Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and corticosteroids.
Chronically high blood glucose levels are known to damage nerves, so keeping blood glucose levels close to the normal, nondiabetic range can greatly reduce neuropathic pain. (Sometimes, however, if nerve damage has caused numbness in the feet, legs, hands, or arms, improving blood glucose control can cause pain in these areas as the nerves start to heal and regain function. The pain is usually temporary.)

The review affirmed how effective surgery is at treating diabetes (possibly even type 1 diabetes). Around two-thirds of patients with diabetes experience a full remission soon after surgery, while the rest are often better able to control their blood sugar through diet, exercise and medication. Other studies have shown that diabetics who have surgery outlive those who haven’t. Some longer-term research has suggested that one-third of these successes slide back into having active diabetes after five years, but to a lesser degree than they might have without surgery. By contrast, a 2014 study found that fewer than 2 percent of diabetes patients given standard care experienced any remission within a seven-year span.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Type 2 diabetes is a completely preventable and reversible condition, and with diet and lifestyle changes, you can greatly reduce your chances of getting the disease or reverse the condition if you’ve already been diagnosed. If you are one of the millions of Americans struggling with diabetes symptoms, begin the steps to reverse diabetes naturally today. With my diabetic diet plan, suggested supplements and increased physical activity, you can quickly regain your health and reverse diabetes the natural way.

Preventative soon drew enough attention that The New York Mirror devoted a whole column to it in the newspaper's March 6, 1824, edition. "The conversion of preventive into preventative is an error too common," wrote the anonymous scribe. "Some fall into it from ignorance, and others from inadvertence." The writer attributed its use to "a disposition in people to spell words with more letters than belong to them; or to insert a syllable or syllables, where addition, so far from being advisable or requisite, proves injurious." The column concluded with a call to action: "Let those, then, who from carelessness or any other cause, have been in the habit of using preventative, make it henceforth an invariable rule, whether in writing or in utterance, to prefer the proper and unexceptionable term preventive."


Antidepressants most commonly treat depression. However, they can be prescribed for diabetic nerve pain because they interfere with chemicals in your brain that cause you to feel pain. Your doctor may recommend tricyclic antidepressants, such as amitriptyline, imipramine (Tofranil), and desipramine (Norpramin). These can cause unpleasant side effects like dry mouth, fatigue, and sweating.
I am very excited by the closed-loop artificial pancreas trial which is now in its final stages. Professor Roman Hovorka at the University of Cambridge is currently perfecting an algorithm that enables a continuous glucose monitor and an insulin pump to talk to each other, and take over the delivery of insulin throughout the day and night, to keep glucose levels in range.
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Type 1 diabetes is commonly called “juvenile diabetes” because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cow’s milk and soy. (4)
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses, a lack of insulin may also develop.[12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is a combination of excessive body weight and insufficient exercise.[2]
In 2016, the 2nd Diabetes Surgery Summit released its own guidelines, arguing that surgery should be widely recommended for moderately obese people with diabetes who haven’t responded well to other treatments. They also agreed it should be considered for mildly obese people. And because of how cost-effective surgery is, especially compared to standard treatment, insurance companies should be willing to foot the bill, it said.
Trick (most important): Go for longer periods of time without eating (yes, yes, fasting). Consume water only for days or weeks at a time. Your fat will literally dissolve away, and with it your type 2 diabetes and other ailments. The definitive book here is Dr. Joel Fuhrman’s book, Fasting and Eating for Health: A Medical Doctor’s Program for Conquering Disease. I highly recommend it; if you’re skeptical, read the 200+ testimonial comments on Amazon. I and at least 20 of my friends have tried fasts lasting days to weeks. It works, and it is amazing.

