What is Addison's disease?

Addison's disease is a result of diseases of the endocrine hormonal imbalance adrenal gland above the kidney directly. And affects different age groups. Also affects women and men in equal proportions. And disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and in some cases change the color of the skin to dark color.

The disease occurs due to the production of the adrenal gland, an adequate amount of the hormone cortisol and, in some cases, the hormone aldosterone. And the disease is also called adrenal insufficiency Adrenal Insufficiency or lack of cortisol hypocortisolism.What is cortisol?
Cortisol is a hormone produced in the adrenal gland above the kidney directly. And he belongs to a group of hormones called glucocorticoids Aljlecoqorticad and affecting nearly all the members and the body's cells.And scientists believe that the hormone cortisol has hundreds of effects on the body.
What is the function of the hormone cortisol?The function of the hormone cortisol in the following:

    Maintain the function of the heart and blood pressure.

    Balance between the effects of insulin in breaking the sugar for energy.

    The organization of metabolism of proteins, carbohydrates, and fats.

    Slow down the inflammation resulting from a reaction of the immune system.
The organization of the hormone cortisol:The organization of the hormone cortisol gland located the brain called the hypothalamus gland (Alheibozalams) Hypothalamus gland and the other called the pituitary gland Pituitary gland. The gland the hypothalamus sends signals to the pituitary gland in the form of hormones make them secrete hormones regulate growth, thyroid function, and function of the adrenal gland, as well as sex hormones such as estrogen and testosterone.
When the signals reach the hypothalamus gland of the pituitary gland the pituitary gland secretes a hormone called ACTH - adrenocorticotropin and is the hormone which stimulates the adrenal gland to produce cortisol.What is the hormone aldosterone?Hormone aldosterone is a hormone that is produced in the adrenal gland and helps maintain blood pressure in the normal range, as well as to maintain a balance between body salts and water by helping the kidneys to retain sodium and potassium output. And when at least the level of the hormone aldosterone are impaired kidney function, leading to severe reduction in blood pressure.

Treatment of pituitary insufficiency Activity

Drug therapy for the lack of activity of the pituitary gland
Includes the treatment of compensatory hormones. And choose the appropriate treatment depends on the hormone affected by the disease. And medicines are as follows:

     Cortisone hydrocortisone.

     Estrogen and testosterone Estrogen & Testosterone.

     Djinotroben Genotropin.

     Evotheiroxan of levothyroxine.

And the patient must follow the doctor the doctor may need to adjust the dose of drug replacement therapy. The higher the dose the more appropriate replacement therapy has become the best treatment outcomes.

Surgical treatment of pituitary insufficiency Activity
Is in cases of pituitary tumor. And depends on the type and location of the tumor.

Symptoms of lack of activity of the pituitary gland

In the case of lack of activity of the pituitary gland deficiency occurs or not to produce as much as is enough for one or more of the pituitary hormones, which affect the function of the member or controlled by thyroid hormone.

The reasons and lack of pituitary hormones in the following:


     Tumor pituitary gland or the hypothalamus.

     The destruction of the pituitary gland by the use of radiation therapy, surgery, or infection such as meningitis meningitis.

     Head injury causing bleeding or damage to the pituitary gland.

     Exposure to hypoxia at birth.

     In some cases the cause is unknown.

What is the lack of activity of the pituitary gland

Lack of activity of the pituitary gland is a condition caused by lack of or not enough to produce as much as one or more pituitary hormones Pituitary Gland (a small gland found at the base of the brain). And be the result of pituitary disease itself or the hypothalamus gland Hypothalamus (the part of the brain containing the hormones that control the pituitary gland). And when a shortage or lack of production in all pituitary hormones called that case Panhypopituitarism. And affects children and adults.
What is the function of the pituitary gland?Pituitary function is to send signals to other glands of the body (such as thyroid) so stimulated the secretion of hormones (such as hormone Iierwid). And therefore, those hormones are different functions in all parts of the body such as growth, reproductive function, blood pressure ...

When missing or does not produce sufficient amount of one of the hormones it affects the different functions of the organs of the body.
What are the pituitary hormones?The pituitary gland produces many hormones. And most important of these hormones are:

    CRH Adrenocorticotropic hormone - ACTH: is a hormone that stimulates the (alert), adrenal gland (gland located above the kidneys) to secrete the hormone cortisol, which helps to maintain blood pressure, and also affects the metabolism of carbohydrates, protein and fat, and reduces inflammation.
    

    Thyroid stimulating hormone Thyroid-stimulating hormone - TSH: is a hormone that stimulates the (call) the production and secretion of hormones from the thyroid gland Iierwid. And function of hormones is to regulate the Iierwid metabolism in cells, and are necessary for natural growth and maturity.
    

