Connect with us

Diabetes

An overview of diabetes types and treatments

Published

on

Diabetes is a disorder that impairs the capacity of the body to absorb blood glucose, otherwise referred to as blood sugar.

The total number of people over 18 years of age living with diagnosed and undiagnosed diabetes in the United States is 30,2 million. The figure represents a population of between 27.9 and 32.7 per cent.

Without constant careful management, diabetes can lead to a accumulation of blood sugars that can increase the risk of dangerous complications, including stroke and heart disease.

Different types of diabetes will occur, and the form depends on how you treat the disease. Not all types of diabetes stem from an overweight person or living an unhealthy lifestyle. In reality, some are from infancy.

Types

Diabetes check system
There are several types of diabetes.

We may develop three major types of diabetes: type 1, type 2, and gestational diabetes.

Type I diabetes: This type also known as juvenile diabetes occurs when insulin is not released by the body. Individuals with type I diabetes are insulin dependent, meaning they have to take artificial insulin daily to stay alive.

Type 2 diabetes: Type 2 diabetes affects how insulin is used in the body. While the body still produces insulin, the cells in the body don’t respond to it as effectively as they once did, unlike in type I. According to the National Institute of Diabetes and Digestive and Kidney Diseases, this is the most common type of diabetes and it has strong ties to obesity.

Gestational diabetes: This type occurs in pregnant women when the body may become less susceptible to insulin. Gestational diabetes is not present in all women, and usually resolves after birth.

The less popular diabetes types include monogenic diabetes and diabetes associated with cystic fibrosis. EOLBREAK

For more information on type I diabetes click here.

Prediabetes

Doctors refer to some people as prediabetes or borderline diabetes when sugar in the blood is typically between 100 and 125 milligrams per deciliter (mg / dL).

Normal blood sugar levels range between 70 and 99 mg / dL, whereas a diabetic individual will have a fasting blood sugar higher than 126 mg / dL.

The amount of prediabetes means blood glucose is higher than usual but not so high as to make up diabetes.

However, people with prediabetes are at risk of developing type 2 diabetes although we usually do not experience complete diabetes symptoms.

The risk factors for prediabetes are close to those for type 2 diabetes. They are:

  • being overweight
  • a family history of diabetes
  • having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
  • a history of high blood pressure
  • having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
  • a history of polycystic ovary syndrome (PCOS)
  • being of African-American, Native American, Latin American, or Asian-Pacific Islander descent
  • being more than 45 years of age
  • having a sedentary lifestyle

If a doctor suspects a person with prediabetes, he or she will recommend making healthy changes that can help avoid the progression to type 2 diabetes. Losing weight and getting a healthier diet can often aid in avoiding the disease.

How insulin problems develop

Doctors do not know exactly why type I diabetes is induced. The causes of type 2 diabetes, also known as insulin resistance, are more apparent.

Insulin allows the glucose from a person’s diet to enter energy supplying cells in their body. In general, insulin resistance results from the following cycle:

  1. A person has genes or an environment that make it more likely that they are unable to make enough insulin to cover how much glucose they eat.
  2. The body tries to make extra insulin to process the excess blood glucose.
  3. The pancreas cannot keep up with the increased demands, and the excess blood sugar starts to circulate in the blood, causing damage.
  4. Over time, insulin becomes less effective at introducing glucose to cells, and blood sugar levels continue to rise.

In the case of type 2 diabetes, insulin resistance takes place gradually. This is why doctors often recommend making lifestyle changes in an attempt to slow or reverse this cycle.

Learn more about the function of insulin by clicking here.

Exercise and diet tips

When a doctor treats a person with type 2 diabetes, improvements in the lifestyle will often be advised to help weight loss and overall health.

A doctor can refer a nutritionist to a person who has diabetes or prediabetes. A specialist can help a diabetic person lead an active, balanced lifestyle and manage the condition.

A healthy diet can help prevent, reverse, or manage diabetes.
A healthy diet can help prevent, reverse, or manage diabetes.

Steps a person can take to embrace a lifestyle with diabetes include:

  • Eating a diet high in fresh, nutritious foods, including whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fat sources, such as nuts.
  • Avoiding high-sugar foods that provide empty calories, or calories that do not have other nutritional benefits, such as sweetened sodas, fried foods, and high-sugar desserts.
  • Refraining from drinking excessive amounts of alcohol or keeping intake to less than one drink a day for women or two drinks a day for men.
  • Engaging in at least 30 minutes exercise a day on at least 5 days of the week, such as of walking, aerobics, riding a bike, or swimming.
  • Recognizing signs of low blood sugar when exercising, including dizziness, confusion, weakness, and profuse sweating.

