Malnutrition Diabetes

Wounds can be categorized as acute (healing quickly on their own) or chronic (healing slowly, and often requiring medication). Chronic wounds, such as ulcers (Table 10.9), occur if some influence disrupts the normal healing process. Such influences can include diabetes, malnutrition, rheumatoid arthritis and ischaemia (inadequate flow of blood to any part of the body). Elderly people are particularly susceptible to developing chronic wounds, often resulting in the necessity for hospitalization. Ulceration (particularly of the limbs or extremities) associated with old age,... 

L In most instances, dental plaque can cause erythema and gingival bleeding, but the gingival response can also be exacerbated by a variety of systemic conditions, including diabetes mellitus, leukemia, malnutrition, puberty and pregnancy. 

An examination by the dentist should eliminate many of the potential systemic issues that can affect the periodontium of this patient. For example, the age of the patient, her appearance, and questions about her diet should be enough to rule in or out issues concerning puberty and malnutrition. However, if systemic conditions cannot be ruled out, an additional physical examination by a physician may be necessary. Additional tests to be requested could include oral glucose tolerance test for diabetes mellitus, human chorionic gonadotropin levels for pregnancy, and/or qualitative and quantitative evaluation of bone marrow cells and blood cells for leukemia. 

Peripheral neuropathy is observed in 10-20% of patients given dosages greater than 5 mg/kg/d, but it is infrequently seen with the standard 300-mg adult dose. Peripheral neuropathy is more likely to occur in slow acetylators and patients with predisposing conditions such as malnutrition, alcoholism, diabetes, AIDS, and uremia. Neuropathy is due to a relative pyridoxine deficiency. Isoniazid promotes excretion of pyridoxine, and this toxicity is readily reversed by administration of pyridoxine in a dosage as low as 10 mg/d. Central nervous system toxicity, which is less common, includes memory loss, psychosis, and seizures. These may also respond to pyridoxine. 

In India, insulin antibodies have been investigated in 25 patients with type 1 diabetes, 19 patients with so-called malnutrition-related diabetes, and eight patients with fibrocalculous pancreatopathy, who used bovine insulin because it was cheaper (147). Antibodies appeared within 3 months of treatment. The development of antibodies was not related to the type of diabetes. There was a fall in antibody titer with increased duration of treatment. There was no correlation between daily insulin requirement and antibody titers. 

F4. Fechner, A., Bohme, C., Gromer, S., Funk, M., Schirmer, R., and Becker, K., Antioxidant stams and nitric oxide in the malnutrition syndrome kwashiorkor. Pediatr. Res. 49, 237—243 (2001). F5. Feillet-Coundray, C., Rock, E., Coudray, C., Grzelkowska, K., Azais-Braesco, V., Dardevet, D., and Mazur, A., Lipid peroxidation and antioxidant status in experimental diabetes. Clin. Chim. Acta. 284, 31-43 (1999). 

Renewable Environments Transforming Urban Neighborhoods Chemistry of Daily Life Malnutrition and Diabetes Nanotechnology Content and Context The Power of Water... 

Non-alcohol steatohepatitis Fat build-up in the liver eventually causes scar tissue associated with diabetes, protein malnutrition, obesity and coronary artery disease. Treatment with corticosteroid medications. Biopsy is needed for full diagnosis. 

The presence of multiple comorbid conditions (e.g., diabetes, asthma, congestive heart failure, obesity) further increases the risk of ADRs. Such patients may have altered physiology and some degree of end-organ dysfunction (e.g., renal, hepatic, cardiovascular, pulmonary). Conditions such as renal dysfunction may not be readily apparent in the elderly or in those with muscle wasting or malnutrition. 

Differential diagnosis Palmar erythema is also found in pregnancy, in hyperthyroidism, collagen diseases, endocarditis, long-standing feverish conditions, tuberculosis, diabetes mellitus, malignant tumours, chronic polyarthritis and in cases of malnutrition — as well as in healthy people. 

Alcohol-induced ketoacidosis must be differentiated from a similar metabolic complication in diabetes melli-tUS (E.S. Dillon et al., 1940 D.W. Jenkins et al., 1971). With chronic alcohol consumption and concurrent malnutrition, metabolic acidosis is caused by a still unclear multifaceted pathogenesis (hypoinsulinaemia, lipolysis, extreme increase in free fatty acids, rise in ketone bodies). The clinical picture shows nausea, vomiting, dehydration, hyperventilation, fruity odour on breath, aceton-uria and acetonaemia as well as a moderate form of hyperglycaemia. This syndrome probably occurs more often than has been hitherto assumed. (54)... 

The following factors are decisive in achieving a favourable prognosis for all forms of alcoholic liver disease (7.) total abstention from alcohol, (2.) extent of irreversible loss of liver parenchyma, (S.) exclusion of other risk factors (e. g. obesity, diabetes mellitus, malnutrition), 4.) additional effects of hepatotoxic substances (e.g. medication, chemical agents), and (5.) coexistence of further alcohol-induced organ damage. (5, 23, 37, 80, 81, 86, 99, 102, 108)... 

Variable factors are coexisting diseases (diabetes, liver or renal disease, endocrinopathies), overweight, malnutrition (e.g. lack of protein), alcohol, additional medication, tobacco smoke particles, heavy metals and pregnancy as well as drug-related overdose, longterm intake or application form, etc. (s. tab. 3.18)... 

Some of the dreaded nutritional diseases of the past — such as scurvy, pellagra, and pernicious anemia — are discussed in this book. Such contemporary problems as infectious diarrhea, xerophthalmia, protein/energy malnutrition, and folate deficiency are discussed, as are diabetes and cardiovascular disease, two of the most sigf cant nutrition-related diseases. The last two conditions can be controlled in part by dietary intervention. 

Patients with alcoholic CP usually present with an initial acute attack followed by successive attacks that are slower to resolve. Continued alcohol use leads to chronic abdominal pain and progressive exocrine and endocrine insufficiency. In about 50% of patients, the pain diminishes 5 to 10 years after the onset of symptoms. Steatorrhea, calcification, and diabetes usually develop after 10 to 20 years of heavy ethanol ingestion. Most patients present with varying degrees of pain, malnutrition, and glucose intolerance. The mortality rate of CP is approximately 50% within 20 to 25 years of the diagnosis. About 15% to 20% actually die of complications associated with acute attacks. Most deaths occur as a consequence of malnutrition, infection, or ethanol, narcotic, and tobacco nse. The clinical course of idiopathic CP is more favorable than that of alcoholic pancreatitis. ... 

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