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مرض السكري مرض مزمن فقط؟
مرض السكري مرض مزمن فقط؟
False
ما هو العامل الرئيسي الذي يمكن أن يؤدي إلى تطور مرضى السكري من النوع الأول؟
ما هو العامل الرئيسي الذي يمكن أن يؤدي إلى تطور مرضى السكري من النوع الأول؟
ما هو المعدل المقدر لمرض السكري في الأشخاص الذين يعانون من السمنة؟
ما هو المعدل المقدر لمرض السكري في الأشخاص الذين يعانون من السمنة؟
يزيد خطر الإصابة بمرض السكري بشكل ملحوظ لدى الأشخاص الذين يعانون من السمنة
ما هو العنصر الغذائي الهام الذي يجب على المصابين بمرض السكري من النوع الثاني الحد من تناوله بشكل كبير؟
ما هو العنصر الغذائي الهام الذي يجب على المصابين بمرض السكري من النوع الثاني الحد من تناوله بشكل كبير؟
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ما هو أحد العوامل التي قد تساهم في ارتفاع مستوى الجلوكوز في الدم عند مرضى السكري؟
ما هو أحد العوامل التي قد تساهم في ارتفاع مستوى الجلوكوز في الدم عند مرضى السكري؟
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ماذا تشير إلى؟ (hyperglycemia)
ماذا تشير إلى؟ (hyperglycemia)
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ما هي بعض الأعراض الشائعة لمرض السكري؟ (اختر جميع الخيارات المناسبة)
ما هي بعض الأعراض الشائعة لمرض السكري؟ (اختر جميع الخيارات المناسبة)
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هل يمكن تشخيص مرض السكري من خلال فحص دم واحد فقط؟
هل يمكن تشخيص مرض السكري من خلال فحص دم واحد فقط؟
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ما هو نوع السكري الذي يصيب عادة المراهقين والأطفال؟
ما هو نوع السكري الذي يصيب عادة المراهقين والأطفال؟
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هل يمكن أن يُورث مرض السكري؟
هل يمكن أن يُورث مرض السكري؟
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ما هو أحد أسباب تشخيص ketosis عند مرضى السكري المصابين بالنوع الأول ؟
ما هو أحد أسباب تشخيص ketosis عند مرضى السكري المصابين بالنوع الأول ؟
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ما هو العلاقة بين الأنواع المختلفة لمرض السكري
ما هو العلاقة بين الأنواع المختلفة لمرض السكري
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ما هو العامل الأساسي الذي تُركز عليه أسلوب الحياة في معالجة مرض السكري من النوع الثاني ؟
ما هو العامل الأساسي الذي تُركز عليه أسلوب الحياة في معالجة مرض السكري من النوع الثاني ؟
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ما هو الفحص الذي يُنصح به لِمُراقبة مستوى السكر في الدم عند مرضى السكري ؟
ما هو الفحص الذي يُنصح به لِمُراقبة مستوى السكر في الدم عند مرضى السكري ؟
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ما هُو الهدف الرئيسي من نظام DASH ؟
ما هُو الهدف الرئيسي من نظام DASH ؟
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هل تُعد النظام الغذائي DASH مناسباً لمرضى السكري ؟
هل تُعد النظام الغذائي DASH مناسباً لمرضى السكري ؟
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ما هي بعض الأطعمة التي يَجِب على مرضى السكري التقليل من تناولها ؟
ما هي بعض الأطعمة التي يَجِب على مرضى السكري التقليل من تناولها ؟
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الشعور بِالتعب المستمر هو أحد أعراض فشل القلب ؟
الشعور بِالتعب المستمر هو أحد أعراض فشل القلب ؟
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ما هو العلاقة بين نوع السكري وعوامل الخطر؟
ما هو العلاقة بين نوع السكري وعوامل الخطر؟
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يُعد فشل القلب من الأمراض التي يُمكن شفائها ؟
يُعد فشل القلب من الأمراض التي يُمكن شفائها ؟
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يُمكن للنساء الحوامل اللاتي يُعانين من السكري الاستفادة من نظام DASH?
