All about diabetes type 1 and type 2

Defining Diabetes
Diabetes is referred to by the medical world as, 'Diabetes Mellitus,' and is
a set of diseases where the person's body is unable to regulate the
amount of sugar in their blood. The particular form of sugar that the
person with diabetes is unable to regulate is called, 'glucose,' and is
used in the body to give the person energy in order to do things in daily
life such as walking, running, riding a bike, exercising, or other tasks.
From food that people eat, the liver produces glucose and puts it into
their blood.
In persons without diabetes, glucose levels are regulated by a number of
hormones including one known as, 'Insulin.' An organ called the,
'Pancreas,' produces insulin, and also secretes additional enzymes which
aid in the digestion of food. Insulin helps the movement of glucose
through a person's blood into different cells, including muscle, fat, and
liver cells so it can be used to fuel activity.
Persons with diabetes who have Type 1 diabetes do not produce enough
insulin. Persons with Type 2 diabetes are unable to use insulin properly.
Several forms of diabetes involve the inability to both produce or use
insulin properly. Persons with diabetes are unable to move glucose from
their blood into their cells. The result is that the glucose remains in their
blood, and damage occurs to the cells that need glucose for energy to
perform activities, as well as harming tissues and organs that are
exposed to increased amounts of glucose that has not been sent to the
cells it should have gone to.
Type 1 Diabetes: Type 1 Diabetes occurs when the body produces
insufficient amounts of insulin, or stops producing insulin altogether; the
body does not produce enough insulin to regulate the amount of glucose
in the person's blood. Approximately ten-percent of persons with
diabetes in America have Type 1 Diabetes, and it is commonly
recognized in people when they are in childhood or during their teenage
years. Former names for Type 1 Diabetes include, 'Juvenile-Onset
Diabetes,' and, 'Insulin-Dependent Diabetes Mellitus.' Persons who are
older can develop Type 1 Diabetes due to destruction of their pancreas.
Things such as damage caused by disease or alcohol, or having the
pancreas removed during surgery, or a progressive failure of pancreatic
beta cells that produce insulin can cause Type 1 Diabetes. Persons with
this form of diabetes need insulin treatment on a daily basis in order to
remain alive.
Type 2 Diabetes: Type 2 Diabetes occurs when a person's body becomes
either partially, or completely, unable to use insulin. Their pancreas may
still secrete insulin, but they have become what the medical field refers
to as, 'Insulin-Resistant.' Their body attempts to fight this resistance by
producing even more insulin. A person who is insulin-resistance
develops Type 2 Diabetes once they cannot continue to secrete enough
insulin to meet the body's demands.
Approximately ninety-percent of persons with diabetes have Type 2
diabetes, which is usually recognized when the person is an adult;
commonly when they are over forty-five years of age. Other names this
form of diabetes has been known by include, 'Non-Insulin Dependent
Diabetes Mellitus,' or, 'Adult-Onset Diabetes Mellitus.' These other names
are no longer appropriate because persons who are younger have this
form of diabetes, and persons with Type 2 diabetes may also need to
use insulin. Control of Type 2 Diabetes usually involves weight loss, diet,
oral medications, and exercise.
Gestational Diabetes: Gestational Diabetes occurs when a woman is
approximately halfway through pregnancy. Women who have this form of
diabetes are more likely to have larger babies than women who do not
have Gestational Diabetes. Women who experience Gestational Diabetes
often find that it simply goes away, once they have delivered the baby,
although women who have this form of diabetes are more likely to
develop Type 2 Diabetes at a later point in their life.
Metabolic Syndrome: Metabolic Syndrome involves a series of
abnormalities, of which Type 2 Diabetes is a part. The syndrome
involves not only Type 2 Diabetes, but high fat levels in the person's
blood, hypertension, decreased HDL cholesterol, elevated LDL cholesterol,
blood clotting, inflammatory responses, and central obesity. Metabolic
Syndrome has a high rate of Cardiovascular Disease associated with it,
and is also referred to as, 'Syndrome X.'
Pre-Diabetes: Pre-Diabetes is a condition that is related to Diabetes that
has the potential to be reversed through both weight loss and exercise,
which can prevent Type 2 Diabetes from occurring. Pre-Diabetes
increases a person's risk of not only developing Type 2 Diabetes, but
their risk of either a stroke, or heart disease. Persons with Pre-Diabetes
experience blood sugar levels which are higher than they should be, yet
are not high enough to be considered either Type 1 or Type 2 Diabetes.
Approximately one-third of the adults in North America who have
diabetes are unaware that they have it. Around seventeen million adults
in North America are aware that they have Diabetes, and one-million
people each year are diagnosed with diabetes. Diabetes is found to be
either the direct cause or a contributing factor in two-hundred thousand
deaths each year, and the numbers of persons being diagnosed with
diabetes is increasing rapidly. Obesity and sedentary lifestyles are
among many reasons why diabetes is increasing.
Complications of Diabetes
Type 1 and Type 2 diabetes eventually lead to excessive levels of sugar
in the blood; this condition is referred to as, 'Hyperglycemia .'
Hyperglycemia damages the body in several ways, including damage to
a person's kidneys, nerves, eyes, and blood vessels. The damage done
through Hyperglycemia to a person's kidneys is known as, 'Diabetic
Nephropathy,' and is a leading cause of kidney failure. The damage done
to a person's nerves is referred to as, 'Diabetic Neuropathy,' and causes
both foot wounds and ulcers, commonly leading to either foot or leg
amputations. Damages to a person's Autonomic Nervous System can
lead to a condition known as, 'Gastroparesis,' or paralysis of their
stomach; it can also cause chronic diarrhea, and an inability in the
person's body to control heart rate and blood pressure as they change
posture. 'Diabetic Retinopathy,' is the medical name for damage done to
a person's retinas in their eyes, and is a leading cause of blindness.
