1 diabetes
It is not known whether hyperglycemia medications taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and become pregnant may be switched to insulin during their pregnancy and while breast-feeding.
PREVENTING COMPLICATIONS
Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.
See also:
FOOT CARE
People with diabetes are more likely to have foot problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until you get a large sore or infection. Diabetes can also damage blood vessels.
Diabetes also decreases the body’s ability to fight infection.
Small infections can quickly get worse and cause the death of skin and other tissues.
To prevent injury to your feet, check and care for your feet every day. See also: Diabetes foot care
Support Groups
For more information, see diabetes resources.
Expectations (prognosis)
After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, or other areas in your body.
If you have diabetes, your risk of a heart attack is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the normal signs of a heart attack.
If you control your blood sugar and blood pressure, you can reduce your risk of death, stroke, heart failure, and other diabetes problems.
Some people with type 2 diabetes no longer need medicine if they lose weight and become more active.
When they reach their ideal weight, their body’s own insulin and a healthy diet can control their blood sugar levels.
Complications
After many years, diabetes can lead to serious problems:
- You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.
- Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be removed. Infection can also cause pain and itching in other parts of the body.
- Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, storke, and other problems. It can become harder for blood to flow to your legs and feet.
- Nerves in your body can get damaged, causing pain, tingling, and a loss of feeling.
- Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.
- High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well, and they may even stop working.
Infections of the skin, female genital tract, and urinary tract are also more common.
To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.
Calling your health care provider
Call 911 right away if you have:
- Chest pain or pressure
- Fainting or unconsciousness
- Seizure
- Shortness of breath
These symptoms can quickly get worse and become emergency conditions (such as convulsions or hypoglycemic coma).
Call your doctor if you have:
- Numbness, tingling, or pain in your feet or legs
- Problems with your eyesight
- Sores or infections on your feet
- Symptoms of high blood sugar (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot)
- Symptoms of low blood sugar (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy)
Prevention
You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.
Stay up-to-date with all your vaccinations and get a flu shot every year.
References
American Diabetes Association. Standards of medical care in diabetes–2011. Diabetes Care. 2011;34 Suppl 1:S11-S61.
Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31.
Pignone M, Alberts MJ, colwell JA, Cushman M, Inzucchi SE, Mukherjee D, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Circulation. 2010;121:2694-2701.
Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009 Mar;122(3):248-256.e5. Review. PubMed PMID: 19272486.
ACCORD Study Group, Gerstein HC, Miller ME, Genuth S, Ismail-Beigi F, Buse JB, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364:818-828.
Alemzadeh R, Ali O. Diabetes Mellitus. In: Kliegman R, ed. 19th ed. Nelson Textbook of Pediatrics. Philadelphia, Pa: Saunders Elsevier; 2011: chap 583.
Review Date:
6/28/2011
Diabetic Diva ~
The triglyceride has been referred to as the “ugly fat” but that is more of an emotional response than one that is firmly anchored in scientific fact.
Nonetheless its association with diabetes cannot be ignored.
Cholesterol has already been identified as a risk factor for heart disease. There are countless adverts and information outlets which confirm the problems that are associated with an uncontrolled diet.
Likewise there are pills and food choices which are promoted as part of the solution.
Consumers get variable results depending on their genetic makeup and the stage at which the condition is arrested.
Exercise programs are also recommended as part of a healthy living process.
The question remains as to whether all these interventions have been effective or whether they are simply a way for the advertizing agencies to make even more money.
- Bundles of fat that can cause havoc: By consensus, triglycerides are small bundles of fat which are found in the blood stream. They increase in number after we consume food. The body will manufacture these fats from the foods which we eat especially if they are fatty in nature. It has been estimated that 90% of all the fat content in non-lean meat consists of triglyceride. Therefore the shopping habits of the risk groups have to reflect this imminent danger.
