The relevant type of diabetes

CARDIOVASCULAR DISORDERS

Cardiovascular risk factors:

- Smoking

- Overweight, sedentary life-style

- Presence of other chronic diseases (e.g., diabetes)

- Stressful life-style

- Diet high at fat, cholesterol, calories or salt

- Family history of cardiovascular disease

- Personal history of cardiovascular disease

Treatment of the cardiovascular disease

- Diet and exercise

- Medication and treatment

- Stress management

- Guidelines for daily living

DIAGNOSTIC TESTS:

- Holter monitoring (ambulatory electrocardiography),

- 12-lead electrocardiography,

- exercise electrocardiography (stress test),

- cardiac catheterization,

- phonocardiography,

- echocardiography,

- apexcardiography.

DISORDERS:

- hypertension,

- congestive heart failure (C.H.F.),

- angina pectoris,

- myocardial infarction (M.I.),

- arterial occlusive disease,

- varicose veins.

HYPERTENSION.

Blood pressure is the pressure exerted by blood against the inside walls of the blood vessels as the heart rhythmically contracts and relaxes. There are two components to BP:

- systolic BP; normally it's 100 to 140 mm Hg

- diastolic BP; normally it's below 90 mm Hg.

Hypertension is blood pressure that is too high. A blood pressure greater than 140 systolic and 90 diastolic is said to be high, or above normal.

Risk factors for hypertension include family history , age, race, smoking, and stress.

Reasons for treating hypertension include the following:

- people with hypertension die younger than people with normal BP;

- hypertension is a risk factor for cardiovascular disease;

- hypertension can damage the kidneys, eyes, blood vessels, and heart, increasing the risk of kidney failure, blindness, stroke, or heart attack.

The components of the treating regimen for hypertension requiring lifelong compliance include the following:

- dietary modifications

- medications

- stress management

- regular exercises

- blood pressure self-measurement

- regular medical follow-up.

The dietary measures to control hypertension include the following:

1. salt intake should be reduced;

2. weight should be reduced, if offered by the physician; obesity may increase blood pressure.

MYOCARDIAL INFARCTION (M.I.)

MI is the death of tissues in the heart muscles (myocardium). The area of dead tissue, called an infarct, will gradually be replaced by scar tissue.

Risk factors for MI include family history, hypertension, smoking, high levels of fats (lipids) and cholesterol in the blood, diabetes mellitus, obesity, a sedentary or stressful life-style, and age.

Symptoms of MI include the following:

- chest pain, which is described as persistent, crushing substernal pain that may radiate to the left arm, the law, the neck, or to the shoulder blades.

- Shortness of breath

- Perspiration

- Nausea / vomiting

- Dizziness

- Weakness

- A feeling of impending doom

- Cold, clammy skin

- Anxiety

- Restlessness.

A post-MI treatment regimenconsists of the following:

- Dietary modifications

- Medications

- Activity changes

- Monitoring pulse rate and rhythm

- Guidelines for daily living.

Dietary modifications used in the management of MI include reducing cholesterol, fat, and salt as well as calories, if the patient is over-weight.

VARICOSE VEINS.

Varicose veins are enlarged subcutaneous blood vessels that may have a bulging or twisted appearance.

The causes of varicose veinsinclude the following:

- The valves may be congenitally weak.

- Disease of the venous system, such as an infection (thrombophlebitis), may weaken the valves or damage the venous wall.

- Sustained pressure increases within the veins can damage the valves. Elevated pressure may occur with excessive abdominal weight in obesity or pregnancy and with prolonged standing in certain occupations.

Some patients are asymptomatic, and symptoms may vary. They include the following:

- A feeling of heaviness, itching, or burning in the general area of the vein.

- A diffuse, dull aching sensation after prolonged standing or walking.

- Leg cramps at night.

- Fatigue.

- Swelling.

- Palpable nodules.

Medical and surgical methods are used to manage varicose veins.

- Medical management includes supportive measures and exercise programs.

- Surgical management is reserved for severe varicose veins.