Diabetes can accelerate the formation of fatty plaque deposits inside a
person's arteries or, 'Atherosclerosis,' leading to a clot or blockages.
Results of the formation of these deposits can include a decrease in the
circulation in the person's legs and arms called, 'Peripheral Vascular
Disease,' or even a heart attack or stroke. Diabetes presents people who
have it with a predisposition for such things as high cholesterol, high
triglyceride levels, and high blood pressure. These conditions alone
increase the risk of heart disease, blood vessel complications, and
kidney disease; along with Hyperglycemia, the risks are even greater.
There are a number of infections that are associated with Diabetes which
are often times more dangerous for a person who has diabetes due to
their body's reduced ability to fight infections. For a person with
diabetes, an infection may make control of glucose levels more difficult,
delaying recovery from an infection.
Hypoglycemia occurs when a person with diabetes has a blood sugar
level that is too low, which happens occasionally. When the person
misses a meal, or exercises more than they usually do, or takes too
much insulin or medication; drinks too much alcohol, or takes certain
other medications in other conditions - they may become Hypoglycemic.
The symptoms of Hypoglycemia include hand tremor, headaches,
sweating, feeling dizzy, and poor concentration. Persons experiencing
Hypoglycemia may faint, or experience a seizure if their blood sugar
level becomes too low.
Diabetic Ketoacidosis involves uncontrolled Hyperglycemia and is a
serious condition. It is usually caused by a highly inadequate level of
insulin in a person's body which, over time, causes a buildup in their
blood of Ketones. Ketones are acidic waste products, and are harmful to
the body. Diabetic Ketoacidosis commonly affects persons with Type 1
Diabetes who don't have good control of their blood glucose levels.
Trauma, infection, stress, missing medications such as insulin, or even a
stroke or heart attack can precipitate Diabetic Ketoacidosis.
Hyperosmolar Hyperglycemic Nonketotic Syndrome is another serious
condition that can affect persons with diabetes, and occurs when the
person's blood sugar becomes very high. Their body attempts to rid
itself of the excessive amounts of blood sugar through urinary output,
which is increased significantly, often leading to dehydration. Persons
with this syndrome can become so dehydrated that they may experience
seizures, coma, or even die. Persons with Type 2 Diabetes who are not
making efforts to control their blood sugar levels and have become
dehydrated, are under stress, have experienced an injury, a stroke, or are
taking some medications such as steroids, are typically those who
experience this syndrome.
Causes of Diabetes
Type 1 Diabetes: Type 1 Diabetes is something that is believed to be an
autoimmune disease. The immune system in the person's body attacks
the cells within the pancreas which produces insulin. There may be a
predisposition to the development of Type 1 Diabetes in some families.
There are some environmental factors, including some viral infections
which are common that can also contribute to causing Type 1 Diabetes.
Persons who are of Non-Hispanic, Northern European descent most
commonly develop Type 1 Diabetes, followed by African Americans and
Hispanic Americans. Persons of Asian descent rarely have Type 1
Diabetes. Slightly more men than women have Type 1 Diabetes.
Type 2 Diabetes: is something that has strong genetic links, and tends to
run in families. Several of the genes involved have been identified; more
are being studied that may be related to causes of Type 2 diabetes.
There are several risk factors for developing Type 2 Diabetes. The risk
factors include a high-fat diet, consuming high amounts of alcohol, a
sedentary lifestyle, high blood pressure, high triglyceride levels, obesity,
and Gestational Diabetes. Persons with a relative who had either Type 2
diabetes or Gestational Diabetes are at greater risk of developing Type 2
Diabetes. African Americans, Native Americans, Hispanic Americans, and
Japanese Americans are at greater risk of developing Type 2 Diabetes.
The risk of developing Type 2 Diabetes increases at age forty-five, and
increases significantly after a person reaches age sixty-five.
Symptoms of Diabetes
Symptoms of Type 1 Diabetes may appear suddenly and are often
dramatic. Increased stress may cause Diabetic Ketoacidosis, with
symptoms that include vomiting and nausea followed by dehydration and
serious disturbances in the person's blood levels of potassium. If the
person is not treated, they may experience a coma, or die.
Symptoms of Type 2 Diabetes are many times subtle. They might be
attributed to either obesity, or aging. Type 2 Diabetes may be
precipitated by either stress, or steroids. Persons with Type 2 Diabetes
may develop Hyperglycemic Hyperosmolar Nonketotic Syndrome. One of
the more dismaying facts about Type 2 Diabetes is the a person may
have it for years without knowing it.
Symptoms Common to Both Major Types of Diabetes
Fatigue: For persons with diabetes, their body cannot efficiently use
glucose to provide energy, or is unable to at all. Instead, their body
either partially or completely metabolizes fat as a source for energy,
requiring more energy. The result of the body doing this is that the
person feels fatigued or consistently tired.
Unexplained Weight Loss: Persons with diabetes are not able to process
many of the calories the consume. Because of this, they might lose
weight, even though the person might eat what seems to be an
appropriate amount or even an excessive amount of food. Loss of sugars
and water through urinary output and through dehydration can also
contribute to weight loss in persons with diabetes.