- Triglycerides are not universally bad: A balanced diet should contain all the relevant elements. It has been estimated that triglyceride have a proportion of 99% of all the fat stored within the human body. You get long term energy sources from these fatty deposits. They are actually stored in a denser from than muscle protein or even starch. Insulin is required in order to form fat. Between meals and overnight, the triglycerides are converted into energy. Fasting and low insulin levels will trigger this reaction. The fat cells have a very high storage capacity and this can lead to obesity in certain situations. If you are undergoing extensive fasting or there is absolutely no insulin in the body then the liver will convert the fat breakdown products into ketones.
- The health complications and their manifestations: It is often the case the low levels of HDL or good cholesterol is associated with high levels of triglyceride. This is then diagnosed as diabetic dyslipidemia. This is a combination of factors that can place the life of the patient in danger. Patients in this situation will have small, dense and ultimately harmful clusters of LDL or harmful cholesterol. The latter format is undesirable by virtue of its atherogenic properties. Eventually the person will develop central obesity. This is one of the defining features of the metabolic syndrome.
- Around 80% of all the people with type 2 diabetes will have this condition. Eventually the person will die prematurely from heart disease.
- Setting the benchmarks for a healthy person: It is imperative that you have some goals on how much triglyceride which you are going to record on the standard scale. This is an indicator of underlying healthy conditions. Therefore you will be in a position to implement a preventative strategy when required to do so. The normal levels of triglycerides are 150 mg/dl. The borderline figure is between 150 and 199. The high level is between 200 and 499 while anything over 500 is a matter of urgency. The normal fasting state will have levels reading between 100 and 150 mg/dl. After a normal meal the figure will rise to 300. Patients with type 2 diabetes will have elevated levels in both the fasting and even state. Prior to the lipid panel test, you should have some overnight fasting for at least 12 hours. Likewise it is not advisable to take alcohol at least 24 hours prior to the test.
- Managing the level of triglyceride in your body: It is to your advantage that you keep the levels of this substance relatively low. Patients with type 2 diabetes have high risk factors and need to work that bit extra to ensure that their levels are 150 mg/dl or even lower. This will help them reduce the possibility of developing cardiovascular diseases. Some people in this category have carried levels that are well over 400. Once you start hitting the 1000 mark then you will suffer skin lesions or xanthomas, memory loss, pancreatic and abdominal pain. Intervention is required at this stage in order to save your life.
- The clinical response: A combination of medication and diet management can have positive results. First of all you have to aim for glucose control. A typical prescription will include Statins such as Zocor, Lipitor, Pravachol, Zetia, Crestor and Vytorin. These medications are meant to lower your cholesterol levels in general.Type 2 diabetes patients may require combination therapy in order to reach the safe levels of triglycerides. You also have to think of ways of lowering your LDL levels. Sometimes the clinician will recommend a series of Fibrates such as Lopid gemfibrozil, Trico fenofibrate and Nicotinic acid or niacin. It is also advisable to include fish oil in your diet.
Having recognized the dangers that can arise from triglycerides in relation to diabetes, you should come up with practical lifestyle changes that will help you avoid the dangerous phases.
In some instances you may have to restrict your fat intake completely. The problem is that this step can cause you to take even more carbohydrates and therefore increase the level of triglyceride in your bloodstream.
Some books recommend substitution healthy fats such as olive oil and other monounsaturated fats.
Do not increase your intake of sugar or white flour products. Alcohol intake should be kept to a minimum.
Take oily fish such as tuna, sardines, salmon, mackerel and anchovies.
They contain omega-3 fatty acids which are known to reduce triglycerides.
Genetic disorders such as hypothyroidism can combine with diseases in order to exacerbate the situation.
Taking drugs such as steroids, birth control pills and Tamoxifen can also be problematic. You are at risk if you suffer from kidney disease, liver failure and high blood pressure.
The writer of this article is a blogger of ayurvedic health care tips.
BEWARE ALWAYS NO STARCHY FOOD
All food that you eat turns to sugar in your body.
Carbohydrate-containing foods alter your sugar levels more than any other type of food.
Carbohydrates are found in starchy or sugary foods, such as
bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets.
Simple carbohydrates are broken down quickly by the body to be used as energy. Simple carbohydrates are found naturally in foods such as fruits, milk, and milk products.
