What is kidney failure?
The main function of the kidneys is to eliminate excess fluid and waste material from the blood. When the kidneys lose this filtering ability, dangerous levels of fluid and waste accumulate in the body leading to a condition known as kidney or renal failure. This may be due to various factors including infections, autoimmune diseases, and other endocrine disorders, cancer, and toxic chemicals. Kidney failure usually occurs in the late stages of the disease processes. Once kidney failure occurs, it requires immediate management and even then prognosis is often not satisfactory unless kidney transplantation is done.
What is the cause?
There are two main types of kidney failure:
Acute renal failure (ARF)
This is characterised by a sudden impairment of renal function marked by rapid, and steadily increasing accumulation of toxic products in the blood, normally excreted by the kidneys. The causes of acute kidney failure include:
factors that interfere with renal blood flow (for example: fluid and electrolyte depletion, haemorrhage, severe infections, cardiac or liver failure, heat stroke, fluid depletion due to burns).
factors that cause obstruction (for example enlarged prostate and kidney stones can also lead to acute kidney failure).
other causes are factors that impair the renal function directly (for example acute tubular injury or acute glomerulonephritis, which is an inflammatory disorder of the kidney).
Chronic renal failure (CRF)
This is characterised by a slow and irreversible impairment of the excretory and regulatory functions of the kidneys. The causes of CRF include:
Chronic disease of the kidneys like glomerulonephritis
Chronic infection like tuberculosis
Anomalies of the kidneys that are present since birth
Vascular disease like hypertension
Endocrine disease like diabetes
Obstructive processes in the kidneys such as kidney stones
Nephrotoxins (toxic chemicals that affect the kidneys)
What are the symptoms?
The symptoms and signs of kidney failure depend upon the type of failure. In acute kidney failure, the patient may have oliguria (reduced urine output) along with generalised swelling (oedema) of the body together with high blood pressure. Sometimes there may be blood in the urine. In the early stages of chronic kidney failure, the patient may merely have increasing fatigue and tiredness and symptoms like nocturia (increased frequency of urination at night). Vomiting, oedema and high blood pressure eventually develop. There is also loss of appetite. Other symptoms depend upon the cause of the failure. For example, if there are kidney stones, then there may be excruciating groin pain or if there is severe haemorrhage or diarrhoea there may be signs of shock. Complications in renal failure include pulmonary oedema (presence of fluid in the lungs), severe sustained increase in blood pressure, acidosis, hyperkalaemia (increased level of potassium in the blood), and infection. If untreated, the last stage of kidney failure is almost invariably fatal.
How is the diagnosis made?
Urine examination is done to determine the presence of protein, sugar, casts and crystals, pH and specific gravity and the quantity of sodium. This gives an idea as to the cause of the failure. Blood tests include tests of renal function like
Blood urea nitrogen
Serum creatinine
Serum electrolytes.
Creatinine clearance is also an important index of renal function.
Blood counts and the haemoglobin levels are also useful. An ultrasound of the abdomen or a CT-scan needs to be taken to assess kidney size with grossly shrunken kidneys indicating a more advanced disease. End-stage renal disease is diagnosed when blood tests consistently show very high levels of urea and creatinine, a sign that kidney function has been severely and permanently damaged.
What is the treatment?
In acute kidney failure, general treatment measures include avoiding drugs that require renal excretion, balancing fluid intake with output, high carbohydrate and low-protein diet, essential amino acid replacement and at least 100gms of glucose per day, decreased intake of salt and potassium, vitamin supplements, prevention of injury or infection, weight management, electrolytes monitoring, and monitoring of vital signs, cardiac status, and mental status. Peritoneal or haemodialysis is the treatment of choice when other measures fail. Drugs are used to reduce the blood pressure; diuretics (drugs that increase urine output) are used in some cases to increase blood flow unless oliguria is present. Antibiotics may be needed to treat associated infections (predominantly only antibiotics excreted by the liver are used if there is no liver disease).
In chronic kidney failure, general treatment measures include a diet low in sodium, potassium, and phosphate, but high in calories and supplemented with essential amino acids. Other measures include balanced fluid intake, and monitoring weight changes, vital signs, electrolyte balance, cardiac and mental status.
Drug therapy: This includes antihypertensives for hypertension, diuretics for oedema and hypertension, phosphate binders for hyperphosphataemia (increased phosphate levels in the body), antibiotics, anticonvulsants for seizures, antiemetics (drugs that prevent vomiting) for nausea, laxatives for constipation, calcium, iron, and vitamin supplements.
Dialysis: Peritoneal dialysis or haemodialysis is often required for end-stage disease.
Surgery: Kidney transplantation is the solution for several patients as dialysis is often a measure that cannot be done indefinitely. The results of transplantation are now extremely good with substantial five-year survival rates.
What is the prevention?
Prevention of the causative factors, wherever possible, may help in preventing the development of the disease. Control of blood sugar in diabetics is of great importance. After the disease has developed, drug therapy may help and dialysis and kidney transplantation are increasingly being performed with excellent results. Control of blood pressure and avoiding smoking, alcohol, and drug abuse are also necessary. Proper diet and exercise also help in delaying the progress of the disease.
Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts
Kidney failure
What is kidney failure?
The main function of the kidneys is to eliminate excess fluid and waste material from the blood. When the kidneys lose this filtering ability, dangerous levels of fluid and waste accumulate in the body leading to a condition known as kidney or renal failure. This may be due to various factors including infections, autoimmune diseases, and other endocrine disorders, cancer, and toxic chemicals. Kidney failure usually occurs in the late stages of the disease processes. Once kidney failure occurs, it requires immediate management and even then prognosis is often not satisfactory unless kidney transplantation is done.
What is the cause?
There are two main types of kidney failure:
Acute renal failure (ARF)
This is characterised by a sudden impairment of renal function marked by rapid, and steadily increasing accumulation of toxic products in the blood, normally excreted by the kidneys. The causes of acute kidney failure include:
factors that interfere with renal blood flow (for example: fluid and electrolyte depletion, haemorrhage, severe infections, cardiac or liver failure, heat stroke, fluid depletion due to burns).
factors that cause obstruction (for example enlarged prostate and kidney stones can also lead to acute kidney failure).
other causes are factors that impair the renal function directly (for example acute tubular injury or acute glomerulonephritis, which is an inflammatory disorder of the kidney).
