In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients' own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.
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.”
Certain drugs that affect the brain can help to control chronic pain. Antidepressants in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which include duloxetine (Cymbalta), are often prescribed for pain. So are tricyclic antidepressants (TCAs) such as amitriptyline (Elavil). SSRIs often boost energy, while TCAs can make you sleepy. According to the Harvard Medical School website, “Some physicians prescribe an SSRI during the day and amitriptyline at bedtime for pain patients.”
^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
2018 was a year whose realities sometimes seemed to approach the dystopias and dramas of fiction, as stories of family trauma, environmental disaster, and sexual assault played out on the world stage. The books our writers and editors were drawn to this year include many that illuminate these struggles and inequities, whether in the form of visceral sonnets, lyrical history, or dizzyingly surreal detective yarns. But they also reach past political themes to the most intimate and universal of stories: a cross-continental meditation on transitory love, a warm and funny account of aging, a timeless reinvention of an ancient myth, and an absorbing deconstruction of faith, to name a few. Our list isn’t definitive or comprehensive, but guided by individual interests and tastes. Below, you’ll find essays, poetry, three striking fiction debuts, the first graphic novel to be longlisted for the Man Booker Prize, and more.
The guidelines, if widely accepted, would affect up to a quarter of Americans living with diabetes whose BMI is between 30 and 35. Worldwide, the effects would be even greater, since the majority of the 422 million people with diabetes have a BMI lower than 35. For people of Asian descent, the DSS-II agreed surgery could be considered for people down to 27.5 BMI, since many patients of Asian decent develop diabetes at a lower BMI.
The main symptoms of diabetes are three – polydipsia, polyphagia and polyuria. These mean increased thirst, increased hunger and increased frequency of urination. In addition patients complain of feeling very tired and weight loss and loss of muscle bulk. Type 1 diabetes can develop quickly, over weeks or even days whereas type 2 diabetes may develop gradually.
Since cardiovascular disease is a serious complication associated with diabetes, some have recommended blood pressure levels below 130/80 mmHg. However, evidence supports less than or equal to somewhere between 140/90 mmHg to 160/100 mmHg; the only additional benefit found for blood pressure targets beneath this range was an isolated decrease in stroke risk, and this was accompanied by an increased risk of other serious adverse events. A 2016 review found potential harm to treating lower than 140 mmHg. Among medications that lower blood pressure, angiotensin converting enzyme inhibitors (ACEIs) improve outcomes in those with DM while the similar medications angiotensin receptor blockers (ARBs) do not. Aspirin is also recommended for people with cardiovascular problems, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.
The word diabetes (/ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɪs/) comes from Latin diabētēs, which in turn comes from Ancient Greek διαβήτης (diabētēs), which literally means "a passer through; a siphon". Ancient Greek physician Aretaeus of Cappadocia (fl. 1st century CE) used that word, with the intended meaning "excessive discharge of urine", as the name for the disease. Ultimately, the word comes from Greek διαβαίνειν (diabainein), meaning "to pass through," which is composed of δια- (dia-), meaning "through" and βαίνειν (bainein), meaning "to go". The word "diabetes" is first recorded in English, in the form diabete, in a medical text written around 1425.
In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
Certain drugs may also help to control pain. These include anti-inflammatory medicines such as ibuprofen, aspirin, naproxen, indomethacin, and many others. While some of these are sold over the counter, they can have side effects, most notably gastrointestinal bleeding. A newer anti-inflammatory, celecoxib (Celebrex), may have fewer gastrointestinal side effects.
Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.
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.
^ Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I (February 2010). "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials". Lancet. 375 (9716): 735–42. doi:10.1016/S0140-6736(09)61965-6. PMID 20167359.
Many people may not want to divulge their bathroom dramas to a doctor, or anyone, or may think that heartburn is common and no big deal. Everyone gets a tummy ache now and again, but if you have diabetes, GI symptoms may indicate that something is chronically wrong. “If it bothers you, it’s worth getting checked out,” says Bragg. With a proper diagnosis, you and your health care provider can come up with a plan to make your whole body feel a whole lot better.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A Wall Street Journal op-ed by Tommy Meyerson, a veteran of the Syria campaign, argues that “the Kurdish-led civil administration does the heavy lifting of guarding hundreds of ISIS’ most dangerous foreign fighters,” asserts that the West “owes them a debt,” and warns that a Turkish invasion into territory they hold “would force Kurdish forces to pull back from the front lines against the remnant of ISIS, allowing the jihadists to regroup and proliferate.”
^ Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016). "Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013". BMJ. 354: i3857. doi:10.1136/bmj.i3857. PMC 4979358. PMID 27510511.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body. Insulin plays a critical role in balancing glucose levels in the body. 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.
Benari, an Ashkenazi Jew, doesn’t fall into that category. But Cummings and other bariatric experts I spoke to said that surgery should be a possible option for any person whose diabetes isn’t improving. Cummings himself is currently working on a clinical trial in India of bariatric patients with BMIs as low as 25. And he expects similar trials will come down the pipeline.
English word formation isn't always that tidy, however. The -ative ending often shows up even when there isn't a corresponding noun ending in -ation: we have authoritative without authoritation, qualitative without qualitation and talkative without talkation. Talk, of course, isn't even from Latin, but the friendly -ative suffix clung to it anyway, by analogy with other verbs that form adjectives by appending -ative, like affirm and affirmative, or represent and representative. Preventative got created from prevent by this same analogical pattern.
Diabetes is a whole-body problem. The disease is marked by too high blood glucose, which affects the many cells fed by the circulatory system. The cells of the gastrointestinal (GI) tract and the nerves that control its movement are no exception. People with diabetes have an elevated risk for a spectrum of GI disorders that can make life uncomfortable. Identifying the cause of GI discomfort is the first step toward getting the right treatment and finding relief.
After breaking this down, Brand took questions from the audience. The first was from a person in the third row who said her brother is an addict who keeps coming to her for money. What should she do? Brand moved to the very front of the stage and looked into the back of her eyes and told her she knows what she has to do—which is cut him off, let him hit rock bottom. She said, yes, she knows, and she cried.
This book was written in 1999 so I had this uncanny feeling in the back of my head that a lot of water has run over the dam since it was written. The author is a medical doctor with type 2 diabetes who weighed 313 pounds and was a first year medical student before he got the message of needing to do something about his health. He has some suggestions about reversal of diabetes that are interesting and give me pause for thought. His message in its majority is addressed to diabetics who are not ta ...more
The least expensive device is called the “research model” high RF frequency generator with a linear amplifier and it costs under $2,500. The more expensive, and far more powerful device, is called the high RF frequency generator with plasma amplifier and it costs about $4,700 with the antenna. The more advanced cases may require the more powerful plasma amplifier with an antenna.
"Advocacy Month was appropriately themed “Midterms Matter: Add your voice,” in light of the Nov. 6 election. ASDA members across the country made sure their fellow students went to the polls to represent the dental profession. It was an especially exciting election season since five dentists were elected to Congress." Read more on ASDA's blog, Mouthing Off
Your body naturally produces small amounts of this antioxidant. When taken in larger doses, it may help regulate blood sugar levels and ease nerve pain. One study found that people who took 600 milligrams daily had a 19% improvement in their diabetic neuropathy symptoms after 5 weeks. "Over the long term, alpha-lipoic damage may protect against further nerve damage," Vinik says.
Wellspring is produced by a quickly growing company called Wanderlust, “a global wellness platform” and “a multi-channel company focused around mindful living” by way of “renowned festival events, a full-service media company, and several permanent yoga centers.” Wanderlust was founded in Brooklyn 10 years ago and has since been putting on small, music-and-yoga-based festivals. But Wellspring is a new and much grander undertaking, lasting multiple days and based mostly on workshops and high-profile panels and lectures.
The progression of nephropathy in patients can be significantly slowed by controlling high blood pressure, and by aggressively treating high blood sugar levels. Angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) used in treating high blood pressure may also benefit kidney disease in patients with diabetes.
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level by promoting the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
Dr. Fung says he decided to experiment with intermittent fasting because he was frustrated seeing so many diabetic patients with kidney failure. “It occurred to me that fasting was an underutilized therapeutic option for losing weight,” he recalls. “I started doing this five years ago, and a lot of people got incredibly good results – it reversed their diabetes.”
Medications include a long (and boring) list of chemical names such as metformin, sulfonylureas, meglitinides, thiazolidinediones … you get the point. Each of these drugs works by either helping the body secrete more insulin, making tissues more sensitive to the hormone, or preventing the secretion of more sugar into the bloodstream. But, ultimately, the first line of defense against diabetes is direct insulin injection because of its high efficacy. And there are at least six main types of insulin, accompanied by another long list of difficult-to-pronounce suffixes, each with a slightly different effect. Along with treatment, diabetes requires constant monitoring for blood sugar levels, which include at-home blood tests, and routine medical check-ups. An insulin pump that monitors and injects insulin when needed is another option.
You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.