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Diabetes - 7 keys messages to the patients

1. Diabetes is self-managed. Caring for diabetes is more than just taking a daily pill or doing your insulin injection. It may feel like a burden but the decisions you make about physical activity, what and when you will eat will affect both how you feel today and your future health and well-being. 2. Take diabetes seriously. It is a multi-systemic disorder and indeed needs a lot of care. Since the symptoms and complications take time to appear you may think that it is a simple disease but it is not in reality!!! 3. Learn everything about the disease. Since most of diabetes care is  about self-care, the more you know about it, the better you will be able to manage it. You can control your diabetes rather than letting your diabetes control you. If possible, try to get updated with latest developments in the field and read to drive away myths about the disease. 4. Your treatment will change over time. Treatment of diabetes will eventually change over time. Changes in treatm

Mediterranean diet and cognitive decline

A Mediterranean diet is one which comprises of fresh vegetables, fruits, beans, whole grains, nuts, olives, and olive oil along with some cheese, yogurt, fish, poultry, eggs, and wine. A recent study has shown that this diet if adopted and followed leads to a slower decline in the cognitive function. The two main hypotheses are that it has a lot of anti-oxidants which prevent cell death in the brain and secondly it has a protective effect on the vasculature of the brain and thus prevents vascular dementia. Thus, the Mediterranean diet not only improve your looks and protects your cardiovascular system but also your brain cells benefit from it.

Highest prevalence of Diabetes Mellitus

Figures till November 2012 show that the top 5 countries with the highest prevalence of Diabetes Mellitus are from the pacific islands. They may be the smallest islands but the epidemic of diabetes is one of the worst there. More than a third of adults in some of these countries have diabetes and the combined toll of complications, deaths and loss of income make diabetes a real threat not just to the individuals experiencing the disease but also to the economies of the countries themselves. Above is an image showing the locations of the pacific islands.

Top 10 countries with Diabetes Mellitus 2012

Data till November 2012 showed that together, these 10 countries make up 75% of the total prevalence of diabetes in the world.  Urbanisation and the accompanying changes in lifestyle are the main drivers of the epidemic in addition to changes in population structure where more people are living longer.

Anemia in diabetic patients - Erythropoietin treatment?

If you encounter a normochromic and normocytic anemia in a diabetic patient, do not forget that it may be a case of erythropoietin deficiency. This deficiency can occur early in diabetic nephropathy (well before stage 5 of chronic kidney disease). In adults, about 85-90% of the erythropoietin comes from the kidneys and 10-15% from the liver. It is produced by interstitial cells in the peritubular capillary bed of the kidneys and by perivenous hepatocytes in the liver. In cases of decreased renal mass, the level of erythropoietin falls and does not increase much in response to hypoxia (anemia). This occurs even if the liver is normal as the latter cannot compensate for the kidney's loss of function. Since the availability of recombinant human erythropoietin to patients in 1989, anemia and transfusion requirements have become relatively  rare in patients on hemodialysis. After adequate treatment with erythropoietin, studies have demonstrated that there is an: 1) enhanced exerci

Thoracic cage injuries - simple and complicated

Acanthosis nigricans - cause and significance

Acanthosis nigricans is a hyperpigmented velvety lesion usually found in the neck and the axillary region. It can also be seen elsewhere e.g. the belt line, creases over the dorsal surface of fingers. The palms and soles are typically not involved. Pathologically, it is characterized by an increased number of melanocytes associated with hyperkeratotic epidermal papillomatosis. It is strongly associated with insulin resistance but it is a non-specific condition and can also be found in obesity, polycystic ovarian syndrome, endocrine diseases like acromegaly and Cushing's syndrome, as well as some malignant tumours. The severity of the acanthosis nigricans correlates with the degree of insulin resistance and the level of serum insulin. The exact mechanism of its formation is still unclear but it is speculated that there are related IGF-1 receptors in the skin which are activated by ambient hyperinsulinemia. If the insulting factor is removed, there may be a regression of the