Individuals may also take steps to decrease their body mass index (BMI), which may help certain individuals with type 2 diabetes control the disease without medication.

Gradual, realistic targets for weight loss are more likely to help a individual maintain long-term benefits.

Using insulin

People with sort I diabetes and some people with type 2 diabetes may need to inject or inhale insulin to avoid becoming too high in their blood sugar levels.

There are different types of insulin and most are categorized by how long their effect lasts. Insulins are strong, regular, moderate, and long-acting.

Most people will use a long-acting insulin injection to maintain the blood sugar levels consistently down. Certain people may use insulin that works fast or a mixture of types of insulins. Whatever the type a person will usually use a fingerstick to test their blood glucose levels.

This method of testing blood sugar levels requires the use of a separate, portable glucometer system. A person with type I diabetes will then use blood sugar amount readings to assess how much insulin they need.

The only way a person can find out their blood sugar levels is by self-monitoring. Taking the level from any physical symptoms that may arise can be dangerous unless a person assumes extremely low glucose and feels they need a fast dose of glucose.

How much is too much?

Insulin helps diabetics lead an active lifestyle. However, it can lead to severe side effects, particularly if a person is taking too much administration.

Excessive insulin can lead to hypoglycemia, or extremely low blood sugar, leading to nausea, sweating and trembling.

It’s important that people carefully monitor insulin and eat a healthy diet that controls as much blood sugar as possible.

Other medications

Certain forms of medication are available, in addition to insulin, which can help a person treat their condition.

Metformin

For type 2 diabetes, a doctor may prescribe metformin in pill or liquid form.

It contributes to:

  • lowering blood sugar
  • making insulin more effective

It can help with weight loss, as well. Having a healthy weight should reduce the diabetes effects.

A person can also have other health risks, as well as diabetes, and they may need medication to control these. A doctor will inform the patient on his or her needs.

SGLT2 inhibitors and GLP-1 receptor agonists

In 2018, new guidelines also recommended prescribing additional drugs for people with:

  • atherosclerotic cardiovascular disease
  • chronic kidney disease

These are receptor agonists of the sodium-glucose cotransporter 2 (SGLT2) or glucagon-like peptide-1 (GLP-1).

The guidelines allow doctors to prescribe an SGLT2 inhibitor for those with atherosclerotic cardiovascular disease and a high risk of heart failure.

GLP-1 receptor agonists work by increasing the amount of insulin the body produces and decreasing the amount of glucose that enters the bloodstream. It is an injectable drug. People may use it with metformin or alone. Side effects include gastrointestinal problems, such as nausea and a loss of appetite.

SLGT2 inhibitors are a new type of drug for lowering blood glucose levels. They work separately from insulin, and they may be useful for people who are not ready to start using insulin. People can take it by mouth. Side effects include a higher risk of urinary and genital infections and ketoacidosis.

Self-monitoring tips

Blood sugar levels self-monitoring is vital to effective diabetes management, helping control meal timing, physical activity, and when to take medication, including insulin.

Although blood glucose (SMBG) self-monitoring devices differ, they usually include a meter and test strip to produce readings, and a lancing device to poke the skin to get a small amount of blood.

In each case, refer to a meter’s specific instructions, as machines will vary. But for many of the devices on the market, the following safeguards and steps will apply:

  • Make sure both hands are clean and dry before touching the test strips or meter
  • Do not use a test strip more than once and keep them in their original canister to avoid any external moisture changing the result.
  • Keep canisters closed after testing.
  • Always check the expiration date.
  • Older meters might require coding prior to use. Check to see if the machine currently in use needs this.
  • Store the meter and strips in a dry, cool area.
  • Take the meter and strips into consultations, so that a primary care physician or specialist can check their effectiveness.
Diabetes self monitoring
Self-monitoring can be vital for moderating blood glucose.

A person who is diabetes self-monitoring uses a tool to poke the skin, called a lancet. While the concept of drawing blood can cause distress to some people, a gentle, simple procedure should be to lance the finger to obtain a blood sample.

Take the following precautions:

  • Clean the area from which the sample will come with soapy, warm water to avoid food residue entering the device and distorting the reading.
  • Choose a small, thin lancet for maximum comfort.
  • The lancet should have depth settings that control the depth of the prick. Adjust this for comfort.
  • Many meters require only a teardrop-sized sample of blood.
  • Take blood from the side of the finger, as this causes less pain. Using the middle finger, ring finger, and little finger may be more comfortable
  • While some meters allow samples from other test sites, such as the thighs and upper arms, the fingertips or outer palms produce more accurate results.
  • Tease blood to the surface in a “milking” motion rather than placing pressure at the lancing site.
  • Dispose of lances in line with local regulations for getting rid of sharp objects.

