Intro:

The U.S. National Library of Medicine says diabetes occurs because of elevated blood glucose levels. The pancreas no longer uses or produces enough insulin for the body to function properly. Without enough insulin, high levels of glucose remain in the bloodstream. Diet plays a major role in controlling blood glucose levels, so people should maintain a nutritionally dense diet. Many diabetics think that they can’t eat fruits when diagnosed with diabetics; however, many fruits are good for diabetes because they have low sugar content.

Diabetes is a disease in which the body is not able to filter glucose levels properly, and that leads to damage of the nerves and blood vessels. When this damage occurs, two main problems happen, nerve damage and poor blood flow. These conditions can lead to many diabetic foot problems. Have a question? Get an answer from a Medical Professional now!

Neuropathy

Diabetic nerve damage is also called neuropathy. When you have neuropathy, your sensation of pain in your feet is diminished. This loss of pain sensation could make one unaware of a sore, blister, cut or rash until it becomes infected. Neuropathy will affect the amount of moisture delivered to your skin and may cause dry, cracked feet. These cracks can also become infected.

Peripheral Vascular Disease

Damage to your blood vessels, or peripheral vascular disease, leads to poor blood flow to your legs and feet. This condition impacts how well your body will be able to heal a cut or blister. Smoking also decreases blood flow to your extremities and will compound the lack of blood flow.

Potential Problems

Neuropathy and peripheral vascular disease work together to create major problems for your feet. For example; you have a rock in your shoe, but you can’t feel it under your toe because of neuropathy. By the end of the day, you have a blister on your toe and it does not heal well because lack of blood flow to your foot. The blister gets infected, and excess glucose in your bloodstream (due to diabetes) feeds on the germs on the infected toe. If this sore does not heal, it may turn to gangrene. If your physician can’t keep this from spreading, you may have to have your toe, foot or part of your leg amputated. Gangrene is a condition where the skin and flesh around a wound turns black and dies.

Calluses

Calluses on your feet are also common when you have diabetes, usually due to poor fitting shoes. You should prevent calluses from forming in the first place, by gently using a pumice stone while your skin is wet. Rub lotion on your feet directly after using the pumice stone. Calluses need to be treated by a doctor. If left without proper care, calluses may get thick and fall off, leave an open wound in the skin, and become infected.

Prevention/Solution

How can you avoid diabetic foot problems? Stop smoking. Buy comfortable, properly fitting shoes. Inspect your feet every day, preferably at night after a long day of usage. Look for redness, sores, cracks, blisters, calluses, cuts and rashes. If you are unable to bend down to look at your feet, use a mirror, or better yet, get someone to check for you. Wash your feet every day in warm water; avoid hot water, as it dries the skin out. Rub a good lotion on them; make sure the foot is completely dry before putting on socks and shoes. Make sure the area between the toes is dry as well. Use a pumice stone on calluses every day. Trim your toenails carefully, or have a professional do it who understands the proper way to avoid skin injury. Wear socks, shoes or slippers to protect your feet. Get the proper amount of exercise each day to keep circulation moving to your feet.

You should be under a physician's care to help protect your feet from diabetic foot problems.

The pancreas, an endocrine gland, produces one of the body’s most important hormones, insulin. Insulin lowers blood sugar levels by allowing cells to accept glucose (sugar) for use as energy. In individuals with diabetes, the pancreas cannot produce insulin. The lack of insulin in the body raises blood sugar levels (hyperglycemia), which can lead to kidney problems, liver problems, vascular disease coma or even death. Have a question? Get an answer from a Medical Professional now!

Type I Classification

The majority of individuals with Type I diabetes develop the disease as children. Diabetes develops because the lost beta cells in the Islets of Langerhans within the pancreas prohibit insulin production. Individuals with Type I diabetes must be on the lookout for skin disorders, nerve damage in the feet, eye care and maintain good dental health.

Type II Classification

Individuals with Type II diabetes develop the disease through a combination of genetics, poor diet and lack of exercise. The pancreas releases insulin to lower blood sugar levels. Excess fat around the muscles can block the absorption of glucose, making the body insulin-resistant. The glucose remains in the bloodstream, raising blood sugar levels and causing the pancreas to release more insulin. The cycle continues until the body becomes completely immune to the effects of insulin.

Type I Prevention/Solution

Since the beta cells no longer produce insulin, the body must get it from other sources to survive. Insulin cannot be taken orally, as it would be broken down during digestion. Without insulin, the body cannot use glucose for energy; therefore, insulin must be injected into the fat under the skin. Most insulin injections are made from synthetic sources, and a few are made from pigs. Extreme cases can be treated with insulin pumps. Pumps deliver insulin through a catheter placed under the skin.