They are also found in processed and refined sugars such as candy, table sugar, syrups, and soft drinks.
The majority of carbohydrate intake should come from complex carbohydrates (starches) and naturally occurring sugars rather than processed or refined sugars.
All food that you eat turns to sugar in your body. Carbohydrate-containing foods alter your sugar levels more than any other type of food.
Carbohydrates are found in starchy or sugary foods, such as bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets.
Exercises
Food and insulin release
Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.
Glucose test
.
Monitor blood glucose – series
Part one
Set up the meter according to the specific directions that come with your meter. Get the supplies ready, including a new test strip and disposable lancet. Place the lancet into the lancing device.
Diabetic blood circulation in foot
People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet.
diabetic type 2 different with diabetic type 1
The type one
Isulin dependend diabetis mellitus
A person with diabetes constantly manages their blood’s sugar (glucose) levels. After a blood sample is taken and tested, it is determined whether the glucose levels are low or high.
If glucose levels are too low carbohydrates are ingested.�
If glucose in the blood is too high, the appropriate amount of insulin is administered into the body such as through an insulin pump
We didnot discuss the diabetic type one because this type must have the medical serious management
IC NEUUOROPATHY
Nerve Complications
Elevated blood sugars can damage the peripheral nerves.
Symptoms of neuropathy include:
- pain, numbness, and tingling of hands and feet
- muscle weakness such as trouble climbing stairs
- nausea and vomiting
- dizziness and lightheadedness
Elevated levels of blood sugar can injure the blood vessels supplying the peripheral nerves, irritating and damaging them in the process.
Such accumulated nerve damage is called diabetic neuropathy.
Better blood glucose control can help restore healthy nerve function.
Nerve Disease
The nervous system includes our brain (central nervous system) and all of the nerves going from the brain to the rest of the body (peripheral nervous system).
The nervous system is always at work.
Sometimes – when we move or feel something – we are aware of it.
But much happens automatically, including the control of our heart rate, the movement of food through the stomach and intestines and regulation of our blood pressure.
Your health care provider can determine that your symptoms are related to diabetes and not to some other condition.
The best way to improve all forms of diabetic neuropathy is to
control your blood sugar levels.
There are two categories of diabetic neuropathy:
- Sensory and motor neuropathy
- Autonomic neuropathy
Symptoms of neuropathy include:
- Pain, numbness, and tingling of hands and feet
- Muscle weakness such as foot drop, double vision, trouble climbing stairs and getting out of a chair
- Stomach symptoms including bloating, nausea, vomiting of undigested food many hours after a meal, feeling full without eating much food. This is also referred to as gastroparesis.
- Bowel trouble such as episodes of diarrhea especially at night
- Difficulty with bladder emptying
- Sexual dysfunction
- Dizziness and lightheadedness from a very fast heart rate and trouble keeping the blood pressure high enough when sitting or standing up.
What is the treatment?
Before any treatment can be decided upon, you need to report any of these symptoms to your health provider.
Your provider needs to make sure that the symptoms are due to diabetic neuropathy and not something else.
Near normal blood sugar control will usually improve all forms of diabetic neuropathy.
Pain medications should be used as needed. Your provider may refer you to an doctor for specialized treatment and evaluation.
Foot Complications
Taking good care of your feet prevents serious complications.
- Get regular foot exams that test for any nerve damage
- Wash, dry and inspect your feet each day
- Wear shoes and socks that fit
- Control your blood glucose
Foot problems are caused by neuropathy, poor circulation or a combination of both.
The loss of feeling that comes with neuropathy is especially dangerous, as you may not be aware of cuts, blisters and bruises.
The loss of sensation can change the way you walk or can damage bones and joints.
Delays in treatment can lead to serious problems. Poor blood circulation means that less oxygen and fewer white blood cells that fight infection can get to a wound.
It also means that antibiotic treatments that travel through the bloodstream are not as effective because they cannot get to the tissue in proper concentrations.