While remembering to self-monitor involves lifestyle adjustments, it need not be an uncomfortable process.

Outlook

Diabetes is a chronic, serious condition. The disease is the seventh leading cause of death in the US, according to the American Diabetes Association (ADA).

While diabetes itself is manageable, its complications can have a severe impact on daily living, and some can be fatal if not promptly treated.

Complications of diabetes include:

  • dental and gum diseases
  • eye problems and sight loss
  • foot problems, including numbness, leading to ulcers and untreated injuries and cuts
  • heart disease
  • nerve damage, such as diabetic neuropathy
  • stroke
  • kidney disease

In the case of kidney disease, this condition can lead to kidney failure, water retention when the body does not properly dispose of water, and a person having bladder control difficulties.

Proper control of blood glucose levels and regulation of glucose consumption can help people avoid complications of type 2 diabetes which are more harmful.

For those with type 1 diabetes the only way to mitigate and control the symptoms of the disease is to take insulin.

Takeaway

Diabetes is a life-changing condition that requires careful management of blood sugar, and a healthy lifestyle for a person to manage it properly. The disease has several different types.

Type I occur when insulin isn’t released by the body. Type 2 occurs when excess consumption of high-sugar products fills the blood supply with glucose and reduces insulin production and efficacy.

People may take additional insulin to control the disease, and improve the absorption of glucose. If a person has prediabetes, regular exercise and a healthy, low-sugar diet will reduce the risk of complete diabetes.

Diabetes complications can be serious like kidney failure and stroke, so it’s important to manage the condition.

Someone suspecting having diabetes will contact their doctor.

Q:

If prediabetes causes no symptoms, how do I know I have it and take steps to reverse the condition?

A:

In general people who are at risk for diabetes often get screened at their doctor’s office. The risk factors are listed above, and different groups have slightly different recommendations about when and how often to screen.

Most of the time, we use a test called a hemoglobin A1C that tells us how you have controlled your sugars over the previous 3 months. This test can also tell your doctor how likely it is that you will develop diabetes in the near future — the higher the level, then the more likely this is main steps to reverse prediabetes are the same things we talk about above — losing weight if you are overweight, getting regular exercise, and eating a balanced diet. Suzanne Falck, MD, FACP

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Click to comment

Leave a Reply

Your email address will not be published.

1 × four =

Alzheimer's / Dementia

Uses of vitamin B-12 level test: Normal ranges, and results

Published

on

The amount of vitamin B-12 in the blood or urine is measured in a vitamin B-12 level test to determine the body’s overall vitamin B-12 reserves.

Vitamin B-12 is required for a variety of body functions, including neuron function, DNA and red blood cell formation.

Treatment is required if a person’s vitamin B-12 levels fall outside of the usual range. Vitamin B12 deficiency can cause neurological symptoms as well as fatigue, constipation, and weight loss. B-12 levels that are too high could indicate liver disease, diabetes, or another condition.

Continue reading to learn more about B-12 testing and what the results indicate.

Purpose of a vitamin B-12 level test

worried lady

The vitamin B-12 level test determines the amount of vitamin B-12 in your body. Doctors can use the data to see if low vitamin B-12 levels are causing symptoms.

If a person exhibits any of the following symptoms, a doctor may recommend a vitamin B-12 level test:

Vitamin B-12 insufficiency

Vitamin B-12 deficiency is thought to affect up to 15% of people in the United States, according to research. The following are signs and symptoms of a deficiency:

  • fast heartbeat
  • numbness and tingling in the hands and feet
  • poor memory
  • a sore mouth or tongue
  • confusion
  • dementia
  • depression
  • difficulty maintaining balance

Vitamin B-12 deficiency in infants can cause them to underachieve. They may have mobility issues in addition to developmental delays.

Pernicious anaemia

A vitamin B-12 level test may be required for people who have signs of low iron. Pernicious anaemia is caused by a lack of vitamin B-12 absorption, resulting in poor red blood cell causes.

It usually affects the elderly or people who are deficient in intrinsic factor. Intrinsic factor is a gastric material that binds to vitamin B-12 and allows it to be absorbed by the body.

The following are signs and symptoms of pernicious anaemia:

  • pale skin
  • weakness
  • weight loss
  • constipation
  • fatigue
  • loss of appetite

High levels of folate in the blood

The level of folic acid in the blood is known as serum folate. High levels of serum folate might disguise the signs and symptoms of vitamin B-12 deficiency, exacerbating the neurological symptoms.

They can also make you more susceptible to anaemia.

Symptoms of other illnesses

Vitamin B-12 levels that are unusually high can be a symptom of liver disease, diabetes, or certain types of leukaemia. The findings of a vitamin B-12 test may be used by a doctor to help them make a diagnosis.