    Stimulating hormone vesicle Follicle-stimulating hormone - FSH and Allotna hormone luteinizing hormone - LH: and are the hormones that stimulate the growth and maturation and release of eggs in women and the growth of sperm and testosterone release in men.
    

    Growth hormone Growth hormone - GH: bone growth and causes various tissues in childhood and adolescence.
    

    Stimulating hormone secretion of milk, Prolactin: the growth of breast and alert the production and secretion of milk.
    

    Hormone antidiuretic Antidiuretic hormone - ADH: and is the hormone that controls the water lost through the kidneys.
In the case of lack of activity of the pituitary gland deficiency occurs or not to produce enough amount of one or more of these hormones, which affect the function of the member or controlled by thyroid hormone.

Treatment of Graves' disease

There is no treatment to stop the immune system on the composition of the antibodies that cause Graves' disease. And treatment is to control the symptoms of the disease by reducing the production of the hormone Iierwid (thyroid hormone) or to prevent his work.
Treatment includes the following:

    Mglqat Beta Beta blockers:
    And is a drug does not prevent the production of a large amount of thyroid hormone, but the prevention of some of the work of thyroid hormone. And thereby prevent some symptoms such as increased heart rate, chills hands, and tension.
    And an example of these drugs Albroobranolol propranolol, Alotanolol atenolol. Usually these drugs are used next to other types of medicines.
    

    Drugs for Terwid Anti-thyroid medications:
    These drugs to prevent the thyroid from producing excessive amount of thyroid hormone. Treatment usually lasts for a period of at least a year. And often are used next to treatment with radioactive iodine or surgery.
    

    Treatment with radioactive iodine Radioactive iodine treatment:
    Are manufactured to thyroid hormone the body needs to use iodine. Give the patient are radioactive iodine accumulates until the thyroid and then begin to eliminate the cells of the thyroid gland, high activity, which leads to the production of a large amount of the hormone Iierwid. And lead to a contraction of the thyroid gland and get rid of the symptoms of the disease gradually over a few weeks or months.

    And where that treatment with radioactive iodine leads to a decline in thyroid activity for that patient needs to eat thereafter Althairoxin to drive the body to supply the quantity of natural thyroid hormone. Sometimes result in treatment with radioactive iodine to the emergence or increase the protruded eye. But often this is a simple and temporary. Therefore, in some cases where the degree of exophthalmos severe eye is not recommended treatment with radioactive iodine.
    

    Surgery Surgery
    The procedure for surgery to remove a thyroid treatment options for Graves' disease in the absence of the ability to use drugs earlier. After surgery the patient needs to take tablets Althairoxin quantity to supply the body's natural thyroid hormone.
    

    Treatment of the eye protruded:

        Industrial use drop tears during the day, and generation of the eye during the night for the prevention of dry eye.

        In severe cases the doctor may prescribe certain types of cortisone to reduce swelling and Alantfaj behind the eye.

    On the patient and follow some simple guidelines, and are:

        Use cold compresses on the eye.

        Wear sunglasses to protect from the sun during the day.

        Use a pillow for the head elevated during sleep so that the level of the head higher than the rest of the body during sleep.
        

    Treat the symptoms of skin:
    In cases of skin cream is used containing cortisone to reduce swelling and inflammation.

Symptoms and diagnosis of Graves' disease

Symptoms of Graves' disease include the following:

    Symptoms of thyroid hyperactivity:

        Goitre.

        Insomnia and nervous tension.

        Fatigue and difficulty sleeping.

        Weight loss despite increased appetite for food.

        Profuse sweat.

        A jerk of the hands or fingers.

        Warmth and moisture of hands.

        Weakness and hair loss.

        Ease of pounding nails.

        Hypersensitivity to heat.

        Increase the number of heartbeat, pulse and increase to more than 90 beats per minute.

        High blood pressure.Symptoms of the eyesIn many cases occur protruded eye (the emergence of the eye). And be the result of swelling of the tissues and muscles behind the eyeball to eyeball Vtthrk forward and get the patient Bgehoz eyes.Exophthalmos and lead the eye to some of the symptoms are:

        Watering of the eye.

        Granules strange feeling for an eye (as if grains of sand for an eye).

        Hypersensitivity to light.
        

    In severe cases:

        Corneal ulcers.

        Double vision.

        Eye movement becomes limited.

        Eye, blurred or impaired vision.
        

    Usually eye problems occur 6 months before or after the diagnosis of Graves' disease. And be more prevalent in patients smokers. And in some cases, the eye problems are the first sign of Graves' disease.
    

