Diabetes Mellitus Type 2
Diabetes Mellitus Type 2 or non-insulin dependent diabetes is more commonly noticed. This is caused due to insufficient production of insulin by the pancreas or when the body is unable to regulate the amount of glucose in the blood. Complications of type 2 diabetes include coronary heart disease, renal failure, diabetic neuropathy and failing eyesight. Diabetes Type 2 is also referred to as late-onset diabetes.
Diabetes Mellitus Type 2 develops when the patient's body becomes insulin-resistant. Symptoms of Type 2 diabetes include blurred vision, weight loss and excessive thirst and fatigue. Yeast infection and fungal infections are common. Weight reduction can go a long way in maintaining blood sugar levels. Smoking and excessive alcohol consumption increase the risk of developing type 2 diabetes. Sedentary lifestyle and obesity also increase a person's chances of diabetes type 2. Often this type of diabetes is heriditary. Persons with excessive abdominal fat are more prone to developing diabetes type 2. Hypertension and high blood cholesterol increases a person's risk of diabetes mellitus type 2.
Blood tests for glucose tolerance help in detecting diabetes mellitus type 2. In some cases, patients suffering from diabetes mellitus type 2 are able to control their condition with diet and exercise. Follow a diet that is low in saturated fat, salt and sugar. Instead opt for high fiber vegetables and fruits. Antidiabetic medications (sulphonylureas) are prescribed for diabetic patients to increase the production of insulin and improve its efficiency. These include glibenclamide and glipizide. Insulin injections are resorted to when all these measures fail to reduce blood sugar levels.
Cardiac Stress Test
A cardiac stress test aids in assessing how the heart can cope during exercise, especially when the body need for oxygen puts extra demands on the heart. A cardiac stress test is called a graded test or exercise tolerance test, exercise stress test or exercise electrocardiography. It helps to primarily evaluate the heart and vascular systems during the exercise. In fact, the American Heart Association has recommended the Cardiac stress test (EKG treadmill in particular) as the first choice to be tried on patients with medium risk of coronary heart disease and who exhibit certain risk factors of smoking, family history of coronary stenosis, high blood pressure, and high cholesterol.
It helps to determine whether coronary arteries are clogged or blocked.
To find the cause of chest pain.
To assess the heart's capability after a heart attack or heart surgery.
To discover the presence of any heart disease.
To set limits on a person's exercise.
To detect arrhythmias, that is extra heart beats, during the exercise.
To assess the capacity of medicine used to control chest pain or extra beats during exercise.
The cardiac stress test can be done in a clinic or a hospital. The patient may be asked to exercise using a bicycle, treadmill or arm ergometer. The patient is attached to an ECG machine. The blood pressure cuff is placed on any one arm. The patient's heart is usually monitored using a 12 - lead EKG or ECG machine. A heart monitor may be used during and after exercise. After a baseline ECG is obtained, the patient begins to perform a low level of exercise, either by walking on a treadmill or pedaling or a stationary bicycle.
At each stage the exercise, the pulse, the blood pressure and ECG are recorded along with any symptoms that the patient may be experiencing. The level of exercise is gradually increased until the patient cannot keep up any longer because of fatigue or until symptoms like chest pain, shortness of breath or lightheadedness prevent further exercise. The goal of this stress test is to diagnose the presence or absence of coronary artery disease. In a sub maximal stress test, the patient exercises only until a pre-determined level of exercise is attained. These tests are used in patients with known coronary artery disease, to measure whether the patient can perform a specific level of exercise with relative safety.
The side effects of a cardiac stress test also include palpitation, chest pain, and shortness of breath, headache, nausea and fatigue. The hypertension caused by stress testing is always considered abnormal and it may lead to severe coronary disease. In stress tests, false positive results are not uncommon. There can be occasions when the patient's ECG changes could suggest ischemia, even in the absence of coronary artery disease. Similarly, in stress test, false negatives are also not uncommon. In some patients, no significant ECG changes will be seen even in the presence of coronary artery disease. Presently, a new concept called nuclear perfusion study is added to the stress test. This factor has helped to minimize the limitations and improve the diagnostic capability of stress tests.
Atherosclerotic Vascular Disease
Atherosclerotic Vascular Disease affects nearly 10% of the population over the age of 65 years. It is noticed more commonly among men. Atherosclerotic vascular disease is probably one of the most common causes for death and disability. Atherosclerotic peripheral vascular disease is a condition where there is a build-up of plaque in the arteries outside the heart. The thickened arteries constrict the flow of blood. This leads to inadequate supply of oxygen to all parts of the body. The mortality rate for this vascular disease is high and there is possibility of loss of limb too. Typically the limbs, kidneys and neck are affected. The symptoms of atherosclerotic peripheral vascular disease include numbness and tingling feeling in the limbs, sores that do not heal and dull, cramping pain in the hips or thighs. Claudication or pain in the lower extremity muscles is a common symptom. Smoking increases chances of peripheral atherosclerotic vascular disease. Other risk factors for atherosclerotic vascular disease are obesity, coronary heart disease and lack of exercise.
ABI (Ankle/Branchial Index) is a popular test that helps in detecting atherosclerotic vascular disease. Angiography is a special x-ray that helps in tracking artery blockages and narrowing. Ultrasonograpy and MRI aid the physician in non-invasive diagnosis of atherosclerotic vascular Disease. Simple tips to keep atherosclerotic vascular disease at bay:
Maitain healthy weight
Keep high blood pressure and high cholesterol under control
Control diabetes
Angioplasty is used to enlarge blocked arteries without surgery. But it is not a permanent solution. Medications such as Pentoxifylline (Trental) and Cilostazol (Pletal) are used to treat atherosclerotic vascular disease. they help in reducing blood viscocity. Surgery is resorted to when the arteries are blocked considerably. Bypass surgeryis a surgical procedure whereby the affected artery is bypassed so that blood flow is restored.
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