Risk factors

Vitamin B-12 deficiency is more common in some people than in others, especially those with low stomach acid or other digestive problems. Stomach acid helps the body absorb vitamin B-12 more effectively by separating it from meals.

Low vitamin B-12 levels are more common in the following groups of people than in others:

  • people with conditions that reduce vitamin B-12 absorption, including celiac disease and Crohn’s disease
  • people who have had gastric bypass surgery
  • those who are breast-feeding
  • people who are taking medicines such as chloramphenicol, proton pump inhibitors, or H2 blockers
  • older adults
  • children
  • vegans and vegetarians
  • people with diabetes

How does the B-12 vitamin level test work?

Vitamin B-12 status is normally determined by a blood test, but home urine tests are now available. Vitamin B-12 levels can be checked as part of a routine blood test by a doctor.

Although fasting is not required before a B-12 test, it may be necessary if the doctor is utilising the test to check at other blood components.

It is important that patients inform their doctors about any medications or supplements they are taking, as some may have an impact on the outcome.

Acknowledging the results

The following are possible results:

  • Low. Vitamin B-12 levels below 200 pg/mL are considered low. This indicates that you may have a vitamin B-12 deficiency, pernicious anaemia, or an overactive thyroid. Neurological symptoms are common in people who have low vitamin B-12 levels.
  • High. Anything over 900 pg/mL is considered excessively high vitamin B-12 status. This result could indicate problems with the liver or kidneys, diabetes, or certain types of leukaemia.

Because the ranges of results differ from one laboratory to the next, it’s important to talk to a doctor about the results and what they signify.

To rule out vitamin B-12 deficiency, the doctor may measure levels of methylmalonic acid (MMA) and other chemicals. These lab results aid in the early detection of vitamin B-12 deficiency.

Vitamin B-12 deficiency treatment

Vitamin B-12 injections are frequently required by people who have low amounts of the vitamin. These shots are more successful at boosting vitamin B-12 levels than supplements, especially when people have medical issues that make supplements difficult to absorb.

High doses of vitamin B-12 supplements may help some people improve their B-12 status. Supplements are sold in the form of capsules or liquids in pharmacies, supermarkets, health food stores. It may also be beneficial to consume extra vitamin B-12-rich foods.

Treatment for high vitamin B-12 levels

There is no upper limit on vitamin B-12 consumption because high amounts do not cause problems. Having naturally high levels of vitamin B-12 in the body, on the other hand, could be cause for alarm, since it could indicate a serious underlying condition. Doctors will focus on treating the underlying medical condition rather than the vitamin B-12 levels.

Vitamin B-12  foods.

Eggs are rich in vitamin B-12.
Vitamin B-12 is abundant in eggs.

Although low vitamin B-12 levels are frequently caused by absorption problems and other medical conditions, some people may be deficient because they do not acquire enough vitamin B-12 through their food. This is especially true for vegans and vegetarians who have been vegetarian for a long time.

Vitamin B-12-rich foods include:

  • fortified plant-based dairy alternatives
  • fortified breakfast cereals
  • fortified nutritional yeast
  • fish and seafood
  • meat
  • eggs
  • dairy products

Vitamin supplements can help vegans and strict vegetarians make up for dietary deficiencies. Older persons should seek to achieve their vitamin B-12 needs through fortified meals and vitamin supplements, as supplements are simpler for their bodies to absorb than naturally occurring vitamin B-12.

Vitamin B-12 dietary recommendations

Vitamin B-12 is required in 2.4 micrograms (mcg) per day for adults and adolescents over the age of 14. During pregnancy, this rises to 2.6 mcg, and breast-feeding raises it to 2.8 mcg.

Conclusion

Vitamin B-12 is an essential nutrient that is necessary for good health. The status of a person’s vitamin B-12 is determined by a vitamin B-12 level test. This test may be recommended by a doctor to people who have symptoms of a deficiency or who are at risk of having low vitamin B-12 levels in their bodies.

Vitamin B-12 deficiency can be avoided by eating a well-balanced diet that includes many sources of the vitamin on a daily basis, or by taking supplements. If they have trouble absorbing vitamin B-12 from food, oral supplements or injections can help them avoid symptoms and consequences.

Sources:

  • https://academic.oup.com/qjmed/article/106/6/505/1538806
  • https://labtestsonline.org/tests/methylmalonic-acid
  • https://www.medicalnewstoday.com/articles/322286
  • https://academic.oup.com/nutritionreviews/article-abstract/71/2/110/1940320
  • https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  • https://www.hsph.harvard.edu/nutritionsource/b-12-deficiency/

Continue Reading

Diabetes

Symptoms, stages, causes, and treatment of diabetic nephropathy

Published

on

Diabetic nephropathy is a type of kidney disease that affects people who have diabetes for a long time. It happens when a person’s kidneys are damaged by high blood glucose levels.