Excessive Thirst: Persons with diabetes may develop high blood sugar
levels which then overwhelm their kidney's ability to reabsorb sugars as
their blood is filtered to produce urine. An excessive amount of urine is
produced by their body as their kidney attempts to get rid of excess
sugar, and the body attempts to counteract this by telling the brain to
dilute their blood, translating it as a message to the person telling them
they are thirsty. The body encourages water consumption in an effort to
dilute high levels of blood sugar and reduce it to normal levels, as well
as to compensate for any water that has been lost through increased
urination. Excessive thirst in persons with diabetes is also referred to as,
'Polydipsia.' Excessive urination is referred to as, 'Polyuria.'
Excessive Eating: If the body of a person with diabetes is able to, it will
secrete additional insulin in an effort to deal with higher blood sugar
levels. Their body is also resistant to the action of insulin in Type 2
Diabetes, on of the functions of which is to stimulate hunger, and higher
insulin level may lead to an increase in the person's hunger and the
amount they eat. Despite eating more the person might gain very little
weight; in fact - they may lose weight.
Poor Healing of Wounds: The presence of high levels of blood sugar
prevents white blood cells, which are important in the body's defense
against bacteria and in cleaning up dead tissue and cells, from working
properly. Improper cell function leads to wounds which take longer to
heal and have the potential to become infected more often. Diabetes that
has been present for a lengthy period of time is associated with
thickening of the blood vessels. This can prevent proper circulation,
which is needed in order to deliver nutrients and oxygen to tissues in the
body.
Infections: Some infection syndromes such as skin infections, urinary
tract infections, and repetitive yeast infections, can be the result of a
suppression of the person's immune system by diabetes through the
presence of glucose in their tissues, which allows bacteria to grow.
These skin infection syndromes may be an indicator of inadequate blood
sugar control in persons with diabetes.
Altered Mental Status: Altered Mental Status in persons with diabetes
may include inattention, confusion, extreme lethargy, agitation, or
unexplained irritability. All of these may be signs that the person has one
of several things, including ketoacidosis, hyperosmolar hyperglycemia
nonketotic syndrome, high blood sugar, or hypoglycemia. Any of these
conditions require immediate medical attention.
Blurry Vision: Persons with diabetes who have high blood sugar levels
may experience blurry vision. There are other conditions that may cause
blurry vision as well that are not specific to diabetes.
Testing and Exams for Diabetes
There are some tests that are used in order to diagnose diabetes, as well
as to monitor blood sugar levels in persons who have already been
diagnosed. If the person is presenting symptoms, but is not diagnosed
with diabetes, evaluation should start with a complete medical interview
followed by a physical exam. A health care provider asks about things
such as the person's past medical issues, the symptoms they are
experiencing, their risk factors for diabetes, and any medications they are
currently taking. The health care provider will also ask about the
person's family and whether there is a history of diabetes, their lifestyle
and habits, and any other medical issues they may be experiencing.
Several laboratory tests are available to both health care providers and
people in order to confirm a diagnosis of Diabetes.
Finger Stick Blood Glucose Test: This test can be performed in
community-based screening programs, or anywhere, and provides rapid
results. The test is not as accurate as blood testing in a laboratory;
however, it provides rapid results, and it is very easy to perform. The
results are accurate within ten-percent of laboratory values. Testing
involves a minor fingerstick of the person's finger in order to obtain a
tiny blood sample, which is then placed onto a strip. The strip is placed
into a small machine that interprets the person's blood sugar level. At
very high or low blood sugar levels, the fingerstick test may prove
inaccurate, and is considered a preliminary screening. The majority of
persons with diabetes use the fingerstick test to monitor their blood
sugar levels.
Fasting Plasma Glucose Test: The Fasting Plasma Glucose Test involves
asking the person to abstain from eating or drinking anything for eight
hours prior to having a blood sample drawn. From the person's blood
sample, information related to their glucose level is taken. If the person's
glucose level while they are fasting is greater than or equal to 126 mg/dl
they most likely have diabetes. If these findings are found in a person
who has not been diagnosed with diabetes, a doctor may have the test
repeated on another day in order to confirm the results. A doctor may
have the person go through an, 'Oral Glucose Tolerance Test,' or possibly
a, 'Glycosylated Hemoglobin Test,' commonly referred to as a,
'Hemoglobin A1c,' test for confirmation purposes.
If the person has a fasting glucose level that is more than 100, but less
than 126 mg/dl - they are considered to have Pre-Diabetes. They do not
yet have Diabetes, but they are at greater risk of developing it in the
near future.
Oral Glucose Tolerance Test: An Oral Glucose Tolerance Test involves
first drawing the person's fasting blood sugar level, and then drawing
another blood sugar level two hours after they have consumed a drink
containing seventy-five grams of sugar. If the person's blood sugar level
after they have consumed the sugar drink is greater than or equal to 200
mg/dl they have Diabetes. If their blood sugar level is between 140 and
199 mg/dl, they are considered to have Pre-Diabetes.
Glycosylated Hemoglobin, or 'Hemoglobin A1c,' Test: The Hemoglobin
A1c test measures how high the person's blood sugar levels have been
over the last 120 days. The test involves drawing a blood sample, and is
the best way to measure blood sugar control in persons with diabetes. If
the test results show 7% or less, the person has good blood glucose
control. If the person has 8% or higher test results, their blood sugar has
been to high for too long.
The Hemoglobin A1c test in not as reliable for use in diagnosing
diabetes, and is used more for follow-up care. Results showing greater
than 6.1% are indicative of Diabetes, although confirmation testing would
be needed before a diagnosis is reached. The test is commonly
performed every three to six months for persons with diabetes. Persons
who are having trouble maintaining control of their blood sugar levels
may have the test done more often to help them maintain good control
of their blood sugar levels.