Type II Prevention/Solution

Type II diabetes develops from insulin resistance. Insulin sensitivity can be restored with modest weight loss; as little as 10 to 15 lbs. can make a difference. Over 90 percent of individuals who lose weight and keep it off do it through a combination of diet and exercise. Until insulin sensitivity is restored, individuals with Type II diabetes may have to take insulin injections.

Misconceptions

Diabetics are no more likely to get the common cold and flu than any other individual. Colds raise blood sugar levels and can be dangerous for diabetics; diabetes does not affect the immune system and is not contagious. Diabetes does not create athersclerosis (hardening of the arteries). However, an obese Type II diabetic is at a greater risk of atherosclerosis than the rest of the population.

Carbohydrates are broken down during digestion into glucose. This substance moves into your blood and a hormone called insulin transfers the glucose to the body cells to give your body energy. People with diabetes either have a problem with insulin production or the cells aren't able to use the insulin which causes glucose to buildup in the blood. According to the National Diabetes Information Clearinghouse, gestational diabetes affects anywhere from three to eight out of 100 women in the United States. This condition is a type of diabetes that occurs during pregnancy but typically resolves after the baby is born. Its symptoms are similar to those of diabetes mellitus. Have a question? Get an answer from a Medical Professional now!

Increased Appetite

An increased appetite can indicate gestational diabetes, but despite this symptom, a pregnant woman may also lose weight. The body responds to the high level of insulin in the blood by producing and releasing more insulin. One action of insulin is to stimulate the appetite, which means that a higher level of insulin leads to an increased hunger. If the cells aren't able to use the insulin, the level of glucose in the blood will continue to build up, so the body breaks down the muscles and fat stores as a way to get the required energy to the cells. The pregnant woman may lose weight as these tissues shrink as well as feel constantly fatigued or lethargic, since this action causes the body to use more energy.

Excessive Thirst and Urination

A pregnant woman with gestational diabetes may have an increased thirst since the body craves liquids to help dilute the excess glucose in the blood. The body also moves liquids from the body tissues to help dilute the blood. For example, the body can pull fluid from the lenses of the eyes. This action can affect the way the eyes focus, which causes blurred vision. The increased fluid intake causes the pregnant women to pass large, excessive amounts of urine, which is different than the frequent passing of small amounts of urine that is typical of pregnancy. Diagnostic testing at the physician's office can reveal high amounts of glucose in the urine.

Infections

Since diabetes interferes with the body's ability to fight infections, the pregnant woman may experience frequent infections in areas such as the bladder, vagina and skin. White blood cells defend the body against bacteria, but these cells aren't able to function normally when a person has a high blood sugar. A woman with gestational diabetes may also complain of a yeast infection in the vagina or on the skin. Yeast cells are normally present in the vaginal area in small amounts. The vaginal secretions and urine contain more glucose when a woman has gestational diabetes. The yeast cells use the glucose as food, which causes the cells to multiply. With the body's immune system compromised by the high level of glucose in the blood, this increase in yeast cells turns into a yeast infection.

High Blood Sugar

Since a woman may not have any noticeable symptoms of gestational diabetes and symptoms can mimic regular pregnancy symptoms, screening for this condition is part of prenatal care for at-risk women between weeks 24 and 28 of pregnancy. Your physician will initially order a blood test called a glucose challenge test. If the glucose challenge test indicates a high blood sugar level, your physician may order a glucose tolerance test to confirm the diagnosis of gestational diabetes. Both tests involve drinking a sweet glucose solution and having your blood drawn after a prescribed amount of time.

Cranial diabetes insipidus

The underlying cause of cranial diabetes insipidus may need treating first. For example, if you are found to have a tumour affecting your hypothalamus or pituitary gland. Your doctor will be able to advise any treatment that you may need.

Otherwise, the following may be suggested:

Careful control of the fluids that you drink. In mild cases, cranial diabetes insipidus may be controlled by ensuring that you are drinking enough fluid to quench your thirst and to keep the salt levels in your blood stable. You may not need any other treatment. Regular monitoring of the salt levels in your blood using blood tests will usually be suggested.

Desmopressin. This is a medicine that resembles ADH. It can have the same effect as ADH on your kidneys. Desmopressin is also known as DDAVP®. It is usually given as nasal drops or nasal spray, or it can be taken as tablets by mouth. You usually need to take desmopressin between one and three times a day. The correct dose for you will be decided by your doctor. The aim is that the medicine should replace the ADH that your body is lacking and so will help to control the amount of urine that you pass.