Diabetic nephropathy is a type of chronic kidney disease caused by diabetes. The kidneys aid in the regulation of fluid and salt levels in the body, which is critical for blood pressure control and cardiovascular health.

When a person has diabetes, whether type 1 or type 2, or gestational diabetes, their bodies are unable to use or manufacture insulin properly. Gestational diabetes is a kind of diabetes that develops during pregnancy and increases the risk of developing type 2 diabetes later in life.

High blood sugar levels are a symptom of diabetes. High glucose levels can harm several parts of the body over time, including the cardiovascular system and the kidneys. Diabetic nephropathy is the term for the kidney damage that occurs as a result of diabetes.

Diabetic nephropathy is a leading cause of chronic kidney disease and end-stage renal disease in people with diabetes (ESRD). The kidneys in ESRD are no longer able to satisfy the demands of daily life. Kidney failure can occur as a result of ESRD, which can be life-threatening.

This page examines how diabetes affects the kidneys, as well as the treatment options and ways to prevent the risk.

Definition

alzheimer’s patients

Because nephropathy is caused by damage caused by high blood glucose levels, it can affect people with any kind of diabetes.

High blood glucose levels have an effect on the arteries in the body, and the kidneys filter the blood that passes through them.

According to the authors of a 2016 study, 20–40 percent of people with diabetes suffer renal disease.

A person’s tests may reveal one or both of the following:

High levels of albumin in the urine: When the kidneys are in good shape, the urine should include no albumin protein.

A low glomerular filtration rate (GFR): The kidneys’ primary role is to filter the blood. Their ability to do so is hampered by kidney disease. The kidneys should ideally function at 100% or have a GFR of 100Trusted Source. A doctor will not diagnose renal disease unless the GFR is 60 percent or higher. Kidney disease affects 15–60% of the population. Kidney failure is indicated by a percentage of less than 15%.

The end stage of renal disease is ESRD. In the United States, diabetic nephropathy is the most common cause of ESRD. Diabetes is responsible for 40–50% of all occurrences of ESRD, according to Trusted Source. Dialysis will be required if a person has ESRD.

Controlling blood sugar levels can help to lower the risk. Whether you have type 1 or type 2 diabetes, you can lower your risk of diabetic nephropathy by doing the following:

  • blood glucose levels should be monitored and kept within the target range
  • consuming a nutritious, low-sugar, low-salt diet
  • exercising on a regular basis
  • adhering to a treatment plan that may include the use of insulin or other drugs
  • keeping a healthy weight is important.

What is chronic kidney disease? Find out more here.

Causes

Kidney damage puts a strain on these critical organs, preventing them from functioning normally.

When this occurs:

  • the kidneys cannot maintain healthy fluid levels in the body
  • the kidneys cannot remove waste products from the blood
  • the body starts to lose protein through the urine

Diabetic nephropathy takes time to develop. According to one study, 15 years after a diabetes diagnosis, a third of people have high levels of albumin in their urine. Only about half of these people will acquire complete nephritis.

Kidney disease is uncommon in people who have had diabetes for less than ten years, according to statistics. Also, if a person does not get nephropathy 20–25 years after diabetes begins, they have a low probability of developing it later.

Diabetic nephropathy is less likely if a diabetic’s blood glucose levels are well controlled.

Because of the damage to blood vessels, high blood glucose levels raise the risk of high blood pressure. Hypertension, or high blood pressure, can aggravate kidney disease.

Other potential dangers

Other aspects to consider are:

Smoking: A relationship between smoking and increased levels of inflammation may cause kidney injury. While the exact link between smoking and diabetes is unknown, people appear to have a higher risk of diabetes, as well as hypertension and kidney disease.

Age: Kidney disease, particularly a low GFR, is more common in people over the age of 65.

Sex: The condition is more common in men than in women.

Ethnicity, race, or both: African Americans, Native Americans, and Asian Americans are more likely to have it.

Conditions of health: Obesity, chronic inflammation, high blood pressure, insulin resistance, and high blood lipids (fats) are all risk factors for kidney disease.

Some of these risks are or appear to be contributing factors to diabetes or complications.

Diabetic nephropathy is distinct from diabetic neuropathy, a condition that affects the nerve system.

Stages and symptoms

A person with diabetic nephropathy may not experience any symptoms in the early stages. Changes in blood pressure and fluid balance in the body, on the other hand, may already be evident. Waste materials can accumulate in the blood over time, causing symptoms.

Stages

Depending on the GFR, which also measures the proportion of functional kidney function, a clinician may divide renal disease into phases.