Foot problems
Foot problems include:
- Changes in sensation from severe pain to numbness
- Increased likelihood of infection (bacterial and fungal)
- Slow wound healing
- Deformation of the joints (Charcot joints, hammertoes, bunions, fallen arches)
Recommendations:
- If you have foot problems, consult a doctor right away. Early diagnosis can make a dramatic difference. Treatment for infection includes antibiotics and regular wound dressing. Impaired circulation sometimes can be helped by blood vessel bypass. This procedure also may help heal wounds and ulcers in combination with skin or tissue growth factors.
- Unfortunately, in advanced cases of poor circulation and uncontrolled infection, amputation may be necessary, usually just a toe or part of a bone is removed. In the most severe cases, it may necessary to remove part of the foot or leg.
It is important to:
- Get regular foot exams that test for any nerve damage
- Not go barefoot
- Not use sharp objects or over-the-counter chemical treatments such as corn/wart removers
- Not use excessively hot water, electric blankets or heating pads, hot water bottles
- Not smoke
- Wash, dry and inspect your feet each day
- Check between your toes
- Wear shoes and socks that fit
- Make sure there is nothing sharp or irritating in your shoes
- Report corns and calluses and injuries that don’t heal to your medical provider
- Cut toenails straight across and not too close to the quick; this will help prevent ingrown nails and associated infections
- Control your blood glucose
Eye Complications
Eye problems range from minor changes to significant visual loss.
Complications include:
- Retinopathy
- Cataracts
- Macular edema
- Glaucoma
People with diabetes are at risk of eye problems, ranging from minor changes with no effect on vision to significant visual loss.
With regular screening and eye exams by an eye doctor (ophthalmologist), and with stable and near normal blood glucose control, most of the serious complications can be avoided or successfully treated.
Vision complications
Putting off an eye exam is very risky. Usually there are few or no symptoms at the time the damage is occurring.
Exams will reveal the problem and allow your eye doctor to treat it. Treatment can slow down the progression and maintain vision even in those who have developed significant eye complications.
Eye complications include:
- Retinopathy
- Cataracts
- Macular edema
- Glaucoma
Healthy eyes require that you:
- Control your blood sugar
- Control your blood pressure
- Control your cholesterol
- Don’t smoke and avoid second hand smoke
- Use Ultra-violet protected eye glasses
- See your ophthalmologist regularly and get retinal exams and eye pressure checked
Symptoms of eye emergencies:
- Loss of vision,
- Holes in vision,
- Showers of sparking white lights,
- Black curtains over vision,
- Spots of fuzzy print, hazy vision,
If you have symptoms of any of the eye emergencies, seek medical care or contact your eye doctor immediately
Self-assessment Quiz
Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Diabetes Complications, take our self assessment quiz when you have completed this section.
The quiz is multiple choice. Please choose the single best answer to each question.
At the end of the quiz, your score will display.
If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information
Quizzes
Take quizzes!
Test your knowledge about diabetes management, treatment, complications, and more.
You may want to see how much you have learned using this website. Below are a series of self assessment quizzes. The questions cover the most important teaching points in each section. If you have trouble with a quiz, you may want to go back and review the section in the website.
Read each section of the site and then take one of our self-assessment quizzes to test your new skills!
- Coping With Your Emotions
- Facts About Diabetes
- Diabetes and Alcohol
- Diabetes Complications
- Diabetes and Exercise
- Insulin Pumps
- Managing Your Weight
- Traveling with Diabetes
- Understanding Carbohydrates
- Understanding Fats and Oils
- Understanding Food
- Understanding Protein
- Monitoring Your Type 1 Diabetes
- Self-management Solutions for Type 1 Diabetes
- Sick Days for Type 1 Diabetes
- Treatment of Type 1 Diabetes
- Monitoring Your Type 2 Diabetes
- Self-management Solutions for Type 2 Diabetes
- Sick Days for Type 2 Diabetes
- Treatment for Type 2 Diabetes
- Treatment of Type 2 Diabetes – Insulin Therapy
Diabetes and Exercise
Take the Diabetes and Exercise quiz.
Test your knowledge about how exercise can help people with diabetes.