While there is currently no cure for diabetes, researchers are hopeful for advancements. A 2017 pilot study may provide hope for a diabetes cure in the future. Researchers found that an intensive metabolic intervention, combining personalized exercise routines, strict diet, and glucose-controlling drugs could achieve partial or complete remission in 40 percent of patients, who were then able to stop their medication. More comprehensive studies are in the pipeline.
I was diabetic for 13 years and was taking metformin 1000 mg twice daily. Last A1C was 15. My symptoms have always been stomach and bowels. I am a 54 year old male. the metformin wasn’t really working so this year, our family doctor started me on Natural Herbal Gardens Diabetes Disease Herbal mixture, With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 7 weeks use of the Natural Herbal Gardens Diabetes disease natural herbal formula. My diabetes is totally reversed! Visit their website www . naturalherbalgardens . com I am thankful to nature
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 CE with type 1 associated with youth and type 2 with being overweight.[108] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination.[108] Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922.[108] This was followed by the development of the long-acting insulin NPH in the 1940s.[108]
The water was in boxes because Wellspring purposely forwent wasteful plastic bottles—a half measure, after inviting thousands of people to exercise in the desert. The water was alkaline because that’s a trendy new way to sell people water, and its maker was a sponsor of the festival. The class, too, was sponsored, an Adidas logo projected onto the wall. Outside was a food truck selling Bulletproof concoctions with “brain octane oil.” In a capacious central cavern was “one of the world’s largest wellness exhibitions,” where vendors pitched cosmetics and supplements and bars and tonics. On offer were complimentary CBD-oil massages (sponsored by the seller of said oils) and a balancing of people’s sacral chakras with something called a BioCharger (trademark), “a natural cellular revitalization platform that uses a full spectrum of light and harmonic frequencies to deliver restorative energy” and that promises to help with “creativity, sexuality, and acceptance of new experiences.”

Pain affects millions of people with diabetes. For most of these people, the pain is chronic, defined as pain persisting for more than six months, experienced almost every day, and of moderate to severe intensity, or that significantly interferes with daily activities. In some cases, a person’s pain is clearly related to complications of diabetes; in other cases, it is not. Regardless of the cause, however, studies show that chronic pain makes diabetes self-management much more difficult and often leads to higher blood glucose levels.
Diabetes experts feel that these blood glucose monitoring devices give patients a significant amount of independence to manage their disease process; and they are a great tool for education as well. It is also important to remember that these devices can be used intermittently with fingerstick measurements. For example, a well-controlled patient with diabetes can rely on fingerstick glucose checks a few times a day and do well. If they become ill, if they decide to embark on a new exercise regimen, if they change their diet and so on, they can use the sensor to supplement their fingerstick regimen, providing more information on how they are responding to new lifestyle changes or stressors. This kind of system takes us one step closer to closing the loop, and to the development of an artificial pancreas that senses insulin requirements based on glucose levels and the body's needs and releases insulin accordingly - the ultimate goal.

Pain has been shown to interfere with self-management activities, sleep, physical functioning, work, family relationships, mood, and quality of life. To make matters worse, pain is often invisible to others, so family members, coworkers, and health-care professionals often have no idea what a person in pain is going through. Many people feel that their physicians don’t understand and tell them they “just have to live with it.”
According to the 2017 National Diabetes Statistics Report, over 30 million people living in the United States have diabetes. That’s almost 10 percent of the U.S. population. And diabetes is the seventh leading cause of death in the United States, causing, at least in part, over 250,000 deaths in 2015. That’s why it’s so important to take steps to reverse diabetes and the diabetes epidemic in America.