RESPIRATORY DISORDERS

Presence of respiratory risk factors:

- Smoking

- Occupational exposure to respiratory irritants and/or pollutants

- Genetic predisposition

- Emotional / stressful life-style

- Obesity

Treatment of the respiratory disease:

- Diet

- Medications

- Exercises

- Relaxation

- Guidelines for daily living

- Additional treatments

Respiratory disorders:

- asthma,

- bronchiectasis,

- chronic bronchitis,

- emphysema,

- pleuritis,

- pulmonary embolism.

ASTHMA.

Asthma is a chronic disease of variable severity, characterized by episodes of airway narrowing that temporarily produces breathing difficulty.

Factors that can trigger an asthma attack include the following:

- Respiratory infections

- Exposure to allergens

- Emotional factors

- Environmental changes, such as air temperature, humidity, and dust.

Symptoms of asthma include the following:

- Wheezing

- Prolonged expiration

- Dyspnea

- Physical exhaustion

- Inability to sleep or rest

- Anxiety

- Dehydration

- Thick, tenacious mucus production

- Use of accessory muscles of respiration; retractions.

Preventive measures:

¨ Avoiding the following bronchopulmonary irritants:

1. Cigarette smoke

2. Industrial pollutants

3. Animal hair

4. Dust

5. Powder, perfume

6. Weeds, pollen, grasses

7. Extreme heat or cold

¨ Avoiding known allergens

¨ Avoiding distressing situations

¨ Avoiding people with respiratory infections

¨ Practicing good oral hygiene to help prevent infection.

The components of the treatment regimen for asthma include the following:

- Medications

- A balanced, nutritious diet with small , frequent meals

- Oxygen therapy

- Stress management

- Regular medical examinations.

ENDOCRINE DISORDERS

Risk factors: gastrointestinal tract disorders, liver and other organs dysfunction.

Causes of E.D.:stress, traumas, hormonal dysfunction.

Symptoms: fatigue, weakness, irritability, nausea, vomiting, loss of consciousness, itchiness.

Treatment: hormonal therapy.

Disorders: diabetes mellitus, hyperthyroidism (Graves' disease), hypothyroidism, Addison's disease.

Diagnostic tests: oral glucose tolerance test, urine glucose determination, urine ketone determination, self-blood glucose monitoring,thyroid scan, thyroid ultrasonography.

Diabetes Mellitus.

D.M. is a chronic disorder in which the pancreas does not produce enough insulin or the insulin produced is not effective. The action of insulin in the body is to transport glucose (sugar) to the body cells for immediate use as energy or to be stored for future use.

Complications of D.M.

Uncontrolled blood glucose can lead to acute and/or chronic problems:

- Acute hyperglycemia may lead to severe fluid and weight loss, loss of consciousness, and even death.

- Chronic hyperglycemia may affect nerves and blood vessels and may cause a variety of other chronic problems, such as heart disease, poor circulation, eye disease, kidney disease, and nerve dysfunction.

- In children, normal growth and development may be retarded.

- In pregnant women, hyperglycemia can affect the health of both mother and child.

The relevant type of diabetes.

The physician will determine whether the patient has Type I or Type II D.M.

- Type I - insulin-dependent D.M. - most commonly occurs in children, although it may occur at any age. Since a person with Type I diabetes does not make enough of his own insulin, he must take insulin every day. Diet and exercises are also part of the treatment.

- Type II - non-insulin-dependent D.M. is more common: more than 80 % to 90% of all patients with diabetes have Type II diabetes. This type most occurs in overweight adults over age 40. A person with Type II diabetes produces some insulin, however, the insulin produced is not very effective, and the body cells resist it. Type II diabetes may be controlled with diet and exercises, but, in some cases, medications (such as oral pills or insulin) are required to control the blood glucose level.

Risk factors of diabetes.

The cause of diabetes is unknown. It is known to run in families, but it's not contagious. Other factors are obesity, pregnancy, physical or emotional stress (such as acute illness or accident), and aging. Diabetes is not caused by eating too much sugar.