Open Sores And Wounds
Having high blood sugar for a long time can lead to poor circulation and nerve damage. You may have developed these if youve had uncontrolled diabetes for a long time.
Poor circulation and nerve damage can make it hard for your body to heal wounds. This is especially true on the feet. These open wounds are called diabetic ulcers.
Diabetes and feet
- Get immediate medical care for an open sore or wound.
- Work with your doctor to better control your diabetes.
Measurement Of Gastric Accommodation
In patients with diabetes and postprandial symptoms, impairment of gastric accommodation may be the sole pathophysiology or it may be associated with impaired gastric emptying, such as accelerated emptying at 1 h. Earlier measurements of gastric accommodation by intra- gastric balloons have been used in a few research centers. The main methods to measure accommodation are single photon emission computed tomography , ultrasonography, and MRI, which can measure gastric volumes in addition to emptying and contractility.33
Single Photon Emission Computed Tomography
The pitfalls are the use of radioactivity and the need for SPECT camera and sophisticated software to perform the 3D reconstruction and calculate volumes.
Imaging-based methods to measure gastric volume include analysis of surface geometry of human stomach using real-time, 3D ultrasonography or, most recently, 3D reconstruction of images acquired by ordinary ultra-sonography assisted by magnetic scan-head tracking.37,38 Three-dimensional ultrasonography has been applied in adolescents and compared to simultaneously measured gastric volumes by SPECT further validation and standardization are necessary.39 A limitation of 3D ultra-sonography is that it allows assessment of only the stomach’s response to a liquid meal.
Neither MRI nor 3D ultrasonography has had sufficient validation in health or disease to recommend use in routine clinical practice.
Tips To Make The Most Of Your Diabetes Management Plan
1. Understand the medicines you are taking and take them exactly as directed.2. Know what your target blood glucose level is and what to do if your numbers are out of range. Check your blood glucose levels as often as your health care provider recommends and keep a record.3. Watch for signs and symptoms of high blood glucose.4. Follow your meal plan and be aware of foods that can cause your blood glucose to go up.5. Be as physically active as you can.6. Have a sick-day plan and follow it.
Understanding diabetic gastroparesis
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Other Ways Diabetes Affects The Gi Tract
It can cause upper GI problems. Nerve issues in the esophagus may cause heartburn and make it hard for you to swallow. Your doctor will tell you what range you should keep your blood sugar in so you can control these symptoms. They might also prescribe or suggest antacids and the amount you should take.
Other GI diseases that are more common in people with diabetes include:
Always see your doctor if you have gut problems that are new or just wonât go away.
The Gene At The Centre Of The Haystack
The team of scientists have spent years trolling through public genetic data bases, in the search for clues behind the pathology of type 2 diabetes.
The systematic search brought the CD44 gene onto their radar. In the 130 gene-activity-level experiments involving diabetic tissues included in their mining operation, 78 showed CD44 expression levels were a lot higher in diabetic tissues.
The problem with this gene is not that it is defective so to speak, but it is definitely excessively busy, in the type 2 diabetic fat tissues, irrespective of whether the tissue is rat, mouse or human.
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Uncovering The Armed Response At Devcon 5
The Stanford team looked for answers in genetically modified mice, specifically, they ran a few experiments on mice that were missing the CD44 gene, so called CD44 knockout mice. The strain of mice they used in their studies, are typically porky with a high propensity to become diabetic when fed too much.
They started overfeeding these special mice, expecting to turn them diabetic, with the continuous high calorie diet. The normal mice got tubby and became insulin resistant, but the mice without the CD44, just became fat they never developed diabetes. The blood sugar levels remained perfectly normal when the CD44 gene was missing.
The CD44 seemed to be the link between obesity turning into something beyond excess wobbly bits. CD44 receptors are involved in creating devcon 5 levels of inflammation in the fat cells.