    Symptoms of skin Graves' dermopathy:
    In rare cases occur redness and an increase in the thickness of the part from the skin of the leg below the knee when pretibial myxedema and at the top of the foot. And still the reason for this is unknown.
    
Diagnosis of Graves' disease DiagnosisDoctor is expected to Graves disease through medical examination. Where indicated the presence of eye protruded, and enlarged thyroid. Also ask the doctor about the patient's medical history, and family history of certain diseases such as diabetes type I, pernicious anemia, vitiligo.
And diagnosis is confirmed through some tests and analyzes:

    Measure the proportion of Iierwid hormones (thyroid hormone) T3 and T4.

    Measuring the rate of thyroid stimulating hormone Thyroid Stimulating Hormone - TSH.

    Sometimes is the work of X-ray of the thyroid gland using radioactive material.

    Blood test to confirm the presence of antibodies that stimulate the thyroid gland blood Thyroid-stimulating antibodies (TSAb).

What is Graves' disease?

Graves' disease is a disease of autoimmune disorder, which affects the thyroid gland and cause an overactive thyroid gland. And is one of the most common type of overactive thyroid prevalent.And it affects men and women, but it is more prevalent in women. And usually starts at the age of twenty years. And returns the name of the disease by that name to the name of the Irish doctor (Robert Graves Robert Graves) who first described the disease for over 150 years ago.
Reasons for CausesGraves' disease is caused by an imbalance in the body's immune system. Usually the immune system protection against any foreign objects enter the body such as bacteria and viruses. This is done through the formation of immune system antibodies by the type of blood cell called lymphocytes. Whereupon those antibodies to attack foreign bodies and destroy them and eliminate them.

And it often happens defect in the immune system begins lymphocytes form antibodies attack the body's tissues and destroy them. And this is what happens in the case of Graves' disease, where antibodies are constipated in the surface cells of the thyroid gland and the Bthvezha to produce a large amount of Iierwid hormones (thyroid hormones). And lead to an overactive thyroid gland. And found that the imbalance in the immune system and Graves disease is often after exposure to stress and pressure very nervous.

Treatment of thyroid hypoactivity neighbor

The choice of appropriate treatment in cases of thyroid hypoactivity neighbor on several factors such as symptoms of the disease, severity of disease, and the general health situation of the patient. And treatment aims to reach a normal level of calcium and phosphorus in the body.

And treatment includes the following:

     Calcium tablets. And may result in high doses of calcium to digestive problems such as constipation. Therefore need to be addressed under the supervision of a doctor.

     Vitamin D: and it helps the body absorb calcium and phosphorus to get rid of.

And the patient must interest in addressing calcium rich foods such as dairy products, fish. And the reduction of phosphorus-rich foods.

In cases of convulsions associated with severe tetany Tetany:
The patient may need to go to the hospital to give him calcium injections through a vein. Then the patient completed treatment after the home through the tablets of calcium and vitamin d.

And because the disease thyroid hypoactivity neighbor is a chronic disease that requires the patient to take treatment throughout his life. And the doctor needs to measure the level of blood calcium on a regular basis to make sure that in the normal range and so can determine the appropriate dose of medication calcium needed by the patient.

Symptoms and diagnosis of thyroid hypoactivity neighbor

Symptoms and diagnosis of thyroid hypoactivity neighborSymptoms of thyroid hypoactivity neighbor as follows:

    Tingling and numbness in the fingertips of the hands, and toes, and tongue.

    Pain in the muscles of the leg, abdomen, or face.

    Muscle spasm of hands, arm, throat, and muscles around the mouth.

    Fatigue and general weakness.

    Pain during the menstrual cycle.

    Loss and thinning hair.

    Dry skin.

    Twice and split nails.

    Tension and nervousness.

    Headache.

    Mood swings and depression.
Complications ComplicationsThere are some complications may occur as a result of the patient and the low level of calcium can be overcome with treatment. And are:

    Altkzz Tetany. And is a:

        Tingling sensation in the lips and fingers and foot.

        Painful cramps in the hands and fingers.

        Cramps the muscles of the face, arm, or throat. May affect breathing.

    Loss of consciousness with convulsions (epilepsy).

    Distort the shape and size of the teeth.

    Weak bones (osteoporosis osteoporosis).

    Heart disorder and fainting.

    Slow growth and development of physical and mental (in children).
Diagnosis DiagnosisDoctor is expected by the likelihood of symptoms suffered by the patient and the medical examination. Also ask the doctor about the patient's medical history and if he made any thyroid surgery or neck area.
And diagnosis is confirmed through some tests and analyzes:

    Analysis to measure the blood level of calcium, phosphorus, magnesium and thyroid hormone neighbor. Where it appears:

        Low level of calcium, magnesium, and thyroid hormone blood neighbor.