Chronic renal failure (CRF)
This is characterised by a slow and irreversible impairment of the excretory and regulatory functions of the kidneys. The causes of CRF include:
Chronic disease of the kidneys like glomerulonephritis
Chronic infection like tuberculosis
Anomalies of the kidneys that are present since birth
Vascular disease like hypertension
Endocrine disease like diabetes
Obstructive processes in the kidneys such as kidney stones
Nephrotoxins (toxic chemicals that affect the kidneys)
What are the symptoms?
The symptoms and signs of kidney failure depend upon the type of failure. In acute kidney failure, the patient may have oliguria (reduced urine output) along with generalised swelling (oedema) of the body together with high blood pressure. Sometimes there may be blood in the urine. In the early stages of chronic kidney failure, the patient may merely have increasing fatigue and tiredness and symptoms like nocturia (increased frequency of urination at night). Vomiting, oedema and high blood pressure eventually develop. There is also loss of appetite. Other symptoms depend upon the cause of the failure. For example, if there are kidney stones, then there may be excruciating groin pain or if there is severe haemorrhage or diarrhoea there may be signs of shock. Complications in renal failure include pulmonary oedema (presence of fluid in the lungs), severe sustained increase in blood pressure, acidosis, hyperkalaemia (increased level of potassium in the blood), and infection. If untreated, the last stage of kidney failure is almost invariably fatal.
How is the diagnosis made?
Urine examination is done to determine the presence of protein, sugar, casts and crystals, pH and specific gravity and the quantity of sodium. This gives an idea as to the cause of the failure. Blood tests include tests of renal function like
Blood urea nitrogen
Serum creatinine
Serum electrolytes.
Creatinine clearance is also an important index of renal function.
Blood counts and the haemoglobin levels are also useful. An ultrasound of the abdomen or a CT-scan needs to be taken to assess kidney size with grossly shrunken kidneys indicating a more advanced disease. End-stage renal disease is diagnosed when blood tests consistently show very high levels of urea and creatinine, a sign that kidney function has been severely and permanently damaged.
What is the treatment?
In acute kidney failure, general treatment measures include avoiding drugs that require renal excretion, balancing fluid intake with output, high carbohydrate and low-protein diet, essential amino acid replacement and at least 100gms of glucose per day, decreased intake of salt and potassium, vitamin supplements, prevention of injury or infection, weight management, electrolytes monitoring, and monitoring of vital signs, cardiac status, and mental status. Peritoneal or haemodialysis is the treatment of choice when other measures fail. Drugs are used to reduce the blood pressure; diuretics (drugs that increase urine output) are used in some cases to increase blood flow unless oliguria is present. Antibiotics may be needed to treat associated infections (predominantly only antibiotics excreted by the liver are used if there is no liver disease).
In chronic kidney failure, general treatment measures include a diet low in sodium, potassium, and phosphate, but high in calories and supplemented with essential amino acids. Other measures include balanced fluid intake, and monitoring weight changes, vital signs, electrolyte balance, cardiac and mental status.
Drug therapy: This includes antihypertensives for hypertension, diuretics for oedema and hypertension, phosphate binders for hyperphosphataemia (increased phosphate levels in the body), antibiotics, anticonvulsants for seizures, antiemetics (drugs that prevent vomiting) for nausea, laxatives for constipation, calcium, iron, and vitamin supplements.
Dialysis: Peritoneal dialysis or haemodialysis is often required for end-stage disease.
Surgery: Kidney transplantation is the solution for several patients as dialysis is often a measure that cannot be done indefinitely. The results of transplantation are now extremely good with substantial five-year survival rates.
What is the prevention?
Prevention of the causative factors, wherever possible, may help in preventing the development of the disease. Control of blood sugar in diabetics is of great importance. After the disease has developed, drug therapy may help and dialysis and kidney transplantation are increasingly being performed with excellent results. Control of blood pressure and avoiding smoking, alcohol, and drug abuse are also necessary. Proper diet and exercise also help in delaying the progress of the disease.
The main function of the kidneys is to eliminate excess fluid and waste material from the blood. When the kidneys lose this filtering ability, dangerous levels of fluid and waste accumulate in the body leading to a condition known as kidney or renal failure. This may be due to various factors including infections, autoimmune diseases, and other endocrine disorders, cancer, and toxic chemicals. Kidney failure usually occurs in the late stages of the disease processes. Once kidney failure occurs, it requires immediate management and even then prognosis is often not satisfactory unless kidney transplantation is done.
What is the cause?
There are two main types of kidney failure:
Acute renal failure (ARF)
This is characterised by a sudden impairment of renal function marked by rapid, and steadily increasing accumulation of toxic products in the blood, normally excreted by the kidneys. The causes of acute kidney failure include:
factors that interfere with renal blood flow (for example: fluid and electrolyte depletion, haemorrhage, severe infections, cardiac or liver failure, heat stroke, fluid depletion due to burns).
factors that cause obstruction (for example enlarged prostate and kidney stones can also lead to acute kidney failure).
other causes are factors that impair the renal function directly (for example acute tubular injury or acute glomerulonephritis, which is an inflammatory disorder of the kidney).
Chronic renal failure (CRF)
This is characterised by a slow and irreversible impairment of the excretory and regulatory functions of the kidneys. The causes of CRF include:
Chronic disease of the kidneys like glomerulonephritis
Chronic infection like tuberculosis
Anomalies of the kidneys that are present since birth
Vascular disease like hypertension
Endocrine disease like diabetes
Obstructive processes in the kidneys such as kidney stones
Nephrotoxins (toxic chemicals that affect the kidneys)
What are the symptoms?
The symptoms and signs of kidney failure depend upon the type of failure. In acute kidney failure, the patient may have oliguria (reduced urine output) along with generalised swelling (oedema) of the body together with high blood pressure. Sometimes there may be blood in the urine. In the early stages of chronic kidney failure, the patient may merely have increasing fatigue and tiredness and symptoms like nocturia (increased frequency of urination at night). Vomiting, oedema and high blood pressure eventually develop. There is also loss of appetite. Other symptoms depend upon the cause of the failure. For example, if there are kidney stones, then there may be excruciating groin pain or if there is severe haemorrhage or diarrhoea there may be signs of shock. Complications in renal failure include pulmonary oedema (presence of fluid in the lungs), severe sustained increase in blood pressure, acidosis, hyperkalaemia (increased level of potassium in the blood), and infection. If untreated, the last stage of kidney failure is almost invariably fatal.