Nuts Eaten In Moderation May Promote Weight Loss
Almonds, walnuts, and other nuts high in healthy monounsaturated fat are shown in some studies to promote belly fat loss, says White, who advises limiting your intake to ¼ cup per day. Nuts are high in calories, so be mindful of portions. Nosh on a small handful, or use them as a topping for cottage cheese or Greek yogurt.
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Gastroparesis Is A Gastrointestinal Condition Occurring In People With Long
with Mahdusudan Grover, MD, and Michael Camilleri, MD
Gastroparesis gets little attention even though it is a relatively common complication arising in many individuals with diabetesboth type 1 diabetes and type 2 diabetes. Its even more common in individuals with both diabetes and obesity.1
If you have diabetes, stomach pains, bloating, and nausea may be a sign that you gastroparesis. Photo: 123rf
Common symptoms include feeling full before you can finish your meal and staying full long after the meal is over as well as bloating, nausea, vomiting, abdominal pain, and even nutritional deficiencies.1,2
According to results of one study,3 as many as 29% of patients with these gastric symptoms also have diabetes and may experience nerve problems in their stomach, similar to that of peripheral neuropathy that causes tingling and numbness, even pain, in the extremities. Poor blood sugar control may also be a contributing factor.4
If you have had diabetes for a while, this might explain the abdominal pain and other baffling symptoms youve been experiencing after you eat.
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How Does Gastroparesis Affect People With Diabetes
People with diabetes are at increased risk for gastroparesisa digestive disorder that can cause severe symptoms and affect quality of life.
Diabetes is the most common known cause of gastroparesis, a digestive disorder that may lead to poor nutrition, problems managing blood glucose, and a reduced quality of life. Here, Dr. Adil E. Bharuchaone of the authors of the chapter, Gastrointestinal Manifestations of Diabetes, in the NIDDK publication Diabetes in America, 3rd Editiondiscusses how health care professionals can diagnose and treat gastroparesis in patients with diabetes.
Q: What is gastroparesis? How common is gastroparesis in people who have type 1 or type 2 diabetes?
A: Gastroparesis is a condition in which the muscles in the wall of the stomach work poorly or dont work at all, slowing or delaying the rate at which food empties from the stomach to the intestine. This is called delayed gastric emptying. In gastroparesis, gastric emptying is delayed because the muscles dont work effectively, not because a blockage prevents food from moving from the stomach to the intestine.
In one study, over a period of 10 years, about 5% of people with type 1 diabetes and about 1% of people with type 2 diabetes developed gastroparesis. Less than 1% of people without diabetes developed gastroparesis during the study.
Q: In people with diabetes, what is the relationship between gastroparesis and blood glucose levels?
Q: How is gastroparesis diagnosed?
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What People With Diabetes Should Know Before Giving It A Try
Dont worry: High-intensity resistance exercise is all about moving your body in a way that feels challenging to you, and it doesnt have to be high-impact. Remember, its important to keep your feet safe, and pounding the pavement or gym floor with high-impact exercise can increase your risk of cuts, blisters, and infection. No one wants that.
The best way to structure high-intensity resistance exercise depends on your current fitness level. After all, the fitter you are, the more weight you can move with each rep and the less you need to rest between sets. But as a general rule of thumb, you should be able to perform 15 to 20 reps per set with proper form, according to an article published in the ACSM’s Health & Fitness Journal. Rest for 30 seconds or less between sets.
And, as with any type of exercise, its important to warm up before and cool down after your high-intensity resistance training. Spend 5 to 10 minutes walking, jogging, or performing gentle bodyweight exercises. Save any stretching for after your training session.
Ideally, youd strength train at least three times per week, on nonconsecutive days. That will give your body the rest time it needs to spring back from each workout stronger and healthier than before.
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Colorful Vegetables Low In Carbs May Help Fight Belly Fat
Eating dark green, bright orange, and yellow veggies may help reduce belly fat. In a study published in November 2014 in the Journal of the Academy of Nutrition and Dietetics, overweight Latino youth who ate veggies in these colors had increased insulin sensitivity and less belly fat.