        The high level of phosphorus in blood.
        
The doctor needs to perform other tests such as:

    Electrical ECG (ECG) Electrocardiogram - ECG: record the electrical activity of the heart. Where the lack of calcium affects the heart.

    Paul test Urine test: If the kidney shows you output a large amount of calcium or not.

    X-rays to measure bone density and bone X-rays and bone density tests: It shows if the lack of calcium may impact on the strength and hardness of the bone or not.

The reasons for lack of thyroid activity Neighbor

In the case of hypoactivity neighbor thyroid glands are parathyroid produces a small amount of thyroid hormone neighbor, leading to:

     Low level of calcium in blood.

     The high level of phosphorus in blood.
 And lack of activity is divided into two types thyroid neighbor, depending on the cause of the disease:

    Hypoactivity neighbor genetic thyroid.

    Hypoactivity neighbor thyroid syndrome.
Hypoactivity neighbor thyroid hereditary Hereditary hypoparathyroidismIn those cases, the parathyroid glands are not present from birth or be present but not functioning as normal. And occurs as a result of acquired genetic problem and the child from the father and mother. Shall be the father and mother Jane Hamlan of the disease but are not infected with the disease and passed the gene to their child starting with the disease. And when the parents are carriers of a disease the opportunity to be a child deficient thyroid neighbor 25%. And show symptoms of disease during the first ten years of age, and often at the age of two years.
Hypoactivity neighbor thyroid syndrome Acquired hypoparathyroidismThose cases, the result of the destruction or eradication of the parathyroid glands in surgery treatment of overactive parathyroid glands or inadvertently eliminated during surgery to remove the thyroid gland. And now this happens less frequently than before because the surgical became more careful to avoid affecting the parathyroid glands during surgery.
In a few cases of thyroid hypoactivity neighbor syndrome be caused by a defect in the immune system's own body, where the composition of the immune system antibodies attack the thyroid glands of the neighbor, as if foreign objects from the body. And thus, can not the parathyroid glands produce a sufficient amount of thyroid hormone neighbor and the disease occurs.
Other reasonsThere are other reasons lead to the failure incidence of thyroid activity neighbor, and are:

    Comprehensive use of radiation therapy in cases of tumors on the face or neck, leading to the destruction of the parathyroid glands.

    The use of radioactive iodine in the treatment of overactive thyroid gland.

    Low level of magnesium in blood. Where it can affect the function of the parathyroid glands. This is because the secretion of a sufficient amount of thyroid hormone neighbor need to be a blood level of magnesium in the normal range.

What is the thyroid hypoactivity neighbor?

Hypoactivity neighbor thyroid is a condition where the thyroid hormone production neighbor less than normal. Thyroid hormone and the neighbor has an important role in controlling and maintaining the balance between calcium and phosphorus in the body.

The disease affects men and women and almost the same percentage. And the disease occurs at any age but it is more prevalent in children less than age 16 years and most adults from the age of 40 years.

And treatment includes supply the body with its needs in the form of calcium tablets. Because the disease hypoactivity neighbor chronic thyroid, so it needs to address the patient's treatment throughout his life.

 

  Parathyroid glands are four small glands in the size of peas, located on the thyroid gland in the neck. And parathyroid glands are quite distinct from the thyroid gland secrete hormones are completely different and have different functions of thyroid hormones. The glands secrete parathyroid hormone neighbor thyroid Parathyroid hormone - PTH.
The functions of thyroid hormone neighbor


    Maintain the balance between calcium and phosphorus in the body.

    Control the level of calcium in blood.

    Release of calcium from bone to blood.

    Absorption of calcium from the intestine.

    Output of calcium in the urine.
When the blood calcium level drops the glands secrete parathyroid hormone, thyroid neighbor to recover the body blood level of calcium in the normal range.
The importance of calcium and phosphorus:

    Calcium important for good health, he was playing an important role in the growth of bones and teeth and maintaining bone strength.

    Important in muscle contraction and nerve transmission through the nerves.

    Phosphorus present in the tissues of the body. And is a key part in every cell and has many roles in cells.

    Calcium and phosphorus together give strength and rigidity to the bones and teeth.
What happens in the case of thyroid hypoactivity neighbor?In the case of hypoactivity neighbor thyroid glands are parathyroid produces a small amount of thyroid hormone neighbor, leading to:

    Low level of calcium in blood.