Diagnosis the Complications of Diabetes
Persons with diabetes should have regular checkups to check for signs
of complications caused by diabetes. Their regular health care provider
can do many of these checks, others may need to be done by a
specialist. The checks that need to be done include having their eyes
checked at least once a year by an eye specialist to look for Diabetic
Retinopathy. The persons urine needs to be checked on a regular basis;
at least two or three times a year, because protein in their urine may be
a sign of Nephropathy.
Health care providers can check the sensation in a person with diabetes
legs using a tuning fork or monofilament device to check for Diabetic
Neuropathy. They can also check the person's lower legs and feet for
things like blisters, cuts, scrapes or other lesions that may become
infected. Persons with diabetes need regular screening for high
cholesterol and high blood pressure, which can contribute to heart
disease.
Treatment of Diabetes at Home
Diet, exercise, and other healthy habits can help persons with diabetes to
improve their blood sugar control, as well as help them to either
minimize or prevent entirely complications of diabetes.
Diet: A healthy diet is the key to control of blood sugar levels in persons
with diabetes, and in the prevention of complications of diabetes.
Persons who are overweight and having difficulty losing weight can work
with their health care provider to find a dietician, or a weight
modification program to help them reach their goal weight. Eating a
consistent and well-balanced diet which is low in saturated fat and
concentrated sweets, as well as high in fiber, in about the same number
of calories at the same times each day is the best thing. Doing so helps
the person's health care provider to prescribe appropriate doses of either
insulin or medication, and helps to keep blood sugar levels fairly even -
as well as helping to avoid dangerously high or low blood sugar levels.
Exercise: Any form of exercise, done on a regular basis, can help to
reduce the risk of developing diabetes in the first place. Exercise and
also help to reduce risking complications of diabetes such as kidney
failure, heart disease, leg ulcers, and blindness. Any form of exercise is
beneficial; even twenty minutes of walking three times a week has
proven beneficial. Some exercise is better than none at all. Some
persons with diabetes who have experienced complications may wish to
speak with a health care provider and ask them about an appropriate
exercise program.
Alcohol Consumption: Persons with diabetes should either moderate, or
eliminate their consumption of alcohol. They should not have more than
seven drinks containing alcohol in a week; never more than two or three
in one evening. One drink is 1.5 ounces of liquor, 12 ounces of beer, or 6
ounces of wine. For persons with Type 2 Diabetes, alcohol is a known
risk factor for Neuritis, high or low blood sugar levels, and increased
triglycerides.
Smoking: Persons with diabetes who smoke; no matter if it involves
cigarettes, a pipe, a cigar, or another form of tobacco - increase their
risk markedly for every complication of diabetes. Persons with diabetes
who use tobacco and need help quitting should speak with their health
care provider.
Blood Sugar Monitoring: Persons with diabetes need to check their blood
sugar levels often. It is recommended that they check their blood sugar
before meals, and before going to bed. They should record their blood
sugar levels in a logbook, which also includes either insulin or
medication doses and the times they were taken, what they have eaten
and at what times, the exercise they have done, and any issues related
to diabetes that were significant. A logbook provides highly useful
information that a health care provider can use to see how the person is
responding to treatment and other planning.
Body Mass Index: According to a study published in Annals of Internal
Medicine, an increase in body mass index (BMI) over time is the most
important factor contributing to the observed increase in diabetes
prevalence since 1976. Diabetes is one of the most common and costly
chronic disorders in the United States. Researchers analyzed data from
National Health and Nutrition Examination Surveys to determine the
extent to which the increase in diabetes prevalence is explained by
changing distributions of race/ethnicity, age, and obesity prevalence in
U.S. adults. They found the prevalence of diabetes nearly doubled from
1976 to 1980 and also from 1999 to 2004. During both time periods,
diabetes prevalence increased more in men than in women. The increase
of certain risk factors, including BMI, race and ethnicity, and age,
coincided with an increased incidence of diabetes, with BMI being the
greatest contributor among the three covariates. The researchers suggest
that public health efforts should focus on interventions that address
obesity. The increased prevalence of diabetes among men could not be
explained by an increased BMI in men. Researchers suggest that future
research should investigate what additional factors may contribute to the
faster rise in diabetes in men than in women.
Medical Treatment of Diabetes
People are treated for diabetes individually depending on the type of
diabetes they have. The form of treatment a health care worker provides
also depends on whether or not the person has additional complications
from diabetes and their general health at the time they are diagnosed.
Treatment of diabetes involves lifestyle changes and blood sugar control,
and creation of a plan to meet treatment goals.
Persons who have just been diagnosed with diabetes will often times find
a care team spending a great deal of time educating them about the
condition and its treatment, along with everything the person needs to
know in regards to caring for themselves daily. The team includes not
only a health care provider and their staff members; but specialists
involved with eye care, foot care, Neurology, Diabetes Education, and a
Professional Dietician. The team interacts with the person who has
diabetes at appropriate intervals to check on their progress and goals.
Education is essential for persons with all types of diabetes.
Treatment of Type 1 Diabetes
Treatment of Type 1 Diabetes nearly always involves daily injections of
insulin, usually in the form of a combination of short acting insulin.
Insulin cannot be taken orally; if it were, the insulin would be destroyed
in the person's stomach before it would be distributed in their
bloodstream, which is where it is needed. The majority of persons with
Type 1 Diabetes administer insulin injections to themselves. If someone
else gives the person with diabetes their insulin injections, it is still
important that the person with diabetes know how to administer the
injection themselves in the event that another person is unavailable.
