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Diabetes

Diabetes is a condition affecting the production or usage of insulin by the body. Insulin is a natural hormone produced by the pancreas to control the availability of energy to the body's cells from the food we eat.

Diabetes Australia estimates that approximately 800,000 Australians have diabetes,with half being unaware of their condition!

Within the body, glucose, a simple sugar, is the main
Form of energy used by cells, especially the brain. Insulin
Abnormalities mean that glucose levels in the blood build
Up, but are unable to be used effectively by cells.

This has two major effects:

The body is starved of energy and cannot function well high glucose levels cause damage to blood vessels and nerves throughout the body


There are three different types of diabetes:

Type I or juvenile-onset diabetes
Type II or adult-onset diabetes
Gestational diabetes (diabetes of pregnancy)

a. Type I or juvenile-onset diabetes

usual onset in childhood, but may occur later in life, and is often abrupt\results from too little insulin being produced by the pancreas\appears to result from the body's own immune system destroying the\insulin-producing cells of the pancreas (the Beta-cells) The cause of the auto-immune attack is not certain, but possibly results from a combination of factors including genetics and possibly a virus (whose identity is not yet known) risk factors include: family history accounts for 15% of diabetes cases

b. Type II or adult-onset diabetes

usual onset in middle age, but may be earlier or later in some people results from failure of the body's cells to use insulin to full effect often normal or high levels of insulin are found in the early stages, with levels dropping as the condition progresses and the pancreas becomes exhausted risk factors include:

family history (strong factor)
overweight
high fat diet
age over 55 years
low exercise levels
some medications (eg. prednisolone)

accounts for 85% of diabetes cases

c. Gestational diabetes (diabetes of pregnancy)

is more common in women with a family history of Type II diabetes (see
above) may or may not persist after pregnancy may recur with future pregnancies is routinely tested for in pregnancy - affects 1-3% of pregnancies risk factors include: previous pregnancies affected


All types of diabetes share the same symptoms. Symptoms may range from very obvious to quite subtle. In Type I (juvenile-onset) diabetes the symptoms tend to be more noticeable than in Type II (adult-onset) or gestational diabetes. Some people may be unaware of their diagnosis.

Symptoms include:

excessive thirst and urination constant hunger and/or weight loss (despite good intake of food) marked tiredness (despite adequate rest) blurred vision frequent infections or poor healing drowsiness or even coma from excess blood glucose when very severe

Untreated diabetes can result in real damage to vital body organs over time. It is
often mistakenly thought that because it is not painful that it can't be damaging. This is not true! As with high blood pressure, constant stress on the body over time causes significant damage.

Complications
With diabetes the most common consequences of not controlling blood glucose levels are:

clogging of blood vessels causing: angina and heart attacks strokes blindness foot ulcers - may require amputations damage to nerves causing: blindness
numbness or tingling/burning of feet and hands
weakness of some muscle groups
erectile dysfunction (impotence) elevated cholesterol levels

kidney damage which may require dialysis if severe poor immune function causing: increased frequency of infections
slower healing of infections cataracts of the eyes


Currently the best prevention for diabetes (in particular Type II and gestational
types) is: maintaining body weight in the ideal range (for your height) a healthy, low-fat, balanced diet moderate regular exercise

Early diagnosis and management can make a big difference in preventing damage to: eyes nerves
blood vessels which can reduce serious complications like: stroke heart attack amputations

People with a family history or symptoms of diabetes should have regular blood sugar tests by their local doctor.

Other important tests are: blood pressure cholesterol


Although there is no cure for diabetes, early diagnosis and treatment is effective in controlling the disease.