Stage 1: Kidney damage is present, but kidney function is normal and the GFR is 90 percent or higher.

Stage 2: Kidney impairment, with some function loss and a GFR of 60–89%.

Stage 3: Mild to severe function loss, with a GFR of 30–59%.

Stage 4: Severe impairment of function with a GFR of 15–29%.

Stage 5: Kidney failure with a GFR of less than 15%.

Symptoms

A person may not detect any symptoms in the early stages. They may feel sick and exhibit the following symptoms at stage 4 or 5:

  • fatigue due to lack of oxygen in the blood
  • nausea or vomiting
  • a metallic taste in the mouth
  • swollen ankles, feet, lower legs, or hands due to water retention
  • darker urine due to blood in the urine
  • shortness of breath

Cardiovascular disease is a complication of late-stage renal disease.

Following a diabetic treatment plan and getting frequent health checks can help a person with diabetes maintain their blood sugar levels, lower their risk of kidney problems, and detect problems early.

A urine test is used to check for proteins in the urine during screening. Protein in the urine, on the other hand, does not always indicate kidney disease; it could also be the result of a urinary tract infection.

Treatment

Diabetic nephropathy can be delayed or prevented with early treatment.

The major goal of treatment is to keep blood glucose and blood pressure under control. This may entail the administration of drugs.

Drug treatment

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can help to control blood pressure, protect renal function, and avoid future damage.

In individuals with CKD associated with type 2 diabetes, Kerendia (finerenone) is a prescription drug that can minimize the risk of persistent GFR decline, end-stage renal disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure.

In addition, because people with kidney disease generally have low vitamin D levels, a doctor may give vitamin D or a statin to lower cholesterol levels.

For people with type 2 diabetes and CKD, the American College of Cardiology issued guidelines in 2018 supporting the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RAs). These medications may lower the risk of CKD progression, heart attacks, or both.

Dietary changes

If you have kidney disease, your doctor may advise you to track the following nutrients:

Water: Although necessary, drinking too much water or fluid can lead to edema and high blood pressure.

Sodium: Because it is a salt component, it might elevate blood pressure.

Protein: Protein can cause waste to build up in the blood, putting extra strain on the kidneys in people who have kidney disease.

Phosphorus: This can be found in a variety of protein and dairy sources. Phosphorus overload can weaken bones and put strain on the kidneys.

Potassium: Potassium levels in people with kidney disease can be greater than they should be, which can harm nerve cells.

Keeping blood sugar levels in check

This is critical for reducing the risk of diabetes complications such as renal disease, cardiovascular disease, and diabetic neuropathy, a nerve system disorder.

These disorders can also lead to additional difficulties. Blood sugar control can also help prevent these problems from arising.

Late-stage treatment options

Diabetic nephropathy can proceed to end-stage renal disease (ESRD), which necessitates dialysis or a kidney transplant. They will very certainly require dialysis for the remainder of their lives or until a kidney donation becomes available.

Dialysis

Kidney dialysis is a process that separates waste items from the blood and removes them from the body using a machine. Dialysis is used to replace a healthy kidney.

Dialysis comes in a variety of forms:

Hemodialysis: Blood is drawn from the body by a needle in the forearm and transported to a dialysis machine via a tube. The blood is filtered outside the body by the machine, then returned through a tube and needle.

Depending on the choice selected, a person may need to do this three to seven times a week and spend two to ten hours per session.

Dialysis can be done at a dialysis facility or at home, and in some cases, overnight alternatives are available. People are increasingly able to incorporate dialysis into their work and personal routines because to flexible choices.

Peritoneal dialysis: The peritoneum, or lining of the abdomen, is used to filter blood inside the body.

  • Dialysis fluid enters the abdomen by a catheter in continuous ambulatory peritoneal dialysis (CAPD). Before draining out, the fluid lingers inside for several hours, filtering waste materials. It takes 30–40 minutes to drain.
  • Continuous cycler-assisted peritoneal dialysis (CCPD), also known as automated peritoneal dialysis, involves a person sleeping linked to a dialysis machine for 8–10 hours. The fluid drainage is controlled by the machine.

Peritoneal dialysis can be done at home, at work, or while traveling. It provides flexibility and gives the individual some control over their condition. If a person is going to travel, for example, they will need to learn how to operate the essential equipment and make sure they have all of the necessary materials.

Kidney transplant

If diabetic nephropathy has progressed to the point where a kidney transplant is necessary and a qualified donor is available, a doctor may propose it. It may take some time to find a donor.

Because a person can live with only one functioning kidney, some people offer to donate a kidney to a loved one.

The individual who receives the kidney, on the other hand, may find that their body rejects the new organ. The body has the best chance of accepting a kidney donation from a family member.