Persons with diabetes learn how to inject insulin from a trained
professional, who will also show them how to store insulin; usually a
Nurse who works with their health care provider, or diabetes educator.
People with Type 1 Diabetes commonly inject insulin two or three times
daily, usually around meal times. The amount of insulin they use
depends on their individual needs as determined by their health care
provider. There are some longer acting forms of insulin that are usually
injected once or twice a day. Some persons with Type 1 Diabetes have
the insulin they take administered continuously through an infusion
pump in order to receive adequate control of their blood glucose levels.
If a person has taken insulin it is important that they eat because insulin
will lower their blood sugar level whether they have eaten or not. If the
person has taken insulin and not eaten, they risk hypoglycemia, also
referred to as an, 'Insulin Reaction.' While persons with Type 1 Diabetes
are learning how insulin affects them there is a period of time where
they are adjusting. The adjustment period includes how different meals
and exercise, as well as insulin affect them and their blood sugar levels.
It is important to learn to keep blood sugar levels as even as possible.
Equally important is maintaining an accurate record of the person's
insulin dosages and blood sugar levels; health care providers will need
this information in order to provide treatment and management of
diabetes for them. Pursuing a consistently healthy diet that is right for
their weight and size is just as important in the effort to control the
person's blood sugar levels.
Treatment of Type 2 Diabetes
Persons with Type 2 Diabetes may have the opportunity to lower their
blood sugar levels without the need for medication, if their HbA1c test
results warrant this opportunity. Losing weight and exercising are the
best ways to lower blood sugar levels in persons with Type 2 Diabetes. If
a person with this type of diabetes is presented with this opportunity,
they may have from three to six months before their blood sugar and
HbA1c test is checked again. If the blood sugar levels are still high in
the results, the person will start taking oral diabetes medication to
control blood sugar levels.
While on oral medication for Type 2 Diabetes, it is important to lose
weight if the person is overweight, eat a healthy diet, and pursue
appropriate exercise. The person's health care provider will monitor their
progress while they are taking oral medication closely after they have
started taking it to ensure that the proper dose is being administered,
and to make sure that side-effects are at a minimum.
The person's health care provider may choose to combine two forms of
medication in order to achieve blood sugar levels that are within an
appropriate range. Over time, persons with Type 2 Diabetes may need
insulin injections in order to achieve control of blood sugar levels. It is
now becoming more common for persons with Type 2 Diabetes to use a
combination of insulin injections and medication to control their blood
sugar levels.
Diabetes Outlook
The leading cause of death in all industrialized nations is diabetes, and
persons with diabetes have twice the risk of premature death than those
who do not have it. Their prognosis is dependent on the type of diabetes
they have, the development of any complications, as well as the control
they have over their blood sugar levels.
Type 1 Diabetes
Approximately 15% of persons with Type 1 Diabetes die before reaching
forty years of age; twenty-times the rate of that particular age group in
the general population. Their most common cause of death is Diabetic
Ketoacidosis, Heart Failure, or Kidney Failure. The prognosis for persons
with Type 1 Diabetes may be improved through good blood sugar
control, which has been proven to slow the progression of diabetes, or
even prevent it, and even improve complications in persons with Type 1
Diabetes.
Type 2 Diabetes
Persons with Type 2 Diabetes who have been diagnosed while in their
forties have a life-expectancy which is decreased by five to ten years
because of the diagnosis. The leading cause of death among persons
with this type of diabetes is Heart Disease. Strict blood pressure control
and good blood sugar monitoring at a recommended level of less than
100 mg/dl, as well as, 'good cholesterol,' and the use of Aspirin when
indicated, can slow down the progression of this type of diabetes or
prevent or improve any complications.

Common ailments of Christmas

'

The 12 Ailments of Christmas
By essex private doctors
The festive season is upon us once again and we
find that we are busier than ever over Christmas.
Great news is that we are here for you every day,
even Christmas Day, just call us on 01277 201001.
What with goodwill and merriment of the season it
is a time for festivities, joy, families, presents, the
perennial box of Brazil Nuts, and bountiful Turkey.
Yes, December is a veritable winter wonderland of
hearty good cheer and an inimitably warm glow.
At Essex Private Doctors it is also the time for
illnesses and ailments, some self-inflicted, others
not. But the last thing you want amidst the festive
madness of the Queen’s speech and sherry-infused
squabbling aunties is to be feeling a bit peaky.
With our guide to Christmas ailments, you might
not be able to dodge all of them, but at least you’ll
know what to do if you become one of the
afflicted.
1. Bloating and Gas
What with the cracking open of fizzy drinks and
champagne combined with over indulgence in food
and vegetables like brussel sprouts, wind builds up
inside your body. Mainly caused by our diet and
gulping down too much air we can be left in some
quite significant discomfort.
We suggest that you try where possible to
moderate your diet and if you feel great discomfort
you can speak to your pharmacist about antacids.
2. Stomach Upset
Overindulgence of Quality Streets, Cocktails and
Christmas pudding means that you’re going to put
your stomach through its paces over the Yuletide
season.
Typical upset stomach symptoms include a bile
taste in the mouth, stomach pains, ulcers, irregular
bowel movements, and constipation. The pain can
often be made worse by things such as coffee,
fatty foods, onions, alcohol and chocolate – in
other words, a few of Christmas’s favourite
contenders.
You should not need to call on us for this and
there is a variety of medications available over the
counter for these conditions.
3. Hangover
Whilst strictly not an illness, that ‘one for the road’
may have resulted in a morning of splitting
headaches, room-spinning dizziness, gag-inducing
dehydration and vein-popping vomiting?
