Wednesday, April 20, 2011

Living with Diabetes and participating in Elections

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Diabetes is a chronic disorder in which the body loses its ability to effectively utilize glucose for production of energy due to abnormally with insulin function or action.
Living with diabetes is a daily challenge. It requires an individual understanding the physiology of his or her body. The total glucose level of an individual is a combination of what is eaten and the time the food is consumed.
Diabetes does not stop one participating in any Endeavour of life however, the individual need to adopt special approach towards planning to carry on with daily routine.
The Elections period is here, however, participating in the election to avoid a problem requires some careful planning on the part of anybody living with diabetes.
For a person living with diabetes, before going for elections, the person needs to know what is the state of the blood sugar, take breakfast and drugs or insulin before and go to the polling station with snacks. If the person is on insulin, launch pack must be carried along to avoid complications like hypoglycemia which is an emergency and considering that it is crowd, wrong decisions may be taken during such eventuality.
The authorities conducting elections should have a plan for people with diabetes and other health challenges and get necessary first aid measures readily available at polling centres.
Living with diabetes does not stop an individual participating in election but wrong planning could

Saturday, February 26, 2011

Conversation Map Integration into Health Care Systems-NIGERIA

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The importance of Education towards effective and collective management of a person living with diabetes can not be overemphasized. With recent research publications on the improved glycemic control in patients who encounter educational intervention.

The escalating prevalence of type 2 diabetes is threatening to undermine healthcare systems throughout the world.The latest Internationl Diabetes Federation(IDF) estimates suggest that 380 million people will be affected by 2025, with one person dying every 10 seconds. Diabetes is increasingly a problem in developing regions of the world, where the number of people affected has risen dramatically in recent years. At the beginning of the 20th century, diabetes was rare in Africa, but with the rapid urbanization and change in social life style in the 21st century there has been a rise in the disease and its complications.
One of the most effective weapon to fight this global epidemic is Education. A potent tool to fight ignorance which is further fueling this epidemic of diabetes. The type of education is that which involves the patient discussing his or her experience in a learning atmosphere while learning as well. In other words a participatory learning process.
Healthy Interactions USA INC. came up with Conversation Map TM Tool for engaging patients in useful conversations about there experience and with useful guide of a trained facilitator, wealth of learning takes place and the commitments made by patients are more lasting.
With the introduction of Conversation Map Training Tool into the Nigerian Health Systems, how well can it be sustained? Is a silent question with no tangible answer.
Eli Lilly sponsored some Trained Conversation Map Expert Trainers to conduct a noble scheme. The trained about 72 diabetes Educators from across the six geopolitical zones of Nigeria all converged in Abuja, Nigeria. With this training, the 72 persons comprising doctors, pharmacists, nurses, lab scientists, social workers among others were empowered to train patients. This will definitely have a multiplier effect on their various glucose controls. However, the various diabetes educators need to be encouraged to do more in their various localities. The Ministry of Health should make special allocation towards building capacity from primary health care level to Tertiary level to enable prompt education of patients. The major problem of break down of this scheme is finance, in terms of transport and logistics for the educators and need for re-training.
Conversation Map Tool should be deployed in all our health institutions to help us reduce the statistical predictions of prevalence rate estimates in few years ahead. Currently, the Map is made in English language, French and Arabic. We need them translated to our local languages in various geopolitical zones to enable effective use for optimum benefit. With strong political will, this is possible.

Monday, December 20, 2010

Diabetes aids, articles, financial matters etc: Diabetes Education in Middle-age Schools

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Diabetes Education in Middle-age Schools

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Diabetes Education is a recent phenomenon which is an ingredient for Diabetes prevention strategies. The relevance of Diabetes Education cannot be by any means overemphasized. It is relevant to health care professionals, persons living with diabetes, relations of persons with diabetes and those at risk of developing diabetes.
Majority of the damages posed by diabetes is fueled by ignorance which can be effectively cured with education. Schools are environment for learning both moral and academic. It is the environment where peers are much influenced. This is the breeding ground for poor hygiene and eating habits and lifestyle that are on a long run injurious to the body wellbeing. This is the avenue where most smokers where given birth to!
Introducing diabetes education to school curricula is indeed a necessity to help address some of these ills at infancy. Diabetes Education does not involve diabetes matters alone but useful information on how best to enjoy a healthy life style.
Seasoned expert trainers should be sponsored to carry out trainers training to enable reach out to majority of persons living with diabetes presently and to help fight the damage ignorance is posing to those already with diabetes and those at risk of diabetes.
Diabetes education in middle age schools will automatically assist the school in meal planning; there will be appropriate regulation of beverage and fast foods vendors in around school environment and general consciousness on healthy living techniques.
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Saturday, December 11, 2010

DIABETES AND HYPERTENSION THE RELATIONSHIP

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Hypertension is a cardiovascular disease which has been with man for a long time. Most people in the medical palance view hypertension as a twin of diabetes. Hypertension is twice as common in diabetes as in the general population and affects some 10 – 30% of type 1 and 30 – 50% of type 2 diabetic patients. It is also present in about 20 – 40% of people with impaired glucose tolerance.
The World Health organization(WHO) and International Society for Hypertension (ISH) considers lower target range in people with diabetes to be below 130 -140/85mmHg and Lower (<125/80mmHg) in people with nephropathy. There are several ways which insulin resistance or hyperinsulinaemia which is mainly found in type 2 diabetes could lead to hypertension. - Blunting of the vasodilator effect of insulin an action mediated by the release of nitric oxide from endothelium. - Insulin can act in other ways to raise blood pressure and this can be supported by hyperinsulinaemia that accompanies insulin resistance. Insulin stimulates sodium and water absorption at the distal renal tubule, insulin also stimulates the cell membranes Na+ K+ ATPase, which can raise intracellular Na+ and Ca+ in vascular smooth muscles and therefore enhance contractility and peripheral resistance. Several components of the augmented cytokine induced, acute phase inflammatory response associated with type 2 diabetes may cause hypertension including cytokine stimulation of ACTH and glucocorticoid secretion and activation of the sympathetic nervous system. In type 1 diabetes, hypertension is obviously associated with diabetic nephropathy. Blood pressure begins to rise when albumin excretion rate enters the microalbuminuric range (>30mg/24hrs).
Control of hypertension in diabetes is important because hypertension worsens both macrovascular and microvascular complications. The effect of blood pressure on the risk of fatal coronary heart disease is 2 – 5 times greater in diabetic than in non-diabetics.