Treatment includes: a. Diet eat a balanced diet - about 60% complex carbohydrates, 20% protein and
20% fat eat at regular times, especially if diabetes requires insulin carry fast glucose food such as barley sugar or honey to avoid a low blood sugar level crisis (hypoglycaemia)

b. Exercise regular moderate exercise aids the uptake of glucose and sensitivity to
insulin stop exercising and see your local doctor if you experience: chest discomfort shortness of breath light-headedness

c. Monitoring regular self-monitoring of blood glucose levels (check the frequency with
your doctor) with a finger-prick blood test or by urine dipstick test

monitor more frequently during: illness
infections stress increased exercise

keep a notebook record of blood glucose levels, test results, medications used, and contact details of local doctor or specialist. see your doctor or endocrinologist (diabetes specialist) regularly to check:

blood pressure
urine levels of protein
blood tests for kidney function
blood glucose control
foot sensation and any other relevant tests

see a podiatrist regularly to prevent foot ulceration. This is especially important if sensation in the feet is reduced
An eye specialist regularly to assess and manage any eye problems caused
By diabetes. regular dental review to ensure gums and teeth are well maintained.

d. Medications medication may be needed to help control blood glucose levels. The tablets aim to normalize blood glucose levels by: enhancing the body's usage of insulin or increasing insulin production by the pancreas or decreasing glucose production by the liver most Type I and some Type II and gestational diabetics need insulin injections to keep blood sugar levels normal.

Insulin is injected under the skin.
There are different types of insulin that last for different lengths of
Time. Dose and frequency is tailored to their blood sugar levels, activity
Levels, usual diet, and other factors.

Seizues

Definition

A seizure is a sudden, violent, contraction and relaxation of
the muscles, usually caused by uncontrolled electrical
activity in the brain.

Causes

epilepsy
alcohol use
barbiturates, intoxication or withdrawal
brain illness or injury
brain tumor (rare)
choking
drug abuse
electric shock
fever (particularly in young children)
head injury
heart disease
heat illness (see heat intolerance)
high blood pressure
meningitis
poisoning
stroke
toxemia of pregnancy
uremia related to kidney failure
venomous bites and stings (see snake bite)
withdrawal from benzodiazepines (such as Valium)


Symptoms

brief blackout or period of confused behavior
drooling or frothing at the mouth
grunting and snorting
local tingling or twitching in one part of the body
loss of bladder or bowel control
sudden falling; loss of consciousness
temporary absence of breathing
vigorous muscle spasms with twitching and jerking
limbs


Considerations

Most seizures last from 30 to 45 seconds.
When seizures recur, and there are no underlying causes
that can be treated directly, a person is said to have
epilepsy. Epilepsy is usually well controlled with
medication.
There is nothing you can do to stop convulsions once they
have started. All that can be done is to help protect the
victim from injury and get medical help as needed.
If a small child has multiple seizures for the first time,
assume they have swallowed poison and give appropriate
first aid.
Try to time the duration of the seizures so the doctor will
have a measurement of how severe they are.

First Aid

1. When a seizure occurs, the main strategy is to try to
keep the victim from injury. Try to protect the victim from
falls. Lay the victim on the ground in a safe area.
2. Clear the area around the victim of furniture or other sharp
objects.
3. Without limiting the movements of a person having a
seizure, loosen any tight clothing, particularly around the
victim's neck.
4. If vomiting occurs, try to turn the head so that the vomitus
is expelled and is not inhaled into the lungs or windpipe.
5. In an infant or child, if the seizure seems to be the result
of high fever, cool the child gradually, using a dampened
sponge or cool compress and tepid water. An appropriate
dose of acetaminophen (Tylenol) may be used. DO NOT,
however, immerse the child in a cold bath.
6. After a convulsion, most victims go into a deep sleep.
Don't prevent the victim from sleeping. He or she will
probably be disoriented for awhile after awakening.
7. Stay with the victim until recovery or until you have
professional medical help. Meanwhile, monitor their vital
signs (pulse, rate of breathing, blood pressure).

Do Not

DO NOT restrain the victim.
DO NOT place anything between the victim's teeth
during a seizure (including your fingers).
DO NOT move the victim unless he or she is in
danger or near something hazardous.
DO NOT try to make the victim stop convulsing--they can't control themselves during a seizure.
DO NOT perform rescue breathing on a seizure
victim, even if they are turning blue. Most seizures
end long before brain damage would begin.
DO NOT give the victim anything by mouth until the
convulsions have stopped and the victim is fully awake and alert.

Call Immediately For Emergency Medical Assistance
Prevention

Known epileptics should always wear a medical alert tag.
Keep fevers under control, especially in children