Tel: 473.444.1178

Management of Chronic Diseases

Management of Chronic Diseases

Diabetes

To understand diabetes, first you must understand how glucose is normally processed in the body.

How insulin works

Insulin is a hormone that comes from the pancreas, a gland situated behind and below the stomach.

  • The pancreas secretes insulin into the bloodstream.
  • The insulin circulates, enabling sugar to enter your cells.
  • Insulin lowers the amount of sugar in your bloodstream.
  •  As your blood sugar level drops, so does the secretion of insulin from your pancreas.

The role of glucose

Glucose - a sugar - is a main source of energy for the cells that make up muscles and other tissues.

  • Glucose comes from two major sources: food and your liver.
  •  Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
  • Your liver stores and makes glucose.
  • When your insulin levels are low, such as when you haven't eaten in a while, the liver metabolizes stored glycogen into glucose to keep your glucose level within a normal range.

Causes of type 1 diabetes

In type 1 diabetes, your immune system - which normally fights harmful bacteria or viruses - attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream. Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what many of those factors are is still unclear.

Causes of prediabetes and type 2 diabetes

In prediabetes - which can lead to type 2 diabetes - and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it's needed for energy, sugar builds up in your bloodstream. Exactly why this happens is uncertain, although as in type 1 diabetes, it's believed that genetic and environmental factors play a role in the development of type 2. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.

Causes of gestational diabetes

During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin. As your placenta grows larger in the second and third trimesters, it secretes more of these hormones - making it even harder for insulin to do its job.

Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood. This is gestational diabetes.

Hypertension

What are the signs and symptoms of high blood pressure?

High blood pressure may not have any symptoms and so hypertension has been labeled "the silent killer." Longstanding high blood pressure can lead to multiple complications including heart attack, kidney disease, or stroke.

Some people experience symptoms with their high blood pressure. These symptoms include:

  • Headache
  • Dizziness
  • Shortness of breath
  • Blurred vision
  • Feeling of pulsations in the neck or head
  • Nausea

How is high blood pressure diagnosed?

To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 140/90, your doctor will work with you to determine the best regimen for treating your high blood pressure.

What is the treatment for high blood pressure?

Blood pressure is caused by many different factors, so there are many different treatments. The goal of treating high blood pressure is to keep the blood pressure below 140/90.

Treatments for high blood pressure include:

Lifestyle modifications:

  •          Quit smoking
  •          Lose weight
  •         Exercise
  •          Avoid alcohol
  •         Eat a low-sodium, low-fat diet

Medications: There are many different categories of blood pressure medications. Your doctor will work with you to find the right one. The main types include:

  •         Beta blockers
  •         Angiotensin converting enzyme (ACE) inhibitors
  •         Angiotensin II Receptor (ARB) blockers
  •         Calcium channel blockers
  •         Diuretics (water pills)

Treatment of underlying conditions that cause high blood pressure, such as:

  •         Renal artery stenosis
  •         Pheochromocytoma
  •         Congestive heart failure
  •         Diabetes
  •     Obesity

Contacts

Ocean House, Morne Rouge
Grand Anse
St. George's, Grenada
Tel: (473) 444-1178

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