    The high level of phosphorus in blood.What are parathyroid glands? What are the Parathyroid glands

Treatment of hyperaldosteronism

يعتمد علاج Treatment depends on the treatment of hyperaldosteronism reason leading to the disease.

     In cases of increased activity of adrenal Alkzeratan Bilateral adrenal hyperplasia: uses Aloldakton Aldactone. This drug works to treat high blood pressure and the low level of potassium. And its side effects are: breast enlargement for men, poor sexual desire, erectile dysfunction, menstrual disorder, and disorder of the digestive system.
    

     In cases of benign adrenal gland Aldosteronoma: sometimes resort to the eradication of the adrenal gland, adrenalectomy.

Drug therapy and next to the patient must adhere to the system diet and healthy lifestyle:

     Reduction of sodium through food: focus on fresh food, and avoid spices and salt with food.

     Use of cereals, vegetables, and low-fat dairy products to get rid of excess weight and control blood pressure.

     Try to access a healthy weight for the control of high blood pressure.

     Attendance on the exercise. And the simplest way is to walk for 30 minutes a day.

     Stay away from smoking.

     Avoid drinks that contain caffeine (coffee, cocoa, tea, cola) and alcohol.

Symptoms and diagnosis of hyperaldosteronism

And spread of symptoms that indicate infection Baloldosteronih high blood pressure that is not responding to any medication. And spread of signs that also indicate to the disease the low level of potassium, and a benign tumor in one (or both) the adrenal glands.
There are other symptoms of the disease, such as:

    Headache.

    Weakness and muscle cramps.

    Fatigue and exhaustion of the year.

    Extreme thirst.

    Increasing the frequency of urination and the amount of urine.

    Temporary paralysis.
Diagnosis of hyperaldosteronism
When there is a rise in blood pressure and low potassium level in blood is performed some tests to confirm infection Baloldosteronih.


    Measure the level of aldosterone and renin aldosterone renin blood: In the event of injury Baloldosteronih there is a very high level of aldosterone. And renin enzyme is not excreted from the kidneys and helps regulate blood pressure. And many people with high blood pressure have a low level of renin.
    And there are some factors affecting the outcome of this test, such as sodium intake in the diet, the level of potassium in blood, some medicines. Therefore, prior to the test there are some simple guidelines such as reduced sodium food, medications (in the disk image) to control the level of potassium, and stay away from any affect on the outcome of drug testing.
    

    Test measuring the level of aldosterone after increasing the level of sodium: sodium level is increased by increasing the blood sodium food for 3 days prior to the test or giving intravenous salt solution for several hours before testing. Then measure the level of aldosterone in blood. If the aldosterone level it refers to the high incidence of hypertensive Aloldosteronih.
    

    CT scan on the abdomen Abdominal CT Scan: help identify a tumor or enlarged adrenal gland.

Causes of hyperaldosteronism

There is the body's glands Kzeratan Adrenal glands, one above the right kidney, and the other above the left kidney.
And adrenal gland is a small (half the size of your thumb). And produce hormones that control metabolism in the organization of metabolism, the immune system, blood pressure, and other functions necessary for the body.
And of the hormones that the adrenal hormone aldosterone produced aldosterone is responsible for the balance between sodium and potassium in the body. In the event of injury Baloldosteronih the adrenal gland that produces the amount of the hormone aldosterone more than normal, causing an imbalance between the two elements sodium and potassium, the body shall retain body sodium and potassium lost in urine.

And causes of the disease are as follows:

     A benign tumor the adrenal gland, and this is called the initial Baloldosteronih Primary aldosteronism or syndrome that Conn's syndrome.

     Increase the activity of adrenal Alkzeratan.

     The presence of a cancerous tumor in the outer layer of the adrenal gland. And this happens in rare cases.


Genetic changes and genetic mutations. And are also rare causes.

Incidence of cirrhosis of the liver, or heart failure, causing a lack of the amount of blood that reaches the kidneys. This so-called secondary Baloldosteronih Secondary aldosteronism

What is hyperaldosteronism?

Hyperaldosteronism is one of the disorders of adrenal gland (a small gland located above the kidneys), where the adrenal gland to produce a very large amount of the hormone aldosterone, which causes the body to keep the body's sodium and potassium lost in urine.
Normally be coordinated action between sodium and potassium to help maintain the balance of body fluids, transmission of nerve signals, and contraction of muscles and energizes the body. And usually produce a certain amount of the hormone aldosterone by the adrenal gland. But in the case of increasing the amount of the hormone aldosterone produced by the adrenal gland, it causes the body to retain sodium and fluid retention body thus causing high blood pressure.

Hyperaldosteronism and disease more prevalent in people with severe high blood pressure. And treatment of the disease depends on treating the cause of infection.