Maintaining an optimal level of wellness is absolutely crucial to live a higher quality life. Wellness matters. Wellness matters because everything we do and every emotion we feel relates to our well-being. In turn, our well-being directly affects our actions and emotions. It’s an ongoing circle. Therefore, it is important for everyone to achieve optimal wellness in order to subdue stress, reduce the risk of illness and ensure positive interactions.
I was diabetic for 13 years and was taking metformin 1000 mg twice daily. Last A1C was 15. My symptoms have always been stomach and bowels. I am a 54 year old male. the metformin wasn’t really working so this year, our family doctor started me on Natural Herbal Gardens Diabetes Disease Herbal mixture, With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 7 weeks use of the Natural Herbal Gardens Diabetes disease natural herbal formula. My diabetes is totally reversed! Visit their website www . naturalherbalgardens . com I am thankful to nature
To determine your best treatment course, the Diabetes Relief team requires a metabolic test during your consultation. This simple, pain-free, highly accurate breathing test takes only about 10 minutes. From there, the medical team can first determine if the treatment will help. Then they will design an individualized blend of traditional diabetic care coupled with a revolutionary infusion therapy and a supplement protocol as the patient’s care plan to “help you get your life back.” All patient care is overseen by Medical Director Lindsey Jackson, MD, PhD, a multidisciplinary physician with expertise in cell biology, wound healing, and hyperbarics, who has significant scientific publications in books and journals.
Other studies have found that people with pre-diabetes or type 2 diabetes can go into remission through changes to their dietary and exercise habits. People who manage to achieve this with food alone will often express their excitement publicly by claiming they “cured” their diabetes with their diet. In reality, the likely put it into remission, though that remission can last a very long time.
Diabetes doesn’t cause nearly as much of a stir in the media compared to HIV or cancer, but a few well-known names are associated with the disease – Halle Berry, Tom Hanks, and Paula Deen. And who doesn’t love that Food Network maven and American celebrity chef? Scandals aside, diabetes comes in two versions – Type I or Type II. In Type I, the pancreas decides to drop out of the physiological rat race and go on to discover its own metabolic purpose in life. As a result, the body generates little or no insulin, a hormone important in sugar metabolism. In Type II, unfortunate dietary choices, such as eating tons of sugar and carbohydrates, jam up the sugar absorption process, causing the body to become resistant to the insulin hormone. Type 2 makes up 90 percent of all cases of diabetes, which is going to be our focus here as we talk about when there will be a cure for diabetes. (Spoiler alert: Probably only after we ban the Big Gulp and the Big Mac.)
Use any combination of the tricks below to accelerate your weight loss and return to good health. If you use all five wisely, you can get to your ideal weight in 6–12 months or less — even if that means losing 100 pounds or more. Yes, think about your weight 10, 20, 30 years ago. Another friend of mine started on this journey last year weighing 270 pounds. He’s in his mid-thirties and about to reach his college wrestling weight class of 197 pounds and just ran his fastest 2 miles ever. He got to this point by following the two rules above and just 3 of the 5 tricks below.

The fact these improvements can happen independently of weight loss should also signify a shift in how we conceptualize both obesity and diabetes, according to Peter Billings, the Seattle bariatric surgeon who operated on Benari. Billings, a nearly 20-year veteran in the field, has started to perform surgery on other lower-BMI patients similar to Benari, though they often pay out of pocket.
Interestingly, research suggests anxiety may be tied to type 2 diabetes risk. According to a September 2016 study published in the journal Psychoneuroendocrinology, which measured levels of blood glucose and IL-6, a protein in the body that stimulates immune response and healing, found that people with with low inhibition — or attention control — were more likely to have type 2 diabetes.
Weight loss surgery in those with obesity and type two diabetes is often an effective measure.[14] Many are able to maintain normal blood sugar levels with little or no medications following surgery[95] and long-term mortality is decreased.[96] There is, however, a short-term mortality risk of less than 1% from the surgery.[97] The body mass index cutoffs for when surgery is appropriate are not yet clear.[96] It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.[98]
Foods high in fiber: Research shows that 90 percent of the U.S. population doesn’t consume enough fiber on a daily basis. High-fiber foods help slow down glucose absorption, regulate your blood sugar levels and support detoxification. Aim to eat at least 30 grams of fiber per day, which can come from vegetables (like Brussels sprouts, peas and artichokes), avocados, berries, nuts and seeds, especially chia seeds and flaxseeds. (9)
“A significant cost is the association of wellness with money—thinking you need something external, tinctures and potions and balms. Its, you know, it’s the stuff that’s here,” said the Zen priest Angel Kyodo Williams, the second of only four black women recognized as teachers in the Japanese Zen lineage, during a talk in the latter wing as she gestured in the direction of the expo. “And there’s nothing wrong with those things, but we have a psychic connection that wellness equals something I can purchase, something I’m in competition for, something that I have to acquire because it’s not intrinsic to me.”

Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. Some of the antibodies seen in type 1 diabetes include anti-islet cell antibodies, anti-insulin antibodies and anti-glutamic decarboxylase antibodies. These antibodies can be detected in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes.
This event goes well beyond the initial vision of Wanderlust’s CEO, Sean Hoess, who sat down with me one morning by a hotel pool in running clothes. Hoess is 48, but like many Wellspring attendees looks a decade younger. He just renovated a house in Greenpoint, Brooklyn, and is openly “not a wellness buff”—he prefers tennis. After graduating from Columbia University, he went to law school, but quit practicing to start a record label with a college friend, Jeff Krasno. Krasno’s wife, Schuyler Grant, ran a yoga studio above their office, and the three of them had the idea to start a festival combining the two fields.
Treatment for gastroparesis can include dietary changes such as eating less fiber and eating smaller, more frequent meals. Medications are available as well that can spur muscle contractions in the stomach or help control nausea. Another option for some people is to have a gastric pacing device, similar to a heart pacemaker, surgically implanted to stimulate stomach movements.
The tuberculosis skin test is based on the fact that infection with M. tuberculosis produces a delayed-type hypersensitivity skin reaction to certain components of the bacterium. The standard recommended tuberculin test is administered by injecting 0.1mL of 5 TU (tuberculin units) PPD into the top layers of skin of the forearm. "Reading" the skin test means detecting a raised, thickened local area of skin reaction, referred to as induration. The area of induration (palpable, raised, hardened area) around the site of injection is the reaction to tuberculin.
Use any combination of the tricks below to accelerate your weight loss and return to good health. If you use all five wisely, you can get to your ideal weight in 6–12 months or less — even if that means losing 100 pounds or more. Yes, think about your weight 10, 20, 30 years ago. Another friend of mine started on this journey last year weighing 270 pounds. He’s in his mid-thirties and about to reach his college wrestling weight class of 197 pounds and just ran his fastest 2 miles ever. He got to this point by following the two rules above and just 3 of the 5 tricks below.
Type II diabetes is by far the more common form: about 95 percent of the population with diabetes have Type II. With Type II, your body still produces insulin, but your cells are unable to process it correctly. Sometimes a change in diet and exercise regimen can solve the problem. Other times, medication is needed to help your cells process insulin. A few years ago, I was told I also had Type II diabetes, which makes my condition quite rare.
There are major barriers for widespread use of islet also-transplantation that can help people with type 1 diabetes. The shortage of islets from donors is a huge obstacle. The other obstacle is that this is still considered an experimental procedure and until the procedure is considered successful enough to be labeled therapeutic by the FDA instead of experimental, the costs of these transplants come from limited research funds.
Lab studies show that Encellin’s “ultra thin-film implantable cell delivery system” keeps islet cells alive and functioning. In a 2015 study in the journal ACS Nano, Dr. Nyitray and others found that cells in the packaging survived for 90 days in lab animals. New blood vessels grew around the transplants and the cells produced insulin in response to rising glucose levels. In a 2016 study from Dr. Desai’s lab, also published in ACS Nano, human islet cells packaged in the tiny film envelopes survived for six months in mice—and the cells made and released insulin in response to rising blood glucose levels.
Narcotic medicines, which include opiates such as morphine and synthetics such as oxycodone, are sometimes given for pain. Narcotics dampen all senses, not just pain. Because of side effects including sleepiness, constipation, and addiction, they are less often used for chronic pain than they used to be. But they are still very helpful for some people, and most chronic pain specialists will prescribe them.
Talk to your doctor before using treatments based on capsaicin. It can cause allergic reactions, interact with other drugs, or cause dangerous side effects on open sores and irritated or sensitive skin. It might also make you more sensitive to the sun and other sources of heat. Avoid excessive exposure to sunlight or heat when using capsaicin creams or lotions.
When pain is a source of fear, anger, or grief, it usually hurts more. Cancer patients may experience worse pain, because they fear it means their disease is worsening or that they may be dying. Because your thoughts about your pain have a major effect on how bad it feels, it can help to change your thoughts. For example, you might try changing a negative thought such as, “This pain keeps me from doing everything I like,” to a more realistic, positive one such as, “This pain makes it harder to do things, but I can sometimes find different ways to do them.” Doing this can actually turn down your pain level.
Pain specialist Karen Burt, MD, director of Integrative Medicine at Contra Costa Regional Health Center in California, says that spiritual approaches help many people with chronic pain. “With chronic pain,” she says, “one needs to connect or return to all positive aspects of one’s being and one’s life. So if puppies and kids and nature and flowers and hot baths and your sister bring you pleasure and comfort, by all means, keep them in your life. By the same token, everyone has internal sources of positivity: one’s faith, one’s awe and appreciation of nature or life itself, and qualities like strength, courage, wisdom, hope, and inspiration.”
In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique.[100]