يُمكن للنساء الحوامل اللاتي يُعانين من السكري الاستفادة من نظام DASH?
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Study Notes
Nutrition & Diabetes Mellitus
- This chapter discusses diabetes and its related nutrition.
- A separate section will cover hypertension and heart disease.
Diabetes
- Diabetes incidence is rapidly increasing, affecting 10.2% of American adults.
- 24 million people have diabetes, and 25% are undiagnosed.
- It's the 6th leading cause of death.
- Diabetes contributes to other diseases like heart disease and kidney failure.
- Significant damage can occur before symptoms appear.
Prevalence of Diabetes in Adults (2015)
- The prevalence of diabetes increases with age across the global population and in Jordan.
- In the MENA region and Jordan, a clear correlation exists between increasing age and prevalence.
Diabetes Mellitus
- Diabetes is a metabolic disorder characterized by elevated blood glucose and disordered insulin metabolism.
- Possible causes include impaired insulin secretion and cells that don't respond normally to insulin.
- The result is hyperglycemia (high blood sugar).
Symptoms of Diabetes
- Classic symptoms include glycosuria (high glucose in urine), polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (increased hunger).
- Other symptoms include blurred vision, increased infections, weight loss, and constant fatigue.
Diagnosis of Diabetes
- Non-fasting plasma glucose: Above 200 mg/dL with classic symptoms indicates potential diabetes.
- Fasting glucose level: Above 126 mg/dL after 8-12 hours without food suggests diabetes.
- Oral glucose tolerance test (OGTT): A 75 gm glucose load followed by a 2-hour plasma glucose test. A reading above 200 mg/dL points to the condition.
Symptoms of Diabetes
- Frequent urination (polyuria), dehydration, dry mouth, increased thirst (polydipsia), weight loss, increased hunger (polyphagia), blurred vision, increased infections, and fatigue.
Type 1 Diabetes
- Affecting 5-10% of cases, it's an autoimmune disorder that destroys beta cells.
- It's sometimes inherited or triggered by environmental factors.
- Insulin therapy is essential.
- Often develops in childhood or adolescence.
- Ketosis can be an initial sign.
Type 2 Diabetes
- Often asymptomatic, some insulin secretion exists but insulin resistance or relative insulin deficiency.
- Risk factors include obesity, age, decreased physical activity, and genetics.
- Prevalence is increasing in children.
- Beta cells can become exhausted.
Acute Complications of Diabetes
- Disturbances in energy metabolism.
- Fluid and electrolyte imbalances.
- Hyper- and hypoglycemia.
Type 1 Diabetes Acute Complications
- Ketoacidosis (acetone breath, acidosis, hyperventilation, hyperglycemia, polyuria).
- Causes include missed insulin doses, illness, or infections; drug or alcohol abuse; or psychological/physiological stressors.
- Hypoglycemia (low blood sugar) can result from inappropriate management of insulin, excessive insulin or antidiabetic medication, prolonged exercise, skipped meals, or alcohol consumed without food.
Type 2 Diabetes Acute Complications
- Hyperosmolar hyperglycemic state (high blood sugar levels).
- Often evolves slowly, characterized by fluid loss, blood volume depletion, and electrolyte imbalances.
- Glucose rises to 600-1000 mg/dL.
- Treatments involve intravenous fluids, electrolyte replacement, and insulin therapy.
Chronic Complications
- Large blood vessel issues (accelerated atherosclerosis, impaired circulation, foot ulcers).
- Small blood vessel issues (retinopathy, nephropathy).
- Nerve damage (pain, burning, numbness, tingling, loss of sensation, delayed stomach emptying, sexual dysfunction, constipation).
Treatment Goals
- Desirable blood glucose levels.
- Healthy blood lipid concentrations.
- Controlled blood pressure.
- Weight management.
Evaluating Treatment
- Self-monitoring of blood glucose (especially crucial for Type 1), with 3 or more measurements daily, routine blood checks, and lipid & urinary protein/ketone testing.