The first type of diabetes

Diabetes is a chronic disorder in the transformations of food (metabolic) chronic metabolic disorder caused by lack of a relative or full of the hormone insulin, the hormone insulin is produced by beta cells beta cells Islands of Langerhans islets of Langerhans in the pancreas, and the absence of these cells or damage resulting in the first type of diabetes, and dependence on insulin for life outside.

The second type of diabetes is a disorder mixed, and the majority of patients with type II have a resistance to insulin action, where the body's cells become resistant to the effect of insulin, which makes it less effect in reducing the level of blood sugar

 Pathophysiology

Insulin plays a fundamental role in the transformation of food (metabolism) of carbohydrates (starches and sugars), fats, and proteins.
Insulin lowers blood sugar levels by allowing glucose to glucose to enter muscle cells. Alerted by turning glucose into glycogen for glycogen as a carbohydrate Thuzeinh.
Insulin also inhibits the start of glucose stored in the form of liver glycogen and fat to break the triple fat triglycerides and fatty acids, fatty acids and ketones ketones, also call a fat storage, insulin also inhibits the transformation of proteins and fats into sugar glucose in the liver and kidneys

Arises hyperglycemia when the concentration of glucose over 200 mg / 100 ml of blood when examining a random sample, because the lack of insulin does not inhibit transformation proteins and fats into sugar glucose in the liver and kidneys, it also prevents the use of glucose (sugar) found blood or stored.
When there is excess blood sugar, the kidneys can not re-absorption of sugar overload, causing the generation of osmotic Paul osmotic diuresis (where accompanied by the descent of the descent of glucose in urine is greater than the amount of water) and also cause the feeling of thirst and dehydration.
Break increased fat and protein results in the production of ketones and weight loss.
Without wasting insulin happens to the child patient with type I diabetes, may cause death due to diabetic ketoacidosis diabetic ketoacidosis.
Increase insulin prevents the start of blood glucose (sugar), and the resulting lack of blood sugar hypoglycemia when blood glucose concentration of less than 60 mg / 100 ml of blood.
Glucose is the only source of energy for red blood cells, marrow and kidney, and brain.

The second type of diabetes

The second type of diabetes is a group of disorders characterized by high blood sugar level as they are accompanied by complications of minute blood vessels (such as blood vessels, retina), and complications of large blood vessels (such as coronary artery disease) and neurological disorders (such as the peripheral nervous inflammation).

Unlike the first type of diabetes, the patients with Type II do not rely on insulin for life, however, many of whom had treated with insulin in the end.

Pathophysiology

The high level of blood sugar is due to the absence of insulin as in Type I, or the relative lack of insulin as in Type II.
Relative lack of insulin resistance is usually caused by muscle, fat, and liver to insulin action, with the absence of an adequate response to the pancreas beta cells responsible for insulin secretion.
Resistance to the action of insulin leads to a lack of glucose transport in muscle and liver to increase the production of glucose, and increase the break grease.
Associated with type II diabetes, many of the genetic factors.
Most patients have to be resistant to the action of insulin.

Assumed to occur from type II diabetes in people who have updated their lifestyle or cause of sugar (eat excessive calories, lack of calorie consumption, and obesity) with a genetic predisposition.
Seems that the high level of blood sugar is the reason behind the occurrence of complications of minute blood vessels, and metabolic complications.

Diabetes and pregnancy

Organization abnormal sugar maternal happens when 3-10% of pregnancies, studies indicate an increase in diabetes among women of childbearing age, and believes that this increase is due to lifestyle inert, and changes in food systems, and increased risk factors, and obesity. Gestational diabetes and gestational diabetes mellitus is the varying degrees of non-absorption of glucose or with glucose intolerance, which are beginning to identify its presence during pregnancy.

And gestational diabetes represents about 90% of cases of diabetes during pregnancy, and the second type of sugar is about 8% of cases during pregnancy, and diabetes that is present before pregnancy, represents about 1% of the sugar in pregnant women.

And children born to mothers with diabetes before pregnancy have a greater risk of exposure to infections during childbirth, and also for caesarean delivery, and to enter the newborn intensive care unit, and studies suggest that exposure to this risk increases with increasing the level of blood sugar in the mother, and for this reason, the illness of the mother and child because of the sugar during pregnancy are considered to be at the prevention of early diagnosis and effective treatment.