Alcohol is a diuretic – removing fluids from the
body – that leads to dehydration, and this is what
kick-starts a head-busting hangover.
And while there are hangover tips, there aren’t any
cures. However, here’s some sound advice to get
you through: Don’t drink on an empty stomach,
drink soft drinks between the alcoholic ones, and
drink a pint or so of water before you go to bed.
4. Seasonal Flu
Even with granny’s perennially knitted festive
jumpers, the drop in temperature means we’re
more susceptible to those unpleasant winter chills,
coughs and sneezes.
Why not come and see us for your Flu Vaccination
call 01277 201001
Generally, flu symptoms peak after two to three
days and you should feel better within five to
eight. In most cases plenty of rest, drinking lots of
water and keeping warm will get you on the road
to recovery. More serious strains of flu, such as
chest infections or pneumonia, will need to be
treated with antibiotics, in which case you should
consult your Private GP.
5. Indigestion
Indigestion – also known as dyspepsia – is the
discomfort or pain in your chest not long after
you’ve been eating or drinking. It can also make
you feel bloated, make you belch, cause heartburn
and nausea.
Caused as a result of stomach acid coming into
contact with the sensitive, protective lining of the
digestive system, it’s a common problem that
affects a lot of people but only occasionally and
mildly.
Medications such as antacids usually remedy the
problem, although if symptoms persist you should
consult your pharmacist or Private GP.
6. Winter Headaches
Think of Christmas and you imagine nice, warm,
cosy, fluffy things. But those chilly temperatures,
terrible Christmas tunes and meteorological dips
mean you can also be struck by a splitting winter
headache.
A winter headache is triggered primarily because
of the change in temperature and weather, as well
as being caused by the common cold. But they can
also be caused by things such as red wine, MSG,
coffee, cheese, and skipping meals.
Best way to beat – or even better, avoid – a winter
headache is to eat healthily (plenty of fruit and
veg, and protein such as chicken), get plenty of
Vitamin D, sleep (fatigue is a headache trigger),
stay hydrated, and get plenty of exercise.
7. Seasonal Affective Disorder (S.A.D)
Season Affective Disorder (SAD) is a serious
problem that is thought to affect one in 50 people
in the UK. Also known as the ‘winter blues’, it’s a
form of depression that affects people from
September and November, then gradually lifts in
early spring.
Treatments include cognitive behavioural therapy
and antidepressants, and light therapy is thought
to have a short-term effect. Just give us a call if
you are worried that you are suffering from SAD.
8. Eczema and dry skin
A common complaint during the shivery months,
dry skin is also uncomfortable and irritating.
eczema is another skin condition that’s linked to
having an allergic reaction, and can be
exacerbated by heat, cold, dryness, wetness or
harsh wind – conditions of extremes we put our
bodies through after spending hours in the freezing
cold, to then warm up in front the fire.
Moisturising cream – the thicker the better –
applied several times a day is always a reliable
solution to the problem of dry skin, and non-
perfumed, unscented creams are less likely to
irritate the skin.
9. Chilblains and Raynaud’s disease
The painful red, itchy lumps of chilblains and its
equally irritating cousin, Raynaud’s disease, are
common winter conditions. They’re also a
Christmas present you definitely don’t want.
The key is to avoid getting cold in the first place –
precipitously warming yourself up when you’re
already frozen to the bone only makes things
worse. A good, thick pair of gloves and socks will
keep you nice and toasty and keep the chilblains
at bay.
10. Norovirus
When it comes to thoroughly unpleasant winter
bugs, Norovirus – also known as the winter
vomiting bug – is the reigning champion. It is the
most common ailment in the UK, affecting between
600,000 to 1 million people every year.
Highly contagious and affecting people of all ages,
it causes severe vomiting and diarrhea. The
incubation period is usually 12-48 hours but it
shouldn’t last more than a couple of days.
And while there’s no specific cure – meaning you
have to let its unpleasantness work its way
through your system – there are a few things you
can do to ease the symptoms These include:
drinking plenty of water to stay hydrated, taking
paracetamol for the aches and pains, washing your
hands frequently with soap and water, not sharing
towels or flannels, and disinfecting surfaces/
objects that could be infected.
11. Common Cold
It is a mild viral infection of the nose, throat and
sinuses that causes a runny nose, sneezing, a
cough and sore throat. In adults, it lasts for about
a week and in children about two weeks. If you’re
particularly unlucky, you can be afflicted with a
series of colds of various strengths.
Symptoms can usually be relieved by taking over-
the-counter medication such as Paracetamol, and
drinking plenty of fluids to stay hydrated. And you
can prevent germs from spreading by washing
your hands regularly, sneezing and coughing into
tissues, cleaning surfaces, and using your own
crockery.
If symptoms persist for more than three weeks,
however, consult your pharmacist or Private GP.
12. Christmas Tree Syndrome
This is a fairly new modern day ailments and you
might be forgiven for thinking Christmas Tree
Syndrome was as fictional as Santa Claus (I didn’t
just ruin it for you, did I?). Well, you’d be wrong.
The condition is caused by breathing in the mould
and spores growing on the Christmas tree, which
causes an itchy nose, watery eyes, and shortness
of breath, coughing, chest pains, fatigue, along
with problems sleeping.
And the best way to rid yourself of this pine-based
affliction? Doctors have recommended you first
hose down your tree in the garden and let it dry
out before you prop it up alongside the rest of the
Christmas decorations – and then swiftly dispose
of it after Christmas Day.

All about ebola disease

Ebola virus disease
Fact sheet N°103
Updated September 2014
Key facts
Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe,
often fatal illness in humans.