How is the diagnosis made?
Urine examination is done to determine the presence of protein, sugar, casts and crystals, pH and specific gravity and the quantity of sodium. This gives an idea as to the cause of the failure. Blood tests include tests of renal function like
Blood urea nitrogen
Serum creatinine
Serum electrolytes.
Creatinine clearance is also an important index of renal function.
Blood counts and the haemoglobin levels are also useful. An ultrasound of the abdomen or a CT-scan needs to be taken to assess kidney size with grossly shrunken kidneys indicating a more advanced disease. End-stage renal disease is diagnosed when blood tests consistently show very high levels of urea and creatinine, a sign that kidney function has been severely and permanently damaged.
What is the treatment?
In acute kidney failure, general treatment measures include avoiding drugs that require renal excretion, balancing fluid intake with output, high carbohydrate and low-protein diet, essential amino acid replacement and at least 100gms of glucose per day, decreased intake of salt and potassium, vitamin supplements, prevention of injury or infection, weight management, electrolytes monitoring, and monitoring of vital signs, cardiac status, and mental status. Peritoneal or haemodialysis is the treatment of choice when other measures fail. Drugs are used to reduce the blood pressure; diuretics (drugs that increase urine output) are used in some cases to increase blood flow unless oliguria is present. Antibiotics may be needed to treat associated infections (predominantly only antibiotics excreted by the liver are used if there is no liver disease).
In chronic kidney failure, general treatment measures include a diet low in sodium, potassium, and phosphate, but high in calories and supplemented with essential amino acids. Other measures include balanced fluid intake, and monitoring weight changes, vital signs, electrolyte balance, cardiac and mental status.
Drug therapy: This includes antihypertensives for hypertension, diuretics for oedema and hypertension, phosphate binders for hyperphosphataemia (increased phosphate levels in the body), antibiotics, anticonvulsants for seizures, antiemetics (drugs that prevent vomiting) for nausea, laxatives for constipation, calcium, iron, and vitamin supplements.
Dialysis: Peritoneal dialysis or haemodialysis is often required for end-stage disease.
Surgery: Kidney transplantation is the solution for several patients as dialysis is often a measure that cannot be done indefinitely. The results of transplantation are now extremely good with substantial five-year survival rates.
What is the prevention?
Prevention of the causative factors, wherever possible, may help in preventing the development of the disease. Control of blood sugar in diabetics is of great importance. After the disease has developed, drug therapy may help and dialysis and kidney transplantation are increasingly being performed with excellent results. Control of blood pressure and avoiding smoking, alcohol, and drug abuse are also necessary. Proper diet and exercise also help in delaying the progress of the disease.
Nephrotic syndrome
What is Nephrotic syndrome?
Nephrotic syndrome is a condition marked by very high levels of protein in the urine (proteinuria); low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol. Nephrotic syndrome results from damage to the kidneys' glomeruli, which are tiny blood vessels that filter waste and excess water from the blood and send them to the bladder as urine. Nephrotic syndrome can occur with many diseases, including the kidney diseases caused by diabetes mellitus, but some causes are unknown.
Nephrotic syndrome can affect all age groups. In children, it is most common from the age of 2 to 6 years. Males are slightly more likely to be affected than females.
What is the cause?
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine. The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
This condition can also occur as a result of infection, drug exposure, malignancy, hereditary disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis. It can accompany kidney disorders, including glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
What are the symptoms?
Swelling (oedema): general, around the eyes, in the extremities, especially the feet and ankles
Swollen abdomen
Facial swelling
Foamy appearance of the urine
Weight gain (unintentional) from fluid retention
Poor appetite
High blood pressure
How is it diagnosed?
Physical examination can detect some symptoms. Other symptoms and signs of causative disorders can also be found with examination. Urinalysis reveals large amounts of urine protein. Fats are often also present in the urine. Tests to rule out various causes may include the following:
Glucose tolerance test
Antinuclear antibody
Rheumatoid factor
Cryoglobulins
Complement levels
Hepatitis B and C antibodies
VDRL serology
Serum protein electrophoresis
Kidney biopsy
Nephrotic syndrome can also alter the results of the following tests:
Urinary casts
Triglyceride
Protein electrophoresis - urine
Serum iron
Cholesterol
Albumin
What is the treatment?
The goals of treatment are to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment of the causative disorder is necessary to control nephrotic syndrome. Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may help control symptoms. Antibiotics may be needed to control infections. Angiotensin converting enzyme (ACE) inhibitors may significantly reduce the degree of protein loss in the urine and are therefore frequently prescribed for treatment of nephrotic syndrome.
If hypertension occurs, it must be treated vigorously. Treatment of high blood cholesterol and triglyceride levels is also recommended to reduce the risk of atherosclerosis. Dietary limitation of cholesterol and saturated fats may be of little benefit, as the high levels which accompany this condition seem to be the result of overproduction by the liver rather than from excessive fat intake. Medications to reduce cholesterol and triglycerides may be recommended.
In many patients, reducing the amount of protein in the diet produces a decrease in urine protein. In most cases, a moderate-protein diet is usually recommended. Sodium (salt) may be restricted to help control swelling. Vitamin D may need to be replaced if nephrotic syndrome is chronic and unresponsive to therapy.
Nephrotic syndrome may go away once the underlying cause, if known, has been treated. In children, 80 percent of cases of nephrotic syndrome are caused by minimal change disease, which can be successfully treated with prednisone. However, in adults, most of the time the underlying cause is a kidney disease such as membranous nephropathy or focal segmental glomerulonephritis, and these diseases often persist even with treatment. In these cases, the kidneys may gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the patient will need dialysis or a kidney transplant.
What is the prognosis?
The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy. The cause and development of complications also affects the outcome.
What are the complications?
Atherosclerosis and related heart diseases
Renal vein thrombosis
Chronic and acute renal failure
Infections, including pneumococcal pneumonia
Malnutrition
Fluid overload, congestive heart failure, pulmonary oedema
Can it be prevented?
Treatment of causative disorders may prevent the development of nephrotic syndrome.
Nephrotic syndrome is a condition marked by very high levels of protein in the urine (proteinuria); low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol. Nephrotic syndrome results from damage to the kidneys' glomeruli, which are tiny blood vessels that filter waste and excess water from the blood and send them to the bladder as urine. Nephrotic syndrome can occur with many diseases, including the kidney diseases caused by diabetes mellitus, but some causes are unknown.