Acupuncture is a procedure where a practitioner inserts very thin needles into specific points on your skin. Some scientists say that acupuncture triggers the release of the body's natural painkillers. Acupuncture has been shown to offer relief from chronic pain and is sometimes used by people with neuropathy, the painful nerve damage that can happen with diabetes.
There are two major types of diabetes, called type 1 and type 2. Type 1 diabetes was also formerly called insulin dependent diabetes mellitus (IDDM), or juvenile-onset diabetes mellitus. In type 1 diabetes, the pancreas undergoes an autoimmune attack by the body itself, and is rendered incapable of making insulin. Abnormal antibodies have been found in the majority of patients with type 1 diabetes. Antibodies are proteins in the blood that are part of the body's immune system. The patient with type 1 diabetes must rely on insulin medication for survival.
Regarding age, data shows that for each decade after 40 years of age regardless of weight there is an increase in incidence of diabetes. The prevalence of diabetes in persons 65 years of age and older is around 25%. Type 2 diabetes is also more common in certain ethnic groups. Compared with a 7% prevalence in non-Hispanic Caucasians, the prevalence in Asian Americans is estimated to be 8.0%, in Hispanics 13%, in blacks around 12.3%, and in certain Native American communities 20% to 50%. Finally, diabetes occurs much more frequently in women with a prior history of diabetes that develops during pregnancy (gestational diabetes).
Home blood sugar (glucose) testing is an important part of controlling blood sugar. One important goal of diabetes treatment is to keep the blood glucose levels near the normal range of 70 to 120 mg/dl before meals and under 140 mg/dl at two hours after eating. Blood glucose levels are usually tested before and after meals, and at bedtime. The blood sugar level is typically determined by pricking a fingertip with a lancing device and applying the blood to a glucose meter, which reads the value. There are many meters on the market, for example, Accu-Check Advantage, One Touch Ultra, Sure Step and Freestyle. Each meter has its own advantages and disadvantages (some use less blood, some have a larger digital readout, some take a shorter time to give you results, etc.). The test results are then used to help patients make adjustments in medications, diets, and physical activities.
This deluge of products alternately offered to fill attendees with energy or to calm us down, but almost never to keep us as we were. The implicit allure of such products was that we were not okay, or at least could be better. Given all the ways in which most people believe we could be improved, “wellness” has become an all-encompassing concept and industry that not only eats into the territory of mainstream medicine, but that has subsumed what used to be called “alternative medicine”—that which alludes to scientific claims when convenient and also defines itself in opposition to the scientific establishment.
If possible, find a pain center that your insurance will pay for. Pain centers should combine physical, mental, and medical approaches and provide support from both professionals and other people living with pain. Some have brief residential programs followed by outpatient services. Most are entirely outpatient, and appointments are scheduled for several times a week at first, until a person’s pain is controlled adequately. A pain center may provide physical therapy, counseling, medication, self-management training, and more.
Findings from the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) have clearly shown that aggressive and intensive control of elevated levels of blood sugar in patients with type 1 and type 2 diabetes decreases the complications of nephropathy, neuropathy, retinopathy, and may reduce the occurrence and severity of large blood vessel diseases. Aggressive control with intensive therapy means achieving fasting glucose levels between 70-120 mg/dl; glucose levels of less than 160 mg/dl after meals; and a near normal hemoglobin A1c levels (see below).
Trick (most important): Go for longer periods of time without eating (yes, yes, fasting). Consume water only for days or weeks at a time. Your fat will literally dissolve away, and with it your type 2 diabetes and other ailments. The definitive book here is Dr. Joel Fuhrman’s book, Fasting and Eating for Health: A Medical Doctor’s Program for Conquering Disease. I highly recommend it; if you’re skeptical, read the 200+ testimonial comments on Amazon. I and at least 20 of my friends have tried fasts lasting days to weeks. It works, and it is amazing.
Diabetes Relief’s treatment program actually reconditions your metabolism. Consider this: Diabetes is not the root cause of your condition but a label used to categorize your comorbidities. Diabetes stems from a metabolic disorder and, through infusion therapy and natural supplements custom designed as part of the care plan, a patient’s metabolism gets a much-needed boost between treatments. Not only are patients reporting a decreased dependency on insulin, but wounds are healing, neuropathy is dissipating, and vision is returning!
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).

Everyone strays; everyone tries to avoid pain instead of learning from it; everyone has ways of escaping anxiety that aren’t productive. At its best, wellness offers habits and practices around which to build a community that will help you feel whole, or at least distract from the sense of inadequacy that drives people to self-injurious behavior—whether it be substance abuse or gambling or mistreating others or spending three hours a day on Instagram despite knowing it makes us feel bad.


Though it may be transient, untreated GDM 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 infant 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.[51]
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