The term of Diabetes mellitus refers to a group of metabolic diseases in which the blood sugar level remains consistently high. The blood sugar (glucose) is one of the main sources of energy for our body. Whether the patient has type 1 or type 2 diabetes, he/she will face difficulties to maintain the blood glucose level within normal limits, which would lead to chronic hyperglycemia with hypertriglyceridemia and other metabolic and organic disorders.
Other sugar disorders are Prediabetes – a condition when the blood sugar levels are high, but not enough to be diagnosed as diabetes mellitus - and gestational diabetes, which is related with the pregnancy and conclude after child delivery. Some of the clinical manifestations of diabetes include excessive thirstiness, significant hunger, frequent urination, weight loss/gain, easy fatigability, slow-healing wounds and frequent infections.
Treatment include oral hypoglycemic agent and/or injected insulin and to aim an optimal diabetes control patients are encouraged to know as much as possible about this disease, so they might be able to monitor and manage their condition on their own. Special attention should be brought to healthy diet with carbohydrate intake from whole grains, vegetables, fruits, and legumes, and an emphasis on foods higher in fiber and lower in glycemic load. Patients are also recommended to avoid sugar-sweetened beverages.
On the other hand adults with diabetes are advised to exercise at least 150 min/week (moderate-intensity aerobic activity), spread over at least 3 days/week and with no more than 2 consecutive days without exercise. All patients are also encouraged to reduce sedentary time, breaking up extended amounts of time (90 min) spent sitting.
Hypertension (HTN) is a long-term disease with persistent high blood pressure in the arteries; it is defined as a systolic blood pressure of 140 mmHg or more, or a diastolic blood pressure of 90 mmHg or more. Nearly 95 % of the patient with HTN has no demonstrable cause for the disease; it is called essential hypertension and is associated with genetics and lifestyle factors such as overweight /obesity, salty diet, smoking and alcohol. The rest of the patient might develop HTN due to an identifiable cause such as kidney disease, endocrine disease or drugs; in those cases it’s called secondary HTN.
Most patients have no symptoms referable to their blood pressure elevation, but sometimes patients have “hypertensive headache” which generally occurs only in severe hypertension. Other nonspecific symptoms include palpitations, dizziness and easy fatigability. Long-standing HTN might produce target organ damage and it can lead to serious conditions such as angina/myocardial infarction, heart failure, stroke or transient ischemic attack, chronic kidney disease, peripheral arterial disease and retinopathy.
Patients with HTN need medications to reach normal levels of blood pressure and they are encouraged to do also some lifestyle modifications such as reduce body weight, limit alcohol consumption and stop smoking. It’s also sensible to reduce the intake of sodium, saturated fat and cholesterol. Patients are also exhorted to engage in regular aerobic exercise at least 30 minutes daily. Regular follow-up it’s also recommended for patients with this condition.
Coronary Artery Disease
Coronary artery disease includes a group of diseases, including angina, heart attack and sudden cardiac death, in which the coronary arteries (blood vessels that supply oxygenated blood with nutrients to the heart) are damaged. The main cause for this condition is related to cholesterol plaques in the coronary arteries that lead to blood supply obstruction.
Patients complain about chest pain which may radiate to the shoulder, arm, back, neck, or jaw; sometimes the chest discomfort is referred to be similar to heartburn. Patients may also refer shortness of breath, dizziness and palpitations. Usually symptoms are related with physical activities or stress. Some complications may include heart failure or irregular heartbeat.
Depending on the severity of the condition and its onset patients may need emergency attention (e.g. heart attack) or may continue an oral treatment (e.g. angina). The treatment goals are to relieve symptoms and to prevent future cardiac events.
The treatment includes lifestyles modification such as quit smoking, avoiding fatty and salty foods. Pharmacologic therapy includes anti-platelet agents, nitrates, beta-blockers, statins, calcium-channel blockers. In some cases surgical procedures are needed such as angioplasty and stent placement or coronary artery bypass surgery.