To lessen the risk of the new kidney being rejected by the body, the individual who has had a kidney transplant will need to take medicine. This can have some negative consequences, such as raising the risk of infection.

Financial help

Many people can get financial assistance. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Medicare and Medicaid normally cover kidney failure treatment.

If all of the following apply, a person can acquire Medicare for ESRD at any age:

  • Their kidneys are no longer functional.
  • They require dialysis on a regular basis or have had a kidney transplant.
  • They have worked for Social Security, the Railroad Retirement Board, or as a government employee for the required amount of time.
  • They are receiving Social Security or Railroad Retirement payments or are eligible for them.
  • They are the dependent kid or spouse of someone who fits one of the aforementioned criteria.

The individual should discuss their options with their insurance provider or their doctor.

Prevention

Controlling blood sugar and blood pressure is the greatest strategy for someone with diabetes to lower their risk of diabetic nephropathy.

This can be aided by making the following lifestyle changes:

  • checking blood glucose levels regularly
  • following any treatment plan their doctor suggests
  • limiting stress where possible
  • eating a nutritious diet that is high in fiber and low in sugar, processed carbohydrates, and salt
  • exercising regularly
  • limiting alcohol intake
  • avoiding tobacco

Learning as much as possible about diabetes and related consequences, such as kidney disease, can make a person feel more confident and in charge of their condition and prevention options.

The National Kidney Disease Education Program of the National Institute of Diabetes and Digestive and Kidney Diseases provides a downloadable record of test results that can assist a person maintain track of their kidney testing and development.

Outlook

The outlook for diabetic nephropathy people will be determined by how well they manage their blood sugar and blood pressure levels, as well as the stage at which they are diagnosed. The sooner therapy begins, the better the outlook.

Diabetic nephropathy can be slowed or stopped with treatment. People with diabetes should have their blood pressure checked as recommended by their doctor and take precautions to prevent kidney disease from worsening.

Sources:

  • https://www.nejm.org/doi/full/10.1056/NEJMoa2025845
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment
  • https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/eating-right
  • https://www.kidney.org/atoz/content/gfr
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297507/
  • https://www.medicalnewstoday.com/articles/319686
  • https://www.ahajournals.org/doi/10.1161/JAHA.116.003280
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/kidney-transplant
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206379/
  • https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis
  • https://www.medicare.gov/information-for-my-situation/signing-up-for-medicare-if-you-have-esrd
  • https://www.jwatch.org/fw114803/2018/11/27/sglt2-inhibitors-glp-1ras-recommended-type-2-diabetes-and

Continue Reading

Blood / Hematology

Exercise-induced hypoglycemia: Things to know

Published

on

The medical name for low blood sugar during or after exercise is exercise-induced hypoglycemia (EIH). The condition can cause itself in a variety of ways, including weakness, shakiness, and extreme exhaustion.

The body’s major source of energy is glucose. The body requires more energy during activity and hence uses more glucose. EIH is caused by an increase in the desire for glucose. Other factors could also be at play.

The symptoms, causes, treatment, and prevention of EIH are all covered in this article. It also covers if EIH is an indication of diabetes and when EIH should be treated.

When to ask assistance

If blood glucose levels go too low, hypoglycemia can be fatal. If you have one or more of the following symptoms, you should get medical help right away:

  • loss of consciousness
  • confusion
  • symptoms that persist despite resting or consuming more food
  • seizure

If people commonly develop EIH or hypoglycemia at other times, they should see a doctor. If the person has diabetes, this could indicate that they are taking too much insulin or that their diabetes medicine dosage is inaccurate.

What is EIH?

Exercise-induced hypoglycemia

Hypoglycemia is a condition in which the blood glucose level is insufficient to supply the body’s energy requirements. Hypoglycemia is defined as a blood glucose level of less than 70 milligrams per deciliter (mg/dl) according to doctors. Most people, however, do not experience hypoglycemia symptoms until their blood glucose levels fall below 55 mg/dl.

Carbohydrates are broken down into glucose by the body. The glucose then enters the bloodstream, prompting the pancreas to produce insulin in response. Insulin aids glucose entry into the body’s cells, allowing it to be used as fuel.

Because active muscles require more fuel, exercise raises glucose demand. Exercise may also make a person more insulin sensitive, which means the insulin works more efficiently and lowers blood glucose levels faster. These factors, when combined, can cause in EIH.

If a person has the following characteristics, they are more prone to develop EIH:

  • have insulin sensitivity or take insulin
  • already have low blood glucose, such as from hunger or from diabetes medication
  • do an intense workout that demands more energy

Symptoms of EIH

Glucose fuels the majority of major bodily activities. As a result, EIH symptoms can vary. The following are some probable signs and symptoms:

  • weakness
  • confusion
  • anxiety
  • fainting
  • shaking
  • dizziness

Hypoglycemia that lasts for a long time or is severe might be fatal. It could result in the following:

Causes

Exercise increases the body’s energy demands, causing it to respond by burning more glucose. People with low glucose levels or those whose bodies metabolize glucose quickly can develop hypoglycemia.