// //
Top of Form
The benefits of exercise include:
Improved insulin sensitivity
Lowered risk of heart disease
Reduced stress and enhanced quality of life
All of the above
All of the answers are correct. Aerobic exercise, including brisk walking, swimming and cycling, has a long list of health benefits. Other benefits include reduced body fat, preserved bone mass and improved circulation.
Managing Your Weight
Take the Managing Your Weight quiz.
Test your knowledge about tips and techniques for managing your weight.
// //
Top of Form
If you are overweight or obese, the health benefits of losing weight through diet and exercise include:
Improved sensitivity to the action of insulin and improved blood sugar levels
Lowered risk of developing heart disease, like heart attacks and stroke
Prevention or delaying of serious health conditions, like breathing problems, joint and bone disorders
All of the above.
All of the answers are correct. However, the best answer is “All of the above”. While weight loss may prevent or delay serious health conditions, weight loss also lowers your risk for heart disease, decreases insulin resistance and improves blood sugar levels. Bottom of Form
Bottom of Form
Understanding Carbohydrates
Take the Understanding Carbohydrates quiz.
Test your knowledge about carbohydrates.
// //
Top of Form
Carbohydrates are found in which foods?
Starch, fruit, milk, starchy vegetables
Cheese, steak, chicken
Olive oil, butter and fish
Starch, fruit, milk, and starchy vegetables contain carbohydrate. Cheese, steak, chicken, and fish are types of protein, while olive oil and butter are types of fat.
Understanding Food
Take the Understanding Food quiz.
Test your knowledge about food.
// //
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What are the 3 primary sources of nutrition in a balanced diet?
Carbohydrate, protein and fat
Carbohydrate, protein and alcohol
Fat, protein and leafy vegetables
Carbohydrate, protein and fat are the 3 primary sources of nutrition in a balanced diet. While alcohol has calories, it is not one of the 3 main sources of nutrition in the diet. Leafy vegetables also have some carbohydrates, but they do not supply all of your daily carbohydrate requirements.
Monitoring Your Type 1 Diabetes
Take the Monitoring Your Type 1 Diabetes quiz.
Test your knowledge about monitoring type 1 diabetes.
Monitoring your blood glucose will:
Ensure that your blood glucose levels stay normal
Give you the feedback you need to keep your blood glucose in target range
Not be necessary, as long as you eat right
Monitoring alone does not change the blood glucose level, but the only way to know if you are keeping your blood glucose levels in the target range is to monitor your blood glucose. While it is important to eat a healthy diet, diet alone may not be sufficient. Monitoring your blood glucose will give you the feedback you need.
Monitoring Your Type 2 Diabetes
Take the Monitoring Your Type 2 Diabetes quiz.
Test your knowledge about monitoring type 2 diabetes.
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Monitoring your blood glucose will:
Ensure that your blood glucose levels stay normal
Give you the feedback you need to keep your blood glucose in target range
Not be necessary, as long as you eat right
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Monitoring alone does not change the blood sugar level, but it does help you know if your treatment plan is successful. The only way to find out if you are keeping your blood sugar levels in the target range is to monitor your blood sugar.
Self-management Solutions for Type 1 Diabetes
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Test your knowledge about self-management solutions for type 1 diabetes.
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When your blood sugar is not well controlled, it is helpful to:
Monitor your blood sugar at different times of the day such as before and after meals, bedtime, middle of the night, and whenever feeling low
Keep a logbook of your blood sugar test results, food, activity/exercise and medication doses
Discuss the problem with your medical provider
All of the above
All of the above
All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently throughout the day including overnight.
Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and the insulin dose. You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar.
Self-management Solutions for Type 2 Diabetes
Take the Self-management Solutions for Type 2 Diabetes quiz.
Test your knowledge about self-management solutions for type 2 diabetes.
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When your blood sugar is not well controlled, it is helpful to:
Monitor your blood sugar at different times during the day
Keep a logbook of your blood sugar test results, food, exercise and medication doses
Discuss the problem with your medical provider
All of the above
All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently and at different times of the day. Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and medication doses (including insulin). You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar.Bottom of Form
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Monitoring alone does not change the blood glucose level, but the only way to know if you are keeping your blood glucose levels in the target range is to monitor your blood glucose. While it is important to eat a healthy diet, diet alone may not be sufficient. Monitoring your blood glucose will give you the feedback you need.