Nephrotic syndrome can affect all age groups. In children, it is most common from the age of 2 to 6 years. Males are slightly more likely to be affected than females.
What is the cause?
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine. The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
This condition can also occur as a result of infection, drug exposure, malignancy, hereditary disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis. It can accompany kidney disorders, including glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
What are the symptoms?
Swelling (oedema): general, around the eyes, in the extremities, especially the feet and ankles
Swollen abdomen
Facial swelling
Foamy appearance of the urine
Weight gain (unintentional) from fluid retention
Poor appetite
High blood pressure
How is it diagnosed?
Physical examination can detect some symptoms. Other symptoms and signs of causative disorders can also be found with examination. Urinalysis reveals large amounts of urine protein. Fats are often also present in the urine. Tests to rule out various causes may include the following:
Glucose tolerance test
Antinuclear antibody
Rheumatoid factor
Cryoglobulins
Complement levels
Hepatitis B and C antibodies
VDRL serology
Serum protein electrophoresis
Kidney biopsy
Nephrotic syndrome can also alter the results of the following tests:
Urinary casts
Triglyceride
Protein electrophoresis - urine
Serum iron
Cholesterol
Albumin
What is the treatment?
The goals of treatment are to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment of the causative disorder is necessary to control nephrotic syndrome. Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may help control symptoms. Antibiotics may be needed to control infections. Angiotensin converting enzyme (ACE) inhibitors may significantly reduce the degree of protein loss in the urine and are therefore frequently prescribed for treatment of nephrotic syndrome.
If hypertension occurs, it must be treated vigorously. Treatment of high blood cholesterol and triglyceride levels is also recommended to reduce the risk of atherosclerosis. Dietary limitation of cholesterol and saturated fats may be of little benefit, as the high levels which accompany this condition seem to be the result of overproduction by the liver rather than from excessive fat intake. Medications to reduce cholesterol and triglycerides may be recommended.
In many patients, reducing the amount of protein in the diet produces a decrease in urine protein. In most cases, a moderate-protein diet is usually recommended. Sodium (salt) may be restricted to help control swelling. Vitamin D may need to be replaced if nephrotic syndrome is chronic and unresponsive to therapy.
Nephrotic syndrome may go away once the underlying cause, if known, has been treated. In children, 80 percent of cases of nephrotic syndrome are caused by minimal change disease, which can be successfully treated with prednisone. However, in adults, most of the time the underlying cause is a kidney disease such as membranous nephropathy or focal segmental glomerulonephritis, and these diseases often persist even with treatment. In these cases, the kidneys may gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the patient will need dialysis or a kidney transplant.
What is the prognosis?
The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy. The cause and development of complications also affects the outcome.
What are the complications?
Atherosclerosis and related heart diseases
Renal vein thrombosis
Chronic and acute renal failure
Infections, including pneumococcal pneumonia
Malnutrition
Fluid overload, congestive heart failure, pulmonary oedema
Can it be prevented?
Treatment of causative disorders may prevent the development of nephrotic syndrome.
Retinal detachment
What is retinal detachment?
A retinal detachment is a medical emergency requiring immediate treatment. In this separation of the light sensitive membrane in the back of the eye (retina) becomes separated from its supporting layers (the outermost pigment layer).
Who is at risk for retinal detachment?
Those at risk for developing retinal detachment include:
Nearsighted (myopic) adults
People over 50 years of age
Those who have had an eye injury
After cataract surgery
People with a family history of retinal detachment
What are the causes of retinal detachment?
The following conditions may cause retinal detachment:
Scarring or shrinkage of the vitreous (the jelly like substance in the eye) can pull the retina inward.
Small tears in the retina allow liquid to seep behind the retina and push it forward.
Injury to the eye can knock the retina loose.
Bleeding behind the retina, most often due to diabetic retinopathy or injury, can push it forward.
Retinal detachment may be spontaneous, which occurs most often in the elderly or in very near sighted (myopic) eyes.
Tumours.
What are the symptoms of retinal detachment?
Retinal detachment causes a sudden defect in vision; it appears as though a shadow has fallen across the eye. There may be bright flashes of light, in the peripheral areas of vision. Sometimes, translucent specks of various shapes (floaters) are seen in the eye. The vision may become blurred.
How are retinal detachments diagnosed?
If the eye is clear, a detachment can be seen by looking into the eye with a hand-held instrument called an ophthalmoscope. Other special lenses also may be used to examine the back of the eyes. The commonest instrument used for examination is a binocular indirect ophthalmoscope.
What is the treatment of retinal detachment?
The treatment of retinal detachment is by surgery. Several procedures are available. Laser can be used to seal the tears or holes in the retina that generally precede retinal detachment. The application of intense cold with an ice probe (known as cryopexy) leads to the formation of a scar that holds the retina to the underlying layer. Surgical reattachment involves indentation of the sclera to relieve pressure on the retina, allowing it to re-attach. This procedure is called scleral buckling.
Sometimes, the eye may have to be entered to pump in air or gas to force the retina outward against the sclera. This is called pneumatic retinopexy, can generally be done under local anaesthesia and causes minimum discomfort. Sixty to 90% patients with retinal detachment can be treated by this method. If these methods are unsuccessful, or if there is disease in the vitreous, the vitreous may have to be removed and replaced with saline through a procedure called vitrectomy.
What is the outcome of retinal detachment?
The outcome depends upon the location and extent of the detachment and its early treatment. If the macula (the central, most sensitive part of the retina) has not detached, the results of treatment can be excellent. 5 to 10% of people will not get back their vision.
How can retinal detachment be prevented?
Regular eye examinations are important for patients with high myopia who are more prone to detachment. In diseases with a high incidence of retinal problem, such as diabetes, routine eye examinations can detect early changes in the eye that a patient himself may not sense.
A retinal detachment is a medical emergency requiring immediate treatment. In this separation of the light sensitive membrane in the back of the eye (retina) becomes separated from its supporting layers (the outermost pigment layer).
Who is at risk for retinal detachment?
Those at risk for developing retinal detachment include:
Nearsighted (myopic) adults
People over 50 years of age
Those who have had an eye injury
After cataract surgery
People with a family history of retinal detachment
What are the causes of retinal detachment?