Sometimes cranial diabetes insipidus may only last for a short period (perhaps a few weeks) after a head injury or brain surgery and so treatment may only be needed in the short term. However, other causes may mean that you need lifelong treatment for diabetes insipidus.

Nephrogenic diabetes insipidus

As mentioned above, sometimes nephrogenic diabetes insipidus can be caused as a side-effect of certain medicines such as lithium. If you are taking such a medicine and you develop diabetes insipidus, your doctor may recommend that the medicine be changed. However, only make changes to your medication on the advice of your doctor.

Nephrogenic diabetes insipidus is not caused by a lack of ADH and so giving desmopressin will not treat the condition. If you have mild nephrogenic diabetes insipidus, your doctor may suggest that you drink plenty of fluids to avoid dehydration. They may also suggest some changes to your diet to help reduce the amount of urine that you produce. For example, eating fewer salty and processed foods and fewer foods that contain protein (such as meat, fish and eggs). You may be referred to a dietician for specialist advice about your diet. You should not make changes to your diet without the advice of an expert.

If you have more severe nephrogenic diabetes insipidus, medication may be suggested. For example, a medicine called hydrochlorothiazide. This medicine can help to reduce the amount of urine that your kidneys produce.

Some other considerations and advice

If you have diabetes insipidus and you develop diarrhoea and/or vomiting, you need to pay particular attention to make sure that you drink plenty of fluids to help prevent lack of water in your body (dehydration). If you have any vomiting and/or serious diarrhoea, you should see a doctor. You also need to take care in hot weather because you will sweat more and so may become dehydrated more easily.

But it is also important that you don't become overloaded with water. This can happen if you are drinking more fluids than you are passing out in your urine or if you are taking too much desmopressin. Water overload can lead to problems with the levels of salts in your blood, particularly sodium. It can make your sodium levels drop too low. Signs that you may be water-overloaded can include headaches, weight gain and dizziness. Low sodium levels can make you feel drowsy and confused and in severe cases can lead to a fit (seizure) and unconsciousness. You should see your doctor if you are concerned about any of these symptoms. To avoid this, never take more desmopressin than you need and, if you are taking desmopressin, follow the advice of your doctor about how much fluid you should drink. Also, your doctor will usually recommend regular blood tests to check on your sodium and other salt levels if you have diabetes insipidus.

Your doctor may suspect diabetes insipidus by your typical symptoms and because of other things; for example, if you have had a recent head injury, surgery to your brain, etc. In order to confirm the diagnosis, various tests are usually suggested. These can include the following.

Blood and urine tests

For example:

To check the levels of sodium and potassium salts in your blood. These can be high in diabetes insipidus.

To check the level of sugar (glucose) in your blood and urine to exclude diabetes mellitus.

A water deprivation test

This is a special test where you must not drink any water or other fluids for a certain period of time (usually around 6-8 hours). The volume of urine that you produce will be measured to see if there is any change in the amount. If your body is working normally, the amount of urine that you produce should reduce if you have not drunk anything for a long time. However, if you have diabetes insipidus, there will be little change in your urine production.

Antidiuretic hormone test

After the period of fluid deprivation, you may then be given a drug that is similar to ADH. If you have cranial diabetes insipidus, once you have been given this drug, the amount of urine that you produce should reduce. The drug is replacing the ADH that you are lacking. If you have nephrogenic diabetes insipidus, you may have no, or only a small, response to the drug.

Other tests

Other tests may sometimes be suggested to look for possible causes of diabetes insipidus. For example, an MRI scan of your brain and pituitary gland.

Getting the balance right between how much water your body takes in and how much water your body passes out is very important. This is because a large proportion (about 70%) of your body is actually water. Also, water levels in your body help to control the levels of some important salts, particularly sodium and potassium.

Your body normally controls (regulates) water balance in two main ways:

By making you feel thirsty and so encouraging you to drink and take more water in.

Through the action of a hormone called antidiuretic hormone (ADH) which controls the amount of water passed out in your urine.

ADH is also known as vasopressin. It is made in a part of your brain called the hypothalamus. It is then transported to another part of your brain, the pituitary gland, from where it is released into your bloodstream. After its release, ADH has an effect on your kidneys. It causes your kidneys to pass out less water in your urine (your urine becomes more concentrated).

So, if your body is lacking in water (dehydrated), your thirst sensation will be triggered, encouraging you to drink. As well as this, more ADH will be released by your pituitary gland, so reducing the amount of water that is passed out in your urine. However, if you have too much water on board already, your thirst sensation will be switched off. This removes your desire to drink and take in more water. At the same time, less ADH will be released by your pituitary gland, so increasing the amount of water that is passed out in your urine (your urine becomes more diluted).