Monitor your blood glucose more frequently when:
You are sick
You are traveling
Your routine changes
Your diabetes medication changes
You are more active or exercising
All of the above
All of the answers are correct. However, the best answer is “All of the above”. Illness, traveling, lifestyle changes, diabetes medication, and increased activity can all impact your blood glucose control. Monitor your blood glucose more frequently on these occasions to be sure your blood sugar levels are on target.
Alternative site testing is NOT recommended when:
You feel like your blood glucose might be low
You have eaten or exercised within the last 2 hours
You have hypoglycemia unawareness and don’t feel the symptoms of low blood glucose
All of the above
All of the choices are correct. However, the best answer is “All of the above”. Fingerstick testing is the most accurate reflection of sugar levels in the blood stream. Alternative site testing lags behind fingerstick testing by 20 minutes or more. Alternative site testing is similar to fingerstick testing only when the blood sugar is steady, and not moving rapidly up or rapidly down. If you really had a low blood sugar, the alternative site testing result might be misleadingly high. This could lead to making the wrong decision to reach your target blood glucose level by not eating a carbohydrate-containing snack (PDF) or taking other corrective action.
Using a continuous glucose monitor means:
You won’t have to do fingerstick testing with a meter anymore
Readings can be used for making immediate treatment decisions
You will have trend information that can help you manage your blood glucose more effectively
Many people find the information about their blood glucose trends very helpful in managing their care, and have been able to increase the time their blood sugars are in the target range. Before making any immediate treatment decisions, you will still need to do traditional blood glucose testing to verify a glucose level determined by a sensor. The sensors still have to be calibrated or reconciled with blood glucose readings obtained with a blood glucose meter, and the continuous glucose sensor results have to be verified before you change your therapy.
Diabetic Neurophaty treatment
Research Front Maps
Research front maps are diagrammatic representations of the core papers comprising each front. They are selected from the current Research Front set that are relevant to the featured special topic.
The title for this Research Front Map is “DIABETIC NEUROPATHIC PAIN TREATMENT,” containing 30 core papers. Source dates: 1999-February 28, 2009 (first bimonthly period 2009).
Each circle represents a highly cited paper whose bibliographic information is displayed when the user clicks on the circle.
The solid lines between circles represent the strongest co-citation links for each paper (that is, indicating that the papers are frequently cited together); weaker links are indicated by dashed lines.
Papers close to each other on the map are generally more highly co-cited. The most recent paper(s) are indicated in pink. Annotations may have been added to this map which represent the main research themes. These appear as labels attached to specific regions on the maps.
Note: For best results use the “landscape orientation” option when printing this page.
Treatment of Type 1 Diabetes
Take the Treatment of Type 1 Diabetes quiz.
Test your knowledge about type 1 diabetes treatment.
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The ultimate goal of insulin therapy is to mimic normal insulin levels.
True
False
If you have type 1 diabetes, your body is no longer producing enough insulin. We try to mimic normal insulin levels with insulin injections or infusion through an insulin pump.
Treatment for Type 2 Diabetes
Take the Treatment quiz.
Test your knowledge about diabetes treatment.
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Type 2 diabetes mellitus is treated with:
Lifestyle changes – a healthy diet, adequate activity/exercise and, as needed, losing weight
Pills that help return the blood sugar (plasma glucose) to the normal range
Pills that increase the secretion of insulin from the pancreas
Insulin
All of the above
All of the answers are correct. However, the best answer is “All of the above”.
There are many different treatments for type 2 diabetes mellitus. Every treatment regimen starts with lifestyle changes – a healthy diet, adequate activity/exercise, and, as needed, losing weight. If lifestyle changes are not sufficient to control the blood sugar, then medications are added.
Usually the first medication to be added is Metformin (a biguanide). It helps to return the blood sugar (plasma glucose) back to the normal, non-diabetic range.