The following conditions may cause retinal detachment:
Scarring or shrinkage of the vitreous (the jelly like substance in the eye) can pull the retina inward.
Small tears in the retina allow liquid to seep behind the retina and push it forward.
Injury to the eye can knock the retina loose.
Bleeding behind the retina, most often due to diabetic retinopathy or injury, can push it forward.
Retinal detachment may be spontaneous, which occurs most often in the elderly or in very near sighted (myopic) eyes.
Tumours.
What are the symptoms of retinal detachment?
Retinal detachment causes a sudden defect in vision; it appears as though a shadow has fallen across the eye. There may be bright flashes of light, in the peripheral areas of vision. Sometimes, translucent specks of various shapes (floaters) are seen in the eye. The vision may become blurred.
How are retinal detachments diagnosed?
If the eye is clear, a detachment can be seen by looking into the eye with a hand-held instrument called an ophthalmoscope. Other special lenses also may be used to examine the back of the eyes. The commonest instrument used for examination is a binocular indirect ophthalmoscope.
What is the treatment of retinal detachment?
The treatment of retinal detachment is by surgery. Several procedures are available. Laser can be used to seal the tears or holes in the retina that generally precede retinal detachment. The application of intense cold with an ice probe (known as cryopexy) leads to the formation of a scar that holds the retina to the underlying layer. Surgical reattachment involves indentation of the sclera to relieve pressure on the retina, allowing it to re-attach. This procedure is called scleral buckling.
Sometimes, the eye may have to be entered to pump in air or gas to force the retina outward against the sclera. This is called pneumatic retinopexy, can generally be done under local anaesthesia and causes minimum discomfort. Sixty to 90% patients with retinal detachment can be treated by this method. If these methods are unsuccessful, or if there is disease in the vitreous, the vitreous may have to be removed and replaced with saline through a procedure called vitrectomy.
What is the outcome of retinal detachment?
The outcome depends upon the location and extent of the detachment and its early treatment. If the macula (the central, most sensitive part of the retina) has not detached, the results of treatment can be excellent. 5 to 10% of people will not get back their vision.
How can retinal detachment be prevented?
Regular eye examinations are important for patients with high myopia who are more prone to detachment. In diseases with a high incidence of retinal problem, such as diabetes, routine eye examinations can detect early changes in the eye that a patient himself may not sense.
Diabetes trivia
Some interesting, but lesser known facts about Diabetes.
Did you know that…
Insulin, was discovered by Dr. Frederick Banting and Dr. Charles Best in 1921 at the University of Toronto.
In 1924, a 14 year old boy Leonard Thompson was the first human with diabetes to receive insulin.
Eli Lilly was the first company to make insulin available commercially.
Almost 1 in 17 people worldwide are diabetic. More than 1800 cases of diabetes are diagnosed everyday.
India has the largest number of diabetics in the world; a total of 10 million.
Vitamin D reduces the risk of diabetes.
Research on insulin inhalers is going on which will make treatment of diabetes simple and pain-free.
Some famous personalities (both past and present) with diabetes:
Sportsmen
Wasim Akram; Craig McMillan – Cricket
Arthur Ashe; Billy Jean King – Tennis
Actors
Elizabeth Taylor; Vanessa Williams
Musicians
Syd Barrett; Nusrat Fateh Ali Khan; Tommy Lee (Motley Crew); Elvis Presley; Neil Young; B.B. King; Meatloaf
Leaders
Mikhail Gorbachev; Winnie Mandela
Authors
Ernest Hemingway; Linda Goodman; Mario Puzo; H.G. Wells
Scientist
Thomas Alva Edison
Did you know that…
Insulin, was discovered by Dr. Frederick Banting and Dr. Charles Best in 1921 at the University of Toronto.
In 1924, a 14 year old boy Leonard Thompson was the first human with diabetes to receive insulin.
Eli Lilly was the first company to make insulin available commercially.
Almost 1 in 17 people worldwide are diabetic. More than 1800 cases of diabetes are diagnosed everyday.
India has the largest number of diabetics in the world; a total of 10 million.
Vitamin D reduces the risk of diabetes.
Research on insulin inhalers is going on which will make treatment of diabetes simple and pain-free.
Some famous personalities (both past and present) with diabetes:
Sportsmen
Wasim Akram; Craig McMillan – Cricket
Arthur Ashe; Billy Jean King – Tennis
Actors
Elizabeth Taylor; Vanessa Williams
Musicians
Syd Barrett; Nusrat Fateh Ali Khan; Tommy Lee (Motley Crew); Elvis Presley; Neil Young; B.B. King; Meatloaf
Leaders
Mikhail Gorbachev; Winnie Mandela
Authors
Ernest Hemingway; Linda Goodman; Mario Puzo; H.G. Wells
Scientist
Thomas Alva Edison
Travel tips for diabetics
Diabetes is a chronic illness and needs to be continuously managed. However, it does not mean that diabetics cannot travel or will have any problems while on a trip. There are only some tips that the patient needs to keep in mind to have a tension-free and safe holiday.
Get the location and duration of the trip approved by the treating physician.
If possible, get the doctor to prescribe medication that may be required during the travel period. The medications may include not only those used to treat diabetes, but also ones for preventing nausea, vomiting, diarrhoea etc.
Make preparations for getting your blood sugar checked at the destination. You should also try to identify medical services in the vicinity of your area for any emergency.
Travel tips:
Apart from the medical services available at the place of your stay, it is also necessary to be alert and make preparations thereof, during the duration of your journey. Some tips for the journey are:
Keep the insulin or the oral anti-diabetic drugs handy; carry it in hand baggage in the plane or train.
Protect the insulin from extreme heat or cold.
Maintain your food habits even when your routine is different. Eat at regular intervals and do not overeat.
Keep candies or toffees handy in case of a sudden drop in blood sugar.
Get the location and duration of the trip approved by the treating physician.
If possible, get the doctor to prescribe medication that may be required during the travel period. The medications may include not only those used to treat diabetes, but also ones for preventing nausea, vomiting, diarrhoea etc.
Make preparations for getting your blood sugar checked at the destination. You should also try to identify medical services in the vicinity of your area for any emergency.
Travel tips:
Apart from the medical services available at the place of your stay, it is also necessary to be alert and make preparations thereof, during the duration of your journey. Some tips for the journey are:
Keep the insulin or the oral anti-diabetic drugs handy; carry it in hand baggage in the plane or train.
Protect the insulin from extreme heat or cold.