Pathophysiology

Going through a pregnant woman with every meal with a series of complex interactions of hormonal (increased blood glucose, the secretion of insulin from the pancreas, the secretion of glucagon, and the secretion of Alsomatutedinat somatomedins, and Katekolaminac gland over total adrenal catecholamines) and these interactions provide a glucose sufficient - and non-plus - for the mother and fetus.
Pregnant women happen to them down the sugar (the average blood sugar 65 to 75 mg / 100 ml blood) between meals and during sleep, occurs due to the continuing withdrawal of the fetus to the sugar glucose across the placenta from the mother's blood, even during periods of fasting or not eating, Increasingly, low blood sugar between meals a pregnant woman with the progress of pregnancy, the fetus with increased need for glucose.
Increase the level of hormones the placenta of steroids and peptides (such as estrogens estrogens, and progesterone, progesterone, and luteinizing hormone stimulant physical Milky placenta chorionic somatomammotropin) during the past three months, the middle and the last of the pregnancy, these hormones have an effect resistant to insulin action, and therefore escalate the need for insulin secretion with the pregnancy progresses, and the average secretion insulin within 24 hours in the last three months of pregnancy increased by 50% compared to its level at the non-pregnant lady.


Response when the pancreas to secrete insulin when the mother is not enough there is a decline of blood sugar in the mother and fetus, and it appears in the form of recurrent episodes of low blood sugar after a meal, and the majority of these seizures due to the rapid growth of the fetus.
The level of blood sugar in the mother and the fetus is accompanied by episodes of increased insulin blood of the fetus fetal hyperinsulinemia, and more than that of storing the food surplus, and cause an increase in fetal weight macrosomia, and the energy consumption associated with the transformation of glucose into fat caused a decrease in the level of oxygen the blood of the fetus.
Cause bouts of lack of oxygen flow waves of catecholamines from the gland above the kidney, and cause high blood pressure, hypertension, and alert the increase of red blood cells, and increased bilirubin after birth.
During normal pregnancy, blood sugar level at least up to about 75 mg / 100 ml blood in the Mediterranean, and the level of blood sugar after a meal is rarely less than 120 Mmla g / 100 ml blood, and reduces that of an increase in fetal weight.
Increasing weight of the fetus during pregnancy when diabetics for up to 20% at the low level of blood sugar two hours after a meal than 120 mg / 100 ml blood, and up to 35% when increasing the level of blood sugar after a meal than 160 mg / 100 ml blood.

Diabetic neuropathy

Distinguish diabetic neuropathy and damage to growing nerve fibers, and this damage can be assessed in ways that is unfair to many of the tests the functions of the nerves, and these tests include studies of nerve conduction and electromyography muscle, testing sensory quantification, and tests of function of independent autonomic function.


Is known as diabetic peripheral neuritis the presence of symptoms and signs of disorder and function of peripheral nerves in patients with diabetes after the exclusion of other causes, as infection can be divided into peripheral nervous to many syndromes each with a distinct pattern, and overlap between these syndromes when the majority of patients.


Has been described nerve disorders in patients with diabetes type I and II, and patients with diabetes that occurs secondary to multiple causes, and suggests that a mechanism based on the presence of chronic high blood sugar level.

Hypoglycaemia

Hypoglycaemia is a syndrome characterized by low concentration of glucose blood level causes the symptoms of low blood sugar, and a lack of blood sugar, arising from abnormalities in the mechanisms of balance of glucose in blood, and the diagnosis of hypoglycaemia must make sure that the presence of low blood sugar, and the presence of symptoms of low sugar blood, and also fell upon the return of these symptoms of blood sugar to normal level.


Hypoglycaemia is a syndrome characterized by low concentration of glucose blood level causes the symptoms of low blood sugar, and a lack of blood sugar, arising from abnormalities in the mechanisms of balance of glucose in blood, and the diagnosis of hypoglycaemia must make sure that the presence of low blood sugar, and the presence of symptoms of low sugar blood, and also fell upon the return of these symptoms of blood sugar to normal level.

Pathophysiology


    Related to symptoms of low blood sugar the brain and the sympathetic nervous system sympathetic nervous system.

    Low levels of glucose leads to lack of availability of the brain need glucose.

    Neuropathy occurs due to lack of sugar neuroglycopenia, and show that mixing in the form of mental confusion, difficulty concentrating, and irritability, and hallucinations, and focal defect (such as paraplegia hemiplegia) and eventually coma, coma and death.

    Alert the sympathetic nervous system resulting in a sweat, palpitations, and trembling, and anxiety, and hunger.

    In most cases the symptoms of pre-alert the sympathetic nervous system symptoms of neuropathy due to lack of sugar, and serve as a kind of early warning to the patient.
Spread of the disease

    Difficult to estimate the prevalence of the disease.

    Because doctors and patients - in most cases - symptoms such as anxiety, irritability, hunger, a lack of blood sugar without making sure there is a lack of blood sugar.

