The disease is marked by alternating episodes of hypoglycemia and hyperglycemia. Frequent adjustments of dietary intake and insulin dosage are required. Etiology. Diabetes may be brittle when insulin is not well absorbed; insulin requirements vary rapidly; insulin is improperly prepared or administered; the Somogyi phenomenon is present; the patient has coexisting anorexia or bulimia; the patient's daily exercise routine, diet, or medication schedule varies; or physiological or psychological stress is persistent. Synonym: brittle diabetes mellitusbrittle diabetes mellitus. Brittle diabetes. Hemochromatosis. chemical diabetes. Asymptomatic DM, a stage in which no obvious clinical signs and symptoms of the disease are present but blood glucose measurements are abnormal. Type 2 DM occurring in an obese child or adolescent. MSN Health and Fitness has fitness, nutrition and medical information for men and women that will help you get active, eat right and improve your overall wellbeing.The syndrome is sometimes referred to as . It is the most common complication of CF other than those conditions that affect the lungs. It is caused by destruction of islet cells (the cells in the pancreas that make insulin) as well as a decrease in sensitivity of the liver and muscles to the actions of insulin. The disease usually first becomes clinically obvious in young adults. Patient Care. Although CFRD can be diagnosed with fasting glucose blood tests or hemoglobin A1c levels, many experts recommend using an oral glucose tolerance test. Fifteen to thirty percent of patients with CF are affected by their 2. CFRD is associated with more severe lung disease than is experienced by patients with CF and normal glucose tolerance. Our co-packing suites are climate controlled and segregated from each. I know it may be challenging to follow a healthy low-carb diet, especially if you are new to it. I hope this comprehensive list of keto-friendly foods will help you. Oral hypoglycemic agents, insulin, and exercise are the primary methods of treatment. Caloric restriction, a cornerstone of treatment for other forms of diabetes, is relatively contraindicated because of the need for aggressive nutritional supplementation in CF patients. A colloquial term for hybrid diabetes, also called type 3 diabetes or type 1 and a half diabetes. DM caused by diseases of the ovaries, pituitary, thyroid, or adrenal glands. A rare form of DM caused by chronic tropical pancreatitis and destruction of insulin- producing islet cells. Abbreviation: GDMDM that begins during pregnancy owing to changes in glucose metabolism and insulin resistance. GDM affects a large percentage of pregnant American women, ranging from about 1. Although gestational diabetes usually subsides after delivery, women with GDM have a 4. Diagnosis. Although many diabetic specialists recommend universal screening for GDM, it is agreed by all diabetologists that women at risk for GDM (women over age 2. DM) should undergo oral glucose tolerance testing as soon as possible to assess blood glucose levels while fasting and after meals. Testing should be repeated at 2. The Bulletproof Diet Roadmap is a great way to start making yourself more Bulletproof, melt the fat away, help you focus, and stay energized - all day. 14 diabetic diet plans you can use to lose weight and/or gain muscle depending on your weight and height. One quick update: Two weeks ago I was interviewed by the great folks at A Sweet Life. Their site is a great resource, especially for folks with diabetes, but really. Treatment. A calorically restricted diet, regular exercise, and metformin or insulin are used to treat GDM. Patient care. Blood glucose self- monitoring is essential to management, and patients should be taught to monitor glucose levels four times each day, obtaining a fasting level in the morning, followed by three postprandial levels (1 hr after the start of each meal). Blood glucose levels at 1 hr after beginning a meal are considered the best predictor for subsequent fetal macrosomia. Target blood glucose levels are 9. L or less (fasting) and 1. L postprandially. The patient and her partner should be instructed that food, stress, inactivity, and hormones elevate blood glucose levels and that exercise and insulin lower them. They will need to learn about both pharmacological (measuring and injecting insulin) and nonpharmacological (menu management and physical activity) interventions to maintain a normal glycemic state (euglycemia) throughout the pregnancy, while ensuring adequate caloric intake for fetal growth and preventing maternal ketosis. Women who have no medical or obstetrical contraindicting factors should be encouraged to participate in an approved exercise program, because physical activity increases insulin receptor sensitivity. Even performing 1. If euglycemia is not achieved by nutrition therapy and exercise within 1. Pregnant women require three to four times the amount of insulin needed by a nonpregnant woman. Human minimally antigenic insulin should be prescribed. Often one dose of long- acting insulin at bedtime is sufficient, with rapid- acting insulins, i. Novolog), or insulin lispro recombinant (Humalog) used to aid optimal glycemic control. Insulin glargine (Lantus), once used for gestational diabetes, is no longer recommended for pregnant women. Because stress can significantly raise