The virus is transmitted to people from wild animals and spreads in the human
population through human-to-human transmission.
The average EVD case fatality rate is around 50%. Case fatality rates have varied
from 25% to 90% in past outbreaks.
The first EVD outbreaks occurred in remote villages in Central Africa, near tropical
rainforests, but the most recent outbreak in west Africa has involved major urban as
well as rural areas.
Community engagement is key to successfully controlling outbreaks. Good outbreak
control relies on applying a package of interventions, namely case management,
surveillance and contact tracing, a good laboratory service, safe burials and social
mobilisation.
Early supportive care with rehydration, symptomatic treatment improves survival.
There is as yet no licensed treatment proven to neutralise the virus but a range of
blood, immunological and drug therapies are under development.
There are currently no licensed Ebola vaccines but 2 potential candidates are
undergoing evaluation.
Background
The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola
virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara,
Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in
a village near the Ebola River, from which the disease takes its name.
The current outbreak in west Africa, (first cases notified in March 2014), is the largest
and most complex Ebola outbreak since the Ebola virus was first discovered in 1976.
There have been more cases and deaths in this outbreak than all others combined. It
has also spread between countries starting in Guinea then spreading across land
borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1
traveller) to Senegal.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak
health systems, lacking human and infrastructural resources, having only recently
emerged from long periods of conflict and instability. On August 8, the WHO Director-
General declared this outbreak a Public Health Emergency of International Concern.
A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the
Democratic Republic of Congo.
The virus family Filoviridae includes 3 genera: Cuevavirus, Marburgvirus, and Ebolavirus.
There are 5 species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï
Forest. The first 3, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have
been associated with large outbreaks in Africa. The virus causing the 2014 west African
outbreak belongs to the Zaire species.
Transmission
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts.
Ebola is introduced into the human population through close contact with the blood,
secretions, organs or other bodily fluids of infected animals such as chimpanzees,
gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the
rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through
broken skin or mucous membranes) with the blood, secretions, organs or other bodily
fluids of infected people, and with surfaces and materials (e.g. bedding, clothing)
contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with
suspected or confirmed EVD. This has occurred through close contact with patients
when infection control precautions are not strictly practiced.
Burial ceremonies in which mourners have direct contact with the body of the deceased
person can also play a role in the transmission of Ebola.
People remain infectious as long as their blood and body fluids, including semen and
breast milk, contain the virus. Men who have recovered from the disease can still
transmit the virus through their semen for up to 7 weeks after recovery from illness.
Symptoms of Ebola virus disease
The incubation period, that is, the time interval from infection with the virus to onset of
symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms.
First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore
throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and
liver function, and in some cases, both internal and external bleeding (e.g. oozing from
the gums, blood in the stools). Laboratory findings include low white blood cell and
platelet counts and elevated liver enzymes.
Diagnosis
It can be difficult to distinguish EVD from other infectious diseases such as malaria,
typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus
infection are made using the following investigations:
antibody-capture enzyme-linked immunosorbent assay (ELISA)
antigen-capture detection tests
serum neutralization test
reverse transcriptase polymerase chain reaction (RT-PCR) assay
electron microscopy
virus isolation by cell culture.
Samples from patients are an extreme biohazard risk; laboratory testing on non-
inactivated samples should be conducted under maximum biological containment
conditions.
Treatment and vaccines
Supportive care-rehydration with oral or intravenous fluids- and treatment of specific
symptoms, improves survival. There is as yet no proven treatment available for EVD.
However, a range of potential treatments including blood products, immune therapies
and drug therapies are currently being evaluated. No licensed vaccines are available yet,
but 2 potential vaccines are undergoing human safety testing.
Prevention and control
Good outbreak control relies on applying a package of interventions, namely case
management, surveillance and contact tracing, a good laboratory service, safe burials
and social mobilisation. Community engagement is key to successfully controlling
outbreaks. Raising awareness of risk factors for Ebola infection and protective measures
that individuals can take is an effective way to reduce human transmission. Risk
reduction messaging should focus on several factors:
Reducing the risk of wildlife-to-human transmission from contact with infected fruit
bats or monkeys/apes and the consumption of their raw meat. Animals should be
handled with gloves and other appropriate protective clothing. Animal products
(blood and meat) should be thoroughly cooked before consumption.
Reducing the risk of human-to-human transmission from direct or close contact with
people with Ebola symptoms, particularly with their bodily fluids. Gloves and
appropriate personal protective equipment should be worn when taking care of ill
patients at home. Regular hand washing is required after visiting patients in hospital,
as well as after taking care of patients at home.
Outbreak containment measures including prompt and safe burial of the dead,
identifying people who may have been in contact with someone infected with Ebola,
monitoring the health of contacts for 21 days, the importance of separating the
healthy from the sick to prevent further spread, the importance of good hygiene and
maintaining a clean environment.
Controlling infection in health-care settings:
Health-care workers should always take standard precautions when caring for patients,
regardless of their presumed diagnosis. These include basic hand hygiene, respiratory
hygiene, use of personal protective equipment (to block splashes or other contact with
infected materials), safe injection practices and safe burial practices.
Health-care workers caring for patients with suspected or confirmed Ebola virus should
apply extra infection control measures to prevent contact with the patient’s blood and
body fluids and contaminated surfaces or materials such as clothing and bedding.
When in close contact (within 1 metre) of patients with EBV, health-care workers should
wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile
long-sleeved gown, and gloves (sterile gloves for some procedures).