EIH can be caused by a number of reasons, including:

  • exercising immediately after a meal
  • being sick
  • drinking too much alcohol without food
  • using insulin or other diabetes medications
  • not eating enough, or fasting
  • not consuming enough carbohydrates

Exercise causes a significant increase in insulin, which eliminates glucose from the blood, in certain people. Even if a person is well-nourished and does not take blood glucose-lowering drugs, this rise might cause hypoglycemia.

If a person has persistent EIH, a doctor may prescribe medicine to help them recover. Most people, however, can solve the problem by making proper lifestyle modifications.

Is EIH a sign of diabetes?

EIH is not always a symptom of diabetes. Exercise by itself can significantly lower blood glucose levels. People with diabetes, on the other hand, have increased risk factors for hypoglycemia.

Hyperglycemia, or high blood glucose, is a complication of untreated diabetes. If people who take diabetes drugs take more than they need, they are more likely to develop hypoglycemia. It’s also possible that you’re not getting enough nourishment to match your exercise level.

Also, if people with diabetes take diabetic medicine while fasting or commencing a restrictive diet, they may develop hypoglycemia.

Treatment for EIH

Mild EIH normally does not necessitate therapy. In many cases, the condition arises as a result of a person not eating enough food before exercising. Individuals should consume a carbohydrate-rich meal 1–2 hours before a workout to avoid EIH.

Chronic EIH might occasionally indicate a problem with insulin manufacturing. A doctor may administer diazoxide to treat low blood sugar in people who have chronic EIH.

A doctor may consider removing a portion of the pancreas to reduce insulin production in rare circumstances.

Prevention in people with diabetes

People who take diabetic drugs to control their blood glucose levels should check their blood glucose levels before exercising, according to the American Diabetes Association (ADA). If their blood glucose level is below 100 mg/dl, they should consume 15–20 grams (g) of carbs to raise it.

Among the possibilities are:

  • 4 glucose tablets
  • 1 glucose gel tube
  • 1 tablespoon of honey or sugar
  • 4 ounces (oz) of soda or juice

The American Diabetes Association recommends that a person recheck their blood glucose after 15 minutes. If the blood sugar level stays below 100 mg/dl, they should eat another 15 g carbohydrate portion. They should do this every 15 minutes until their blood glucose level reaches at least 100 mg/dl.

Anaerobic exercise, such as high intensity interval training (HIIT), may reduce the incidence of hypoglycemia in people with diabetes, according to a 2019 review. Short bursts of intensive activity are followed by a rest and then another brief burst of intense activity in HIIT.

Prevention in people without diabetes

People without diabetes can usually avoid EIH by doing the following:

  • avoiding drinking alcohol before a workout
  • eating regular meals throughout the day
  • gradually building up to new exercise routines to give the body time to adapt

Stop and take a break if you start to feel unsteady or dizzy throughout your workout. They should drink 4 oz (113 g) of juice or eat a slice of toast before continuing their workout.

Conclusion

Hypoglycemia occurs when blood glucose levels fall too low to meet a person’s body’s energy needs. Hypoglycemia that happens during or after exercise is known as EIH. The condition can affect both people and non-diabetics.

Diabetes patients are more likely to develop EIH, especially if they use insulin or other blood glucose-controlling drugs. In such circumstances, a person should consult a doctor to see whether their drug amounts can be adjusted.

EIH is most commonly caused by not eating enough before exercising or not giving the body enough time to acclimatize to a new exercise schedule in people who do not have diabetes. If a person continues to have regular EIH despite following the necessary precautions, they should seek medical advice to establish the underlying cause.

Sources:

  • https://www.diabetes.org/healthy-living/fitness/getting-started-safely/blood-glucose-and-exercise
  • https://www.frontiersin.org/articles/10.3389/fendo.2019.00326/full
  • https://drc.bmj.com/content/6/1/e000578.abstract
  • https://www.medicalnewstoday.com/articles/exercise-induced-hypoglycemia-what-to-know
  • https://www.cdc.gov/diabetes/basics/insulin-resistance.html
  • https://www.ncbi.nlm.nih.gov/books/NBK534841/
  • https://www.hormone.org/diseases-and-conditions/diabetes/non-diabetic-hypoglycemia
  • https://www.frontiersin.org/articles/10.3389/fendo.2020.00578/full

Continue Reading

Copyright © 2022 NccMed.com