Maintain your food habits even when your routine is different. Eat at regular intervals and do not overeat.
Keep candies or toffees handy in case of a sudden drop in blood sugar.
How to take an insulin shot
Diabetes is of two types. Type I is also known as insulin dependent diabetes mellitus, IDDM, or juvenile-onset diabetes mellitus. People with this type of diabetes mellitus make little or no insulin in their body, and need regular insulin injections to manage the problem. Patients with IDDM have to take insulin shots or injections whenever their blood glucose level increases. Most such patients have to learn to inject themselves with insulin, which is a simple procedure. Following are the steps involved in preparing and giving an insulin shot:
Wash your hands thoroughly with soap and water.
Mix the insulin in the ampoule gently by rotating the bottle between your palms or by inverting it slowly from end to end.
Take off the cap and clean the top with sterilised cotton/gauze swab soaked in spirit.
Remove the cover from the needle and pull the plunger back till the marking corresponding to your insulin dose. The syringe should be filled with air and NOT the insulin at this time.
Push the needle into the insulin bottle and release the air inside without taking in any of the insulin.
Invert the insulin ampoule and insert the tip of the needle into the insulin. Now pull the plunger back till the marking of your dose to suck in the required amount of insulin. Take care to avoid sucking in any air bubbles. If you can see air bubbles inside the syringe, discard the dose and repeat the procedure.
If any extra amount of insulin is sucked in, carefully discard the extra amount outside the bottle. Do NOT inject the insulin back into the bottle.
Choose the site for the shot carefully. The sites can be discussed with the doctor beforehand.
Clean the skin at the site of injection with an alcohol swab.
Pinch up an area of the skin and insert the needle at a right angle fully into the skin.
Release the plunger and push it all the way down to inject the insulin into your body. Release the pinched skin.
Pull the needle out and pat the area with the swab. Do not rub the site of injection.
Dispose off the needle after use.
Though the procedure seems fairly easy and becomes a routine after some practice, it should always be practised first in front of the doctor.
Wash your hands thoroughly with soap and water.
Mix the insulin in the ampoule gently by rotating the bottle between your palms or by inverting it slowly from end to end.
Take off the cap and clean the top with sterilised cotton/gauze swab soaked in spirit.
Remove the cover from the needle and pull the plunger back till the marking corresponding to your insulin dose. The syringe should be filled with air and NOT the insulin at this time.
Push the needle into the insulin bottle and release the air inside without taking in any of the insulin.
Invert the insulin ampoule and insert the tip of the needle into the insulin. Now pull the plunger back till the marking of your dose to suck in the required amount of insulin. Take care to avoid sucking in any air bubbles. If you can see air bubbles inside the syringe, discard the dose and repeat the procedure.
If any extra amount of insulin is sucked in, carefully discard the extra amount outside the bottle. Do NOT inject the insulin back into the bottle.
Choose the site for the shot carefully. The sites can be discussed with the doctor beforehand.
Clean the skin at the site of injection with an alcohol swab.
Pinch up an area of the skin and insert the needle at a right angle fully into the skin.
Release the plunger and push it all the way down to inject the insulin into your body. Release the pinched skin.
Pull the needle out and pat the area with the swab. Do not rub the site of injection.
Dispose off the needle after use.
Though the procedure seems fairly easy and becomes a routine after some practice, it should always be practised first in front of the doctor.
Diabetes mellitus
Diabetes mellitus (DM) is a condition in which he the most widely recognized problem is the body's inability to regulate the level of glucose in the blood. Glucose is the main form of sugar in the body. The body breaks down food into glucose and uses it as a source of energy. In healthy people insulin helps to regulate the glucose (sugar) levels. Insulin is a hormone produced by the pancreas (a long, thin organ located behind the stomach against the back).
In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycemia").
There are four main types of diabetes mellitus:
a) Type 1, earlier known as insulin dependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. People with this type of diabetes make little or no insulin in their body, and need regular insulin injections for survival and management of diabetes. It usually starts in childhood, but can occur at any age.
b) Type 2 (DM2), earlier known as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This is the most common form of diabetes, and is strongly associated with genetic tendency and obesity. The body produces normal or even high levels of insulin, but certain factors make its utilization ineffective ("insulin resistance"). Sedentary lifestyle, unhealthy dietary patterns, and the consequent obesity are common causes. It usually starts in adulthood, but is beginning to be seen in obese adolescents also.
c) Gestational diabetes mellitus, or pregnancy-induced diabetes.
d) Secondary diabetes mellitus, caused by genetic conditions, pancreatic diseases (e.g. inflammation, surgery or malignancy of the pancreas, etc.), drugs (e.g. steroids like prednisolone, pentamidine, excess thyroid hormone, etc.) or other medical conditions (acromegaly, Cushing syndrome, pheochromocytoma, hyperthyroidism, congenital rubella, etc). Medications such as thiazide diuretics or oral contraceptives can precipitate diabetes in a person predisposed to get it later.
Symptoms depend on the type and duration of diabetes. Some of the signs and symptoms are related to the high blood sugar levels. These include:
Increased urination,
Increased thirst and
Hunger.
Other common symptoms:
Fatigue,
Blurred vision,
Urinary and vaginal infections
Skin infections, especially fungal or more serious bacterial infections.
Frequently upset stomach, stomach pains, nausea and vomiting
There may be weight loss, especially if the amount of insulin made by the body is decreasing. If insulin deficiency is marked, the person can become drowsy and then go into coma. This is called Ketoacidosis, and usually occurs in DM1. Rarely, if the diabetes is completely out of control, it can also occur in DM2. Other symptoms of ketoacidosis include:
Deep rapid breathing, sometimes with a fruity odour to the breath
Pain in the stomach, with nausea and vomiting.
Diabetes affects all organs of the body. The long-term effects include:
Retinopathy: damage to the retina of the eye that can cause blindness.
Nephropathy: damage to the kidneys that can lead to kidney failure.
Peripheral neuropathy: damage to the nerves in the limbs, which causes numbness, tingling (eg feeling like crawling of ants over the skin) and pain in the feet, legs and hands.
Autonomic neuropathy: damage to the nerves of the internal organs, resulting in problems with digestion, diarrhoea, impotence, fast heartbeat ("tachycardia") and altered blood pressure.
Atherosclerosis: hardening or blockage of arteries, that can lead to heart attack and stroke ("Brain attack").
