DIABETIC MELLITUS
Diabetes mellitus is a life style disease. It is mainly affecting the body’s blood sugar level (glucose). Glucose is the energy for the cells that make up your muscles and tissues. The main energy for brain is glucose.
Classification Of Diabetics
- TYPE 1 DIABETES
- TYPE 2 DIABETES
- GESTATIONAL DIABETES
Risk Factors
- FAMILY HISTORY OF DIABETES
- OBESITY
- PHYSICAL INACTIVITY
- PREVIOUSLY IDENTIFIED IGT
- HISTORY OF GESTATIONAL DM
- DELIVERY OF BIG BABY (>4)
- HYPERTENSION
- HDL LEVEL<35MG/DL
- TGL LEVEL>250 MG/DL
- POLYCYSTIC OVARY SYNDROME
- ACANTHOSIS NIGRICANS
- HISTORY OF VASCULAR DISEASE
Signs & Symptoms
- Frequent micturition
- Unexplained weight loss
- Extreme hunger
- Fatigue
- Unhealed wound, fungal infections, pruritus vulva or balanitis
- Patient can have frequent change in refractory error and may have early development of cataract
- Some patient can be asymptomatic
General Management
- Diet planning- Reduce carbohydrates and sugars
- Exercise- Regularly for 45 mts
INVESTIGATIONS
BLOOD INVESTIGATIONS
- Fasting plasma glucose
- 2 hours plasma glucose
- Random plasma glucose
- Hba1c
URINE EXAMINATION
- Ketone urine
- Acidosis
ORAL GLUCOSE INTOLERANCE TEST
OTHER TESTS
- BUN- 20 to 30 mg/dl due to volume depletion
- WBC-15000 to 20,000 /in infection
- Serum amylase level is increased (may be due to increase in pancreatic or salivary amylase)
- Increased transaminase
HOMOEOPATHIC MANAGEMENT
Homoeopathic treatment is based on the symptom of the patient, by considering the patient as a whole. Here in disease like diabetic the medicine will be acting in organ level and will reduce the blood sugar level, the doctor will be advising the patient with diet and 30 -60 min of exercise , which help the patient in achieving the diabetes free life. Immunity boosters are also added with the medicines which help in increasing the immunity of the patient. A proper blood sugar monitoring is done during the course of treatment.
OBESITY
A person is said to be obese, if his body weight is >20% of ideal body weight, and his body mass index >30. It comes under lifestyle disease. As per the state of nutrition, the individuals can be classified as normal, overweight, and underweight.
The State Of Nutrition Can Be Assessed In The Following Ways
IDEAL BODY WEIGHT = 22.5 X (HEIGHT IN METERS)2
- Over weight-more than 10% of IBW
- Under weight-less than 20% of IBW
- Obesity- more than 20% of IBW
BODY MASS INDEX
- BMI =weight in KG /(height in METER)2
- BMI- In males 20 to25, in females-18 to 23
- Overweight-BMI is between 25 and 30
- Under weight- for males – BMI below 18, for females- BMI below 16
- Obesity-BMI is more than 30
SKIN FOLD THICKEN
- Normal triceps, skin – fold thickness
- Adult males- 12.5mm
- Adult female-16.5mm
ROUGH CALCULATION OF BODY WEIGHT IN AN ADULT(BROCAS INDEX)
- Height in INCHES= weight in KG
- Height in cm -100= desired body weight in KG
WAIST – HIP RATIO
- Waist – Hip ratio is useful to assess the prognosis in a case of obesity
- Waist – Measurement of narrowest segment between ribcage and illec crest.
TYPES OF OBESITY
- Generalised obesity- uniform deposition of excess fat throughout the body
- Android obesity-excess deposition of fat over the waist
- Gynoid obesity- excess deposition fat over the hip and thighs
- Superior or central type of obesity-excess deposition of fat over the face, neck, upper part of the trunk and the limbs are thin- Cushing’s syndrome
MANAGEMENT
- Diet- design diet with low calorie
- Exercise
COMPLICATIONS
- Hyperlipidemias
- Hypertension
- Diabetic Mellitus type 2
- Insulin resistance
- Atherosclerosis
- Coronary artery disease
- Osteoarthritis of knee, hip, foot and spine
- Varicose veins, deep vein thrombosis, pulmonary embolism
- Gallstone
- Ventral and haital hernias
- Infertility, Hirutism
- Psychological – depression
HOMOEOPATHIC MANAGEMENT
Obesity is a life style disease, it can also be caused due to some underlying diseases like pcod, hypothyroidism etc. In this system of medicine the case is taken in detail and if the obesity is due to some underlying disease it is treated according to its signs and symptoms which later reduces the obesity, in other cases if the obesity is due to the food habits – a proper diet plan and a proper exercise pattern is advise to the patient, along with the medicines. These medicines given don’t have any side effects.
