Diabetes is a chronic medical condition characterized by high levels of blood sugar (glucose). This occurs either because the body doesn’t produce enough insulin (a hormone that regulates blood sugar) or because the cells don’t respond properly to the insulin that is produced. Insulin is necessary for the body to effectively use glucose as a source of energy.
History for diabetes mellitus type 1 and 2:
Symptoms of hyperglycemia
Thirst, dry mouth
Polyuria
Nocturia
Tiredness, fatigue, lethargy
Noticeable change in weight (usually weight loss)
Blurring of vision
Pruritus vulvae, balanitis (genital candidiasis)
Nausea; headache
Hyperphagia; predilection for sweet foods
Mood change, irritability, difficulty in concentrating, apathy
Family history
Physical examination for diabetes mellitus type 1 and 2
BMI
Retinal examination
Orthostatic blood pressure
Foot examination
Peripheral pulses
Insulin injection sites
Peripheral neuropathy
Type 1 Vs Type 2 Diabetes mellitus DM
Type 1
Type 2
Onset
Sudden
Gradual
Age at onset
Any (mostly young)
Mostly in adults
Body habitus
Thin or normal
Often obese
Ketoacidosis
Common
Rare
Autoantibodies
Usually +
Absent
Endogeneous insulin
Low or absent
Normal, decreased or increased
Concordance in identical twins
~ 50%
~90%
Prevalence
Less prevalent
More prevalent (~90-95% of US diabetics)
Biochemical
C-peptide disappears
C-peptide persists
Increased bloog glucose sugar level definition is called when
Two-hour glucose during OGTT <140 mg/dL (7.8 mmol/L)
Categories of increased risk for diabetes:
•Impaired fasting glucose(IFG)
FPG between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
•Impaired glucose tolerance(IGT)
Two-hour – 75 g OGTT between 140 and 199 mg/L (7.8 to 11.0 mmol/L).
•A1C – Persons with 5.7 to 6.4 percent (39 to 46 mmol/mol
Diagnostic criteria of Diabetes mellitus
1. A1C ≥6.5 percent OR 2. Fasting Plasma Glucose ≥126 mg/dL (7.0 mmol/L) (Fasting is defined as no caloric intake for at least eight hours.) OR 3. Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT. (The test should be performed using a glucose load containing the equivalent of 75-gram anhydrous glucose dissolved in water.) OR 4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).
1. A1C ≥6.5 percent
OR
2. Fasting Plasma Glucose ≥126 mg/dL (7.0 mmol/L)
(Fasting is defined as no caloric intake for at least eight hours.)
OR
3. Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT.
(The test should be performed using a glucose load containing the equivalent of 75-gram anhydrous glucose dissolved in water.)
OR
4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).
Advice to patients with Impaired glucose tolerance
Have an increased risk both of progression to type 2 diabetes and of developing macrovascular disease
Advice lifestyle modification reduces the risk of progression in IGT
Monitor annually by measurement of fasting blood glucose
Other cardiovascular risk factors treate aggressively
Lung canceris one form of cancer that begins in lung cells. It is one of the most prevalent cancers and the main reason for cancer-related deaths globally. Lung cancer is also called bronnchogenic carcinoma.
Non-small cell lung cancer (NSCLC) and small cell lung cancer are the two main subtypes of lung cancer. (SCLC). Compared to SCLC, NSCLC is more prevalent and typically develops and spreads more slowly.
What causes lung cancer? Does smoking cause lung cancer?
Smoking is the leading risk factor for lung cancer, although other dangers include radon exposure, air pollution, and exposure to secondhand smoke.
What are the symptoms of lung cancer?
Initilaay the aptient may not be symptomatic.The patient may have constitutional symptoms like weight loss, loss of appetite, decreased energey and weakness. The llung cancer sumptoms include: coughing, chest pain, shortness of breath, and weight loss are all possible signs of lung cancer. The sputum may contain blood in it and cough remains for longer duration of time and is not cured even after treatment for other conditions.
Diagnosis of lung cancer
After patient is suspected of lung cancer, the patient may be needed to be investigated for it. The possible investigations may include complete blood counts, inflammatory markets, imaging studies like chest x ray, contrast or non contrast CT scan of chest, bronchoscopy.
The other disgnostic tests include CT guided needle biopsy, PET or positron emission tomography, bone scan, sputum cytology, thoracocentesis, needle biopsy like FNAC or in some cases even thrascopy may also be needed.
The supportive investigations to rle out the other causes include lunf functions tesst, arterial bood gas ABG analysis, liver function tests etc.
What is the treatment of lung canncer?
Depending on the kind and stage of the cancer, a lung cancer patient may receive surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. Early detection through screening can enhance results and raise the likelihood of a successful outcome.
Prevention of lung cancer
Avoiding smoking and exposure to secondhand smoke is important for lung cancer prevention, as is limiting exposure to other risk factors including radon and air pollution.
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