Other medications, including insulin, may be added to the metformin and lifestyle therapy.
There is not a single treatment plan that is best for everyone. Talk with your provider about the best treatment plan for you.
REFRENCESBottom
Recognition of Any Warning Symptoms for Diabetic Neuropathy
By Hendra Excel
Recognition of any warning symptoms for DIABETIC NEUROPATHY happen to be for serious great importance given that that will lose him or her can get daily life switching or violent strikes.
Diabetic neuropathy is certainly because of any the wall surfaces within the problematic veins who supply any phobia being more powerful. The decreases the option within the phobia that will run impulses back in the brain. Sorbitol at the same time methods together with gathers during the Schwann debris inducing deeper sensors conduction disadvantages.
One can find several different types of neuropathies which can mode utilizing diabetes; polynueropathies together with mononeuropathies. When the warning symptoms seem to be would depend what precisely phobia components happen to be infected.
Any warning symptoms may vary among the consumers as well as being impacted by the sum of hurt finished into the phobia. Many other warning symptoms consist of some sort of soreness problems, a good eliminating or simply blasting impression, or simply becoming like your story own frigid your feet.
When the neuropathy progresses any warning symptoms consist of drunken sensations for problems, impression, environment, vibration, together with two-point discrimination. In order to remedy polyneuropathy is certainly thru direction within the diabetes again.
Mononeuropathies happen to be remoted gatherings the fact that change simple phobia. Any warning symptoms for this style of neuropathy happen to be wholly impacted by which unfortunately a sensor is certainly infected. They’ll change any coulometer sensors which unfortunately lead to annoyance, total eye problems together with some sort of failing to safely move a person’s eye in any focus.
Most of the victims of diabetes, irrespective of whether model 1 or simply model a pair of, have to pay attention to any warning symptoms for diabetic neuropathy. The sooner it is actually sent to the interest within the victims of diabetes health-related service providers the sooner it really is monitored thru adequate standard of living opportunities that will be devoted to eating routine, activity, together with adequate health related direction.
Diabetic Neuropathy Remedy?
The actual DIABETIC NEUROPATHY is actually neural harm to entire body extremities, your toes as well as fingers for instance, in addition neural harm to internal organs, digestive system and also the center for instance.
Here Are the Actual Diabetic Neuropathy Treatments
*The remedy with regard to diabetic neuropathy very first choice would be to manage the actual blood sugar amounts therefore you will find not really inconsistent levels as well as levels. Administration consists of diet plan as well as physical exercise, in addition medicine in the event that recommended.
* In order to avoid heartburn, physicians claim that diabetes sufferers ought to consume lower foods as well as restrict body fat as well as meals full of dietary fiber. Additionally bloodstream stress medicines probably will advantage the actual diabetic as well.
An average lotion is actually capsaicin lotion.
The Actual Diabetic Neuropathy Details
1 most unfortunate problems associated with diabetes may be the neural harm already been brought on by diabetes. The actual diabetes neuropathy may cause moderate uneasiness for many people, while with regard to other people this particular condition is actually disabling as well as sometimes crucial.
Here Are the Actual Diabetic Neuropathy Signs and Symptoms
The actual DIABETIC NEUROPATHY signs and symptoms tend to be based on the kind as well as which anxiety which obtained impacted. The actual signs and symptoms consist of muscle mass coordination difficulties, heartburn, weak point, numbness, discomfort or even tingling (usually within the ft or even fingers), nausea or vomiting as well as bladder difficulties. It might curiosity you to definitely realize that extended blood sugar levels extreme conditions blood sugar levels that is possibly excessive or even as well reduced with regard to too much time could cause numerous problems, which can result in the diabetic coma.