Green vegetables, such as kale and spinach, are low in carbohydrates and do not affect insulin or blood sugar, White says. They provide fiber, which promotes weight loss. Theres no need to limit portions on greens, she says.
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Work Out The Details With Your Doctor
The best thing a patient can do is ask questions. Make sure you understand all the reasons you might be gaining weight, what medications youre taking that have that side effect and what alternatives are available. A screening test for low thyroid hormone is appropriate.
Youll also want to find out the out-of-pocket costs for each specific drug. Some are costly and youll need to consider whether you can easily afford these medications long-term.
Managing diabetes is a challenge, and your treatment plan has to work for you. Talk to your doctor and other healthcare providers and make adjustments until your plan is working well.
If you can effectively make the right lifestyle choices, you can minimize your need for medication. This means less cost, less side effects and an overall feeling of well-being.
/6diabetic Stomach Pain: All You Need To Know
Managing diabetes is not easy. You have to change your lifestyle to manage the condition along with taking the prescribed medications.
Diabetics may also notice some change in their gut or how their gastrointestinal tract feels, sounds and responds. In some cases, it can also cause stomach ache. Here is why diabetes can lead to stomach aches and how to treat it.
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The Key Role Of Dpp4 Inhibitors In Diabetes
Dr. Tabas and his colleagues used obese mice to test whether blocking an enzyme called DPP4 would lower the inflammation in their abdominal fat.
The researchers focused on DPP4 because humans who already have diabetes are prescribed DPP4 inhibitors to help them manage their symptoms. DPP4 inhibitors work by preventing the enzyme from interacting with an insulin-boosting hormone.
In this study, DPP4 did not lower abdominal inflammation in mice. Dr. Tabas explains these findings, suggesting that they may be down to the difference between how DPP4 inhibitors work in the gut versus how they work in the liver.
DPP4 inhibitors lower blood sugar by inhibiting DPP4 in the gut. But we have some evidence that DPP4 inhibitors in the gut also end up promoting inflammation in fat, he states. That cancels out the anti-inflammatory effects the drugs may have when they reach inflammatory cells, called macrophages, in the fat.
From our studies, adds Dr. Tabas, we know that DPP4 interacts with a molecule on these cells to increase inflammation. If we could block that interaction, we might be able stop the enzyme from causing inflammation and insulin resistance.
So, the researchers targeted DPP4 in the liver cells instead of the gut. This reduced adipose inflammation and lowered insulin resistance.
DPP4 inhibitors also decreased blood sugar.
Gastroparesis Affects 12 To 15% Of People Living With Diabetes
What is gastroparesis?
Gastroparesis is a condition when the stomach takes a long time to empty its contents into the small intestine. It is also referred to as delayed gastric emptying, gastric stasis, slow stomach, lazy stomach, and diabetic enteropathy. It usually occurs in people who have been living with diabetes for at least 10 years, and typically presents together with complications of the eye, kidney and others linked to the nervous system.
Normally, when food is swallowed, the muscles in the stomach wall help break the food down into smaller pieces, pushing it into the small intestine to continue digestion. This action is controlled by the vagus nerve, part of the so-called autonomic nervous system, which automatically regulates many bodily functions such as breathing and heart rhythm. If the vagus nerve is damaged or stops working, the muscles in the stomach and intestines do not function normally, and the movement of food stops or slows down. If the food stays in the stomach too long, the food ferments and causes an overgrowth of gas-producing bacteria.
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What Causes Discomfort And Bloating In The Lower Abdomen
Abdominal bloating and lower abdominal discomfort may be exacerbated by swallowing too much air, eating high-fat meals that delay stomach emptying, and even worry. Constipation is one of the intestinal and stomach-related disorders that may produce these symptoms. an allergy to a particular substance, such as lactose or gluten.