blood glucose levels, stress management is a vital part of therapy. Coping strategies should be explored. The patient is taught about deep breathing and relaxation exercises and encouraged to engage in activities that she enjoys and finds relaxing. She and her partner should learn to recognize interaction tensions and ways to deal with these to limit stress in their environment. Maternal complications associated with GDM include pregnancy- induced hypertension, eclampsia, and the need for cesarean section delivery. A form of DM that has characteristics of both types 1 and 2. The patient may have episodes of diabetic ketoacidosis but marked insulin resistance and an obese body type. Urinary output is often massive, e. L/day, which may result in dehydration in patients who cannot drink enough liquid to replace urinary losses, e. The urine is dilute (specific gravity is often below 1. If water deficits are not matched or the urinary losses are not prevented, death will result from dehydration. Etiology. DI usually results from hypothalamic injury (such as brain trauma or neurosurgery) or from the effects of certain drugs (such as lithium or demeclocycline) on the renal resorption of water. Other representative causes include sickle cell anemia (in which renal infarcts damage the kidney's ability to retain water), hypothyroidism, adrenal insufficiency, inherited disorders of antidiuretic hormone production, and sarcoidosis. Symptoms. The primary symptoms are urinary frequency, thirst, and dehydration. Treatment. When DI is a side effect of drug therapy, the offending drug is withheld. DI caused by failure of the posterior pituitary gland to secrete antidiuretic hormone is treated with synthetic vasopressin. Patient care. Fluid balance is monitored. Fluid intake and output, urine specific gravity, and weight are assessed for evidence of dehydration and hypovolemic hypotension. Serum electrolyte and blood urea nitrogen levels are monitored. The patient is instructed in nasal insufflation of vasopressin (desmopressin acetate, effective for 8 to 2. The length of the therapy and the importance of taking medications as prescribed and not discontinuing them without consulting the prescriber are stressed. Hydrochlorothiazide can be prescribed for nephrogenic DI not caused by drug therapy; amiloride may be used in nephrogenic DI caused by lithium administration. Meticulous skin and oral care are provided; use of a soft toothbrush is recommended; and petroleum jelly is applied to the lips and an emollient lotion to the skin to reduce dryness and prevent skin breakdown. Adequate fluid intake should be maintained. Both the patient and family are taught to identify signs of dehydration and to report signs of severe dehydration and impending hypovolemia. The patient is taught to measure intake and output, to monitor weight daily, and to use a hydrometer to measure urine specific gravity. Weight gain should be reported because this may signify that the medication dosage is too high. Recurrence of polyuria may indicate dosing that is too low. The patient should wear or carry a medical ID tag and have prescribed medications with him or her at all times. Both patient and family need to know that chronic DI will not shorten the lifespan, but lifelong medications may be required to control the signs, symptoms, and complications of the disease. Counseling may be helpful in dealing with this chronic illness. Abbreviation: IDDMType 1 diabetes. A dated term for type 1 diabetes. Before the stress, no clinical or laboratory findings of diabetes are present. There is a very strong chance that affected people will eventually develop overt type 2 DM. Most patients affected by LADA eventually require insulin therapy, like patients with type 1 DM. Children with this form of DM are not prone to diabetic ketoacidosis. DM results either from failure of the pancreas to produce insulin (type 1 DM) or from insulin resistance, with inadequate insulin secretion to sustain normal metabolism (type 2 DM). Either type of DM may damage blood vessels, nerves, kidneys, the retina, and the developing fetus and the placenta during pregnancy. Type 1 or insulin- dependent DM has a prevalence of just 0. Type 2 DM (formerly called adult- onset DM) has a prevalence in the general population of 6. In some populations (such as older persons, Native Americans, African Americans, Pacific Islanders, Mexican Americans), it is present in nearly 2. Type 2 DM primarily affects obese middle- aged people with sedentary lifestyles, whereas type 1 DM usually occurs in children, most of whom are active and thin, although extremely obese children are now being diagnosed with type 2 diabetes as well. See: table; dawn phenomenon; insulin; insulin pump; insulin resistance; diabetic polyneuropathy; Somogyi phenomenon. Type 1 DM usually presents as an acute illness with dehydration and often diabetic ketoacidosis. Type 2 DM is often asymptomatic in its early years. The American Diabetes Association (1- 8. DIABETES) estimates that more than 5 million Americans have type 2 DM without knowing it. Etiology. Type 1 DM is caused by autoimmune destruction of the insulin- secreting beta cells of the pancreas. The loss of these cells results in nearly complete insulin deficiency; without exogenous insulin, type 1 DM is rapidly fatal.
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