Laboratory workers are also at risk. Samples taken from humans and animals for
investigation of Ebola infection should be handled by trained staff and processed in
suitably equipped laboratories.
WHO response
WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus
disease and supporting at-risk countries to developed preparedness plans. The
document provides overall guidance for control of Ebola and Marburg virus outbreaks:

Addresses of NYSC Orientation Camps

Addresses of NYSC Orientation Camps
A
ABIA (AB)
NYSC Permanent Orientation Camp, Umunna, Bende Local Government Area, Abia State.
ADAMAWA (AD)
NYSC Permanent Orientation Camp, Old Gongola Brewery Damare Village Along Lapondo
Road, Girei LGA, Adamawa State.
AKWA IBOM (AK)
NYSC Permanent Orientation Camp, Ikot Itie Udung, Nsit Atai Local Government Area,
Akwa Ibom State.
ANAMBRA (AN)
NYSC Permanent Orientation Camp, Progressive Senior Secondary School, Umunya, Oyi
Local Government Area, Anambra State.
Anambra Camp Pictures
B
BAUCHI (BA)
NYSC Permanent Orientation Camp, Wailo, Ganjuwa Local Government Council, Bauchi
State.
BAYELSA (BY)
Kaiama Grammar School , Kaiama, Kolokuma/Opokuma L.G.A Kaiama Grammar School,
Kaiama, Kolokoma-Opokuma Local Government Area, Bayelsa State.
BENUE (BN)
NYSC Permanent Orientation Camp, Wannune, Tarka Local Government Area, Kilometer 35
Makurdi Gboko Road, Benue State.
BORNO (BO)
NYSC Permanent Orientation Camp, Biu Road, Maiduguri LGA, Maiduguri, Borno State.
C
CROSS RIVER (CR)
NYSC Permanent Orientation Camp, Obubra, Obubra Local Government Area, Cross River
State.
D
DELTA (DT)
NYSC Permanent Orientation Camp Former Martins TTC, Issele-Uku, Aniocha North L.G.A.
Delta State.
E
EBONYI (EB)
NYSC Permanent Orientation Camp, Macgregor College, Afikpo Local Government Area,
Ebonyi State.
EDO (ED)
Okada Grammar School, Okada, Ovia North-East Local Government Area, Edo State.
EKITI (EK)
NYSC Permanent Orientation Camp, Ise-Orun/Emure Local Government Area, Ekiti State.
ENUGU (EN)
NYSC Permanent Orientation Camp, Awgu Local Government Area, Enugu State.
F
FCT (ABUJA) (FC)
NYSC Permanent Orientation Camp, Kubwa, Bwari Area Council, FCT.
G
GOMBE (GM)
NYSC Permanent Orientation Camp, Kilometer 27, Mallam Sidi, Kwame Local Government
Area, Gombe State.
Gombe Camp Pictures
I
IMO (IM)
NYSC Permanent Orientation Camp, Umudi Nkwerre Local Government Area, Imo State.
J
JIGAWA (JG)
NYSC Permanent Camp, opposite Army Barrack, Fanisua Dutse Local Government Area,
Jigawa State.
K
KADUNA (KD)
NYSC Permanent Orientation Camp, Kaduna – Abuja Road, Kaduna State.
KANO (KN)
NYSC Permanent Orientation Camp, Kusala Dam, Karaye, Karaye Local Government, Kano
State.
KATSINA (KT)
Youth Multi-purpose Centre/ NYSC Permanent Orientation Camp, Mani Road, Katsina
State.
KEBBI (KB)
NYSC Temporary Orientation Camp, Government Science College, Dakingari Local
Government Area, Kebbi State.
KOGI (KG)
NYSC Permanent Orientation Camp, Asaya, Kabba Local Government Area, Kogi State.
KWARA (KW)
NYSC Permanent Orientation Camp, Yikpata, Edu Local Government Area, Kwara State.
L
LAGOS (LA)
NYSC Permanent Orientation Camp, Iyana Ipaja, Agege, Lagos State.
N
NASSARAWA (NS)
Magaji Dan-Yamusa Permanent Orientation Camp, Keffi, Nasarawa State.
NIGER (NG)
NYSC Permanent Orientation Camp, (Former Abubakar, Dada Senior Secondary School),
Paiko, Niger State.
O
OGUN (OG)
NYSC Permanent Orientation Camp, Ikenne Road, Sagamu Local Government Area,
Sagamu, Ogun State.
ONDO (OD)
NYSC Permanent Orientation Camp, Ikare-Akoko Local Government Area, Ondo State.
OSUN (OS)
NYSC Permanent Orientation Camp, Aisu College Hospital Road, Ede North Local
Government Area, Ede, Osun State.
OYO (OY)
NYSC Permanent Orientation Camp Iseyin, Iseyin Local Government Area, Iseyin, Oyo State
P
PLATEAU (PL)
NYSC Permanent Orientation Camp, Mangu, Mangu Local Government Area, Plateau State.
Plateau Camp Pictures
R
RIVERS (RV)
NYSC Permanent Orientation Camp, Nonwa-Gbam Tai Local Government Area, Rivers
State.
S
SOKOTO (SO)
NYSC Permanent Orientation Camp Wamakko, Wamakko LGA Sokoto State
T
TARABA (TR)
Government College, Jalingo, Jalingo Local Government Area Taraba State.
Y
YOBE (YB)
NYSC Permanent Orientation Camp, Fika, Fika Local Government Area, Yobe State.
Z
ZAMFARA (ZM)
NYSC Permanent Orientation Camp, Beside FRSC Office, Tsafe Local Government Area,
Zamfara State.