- Long-term glycated hemoglobin (HbA1c) measurements assess 2-3 month glycemic control.
Body Weight Concerns in Diabetes
- Type 1 diabetes patients often gain weight with insulin therapy.
- Type 2 patients are frequently overweight initially, and weight loss aids in managing insulin resistance.
Nutrient Recommendations in Diabetes
- Carbohydrates: High fiber and whole grains, same as general population, minimize added sugars.
- Fats: Less than 7% saturated fat, cholesterol less than 200 mg/day, use alcohol with meals, micronutrient levels same as general population.
- Protein: 15-20% of total calories.
Meal-Planning Strategies
- Carbohydrate counting (simpler, more flexible) involves specifying daily carbohydrate allowances and allocating them across meals and snacks.
- Exchange lists (more complex) categorize foods based on carbohydrate, fat, and protein proportions; each food item has similar macronutrient and energy content.
Insulin Therapy
- Required for Type 1 diabetes patients and some with Type 2, as their bodies cannot produce sufficient insulin.
- Delivery methods include syringes, pens, and pumps.
Oral Antidiabetic Management
- Modes of action include improving insulin secretion, suppressing glucagon secretion, decreasing insulin resistance, and delaying carbohydrate digestion and absorption.
Physical Activity in Diabetes
- Improves insulin sensitivity.
- Improves lipid levels, lowers blood pressure, and promotes weight loss (crucial for Type 2 diabetes).
- Insulin dosages need adjustment based on activity, and blood glucose monitoring is essential before and after exercise.
- Requires physician evaluation before initiating new exercise regimens.
Diabetes Management & Pregnancy
- Pregnancy increases insulin resistance, requiring increased insulin requirements and careful glycemic management.
- Uncontrolled diabetes during pregnancy may cause miscarriages, birth defects, or fetal death.
- Type 2 diabetic pregnant women often deliver larger babies and might need C-sections.
- Gestational diabetes can develop in pregnant women without a history of the disease.
Pregnancy & Type 1 & 2 Diabetes
- Glycemic control is crucial throughout pregnancy, with specific emphasis on the first trimester (birth defects) and the second and third trimesters (large babies and infant mortality).
Gestational Diabetes
- Risk factors include family history of diabetes, obesity, certain ethnic origins, and large babies at birth.
- Often involves restricting carbohydrates (40-45% of total calories), spacing carbohydrates throughout the day, regular aerobic exercise, and potentially insulin therapy.
Nutrition & Disorders of the Heart & Blood Vessels
- This section addresses nutrition and heart/blood vessel health, which comes after the diabetes section and covers the second part of the topic.
Cardiovascular Disease
- Coronary heart disease is the most frequent type and involves atherosclerosis in coronary arteries.
- Reduced blood flow may result in myocardial infarction (MI).
- A stroke occurs due to reduced blood flow to the brain.
Atherosclerosis
- A chronic condition marked by artery wall thickening due to plaque accumulation.
- Minimal but chronic injuries lead to arterial wall damage.
Consequences of Atherosclerosis
- Lumen narrowing, causing ischemia in affected tissues, which can lead to embolisms, thrombi, angina, heart attacks, strokes, and aneurysms.
Causes of Atherosclerosis
- Inflammation and infection, shear stress or hypertension, and smoking act as contributing factors.
- Diabetes, aging, and high LDL and VLDL levels are additional causes..
- Gender (Men > 45 and Women > 55).
Coronary Heart Disease
- Common and leading cause of death in the United States.
- Risk factors include smoking, elevated LDL ("bad") cholesterol, high blood pressure, diabetes, obesity, and inactivity.
Risk Factors for Coronary Heart Disease (CHD)
- Non-modifiable (age, male gender, family history of premature heart disease, and increasing age).
- Modifiable (high blood LDL cholesterol, low blood HDL cholesterol, hypertension, diabetes, obesity, physical inactivity, cigarette smoking and high saturated fat, low in vegetables, fruits, and whole grains "atherogenic diet").
