Medical Disorders & Health Issues

Diabetes

Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat and is also made in your liver and muscles. Insulin made by the pancreas is a hormone that helps the glucose get into your cells to give them energy. Diabetes affects the body's ability to use blood sugar for energy. Over 6 million people in the U.S. (both adults and children) have undiagnosed diabetes. 

Most often, there are no diabetes symptoms or a very gradual development of the symptoms of type 2 diabetes.

The symptoms of type 2 diabetes due to high blood sugar may include:

·         Increased thirst

·         Increased hunger (especially after eating)

·         Dry mouth

·         Frequent urination

·         Unexplained weight loss (even though you are eating and feel hungry)

·         Fatigue (weak, tired feeling)

·         Blurred vision

·         Headaches

·         Loss of consciousness (rare)

·         Slow-healing sores or cuts

·         Itching of the skin (usually around the vaginal or groin area)

·         Frequent yeast infections

·         Recent weight gain

·         Velvety dark skin changes of the neck, armpit and groin, called acanthuses Nigerians

·         Numbness and tingling of the hands and feet

·         Decreased vision

·         Impotency

Types

Type 1 Diabetes

In type 1 diabetes, previously known as juvenile diabetes, the body’s immune system destroys insulin-producing cells in the pancreas.

Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes accounting for 90%-95% of people with diabetes. It’s been seen more in children with diabetes too.

Predicaments and Insulin Resistance

Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is, if you have pre-diabetes, you can reduce your risk of getting diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes and even return to normal glucose levels. 41 million people in the U.S. with predicaments (impaired glucose tolerance) 

Gestational Diabetes

Gestational diabetes occurs during pregnancy and affects about 4% of all pregnancies. It increases complications for mother and baby.

Complications

Uncontrolled diabetes may damage nerves, making it harder to notice foot problems due to diabetes that can eventually require amputation.

Infections and Diabetes

Diabetes may make the body more vulnerable to skin infections and other illnesses.

Insulin Resistance

Find out about insulin resistance and its dangerous ties to heart disease.

Skin Problems and Diabetes

Up to a third of diabetes patients have diabetes-related skin problems at some point in their lives.

Eye Problems, Heart Disease and High Blood Pressure

Uncontrolled diabetes can harm the eyes and cause blindness, Heart disease Is common in people with diabetes. In fact, statistics from the American Heart Association estimate that heart disease and stroke are responsible for two-thirds to three-fourths of the deaths amongst those with diabetes. Hypertension with diabetes -- hypertension is an important risk factor for the development and worsening of many complications of diabetes, including diabetic eye disease and kidney disease. It affects up to 60% of people with diabetes.

Kidney Disease

Diabetes is the leading cause of kidney failure.

The Nerve Damage of Diabetes

Diabetic neuropathy is a nerve disorder caused by diabetes. Symptoms of neuropathy include numbness and sometimes pain in the hands, feet, or legs.

Blood Conditions

Hyperglycemia, hypoglycemia and ketoacidosis
 

How to take care of your diabetes

After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, and gums and teeth. But the most serious problem caused by diabetes is heart disease. When you have diabetes, you are more than twice as likely as people without diabetes to have heart disease or a stroke.

If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.

You can reduce your risk of developing heart disease by controlling your blood pressure and blood fat levels. If you smoke, talk with your doctor about quitting. Remember that every step toward your goals helps!

The best way to take care of your health is to work with your health care team to keep your blood glucose, blood pressure, and cholesterol in your target range.

Sleep Apnea

The Greek word "apnea" literally means "without breath." Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may have sleep apnea if you snore loudly and you feel tired even after a full night's sleep?

There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.

In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe.
 

Mixed apnea, as the name implies, is a combination of the two.

With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.

Sleep apnea is very common, and affects more than twelve million Americans. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. The vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated.

Symptoms

• The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making the type of sleep apnea more difficult to determine. The most common signs and symptoms of obstructive and central sleep apneas include:

• Excessive daytime sleepiness (hypersomnia)

• Loud snoring, which is usually more prominent in obstructive sleep apnea

• Observed episodes of breathing cessation during sleep

• Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea

• Awakening with a dry mouth or sore throat

• Morning headache

• Difficulty staying asleep (insomnia)

• Several treatment options exist.

Therapies

§    Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.

Although CPAP is a preferred method of treating sleep apnea, some people find it cumbersome or uncomfortable. With some practice, most people learn to adjust the tension of the straps to obtain a comfortable and secure fit. You may need to try more than one type of mask to find one that's comfortable. Some people benefit from also using a humidifier along with their CPAP system.

Don't just stop using the CPAP machine if you experience problems. Check with your doctor to see what modifications can be made to make you more comfortable. Additionally, contact your doctor if you are still snoring despite treatment or begin snoring again. If your weight changes, the pressure settings may need to be adjusted.

§        Adjustable airway pressure devices. If CPAP continues to be a problem for you, you may be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping. For example, units that supply bi-level positive airway pressure (Biped) are available. These provide more pressure when you inhale and less when you exhale.

§   Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more effective than oral appliances, but oral appliances may be easier for you to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.

Surgery

The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea. Surgical options may include:

§    Uvulopalatopharyngoplasty (UPPP). During this procedure, your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.

§    Maxillomandibular advancement. In this procedure, the upper and lower part of your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success.

§    Tracheotomy. You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.

Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) or with radiofrequency energy (radiofrequency ablation) are procedures that doctors sometimes use to treat snoring. Although sometimes these procedures are combined with others, they aren't usually recommended as sole treatments for obstructive sleep apnea.

Other types of surgery may help reduce snoring and contribute to the treatment of sleep apnea by clearing or enlarging air passages:

§       Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum)

§       Surgery to remove enlarged tonsils or adenoids

Treatments for central and complex sleep apnea may include:

Therapies

§    Treatment for associated medical problems. Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.

§    Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.

§    Continuous positive airway pressure. This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway to keep it from collapsing. CPAP may eliminate snoring and prevent sleep apnea. As with obstructive sleep apnea, it's important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made.

§    Bi-level positive airway pressure (BiPAP). Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, BiPAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to assist the weak breathing pattern of central sleep apnea. Some BiPAP devices can be set to automatically deliver a breath if the device detects you haven't taken one after so many seconds.

§    Adaptive servo-ventilation (ASV). This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing. ASV may be more successful than CPAP at treating central sleep apnea. However, more study is needed.

Along with these treatments, you may read or hear about different treatments for sleep apnea, such as implants. Although a number of medical devices and procedures have received Food and Drug Administration clearance, there's limited published research regarding how useful they are, and they aren't generally recommended as sole therapies.