    Patients who have reached the level of blood sugar to less than 50 mg / 100 ml blood, representing approximately 5-10% of people who show symptoms of hypoglycemia with blood.

    Happens hypoglycaemia when patients sugar overdose of treatment.

    Insulin-producing tumors are rare, but a reason for hypoglycemia can be treated, which occurs on average 1-2 cases / million people per year.

    Reactive hypoglycemia reactive hypoglycemia occurs in women more than men when it occurs.

    Reactive hypoglycemia is noted to occur in women aged 25-35 years.

    The majority of cases the tumor Jaziri insulinoma occur in the early forties, however, reports indicated the possibility of occurrence from birth to age 80 years.
Morbidity and mortality

    Reactive hypoglycaemia (which is related to food can occur 1-3 hours after a meal rich in carbohydrates and sugars) when the majority of cases treated successfully by changing the food and be accompanied by a slight impairment in the absence of mortality.

    Common occurrence of mild cases of hypoglycaemia in patients with diabetes as a complication of treatment, the percentage of these cases to more than 50% of diabetic patients who take treatment because of overdoses.Pathophysiology

Diabetic ketoacidosis

Diabetic ketoacidosis is an acute and significant increase of diabetes constitute a threat to the lives of diabetics, ketoacidosis and occurs mainly in a patient with type I diabetes, may also occur in some patients with type II diabetes.

Is known as diabetic ketoacidosis case sharp - for diabetes high non-controlled - the need for urgent treatment with insulin and fluids given to patients intravenously, it happens when it increases the concentration of ketones than 5 ms equivalent / liter (5 milliequivalent \ liter) and increases the level of blood sugar for 250 ml g / 100 ml blood, and less acid pH of the blood (blood pH) of 7.2, and the blood bicarbonate at a level equivalent to 18 ms / l or less.

Pathophysiology

Ketoacidosis is a state of metabolic metabolic state turbulent and complex is characterized by high blood sugar levels, and acidosis, and albuminuria ketone ketonuria, which is caused by insulin deficiency coupled with hormones regulatory counter (glucagon, and cortisol, and growth hormone, and epinephrine), and this type of hormonal imbalance increases the decomposition of glycogen glycogenolysis and gluconeogenesis liver gluconeogenesis and lipid decomposition of lipolysis.
Decomposition of glycogen and gluconeogenesis the liver due to a lack of insulin and increase hormone regulatory anti lead to increased high level of blood sugar, while increasing decomposition of grease from the level of free fatty acids with serum blood free fatty acids, also increases the metabolism of fatty acids liver - as an alternative source of energy - and the resulting media pool and the acidic products (ketones ketones, acids and ketone ketoacids), ketones include acetone and acetone, and beta hydroxy Baotharit beta hydroxybutyrate, aceto acetate and acetoacetate.
Increasingly high blood concentration of these organic acids leads to a state at the outset of the presence of ketones blood ketonemia.
The body's natural protective mechanisms could be in the early stages to reduce the presence of ketones in blood.
When you exceed the pool ketones ability of the body taken away, they flow with the urine, causing albuminuria ketone, and when not to speed treatment of this case, collect more organic acids leads to the appearance of signs and symptoms of metabolic acidosis metabolic acidosis (ketoacidosis) with a decrease of the pH of the acid and bicarbonate serum blood.
Result in compensation for respiratory acidosis ketoacidosis to rapid and shallow breathing (Kussmaul breathing Kussmaul respiration).
Ketones cause nausea and vomiting, leading to increased loss of fluids and salts from the body.
Cause the smell of ketones in patients with self fruit ketoacidosis.
Occur because of glycosuria glycosuria exceeded the ability of the kidneys re-absorb the sugar.
Increases water loss in urine due to diuresis Altnavve osmotic diuresis, and lead to dehydration, and thirst, and lack of body tissue blood flow, with the possibility of lactic acidosis lactic acidosis.
Loss occurs for about 6 liters of water from the body or 100 ml / kg of body weight, and half this amount of fluid inside the cells and never lost the emergence of drought, while the other half of the water lost from the fluid outside the cells is responsible for the occurrence of drought.

Cause increased blood sugar levels, and diuresis Altnavve, excessive Osmolih serum serum hyperosmolarity, and metabolic acidosis severe disruptions Eharl electrolyte, most notably the loss of potassium from the cells of the body and out to the fluid between cells and loss of urine, and also the loss of sodium and chloride in urine.
Be the outcome of hyperthyroidism Osmolih serum, and dehydration, and acidosis is to increase the osmolarity osmolarity brain cells, which appear as a change level of awareness.