Wednesday, December 1, 2010

GASTROPARESIS AND DIABETES

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Gastroparesis is a stomach disorder that results due to a complication of Diabetes called neuropathy. When there is nerve damage, sensation to the stomach muscles reduce and these cause the stomach to empty too slowly.
Gastroparesis could occur in people without diabetes but it is a common occurrence in persons living with diabetes especially type 2 diabetes. People with type 1 diabetes do not develop gastroparesis until they have had diabetes for a long time about 20 years. Women appear to be more likely to get gastroparesis than men.
The most important factor in preventing gastroparesis is good blood glucose control. These are for two major reasons:
- High levels of blood glucose directly slow stomach emptying.
- Good diabetes control slows or prevent the development of complications, including nerve disease called neuropathy.
Symptoms of Gastroparesis
The most common symptoms includes:
- Nausea
- Abdominal pain
- Periods of lows within 1 to 2 hours of eating . others include:
- Feeling full after eating
- Bloating
- Vomiting
- Getting full quickly
- Belching after eating
- Pain in the general area of the stomach
- Upset stomach
- Gastroesophageal reflux.
Diagnosis
In addition to history and physical examination, the doctor can request the following diagnostic tests:
1. Scintigraphy
2. Radioisotope breath test
3. Electrogastrography
4. Manometry
5. Endoscopy
Treatment
The overall treatment goal is aimed at improving blood glucose control, normalizing stomach emptying so that drugs and food absorb properly, and relieving symptoms.
The following multilevel approach is involved:
1. Diabetes Control
Controlling the blood glucose is the foremost treatment measure.
2. Diet
It is important to understand that several small meals are easier for the stomach to process than few large ones. The diet should be low in fat because fat slows stomach emptying. Vegetable consumption in our meals should be encouraged.
3. Exercise
Moderate exercise after eating, studies shows can improve stomach emptying.
4. Review of drugs
The doctor might review a persons drug to remove or change those with side effects of slow stomach emptying also there is the need to cut out alcohol and tobacco.
5. Drug treatment
The doctor may prescribe some range of drugs example
- Prokinetic drugs: to increase stomach activity.
- Antiemetic drugs: to prevent vomiting.
One such drug which has both of these property approved by FDA is metoclopramide.
Other treatment options includes:


1. Surgery
2. Electrical stimulation
3. Electrical pacing.

Sunday, November 28, 2010

Diabetes mellitus and Depression

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Diabetes mellitus is a metabolic disorder resulting in characteristic rise in plasma blood glucose. There is also a cascade of hormonal disturbance as the body try to compensate for this disorder.
The first time a person is diagnosed with diabetes, there seems to be a weight of emotions tied to that person. There is confusion as to what to eat, how to leave and loads of many questions like ‘why me’, ‘what will people say’ amongst others.
The initial reaction or response to this early stage goes a long way to tell how someone copes with diabetes later in life. The early stage of diagnosis if not properly managed by the doctor and relations, then depression automatically finds a root.
Depression could result if one no longer take interest or pleasure in things you used to enjoy doing, you have trouble falling asleep, wake often during the night, or want to sleep a lot more than usual, you wake up earlier than usual and cannot get back to sleep, you eat more or less than you used to, you quickly gain or lose weight. Feeling down once in awhile is normal. But feeling really sad and hopeless for 2 weeks or more might be a sign of serious depression.
Research has shown that depression mostly arises in persons diagnosed with diabetes following periods of denial, anger and frustration.
Diabetes clinics cannot do without the services of Diabetes Educators who are crucial in handling the initial stage of diagnosis and the period of living with the condition.
It is important to make the patient realize that diabetes is not a death sentence, people can have a full and normal life even with diabetes. Relations of people with diabetes must be made to know their responsibilities of care and support. Diabetes must be handled as a team, where the person with the condition is the team leader who takes decision in other for the goal to be attained.
Relations must be on the watch for signs of depression and inform the physician or any member of the diabetes care team promptly.
The following are useful tips on detecting depression:
• You have trouble concentrating, other thoughts or feelings distract you, you have no energy, you feel tired all the time, you are so anxious or nervous, you can’t sit still, you cry often, you feel you never do anything right and are a burden to others, you are less interested in sex, you sad or worse in the morning than you do the rest of the day, you feel you want to die or are thinking of ways to hurt yourself etc.
If someone Notice these sign in oneself or a relation or loved one call for urgent attention.
Some researchers are looking at the bidirectional tendency of depression and diabetes. Some school of taught suggest that people with depression if unattended to could develop type 2 diabetes but the mechanism is still hypothetical but one could infer that insulin resistance might be responsible.
Living with diabetes is not easy, considering the daily challenge of what to eat, what the blood glucose level is and the cost of medications.
Diabetes therefore should be seen as a journey not a destination, hence persons with diabetes requires a lot of support, encouragement and goodwill to make the journey without wearing the clothes of depression.