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Core Papers
| Label: Dworkin-2003 Title: Advances in neuropathic pain – Diagnosis, mechanisms, and treatment recommendations Journal: ARCH NEUROL, 60 (11): 1524-1534 NOV 2003 Citations: 274 Authors: Dworkin, RH;Backonja, M;Rowbotham, MC;Allen, RR;Argoff, CR;Bennett, GJ;Bushnell, MC;Farrar, JT;Galer, BS;Haythornthwaite, JA;Hewitt, DJ;Loeser, JD;Max, MB;Saltarelli, M;Schmader, KE;Stein, C;Thompson, D;Turk, DC;Wallace, MS;Watkins, LR;Weinstein, SM Addresses: Univ Rochester, Sch Med & Dent, Dept Anesthesiol, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA[Back to Map] Label: Dworkin-2003 Title: Pregabalin for the treatment of postherpetic neuralgia – A randomized, placebo-controlled trial Journal: NEUROLOGY, 60 (8): 1274-1283 APR 22 2003 Citations: 171 Authors: Dworkin, RH;Corbin, AE;Young, JP;Sharma, U;LaMoreaux, L;Bockbrader, H;Garofalo, EA;Poole, RM Addresses: Univ Rochester, Sch Med & Dent, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA Univ Rochester, Sch Med & Dent, Rochester, NY 14642 USA Pfizer Global Res & Dev, Ann Arbor, MI USA[Back to Map] Label: Ballantyne-2003 Title: Opioid therapy for chronic pain Journal: N ENGL J MED, 349 (20): 1943-1953 NOV 13 2003 Citations: 162 Authors: Ballantyne, JC;Mao, JR Addresses: Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, 15 Parkman St,WACC 333, Boston, MA 02114 USA Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, Boston, MA 02114 USA Harvard Univ, Sch Med, Boston, MA USA[Back to Map] Label: Goldstein-2005 Title: Duloxetine vs. placebo in patients with painful diabetic neuropathy Journal: PAIN, 116 (1-2): 109-118 JUL 2005 Citations: 144 Authors: Goldstein, DJ;Lu, YL;Detke, MJ;Lee, TC;Iyengar, S Addresses: Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA PRN Consulting, Indianapolis, IN USA Indiana Univ, Sch Med, Dept Pharmacol & Toxicol, Indianapolis, IN 46202 USA Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA Harvard Univ, Sch Med, Boston, MA USA[Back to Map] Label: Finnerup-2005 Title: Algorithm for neuropathic pain treatment: An evidence based proposal Journal: PAIN, 118 (3): 289-305 DEC 5 2005 Citations: 143 Authors: Finnerup, NB;Otto, M;McQuay, HJ;Jensen, TS;Sindrup, SH Addresses: Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Norrebrogade 44, Aarhus 8000, Denmark Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Aarhus 8000, Denmark Odense Univ Hosp, Dept Neurol, Odense 5000, Denmark Churchill Hosp, Pain Relief Unit, Oxford OX3 7LJ, England[Back to Map] Label: Gilron-2005 Label: Rosenstock-2004 Label: Rowbotham-2003 Label: Arnold-2004 Label: Kalso-2004 Label: Goldenberg-2004 Label: Lesser-2004 Label: Crofford-2005 Label: Sabatowski-2004 Label: Goldstein-2004 Label: Freynhagen-2005 Label: Detke-2004 Label: Richter-2005 Label: Raskin-2005 Label: Eisenberg-2005 Label: Arnold-2005 Label: Furlan-2006 Label: Attal-2006 Label: Brannan-2005 Label: Martell-2007 Label: Ballantyne-2007 Label: Ives-2006 Label: Arnold-2007 Label: Vinik-2007 Label: Raskin-2007 KEYWORDS: NEUROPATHIC PAIN TREATMENT; RANDOMIZED MULTICENTER TRIAL COMPARING DULOXETINE; DIABETIC PERIPHERAL NEUROPATHIC PAIN; CENTRAL NEUROPATHIC PAIN; NEUROPATHIC PAIN EVALUATED. |
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thanks for comment and info, I hope another reader will kind to join this communiation forum
Neuropathy can be remedied by high doses of vitamin-B. Vitamin b is really very useful in alleviating neuropathy. “”`*;
Kind thanks http://www.healthmedicinelab.com/pain-under-left-rib-cage/
Yhakns Drew for visit and therapy info, this info very need for the patient who read this article
halo drew,
thanks for your info
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