Diabetes mellitus - Wikipedia. Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. If left untreated, diabetes can cause many complications. This form was previously referred to as . The cause is unknown. The most common cause is excessive body weight and not enough exercise. Control of blood pressure and maintaining proper foot care are important for people with the disease. Type 1 DM must be managed with insulin injections. In addition to the known ones above, they include blurry vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious issues such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon. These typically develop after many years (1. Diabetes doubles the risk of cardiovascular disease. Diabetes- related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle wasting and weakness. There is a link between cognitive deficit and diabetes. Compared to those without diabetes, those with the disease have a 1. This type can be further classified as immune- mediated or idiopathic. The majority of type 1 diabetes is of the immune- mediated nature, in which a T- cell- mediated autoimmune attack leads to the loss of beta cells and thus insulin. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults, but was traditionally termed . This term, however, has no biologic basis and should not be used. Other complications include an impaired counterregulatory response to low blood sugar, infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e. This condition is a common and.Addison's disease). The increase of incidence of type 1 diabetes reflects the modern lifestyle. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 DM is the most common type of diabetes mellitus. At this stage, high blood sugar can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce the liver's glucose production. Type 2 DM is due primarily to lifestyle factors and genetics. Previous Lipodrops Review (Updated September 26, 2014): What You Should Know about Lipodrops Lipodrops is a weight loss supplement in the form of drops. Twitter Get all of the latest updates. Google + +1 us today on Google + © Copyright ConsumerPriceWatch.net 2017 All Rights Reserved. It is nice to see the intermittent fasting approach that I have recommended for some time now is starting to catch on. This is no surprise to me as it.
Consumption of sugar- sweetened drinks in excess is associated with an increased risk. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required. Though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heart and central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus's blood may inhibit fetal surfactant production and cause respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A Caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia. The name of this disease refers to early hypotheses as to its nature. Being due to a defective gene, this disease varies in age at presentation and in severity according to the specific gene defect; thus there are at least 1. MODY. People with MODY often can control it without using insulin. Other types. Prediabetes indicates a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 DM. Many people destined to develop type 2 DM spend many years in a state of prediabetes. Latent autoimmune diabetes of adults (LADA) is a condition in which type 1 DM develops in adults. Adults with LADA are frequently initially misdiagnosed as having type 2 DM, based on age rather than cause. Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin- antagonistichormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells. The ICD- 1. 0 (1. MRDM or MMDM, ICD- 1. E1. 2), was deprecated by the World Health Organization when the current taxonomy was introduced in 1. One of the effects of a sugar- rich vs a starch- rich meal is highlighted. Insulin production is more or less constant within the beta cells. Its release is triggered by food, chiefly food containing absorbable glucose. Insulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body, especially liver, adipose tissue and muscle, except smooth muscle, in which insulin acts via the IGF- 1. Therefore, deficiency of insulin or the insensitivity of its receptors plays a central role in all forms of diabetes mellitus. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen. Insulin is used by about two- thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst (polydipsia). It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full- blown diabetes mellitus, as well as cardiovascular disease. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes). These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. Evidence for the efficacy of this remains equivocal, however. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure. There are a number of different classes of anti- diabetic medications. Some are available by mouth, such as metformin, while others are only available by injection such as GLP- 1 agonists. Type 1 diabetes can only be treated with insulin, typically with a combination of regular and NPH insulin, or synthetic insulin analogs. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique. The greatest increase in rates has however been seen in low- and middle- income countries. Galen named the disease . He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the . He hypothesized a correlation of diabetes with other diseases, and he discussed differential diagnosis from the snakebite which also provokes excessive thirst. His work remained unknown in the West until 1. Latin edition was published in Venice. CE) used that word, with the intended meaning . The Latin word comes from mell- , which comes from mel, meaning . This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians. Society and culture. The 1. 98. 9 . Doing so is important not only in terms of quality of life and life expectancy but also economically . Anabolic steroid - Wikipedia. This article is about androgens as medications. For androgens as natural hormones, see Androgen. Anabolic steroids, also known more properly as anabolic- androgenic steroids (AAS). They are anabolic and increase protein within cells, especially in skeletal muscles. AAS also have varying degrees of androgenic and virilizing effects, including induction of the development and maintenance of masculinesecondary sexual characteristics such as the growth of the vocal cords and body hair. The word anabolic, referring to anabolism, comes from the Greek . The American College of Sports Medicine acknowledges that AAS, in the presence of adequate diet, can contribute to increases in body weight, often as lean mass increases and that the gains in muscular strength achieved through high- intensity exercise and proper diet can be additionally increased by the use of AAS in some individuals. Their use is referred to as doping and banned by most major sporting bodies. For many years, AAS have been by far the most detected doping substances in IOC- accredited laboratories. Testosterone is now nearly the only androgen used for this purpose and has been shown to increase height, weight, and fat- free mass in boys with delayed puberty. These sports include bodybuilding, weightlifting, shot put and other track and field, cycling, baseball, wrestling, mixed martial arts, boxing, football, and cricket. Such use is prohibited by the rules of the governing bodies of most sports. AAS use occurs among adolescents, especially by those participating in competitive sports. It has been suggested that the prevalence of use among high- school students in the U. S. Oral administration is the most convenient. Testosterone administered by mouth is rapidly absorbed, but it is largely converted to inactive metabolites, and only about 1/6 is available in active form. In order to be sufficiently active when given by mouth, testosterone derivatives are alkylated at the 1. This modification reduces the liver's ability to break down these compounds before they reach the systemic circulation. Testosterone can be administered parenterally, but it has more irregular prolonged absorption time and greater activity in muscle in enanthate, undecanoate, or cypionateester form. These derivatives are hydrolyzed to release free testosterone at the site of injection; absorption rate (and thus injection schedule) varies among different esters, but medical injections are normally done anywhere between semi- weekly to once every 1. A more frequent schedule may be desirable in order to maintain a more constant level of hormone in the system. In addition, because estered testosterone is dissolved in oil, intravenous injection has the potential to cause a dangerous embolism (clot) in the bloodstream. Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone- containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 1. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non- medical purposes. Studies indicate that the anabolic properties of AAS are relatively similar despite the differences in pharmacokinetic principles such as first- pass metabolism. However, the orally available forms of AAS may cause liver damage in high doses. AAS were ranked 1. Long- term steroid abusers may develop symptoms of dependence and withdrawal on discontinuation of AAS. Recreational AAS use appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood disorders, and progression to other forms of substance abuse, but the prevalence and severity of these various effects remains poorly understood. As a result, AAS users may get misdiagnosed by a psychiatrist not told about their habit. Case reports describe both hypomania and mania, along with irritability, elation, recklessness, racing thoughts and feelings of power and invincibility that did not meet the criteria for mania/hypomania. Compared with individuals that did not use steroids, young adult males that used AAS reported greater involvement in violent behaviors even after controlling for the effects of key demographic variables, previous violent behavior, and polydrug use. The drug response was highly variable. However: 8. 4% of subjects exhibited minimal psychiatric effects, 1. The mechanism of these variable reactions could not be explained by demographic, psychological, laboratory, or physiological measures. There have been anecdotal reports of depression and suicide in teenage steroid users. A 1. 99. 2 review found that AAS may both relieve and cause depression, and that cessation or diminished use of AAS may also result in depression, but called for additional studies due to disparate data. Most of these side- effects are dose- dependent, the most common being elevated blood pressure, especially in those with pre- existing hypertension. For example, AAS may prematurely stop the lengthening of bones (premature epiphyseal fusion through increased levels of estrogen metabolites), resulting in stunted growth. Other effects include, but are not limited to, accelerated bone maturation, increased frequency and duration of erections, and premature sexual development. AAS use in adolescence is also correlated with poorer attitudes related to health. Development of breast tissue in males, a condition called gynecomastia (which is usually caused by high levels of circulating estradiol), may arise because of increased conversion of testosterone to estradiol by the enzyme aromatase. This side- effect is temporary; the size of the testicles usually returns to normal within a few weeks of discontinuing AAS use as normal production of sperm resumes. Alteration of fertility and ovarian cysts can also occur in females. The kidney damage in the bodybuilders has similarities to that seen in morbidly obese patients, but appears to be even more severe. Water- soluble peptide hormones cannot penetrate the fatty cell membrane and only indirectly affect the nucleus of target cells through their interaction with the cell. However, as fat- soluble hormones, AAS are membrane- permeable and influence the nucleus of cells by direct action. The pharmacodynamic action of AAS begin when the exogenous hormone penetrates the membrane of the target cell and binds to an androgen receptor (AR) located in the cytoplasm of that cell. From there, the compound hormone- receptor diffuses into the nucleus, where it either alters the expression of genes. It has been hypothesized that this reduction in muscle breakdown may occur through AAS inhibiting the action of other steroid hormones called glucocorticoids that promote the breakdown of muscles. Through a number of mechanisms AAS stimulate the formation of muscle cells and hence cause an increase in the size of skeletal muscles, leading to increased strength. Depending on the length of use, the side effects of the steroid can be irreversible. Processes affected include pubertal growth, sebaceous gland oil production, and sexuality (especially in fetal development). Some examples of virilizing effects are growth of the clitoris in females and the penis in male children (the adult penis size does not change due to steroids. Men may develop an enlargement of breast tissue, known as gynecomastia, testicular atrophy, and a reduced sperm count. Compounds with a high ratio of androgenic to an anabolic effects are the drug of choice in androgen- replacement therapy (e. Determination of androgenic: anabolic ratio is typically performed in animal studies, which has led to the marketing of some compounds claimed to have anabolic activity with weak androgenic effects. This disassociation is less marked in humans, where all AAS have significant androgenic effects. The VP weight is an indicator of the androgenic effect, while the LA weight is an indicator of the anabolic effect. Two or more batches of rats are castrated and given no treatment and respectively some AAS of interest. The LA/VP ratio for an AAS is calculated as the ratio of LA/VP weight gains produced by the treatment with that compound using castrated but untreated rats as baseline: (LAc,t. The LA/VP weight gain ratio from rat experiments is not unitary for testosterone (typically 0. Animal studies also found that fat mass was reduced, but most studies in humans failed to elucidate significant fat mass decrements. The effects on lean body mass have been shown to be dose- dependent. Both muscle hypertrophy and the formation of new muscle fibers have been observed. The hydration of lean mass remains unaffected by AAS use, although small increments of blood volume cannot be ruled out. After drug withdrawal, the effects fade away slowly, but may persist for more than 6. Overall, the exercise where the most significant improvements were observed is the bench press. AR agonists are antigonadotropic . By suppressing endogenous testosterone levels and effectively replacing AR signaling in the body with that of the exogenous AAS, the myotrophic- androgenic ratio would be expected to be further increased, and this hence may be yet an additional mechanism contributing to the differences in myotrophic- androgenic ratio. In addition, some AAS, such as nandrolone, are also potent progestogens, and activation of the progesterone receptor is antigonadotropic similarly to activation of the AR.
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