Peripheral vascular disease: damage to the arteries causes poor
circulation in the legs and feet. This poor circulation, along with nerve damage, can result in serious foot and leg infections that may require amputation.
Skin infections, especially fungal infections such as ringworm, jock itch, and athlete's foot. Other bacterial infections are also common and can occasionally be life threatening.
Vaginal infections, as high levels of sugar encourage the growth of yeast
Urinary tract infections.
Diabetes mellitus is diagnosed based on a high level of glucose or sugar in the blood. The doctor may suspect diabetes mellitus after taking the medical history and doing a physical examination. There are several blood sugar tests used for diagnosis:
Fasting plasma glucose test: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked. Normal fasting plasma glucose levels are less than 110 mg/dl. A fasting plasma glucose level of more than 126 mg/dl usually indicates diabetes mellitus. A level of 110-125 mg/dl is called "impaired fasting glucose".
Post prandial (PP) plasma glucose: This is tested two hours after having a meal, which serves as a challenge for the body to regulate the blood sugar. Normal PP levels are <140 mg/dl; a glucose level of more than 200 mg/dl indicates diabetes mellitus, while a level between 140-199 mg/ dl is called "impaired glucose tolerance".
Random plasma glucose test: is that which is done at any other time. A level of 200 mg/dl or higher generally indicates the presence of diabetes.
Oral glucose challenge test (oGTT): The blood glucose is tested 2 hours after giving 75 gm glucose by mouth. This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".
Oral glucose tolerance test: is the preferred way to diagnose pregnancy-induced diabetes. Ideally all pregnant women in India should have a blood glucose test done 30 minutes after taking 50 gm gluocse (screening test). If this is abnormal, the lady should undergo an oGTT: with 100 gm glucose (not the conventional 75 gm). Blood samples are then drawn at intervals of one hour upto 3 hours (ie at 1, 2 and 3 hours post-glucose).
The treatment of diabetes depends on the type of diabetes. It is aimed to decrease symptoms and prevent complications such as low blood sugar levels (hypoglycemia), eye problems, kidney disease, and nerve damage.
DM1 needs treatment with insulin injections to replace the insulin that is not produced in the body. There are several types of insulin available. The most commonly used are the genetically engineered that are similar to human insulin. The difference in the various types of insulin is the times at which they "peak" or are most effective. Insulin schedule depends upon the meal pattern of the individual. This is required to avoid low blood glucose levels, causing hypoglycaemia. Insulin is administered with a syringe, and newer devices such as insulin pens and insulin pumps. The latter devices control diabetes more efficiently.
DM2 (earlier called NIDDM) is initially treated with weight reduction, diet control and regular exercises. When these measures fail to control the blood sugar levels, oral medicines are used. Sulphonylureas are a group of drugs that stimulate the release of insulin from the pancreas. Metformin reduces insulin resistance, and the production of glucose by the liver. Thiazolidenediones also increase insulin efficiency and sensitivity. Acarbose delays the absorption of glucose by the intestines. When the action of oral drugs is insufficient, insulin injections are added.
Exercise: It is an important component of diabetes therapy. Exercise utilizes blood sugar and makes the body more sensitive to insulin. It also reduces high blood pressure and high lipid levels, which are often associated with diabetes.
Diet: There is no such thing as a "diabetic diet". Persons with diabetes should eat a normal, balanced diet, which is designed to meet their nutritional requirements, maintain normal blood sugar levels and at the same time to help in achieving appropriate weight (i.e. reduction in case of obese persons, regain in case of very lean persons). It is also important to eat meals at regular time intervals, especially if insulin is used.
In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycemia").
There are four main types of diabetes mellitus:
a) Type 1, earlier known as insulin dependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. People with this type of diabetes make little or no insulin in their body, and need regular insulin injections for survival and management of diabetes. It usually starts in childhood, but can occur at any age.
b) Type 2 (DM2), earlier known as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This is the most common form of diabetes, and is strongly associated with genetic tendency and obesity. The body produces normal or even high levels of insulin, but certain factors make its utilization ineffective ("insulin resistance"). Sedentary lifestyle, unhealthy dietary patterns, and the consequent obesity are common causes. It usually starts in adulthood, but is beginning to be seen in obese adolescents also.
c) Gestational diabetes mellitus, or pregnancy-induced diabetes.
d) Secondary diabetes mellitus, caused by genetic conditions, pancreatic diseases (e.g. inflammation, surgery or malignancy of the pancreas, etc.), drugs (e.g. steroids like prednisolone, pentamidine, excess thyroid hormone, etc.) or other medical conditions (acromegaly, Cushing syndrome, pheochromocytoma, hyperthyroidism, congenital rubella, etc). Medications such as thiazide diuretics or oral contraceptives can precipitate diabetes in a person predisposed to get it later.
Symptoms depend on the type and duration of diabetes. Some of the signs and symptoms are related to the high blood sugar levels. These include:
Increased urination,
Increased thirst and
Hunger.
Other common symptoms:
Fatigue,
Blurred vision,
Urinary and vaginal infections
Skin infections, especially fungal or more serious bacterial infections.
Frequently upset stomach, stomach pains, nausea and vomiting
There may be weight loss, especially if the amount of insulin made by the body is decreasing. If insulin deficiency is marked, the person can become drowsy and then go into coma. This is called Ketoacidosis, and usually occurs in DM1. Rarely, if the diabetes is completely out of control, it can also occur in DM2. Other symptoms of ketoacidosis include:
Deep rapid breathing, sometimes with a fruity odour to the breath
Pain in the stomach, with nausea and vomiting.
Diabetes affects all organs of the body. The long-term effects include:
Retinopathy: damage to the retina of the eye that can cause blindness.
Nephropathy: damage to the kidneys that can lead to kidney failure.
Peripheral neuropathy: damage to the nerves in the limbs, which causes numbness, tingling (eg feeling like crawling of ants over the skin) and pain in the feet, legs and hands.
Autonomic neuropathy: damage to the nerves of the internal organs, resulting in problems with digestion, diarrhoea, impotence, fast heartbeat ("tachycardia") and altered blood pressure.
Atherosclerosis: hardening or blockage of arteries, that can lead to heart attack and stroke ("Brain attack").
Peripheral vascular disease: damage to the arteries causes poor
circulation in the legs and feet. This poor circulation, along with nerve damage, can result in serious foot and leg infections that may require amputation.