Diabetes Stomach Pain: The Mechanism
Although diabetes stomach pain occurs in both types of diabetes, it is common in type-2 Diabetes. It can result from various causes. However, the primary reason for abdominal or stomach pain in diabetes is food retention in the stomach.
Diabetic involvement can damage the vagus nerve, a nerve linked with the control of stomach emptying. The process is known as diabetic neuropathy. In addition, it leads to gastroparesis, a condition that delays digestion and food retention in your stomach for an abnormally long duration. The condition causes abdominal pain, bloating, feeling of fullness even with comparatively less food intake. The most common symptom is heartburn. However, other symptoms like vomiting, undigested foods and fluctuation in blood glucose levels may also occur.
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When To See A Dermatologist
Diabetes can cause many other skin problems. Most skin problems are harmless, but even a minor one can become serious in people who have diabetes. A board-certified dermatologist can recognize skin problems due to diabetes and help you manage them.
Are all dermatologists board certified?
No. See what it takes to become board certified.
ImagesImage 1: Image Courtesy of Clark C. Otley, MD. All Rights Reserved
Images 3, 7, 8, 9: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Image 2 from DermNetNZ
Some images used with permission of Journal of the American Academy of Dermatology
Images 5, 6 and 10: Getty Images
ReferencesCohen Sabban, EN. Cutaneous manifestations of diabetes mellitus from A to Z. Focus session presented at: 74th Annual Meeting of the American Academy of Dermatology March 4-8, 2016 Washington D.C.
Duff M, Demidova O, et al. Cutaneous manifestations of diabetes mellitus. Clinical Diabetes. 2015 33:40-8.
Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:1461-70.
McKinley-Grant L, Warnick M, et al. Cutaneous manifestations of systemic disease. In: Kelly AP and Taylor S. Dermatology for Skin of Color. . The McGraw-Hill Companies, Inc. China, 2009:481-4.
Original Articles Neuroendocrine Peptides In Stomach And Colon Of An Animal Model For Human Diabetes Type I
Abstract Twelve prediabetic and 12 diabetic non-obese diabetic mice, all females aged 2224 weeks, were investigated. As controls, 12 BLAB/cJ Bom mice of the same age and gender as the NOD mice were used. The concentration of several neuroendocrine peptides was determined by radioimmunoassay of tissue extracts of transmural specimens of antrum and distal colon. The neuroendocrine peptides investigated were peptide YY , somatostatin, vasoactive intestinal polypeptide , neuropeptide Y , neurotensin, and galanin. In the antrum, VIP, NPY, and galanin concentrations were all significantly lower in prediabetic and diabetic NOD mice than in controls. There was no statistical difference between NOD mice and controls regarding neurotensin content. In the colon, the concentrations of PYY, somatostatin, VIP, NPY, and galanin were lower in prediabetic and diabetic NOD mice than in controls. The concentration of neurotensin in prediabetic, but not in diabetic NOD mice was lower than that of controls. The present observations support the previously reported studies on animal models for human type I diabetes that the neuroendocrine system of the gut is disturbed. It also shows that the neuroendocrine system of the stomach and large intestine is affected. The present findings may have some implications for the gastrointestinal dysfunction observed in patients with human type I diabetes.Continue reading > >
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Overall Weight Loss Effects On Stomach Fat
Body fat is categorized as either subcutaneous fat, found under the skin, or visceral fat that surrounds internal organs, including those in the abdominal cavity. While either type of fat can be found in the abdomen, visceral fat is linked to a greater risk of health problems such as prediabetes and T2DM. An article published in the January 2008 “International Journal of Obesity” reviewed results from 61 studies examining visceral and subcutaneous fat loss after weight loss interventions. Researchers found modest weight loss resulted in a preferential loss of abdominal fat, but this benefit is less or even negated in weight loss greater than 20 percent.