Health news blog

Please believe it. You do have diabetes. And you will have diabetes for the rest of your life.Your doctor has measured your blood glucose levels and has found they are above the normal range for healthy adults of your age.An above-normal blood glucose level is a sure sign your body is not functioning properly. This particular defect in function has been labeled by medical experts as Type II, non-insulin-dependent diabetes mellitus.This condition is also called adult-onset diabetes, maturity-onset diabetes, or NIDDM (for non-insulin-dependent diabetes mellitus).There is another type of diabetes mellitus called Type I or insulin-dependent diabetes, juvenile diabetes, youth-onset diabetes, or IDDM. There is also a disease called diabetes insipidus, which has no relationship to the kind of diabetes you have.No doubt you would like to know more about the defect in function within your body that has led to your having diabetes.Here, in brief, is what is wrong.Your body’s cells use glucose (sugar) as fuel to maintain life and to function. Just as your car requires petrol to work, your body’s cells require glucose in order to function. When your car’s petrol tank is empty your car doesn’t move. And without glucose, your body’s cells can’t work and the organs can’t operate.You provide glucose for your body by eating food. Most of the food you eat is processed in your digestive tract and converted into glucose – whether that food starts out as carbohydrate, protein or fat.This conversion of glucose happens during digestion and at different speeds, depending on whether the food is simple carbohydrate, complex carbohydrate, protein or fat. A simple carbohydrate is converted to glucose quickly. A complex carbohydrate takes longer, a protein even longer. (Fat does not convert to glucose, but is converted to “fuel” your fat stores.)Glucose exits the digestive tract and then enters the bloodstream, where it is carried, along with other nutrients such as vitamins and minerals, to all of the cells in your body.For the glucose to leave the bloodstream and enter the cells, where it is burned as fuel, your body needs a substance called insulin. Insulin is a protein hormone made by special cells in the pancreas. When you have the proper balance of insulin and glucose, everything in your body works well.Some people with type II diabetes don’t produce enough insulin. Others produce enough insulin but, for a number of reasons, this insulin doesn’t work effectively to allow the glucose circulating in the bloodstream to enter the cells where it can be used as fuel.Either of these two insulin situations results in a log jam of glucose in the blood. This is what your doctor looks for when he or she measures your blood glucose levels.A quick fix for this problem would be to stop eating, thereby cutting out the addition of more glucose to the already above-normal levels in your blood. But, as you know, cutting out all food is not a practical solution to an ongoing problem such as diabetes.A short-term, medically supervised fast may be recommended for some people with diabetes, but long-term fasts are out of the question.The solution to the lack of balance between insulin and glucose requires a more practical and sophisticated approach – one that includes meal planning, exercise, monitoring of blood glucose levels and the use of anti-diabetes medications if necessary.*3/210/5*

In a recent case series, the cause of an FUO was found to be undetermined in 10% to 25% of cases. Close observation of the patient may be required to determine whether the fevers resolve or a disease becomes apparent. When a patient is clinically deteriorating, however, watchful waiting is not appropriate. In this situation, the clinician should consider empiric therapeutic trials in conjunction with consultation with an infectious disease physician, rheumatologist, or oncologist, if clues lead in one or more of these directions.Knockaert et al followed a group of 60 of these patients for 5 years to determine the prognoses of patients with undiagnosed FUO. Approximately 20% of patients had a diagnosis established and 50% had resolution of symptoms soon after their evaluation. Less than 10% had persistent symptoms.The inability to make a diagnosis can be an anxiety-provoking prospect for a patient who has submitted to countless tests in the hopes of finding a diagnosis. In this situation, one should council the patient on the generally favorable prognosis in this situation, modifying the discussion for factors that might apply in relation to the diagnostic findings. The fever itself should be managed symptomatically. Non-steroidal anti-inflammatory drugs are the first-line agents for this. Meanwhile, observation, with emphasis on a noninvasive approach, should continue.*158/348/5*