In this video, you’ll learn the basics of how to treat a high blood glucose result with a Correction Dose of insulin, how to calculate the Correction Dose, and when not to give a Correction Dose.
Type 1 and type 2 diabetes are characterized by increased blood glucose levels. They affect almost half a billion people around the globe, and this number is projected to rise as we reach the middle of the century. In most individuals, blood glucose levels are kept within a healthy range by a hormone called insulin, which is secreted by the pancreas, but this fine-tuned regulation can go wrong in type 1 and type 2 diabetes. In this animation, we lay out our current understanding of these diseases and explore active areas of research that aim to restore the body’s blood glucose control.
The genius aspergillus is a Fungus extremely common throughout the world. It is in the air almost everywhere, and it’s estimated that most people breathe hundreds of Aspergillus spores into their lungs daily. It affects almost exclusively people with compromised immune systems or with underlying respiratory illness.
COMPROMISED IMMUNITY is often present in people with diabetes, obesity and malnutrition, The very young and very old, Viral infections, particularly AIDS and Covid, cancer, autoimmune diseases, organ transplants, and the list goes on. With the advances in medicine in the past few decades, people are being kept alive longer, often by suppressing their own immunity.
UNDERLYING REPIRATORY ILLNESS is disease such as asthma, cystic fibrosis, sarcoidosis, tuberculosis and COPD.
When I was in an allergy practice, we were always on the alert for allergic bronchopulmonary aspergillosis in asthmatics who were difficult to control. ABPA at that time was reported mainly in England, which is unsurprising due to the wet British climate: fungi grow especially well where is wet.
Another unusual phenomenon is the Aspergillus fungus ball in the lungs, which is sometimes discovered only by chest x-ray. That such a dense mass of fungi could be tolerated in the lungs without invading the body is a tribute to the immune system‘s efficacy.
Galactomannan is in the cell wall of aspergillus, and can be used as a diagnostic test. PCR can also be used, shades of COVID-19. Of course x-ray, or microscopic study of tissues are also often used.
It is estimated that aspergillosis accounts for around 600,000 deaths annually. Africa, with its large number of AIDS patients, contributes heavily to this. It’s difficult to know how common it is in the United States, because aspergillus is not a reportable illness. Please check with the following mayo clinic article for more information.
Fungi are in the outside air, the inside air, and even the air of isolation units In hospitals. The normal human respiratory tract is able to breathe these fungi in, have them deposited on the mucous membrane surfaces and have no problem. The normal respiratory membranes, with their associated cleansing cilia and normal mucus production are able to sweep the invaders out without sustaining any harm.
Problems arise when the respiratory tract is functionally or structurally abnormal, such as in cystic fibrosis, bronchiectasis and COPD. Immunocompromised conditions have been increasing in frequency with the improvement in medical care in recent years. Intravascular catheters and sensors can provide a resting place for pathogens including fungi, as can cavities, scars and other damage to the lung. The immune system may require suppression to accommodate an organ transplants or ameliorate autoimmune conditions.
Cancers, especially of the hematologic or lymphatic system, such as lymphomas, pose a definite problem. Severe burns and malnutrition may weaken the immune system, as may Viral infections, especially AIDS, and more recently COVID-19. More subtle immune problems may arise with diabetes, Obesity, or even a lack of sleep and exercise.
These and other conditions give the fungal infections the OPPORTUNITY to invade the body, and a few dozen of the thousands of species of fungi proceed to do just that. Opportunistic fungi often have special features, depending upon the species. Most prefer the respiratory tract, and if they get in to the bloodstream can go to their favored spots.
Aspergillus, and coccidiomycosis , for instance, prefer the lung. Mucormycosis often involves the sinuses and eyes. Blastomycosis can involve bone. Sporothrix is often found infecting the skin.
Symptoms depend upon the area involved. Of course if it’s a respiratory tract, you have coughing, mucus production, sometimes shortness of breath. With the central nervous system you have headache and confusion. You can see the involvement in the skin.
The number of drugs available to fight fungal infection is fairly limited, and currently involves only three different classes. Many fungi are resistant to one or two of these classes, and can be problematic.
However, fungi do not as a rule spread through the air from person to person, and a true epidemic would be unlikely.
Every year, as millions of people around the world forge new resolutions to eat healthier and lose weight, US News & World Report releases a conveniently timed ranking of the best diets. A panel of experts in obesity, nutrition, diabetes, heart disease, and food psychology rigorously rate each of 39 diets on seven criteria:
- Likelihood of losing significant weight in the first 12 months
- Likelihood of losing significant weight over two years or more
- Effectiveness for preventing diabetes (or as a maintenance diet)
- Effectiveness for preventing heart disease (or for reducing risk for heart patients)
- How easy it is to follow
- Nutritional completeness
- Health risks (like malnourishment, too-rapid weight loss, or specific nutrient deficiencies)
1. Mediterranean diet
Emphasis on fruits, veggies, whole grains, olive oil, beans, nuts, legumes, fish and other seafood. Eggs, cheese, and yogurt can be eaten in moderation. Keep red meats and sugar as treats.
2. DASH (dietary approaches to stop hypertension) diet — TIE
Eat lots of fruits, veggies, lean protein, whole grains, and low-fat dairy. Avoid saturated fats and sugar.
2. Flexitarian diet — TIE
Be a vegetarian most of the time. Swap in beans, peas, or eggs for meats, and consume plenty of fruits, veggies, and whole grains. You can look up more details because there’s actually a full meal plan involving breakfast, lunch, dinner, and two snacks to add up to a total 1500 calories per day. But feel free to also just swap in flexitarian meals ad hoc.
4. Weight Watchers
The first actual paid program on the list, WW uses a points system to guide dieters towards foods lower in sugar, saturated fat, and overall calories while consuming slightly more protein. There are a variety of paid WW plans, with the lowest being about $20 per month.
5. Mayo Clinic diet — TIE
A two-part system, with part one (‘Lose it!’) involving adding a healthy breakfast (i.e. fruits, veggies, whole grains, healthy fats) plus 30 minutes of exercise per day. You’re not allowed to eat while watching TV or consume sugar except what’s naturally found in fruit. Meat is only allowed in limited quantities, as is full-fat dairy. The second phase (‘Live it!’) is basically the first phase but with more flexibility. You aren’t realistically going to cut out sugar forever, and the Mayo Clinic diet acknowledges that. So the long term plan involves lots of whole grains, fruits, veggies, and healthy fats. Less saturated fats and sugar.
In this episode of the JIM Podcast, Editor-in-Chief Richard McCallum speaks with David Cistola of Texas Tech University Health Sciences Center El Paso about American Diabetes Month.