Skin infections, especially fungal infections such as ringworm, jock itch, and athlete's foot. Other bacterial infections are also common and can occasionally be life threatening.
Vaginal infections, as high levels of sugar encourage the growth of yeast
Urinary tract infections.
Diabetes mellitus is diagnosed based on a high level of glucose or sugar in the blood. The doctor may suspect diabetes mellitus after taking the medical history and doing a physical examination. There are several blood sugar tests used for diagnosis:
Fasting plasma glucose test: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked. Normal fasting plasma glucose levels are less than 110 mg/dl. A fasting plasma glucose level of more than 126 mg/dl usually indicates diabetes mellitus. A level of 110-125 mg/dl is called "impaired fasting glucose".
Post prandial (PP) plasma glucose: This is tested two hours after having a meal, which serves as a challenge for the body to regulate the blood sugar. Normal PP levels are <140 mg/dl; a glucose level of more than 200 mg/dl indicates diabetes mellitus, while a level between 140-199 mg/ dl is called "impaired glucose tolerance".
Random plasma glucose test: is that which is done at any other time. A level of 200 mg/dl or higher generally indicates the presence of diabetes.
Oral glucose challenge test (oGTT): The blood glucose is tested 2 hours after giving 75 gm glucose by mouth. This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".
Oral glucose tolerance test: is the preferred way to diagnose pregnancy-induced diabetes. Ideally all pregnant women in India should have a blood glucose test done 30 minutes after taking 50 gm gluocse (screening test). If this is abnormal, the lady should undergo an oGTT: with 100 gm glucose (not the conventional 75 gm). Blood samples are then drawn at intervals of one hour upto 3 hours (ie at 1, 2 and 3 hours post-glucose).
The treatment of diabetes depends on the type of diabetes. It is aimed to decrease symptoms and prevent complications such as low blood sugar levels (hypoglycemia), eye problems, kidney disease, and nerve damage.
DM1 needs treatment with insulin injections to replace the insulin that is not produced in the body. There are several types of insulin available. The most commonly used are the genetically engineered that are similar to human insulin. The difference in the various types of insulin is the times at which they "peak" or are most effective. Insulin schedule depends upon the meal pattern of the individual. This is required to avoid low blood glucose levels, causing hypoglycaemia. Insulin is administered with a syringe, and newer devices such as insulin pens and insulin pumps. The latter devices control diabetes more efficiently.
DM2 (earlier called NIDDM) is initially treated with weight reduction, diet control and regular exercises. When these measures fail to control the blood sugar levels, oral medicines are used. Sulphonylureas are a group of drugs that stimulate the release of insulin from the pancreas. Metformin reduces insulin resistance, and the production of glucose by the liver. Thiazolidenediones also increase insulin efficiency and sensitivity. Acarbose delays the absorption of glucose by the intestines. When the action of oral drugs is insufficient, insulin injections are added.
Exercise: It is an important component of diabetes therapy. Exercise utilizes blood sugar and makes the body more sensitive to insulin. It also reduces high blood pressure and high lipid levels, which are often associated with diabetes.
Diet: There is no such thing as a "diabetic diet". Persons with diabetes should eat a normal, balanced diet, which is designed to meet their nutritional requirements, maintain normal blood sugar levels and at the same time to help in achieving appropriate weight (i.e. reduction in case of obese persons, regain in case of very lean persons). It is also important to eat meals at regular time intervals, especially if insulin is used.
Blood glucose test
Why is a blood sugar test done?
Diabetes mellitus is diagnosed based on a high level of glucose (sugar) in the blood. Blood sugar test, done fasting and 2 hours after breakfast, is used for the diagnosis of diabetes.
How is the test done?
Fasting blood glucose: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked.
Post prandial (PP) blood glucose: This is tested two hours after having a
meal. It serves as a challenge for the body to regulate the blood sugar
after a meal. Random blood sugar or glucose test is that which is done at any other time. The blood glucose can also be tested after giving 75 gm glucose by mouth (glucose challenge test). This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".
Blood glucose tests are also needed for checking the control in diabetes.
What are the normal values?
Normal fasting plasma glucose levels are less than 110 mg/dl.
Normal PP plasma glucose levels are less than 140 mg/dl.
What are the abnormal values?
A fasting plasma glucose level of more than 126 mg/dl indicates diabetes mellitus. A level between 110-125 mg/ dl is called "impaired fasting glucose". A PP or random plasma glucose level of more than 200 mg/dl indicates diabetes mellitus.A level between 140-199 mg/ dl is called "impaired glucose tolerance". A blood sugar exceeding the level of 200 mg/dl or higher generally indicates the presence of diabetes.
What is the role of insulin?
The body breaks down food into glucose (sugar) and uses it as a source of energy. Insulin helps the cells of the body to utilize this glucose for
energy, and to store the excess in the liver for later use. Thus insulin
regulates the blood glucose (sugar) levels.
In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycemia").
Diabetes mellitus is diagnosed based on a high level of glucose (sugar) in the blood. Blood sugar test, done fasting and 2 hours after breakfast, is used for the diagnosis of diabetes.
How is the test done?
Fasting blood glucose: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked.
Post prandial (PP) blood glucose: This is tested two hours after having a
meal. It serves as a challenge for the body to regulate the blood sugar
after a meal. Random blood sugar or glucose test is that which is done at any other time. The blood glucose can also be tested after giving 75 gm glucose by mouth (glucose challenge test). This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".
Blood glucose tests are also needed for checking the control in diabetes.
What are the normal values?
Normal fasting plasma glucose levels are less than 110 mg/dl.
Normal PP plasma glucose levels are less than 140 mg/dl.
What are the abnormal values?
A fasting plasma glucose level of more than 126 mg/dl indicates diabetes mellitus. A level between 110-125 mg/ dl is called "impaired fasting glucose". A PP or random plasma glucose level of more than 200 mg/dl indicates diabetes mellitus.A level between 140-199 mg/ dl is called "impaired glucose tolerance". A blood sugar exceeding the level of 200 mg/dl or higher generally indicates the presence of diabetes.
What is the role of insulin?
The body breaks down food into glucose (sugar) and uses it as a source of energy. Insulin helps the cells of the body to utilize this glucose for
energy, and to store the excess in the liver for later use. Thus insulin
regulates the blood glucose (sugar) levels.
In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycemia").
Subscribe to:
Posts (Atom)