Lifestyle Changes for CHD
- Cholesterol-lowering diet (less than 200 mg), weight reduction, regular physical activity, decrease saturated fat, reduce total fat to 25-35% of calories, increase soluble fiber, plant sterols, stanols, soy products, fatty acids, fish, moderate alcohol consumption, and trans fat reduction.
Lifestyle Changes for Hypertriglyceridemia
- Mild hypertriglyceridemia involves weight reduction, physical activity, smoking cessation, avoiding refined carbohydrates, and limiting alcohol.
- Severe hypertriglyceridemia involves weight reduction, physical activity, a very low-fat diet (less than 15% of calories), and medication.
Vitamin Supplementation
- Existing research does not suggest consistent vitamin supplementation benefits to prevent cardiovascular disease (CVD).
- Antioxidants and B vitamins are not recommended for CVD prevention at this time.
- Research is ongoing.
Drug Therapies for CHD Prevention
- Statins (reduce cholesterol synthesis); bile acid sequestrants (reduce cholesterol and bile absorption); nicotinic acid (lowers triglycerides, increases HDLs); anticoagulants and aspirin (suppress blood clotting); blood pressure medications; and nitroglycerin for angina.
Treatment for Heart Attack
- Drug therapy (thrombolytics, anticoagulants, aspirin, painkillers, blood pressure medications, rhythm stabilizers).
- Soft foods, controlled sodium and fat intake, reduced cholesterol levels, until recovery.
- Cardiac rehabilitation.
Hypertension
- Affects 1/3 of US adults, influenced by cardiac output, peripheral resistance, and hormone secretion from the kidneys.
- Normal blood pressure is below 120/80 mmHg. Pre-hypertension is 120-139/80-89 mmHg. Hypertension is above 140/90 mmHg.
Contributing Factors to Hypertension
- Aging, genetics (more common in African Americans), obesity (alters kidney function and fluid retention), high salt sensitivity, and alcohol consumption (three or more drinks daily).
Treatment for Hypertension
- Weight reduction, low-sodium diet, potassium, calcium, and magnesium-rich diets, regular physical activity, moderate alcohol consumption, and drug therapy.
- DASH diet; it limits red meats, sweets, beverages with sugar, saturated fat (less than 7% of total calories), and cholesterol (less than 150 mg/day).
Lifestyle Modifications for Blood Pressure Reduction
- Weight reduction, adopting the DASH diet, sodium restriction, regular physical activity, and moderate alcohol consumption are essential lifestyle changes for blood pressure reduction.
- These lifestyle changes can lead to a quantifiable drop in systolic blood pressure, such as 5-20 mmHg per 10 kg weight loss and 2-8 mmHg by restricting sodium.
Congestive Heart Failure
- The inability of the heart to adequately pump blood.
- Fluid accumulation in the liver, abdomen, and lower extremities.
- Heart enlargement due to the inability to pump efficient blood.
- Affecting 75% of people 65 years and older.
- Consequences include chest pain, swelling in legs, ankles, and feet, difficulty breathing (SOB), impaired liver and kidney function, and cardiac cachexia.
Medical Management of Congestive Heart Failure
- Sodium and fluid restriction, diuretics, small and frequent meals, vaccinations (influenza and pneumonia), adequate fiber intake, avoidance of alcohol, and liquid supplements (such as those delivered with tubes or through veins).
Stroke
- Third leading cause of death.
- Types: ischemic, hemorrhagic, and transient ischemic attacks (TIAs).
- Prevention includes recognizing risk factors (obesity, diabetes, smoking) and implementing lifestyle changes.
- Management includes thrombolytic drugs, maintaining good nutrition, and treating any coordination or swallowing difficulties.
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يتناول هذا الفصل مرض السكري والتغذية المرتبطة به. كما يتضمن قسمًا منفصلًا حول ارتفاع ضغط الدم وأمراض القلب، مع تسليط الضوء على زيادة انتشار السكري وآثاره على الصحة العامة.