HYPERTENSION
It is the situations in which there is a marked increase in both systolic and diastolic bp, occurring in normal individuals, as during sexual intercourse or on diving into cold water. The blood pressure should be systolic-100 to 140 mm /hg, diastolic-60 to 90 mm/hg.
COMMON CAUSES OF HYPERTENSION
- Essential or primary hypertension
Here mainly the cause of high blood pressure is not known
- Secondary hypertension – here high blood pressure is caused due to some underlying conditions, they appear suddenly and causes higher blood pressure. Some condition and medication, causes this secondary hypertension they are,
- Kidney problem
- Thyroid complaints
- Adrenal gland tumors
- Certain medications, such as birth control pills, cold remedies, decongestants, pain killers
Use of Illegal drugs, such as cocaine.
COMPLICATIONS OF HYPERTENSION
CENTRAL NERVOUS SYSTEM
- Carotid atheroma and transient cerebral ischemic attack
- Cerebral infraction
- Cerebral hemorrhage
- Subarachnoid hemorrhage
- Hypertensive encephalopathy
- Cognitive impairment and dementia
RETINA
- It is mainly affecting change in the optic fundi when there is sever hypertension
CARDIOVASCULAR SYSTEM
- Left ventricular hypertrophy
- Left ventricular failure
- Coronary artery disease
- Aortic aneurysm
- Aortic dissection
KIDNEY
Will damage the renal vessel, longstanding hypertension causes-protein and progressive renal failure
ACUTE CORONARY SYNDROMES- It is a spectrum of disease characterized by either one of the following
- New- onset angina
- Angina at rest
- Progression of angina of increasing frequency or seversity
- Angina is response to lower levels of exertion
INVESTIGATION
- Urine analysis- protein, glucose, haematuria
- Plasma urea/creatinine
- Chest radiography(cardiomegaly , heart failure, rib notching)
- ECG(left ventricular hypertrophy ,ischemia)
- Plasma electrolytes(hypokalaemic alkalosis in the absence of diuretic therapy may indicate primary and secondary hyperaldosteronism
- Plasma cholesterol/ triglycerides
GENERAL MANAGEMENT
DIET -WEIGHT REDUCTION IN OBESE AND OVERWEIGHT PATIENTS
-Avoid excess of salt consumption (advised to restrict salt intake to 3-4 gm/day; normal daily salt consumption is about 10 mg/day
-avoid alcohol
-Fat restriction (saturated, mono and polyunsaturated fatty acids 10%, cholesterol less than 300ma/dl)
-Calcium, magnesium, and potassium
HOMOEOPATHIC MANAGEMENT
In cases of hypertension ,as it is a case of risk , the initial medicines will be targeting to reduce the high blood sugar level by giving acute medicines and after that medicines will be given to normalizing the blood pressure, along with this diet will advised to the patient, frequent monitoring of the blood pressure is done .They are given with immunity booster which help in increases the immunity of the patient.
VARICOSE VEIN
Varicose veins are large swollen veins especially that appear on the leg and feet. Unlike arteries, veins are mode of thin collapsible walls. The veins carry blood towards the heart. Veins have valves so that the blood which travels up in the leg does not come down due to gravity. The job of these valves is to avoid back flow. When due to certain reasons the valves gets damaged the blood flow back and pooling of blood in leg happens. Gradually this causes tortuosity of veins and veins become prominent and bulge they are thin walled.
CAUSES
- Menopause
- Pregnancy
- Being age over50
- Standing for long periods
- Family history of long periods
- Obesity
SYMPTOMS
- Veins look twisted and swollen and bulged
- Veins- blue/bark purple
- Aching legs
- Legs feels heavy , especially after exercise
- Minor injury on effected area can longer bleeding than normal
- Swollen ankles
- Lipodermatosclerosis- fat under the skin just above the ankle can become , hard resulting in skin shrinking
- Telangiectasis (spider vein)
- Brownish or bluish discoloration in varicose vein
- Venous eczema (STASIS DERMATITIS)- skin in the affected area is red , dry , itchy
- Leg cramps when standing up suddenly
- restless leg syndrome
- ATROPHIE BLANCHE- irregular whitish patches that Look like scars appear at ankle
COMPLICATIONS
- Bleeding
- Thrombophlebitis
- Chronic venous insufficiency as skin does not exchange oxygen or nutrients
Or dispose wall it can lead to eczema, lipodermatosclerosis venous ulcers
FOOD FOR VARICOSE VEIN
- Pineapple- rich in enzymes bromelain which prevent blood clots.
- Berries-contains antocyanins, proantocyanin which tones and strengthens walls of veins.
- Apple, beetroot, carrot, celery, citrus, fruits and vegetables.
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Restore Your Health Naturally With Homeopathy.
Homeopathic Specialist
(BHSc (Comp Med), Adv. Dip. Homeopathy)