Diabetes糖尿病

LASheehan,FrancineCoxon,KatieChisholm,JonChien,andBrookeCableGeneralOverviewveryserious,chronicdiseaseoneoftheleadingcausesofdeathinCanadapresently,over2millionCanadiansexpectedriseto3millionin2010epidemicWhatisDiabetes?bodycannotproperlystore/usefoodforfuelInsulinhormoneProducedbybetacellsinthepancreasAllowsglucosetomovefrombloodstreamintomusclestobeusedinenergyproductionIndiabetesinsulinisproducedininsufficientamounts,oritisproducedbutcannotbeusedproperlyTypesofDiabetesType1(insulin-dependentorjuvenilediabetes)bodymistakesbetacellsforforeignbodiesanddestroysthem,sotheycannolongerproduceinsulindailyinjectionsofinsulinarerequiredMostoftenseeninchildrenandyoungadultsOnly10%ofallthosewithdiabetesTypesofDiabetesType2pancreasnolongerabletomeetdemandforinsulinand/orthebodycannolongeruseinsulinproperlymostoftenseeninadults(increasingratesofchildhoodobesitycausinggrowthoftype2inchildrenandyoungadults)almost90%ofallcasesTypesofDiabetesGestationalDiabetestemporaryconditionduringpregnancyoccursin3.5-3.8%ofallpregnanciesIncreasesriskfordevelopingothertypeslaterinlifeforbothmotherandchildComplicationsAlltypesinvolveaninabilitytostoreglucose,andleadtoincreasedbloodglucoselevelshighbloodsugarcanleadtocomplicationsandhugedamagetothebodyCommoncomplications–heartdisease,kidneydisease,nervedamage,visionproblems/blindness,impotence,andamputationsCauses?Althoughitisknownthatdiabetesisduetoinsufficientorineffectiveinsulin,itisnotknownwhatcausesthebodytoattacktheinsulinproducingcellsorwhatcausesthepancreastobeunabletomeetthedemands.However,manyfactorswhichincreasetheriskofdevelopingdiabeteshavebeenidentified…RiskFactorsforDevelopingTypeIDiabetesGenetics(non-modifiable)IncreasedriskifmotherexperiencedgestationaldiabetesRiskFactorsforDevelopingTypeIIDiabetesBeing:Age40orolderAmemberofahigh-riskethnicgroup(Aboriginal,Hispanic,Asian,SouthAsian,orAfricandescent)Overweight(especiallyifweightiscarriedaroundthemiddle)Having:Aparent,orsiblingwithdiabetesGivingbirthtoababythatweighedmorethan4kg(9lb)atbirthHadgestationaldiabetesduringpregnancyImpairedglucosetolerance(IGT)orimpairedfastingglucose(IFG)HighbloodpressureHighcholesterolorotherfatsinthebloodHavingbeendiagnosedwith:PolycysticovarysyndromeAcanthosisnigricans(darkenedpatchesofskin)SchizophreniaGestationalDiabetesRiskFactorsforDevelopingGestationalDiabetesApreviousdiagnosisofGDMAgeover35yearsObesityAhistoryofpolycysticovarysyndromeHirsutism(excessivebodyandfacialhair)Acanthosisnigricans(askindisordercharacterizedbytheappearanceofdarkenedpatchesofskin)Beingamemberofapopulationconsideredtobeathighriskfordiabetes,includingwomenofAboriginal,Hispanic,SouthAsian,AsianorAfricandescent.SubjectiveAssessment:Signs&SymptomsofDiabetesUnusualthirstFrequenturinationWeightchange(gainorloss)ExtremefatigueorlackofenergyBlurredVisionFrequentorrecurringinfectionCutsandbruisesthatareslowtohealTinglingornumbnessinthehandsorfeetTroublegettingormaintaininganerectionSpecialNote:Somepeopledonothaveearlywarningsignsoflowbloodsugar.TypeIDiabetesSigns&SymptomsofHighBloodSugar(HyperglycemiaAbove11mmol/L)AbnormalthirstIncreasedurinateIncreasedexhaustionSigns&SymptomsofLowBloodSugar(Below4mmol/L)HungerShakesorlight-headednessNervousorirritableSweatyWeakNauseousordizzinessFasterheartrateConfusionAnumbnessortinglingintongueorlipsDifficultywithconcentration,seeingorspeakingHeadacheExperiencemoodchangesSigns&SymptomsofVeryLowBloodSugarConfusionanddisorientationLossofconsciousnessSeizuresCausesofLowBloodSugar(Hypoglycemia)NoteatingenoughfoodMissingordelayingamealExercisingwithouttakingthenecessaryprecautionsTakingtoomuchinsulinDrinkingalcoholTypeIIDiabetesSigns&SymptomsofHighBloodSugar(HyperglycemiaAbove11mmol/L)AbnormalthirstIncreasedurinateIncreasedexhaustionSigns&SymptomsofLowBloodSugar(Below4mmol/L)Shaky,light-headedNervous,irritableConfusedHungryFasterheartrateSweaty,headachyWeakAnumbnessortinglinginyourtongueorlipsSigns&SymptomsofVeryLowBloodSugarConfusionanddisorientationLossofconsciousnessSeizuresCausesofLowBloodSugar(Hypoglycemia)MorephysicalactivitythanusualNoteatingontimeEatinglessthannormallyrequiredTakingtoomuchmedicationDrinkingalcoholObjectiveAssessment:ComplicationsofTypeI&IIDiabetesWhenpatientspresentwithspecificsignsandsymptomsrelatedwithpossibleinjuries,theKinesiologistmustbeawareoftheunderlyingproblemsassociatedwithdiabetes.Ifpositiveneuralsignsarefoundduringanobjectiveassessment,itmaybecausedbyandinjuryitselforfromcomplicationsrelatedtodiabetes.DigestiveProblemsItisestimatedthatbetween30and50percentofallpeoplewithdiabeteswillhavesomesortofproblemwiththeirgastrointestinal(digestive)tractandislinkedtohowlongapersonhashaddiabetes,theirbloodsugarcontrol,thepresenceofotherdiabetescomplications,cigarettesmoking,andalowerlevelofHDLcholesterol.WarningSigns:Themostcommonsignsofgastroparesisarenauseaandvomiting.Othersymptomsincludeheartburn,constantlyfeelingfull,gettingfulleasilyonceyoustarttoeat,slightabdominalpainandabdominalbloating.Somepeoplemayalsohavesymptomsthatnotethepresenceofgeneralizedautonomicne