Complications Of Type 2 Diabetes

A Frozen shoulder is a disorder that causes stiffness and discomfort in the shoulder joint. Frozen shoulder, also known as adhesive capsulitis, occurs when the connective tissue around the shoulder joint becomes swollen and rigid. It's a painful disorder that causes a reduction in shoulder range of motion without any indications of arthritis. This inflammation can make it difficult to do everyday tasks, and as the illness progresses, your discomfort and stiffness grow progressively more debilitating. What Exactly Is Frozen Shoulder? Shoulders are made up of bones, ligaments, and tendons that are wrapped in a connective tissue capsule. When the capsule around the shoulder joint thickens and tightens, it gradually restricts movement. The condition usually occurs in three distinct stages: Freezing Stage This happens between six and nine months. Your shoulder hurts to move, and you've lost a lot of range of motion. Frozen Stage This period lasts four to twelve months, during which time your pain may become more bearable, but your mobility may deteriorate as your stiffness develops. Thawing Stage You may notice that your mobility improves and that you may resume numerous tasks six months to many years following the beginning of symptoms. Every patient has a unique experience with frozen shoulder. Early appropriate intervention can reduce the severity of your personal case. Link between Diabetes and Frozen Shoulder The higher your risk, the older you are or the longer you have had diabetes. Because uncontrolled blood sugar levels can alter collagen, a crucial protein that makes up your connective tissue, people with diabetes are more likely to develop frozen shoulder. When sugar attaches to collagen, it becomes sticky, restricting mobility and causing your shoulder to stiffen. When you try to work through the stickiness, you will experience mild to severe pain. In certain circumstances, moving your shoulder is impossible. What Are The Other Risk Factors? If your shoulder is immobilised for an extended period of time, such as when it is in a cast, you run the risk of getting frozen shoulder. After an injury, such as a rotator cuff tear, the disease can also develop. Women are more prone to frozen shoulder than males, those between the ages of 40 and 60 are the most likely to get it. Diagnose and Prevention Frozen shoulder can be diagnosed only on the basis of signs and symptoms. A physician, on the other hand, would usually make the diagnosis by examining your active range of motion (by asking you to move your shoulder) as well as your passive range of motion (by moving your arm for you). Unfortunately, there is no way to guarantee that frozen shoulder will not occur. However, remember that the greatest protection is to keep your blood sugars as low as possible. Beyond that, maintaining a regular stretching and physical exercise programme is critical to maintaining your shoulder's range of motion. Remember that while you can't predict whether or not you'll develop frozen shoulder, you can put yourself in the best possible situation. Treatment for Frozen Shoulder Most patients will, of course, choose non-operative therapies initially, such as physical therapy and non-steroidal anti-inflammatory drugs. Some people choose for steroid injections to relieve joint discomfort and enhance range of motion, but keep in mind that if you have diabetes, they might cause dangerously high blood sugars that can last up to a week, so talk to your doctor first. For the most part, these measures should be effective. If symptoms do not improve, more extensive procedures such as open capsular release or arthroscopic surgery (together with physical therapy) may be considered. A few pointers on how to deal with a frozen shoulder While frozen shoulders are common among diabetics, there are some things you may do to avoid or treat them. Maintain as close to normal blood sugar levels as possible. Before you acquire frozen shoulder, exercise and stretch your shoulders on a regular basis. Anti-inflammatory medications can be used to relieve pain. Strengthen your shoulder and enhance range of motion with the help of a physical therapist. If nothing else works, surgery may be an option. Don't wear a shoulder sling or cease using your arm entirely. A frozen shoulder can be uncomfortable and restrict many of your everyday activities, but the good news is that with proper treatment, the disease usually resolves. (Dr. Biren Nadkarni,Sr. Consultant Orthopedic and Joint Replacement Surgeon) Read More► Your Guide to a Good Night's Sleep

New York: Obesity, often a result of eating too much fat and sugar in combination with low physical activity, is known as a key factor for developing Type 2 diabetes. However, some obese people do not develop the disease that affect millions globally. Turns out their gut bacteria have a role to play. Andrey Morgun and Natalia Shulzhenko of Oregon State University and Giorgio Trinchieri of the National Cancer Institute developed a novel analytical technique, multi-organ network analysis, to explore the mechanisms behind early-stage systemic insulin resistance. The findings, published in the Journal of Experimental Medicine, showed that a particular type of gut microbe leads to white adipose tissue containing macrophage cells, large cells that are part of the immune system, associated with insulin resistance. In the human body, white adipose tissue is the main type of fat. "Our experiments and analysis predict that a high-fat/high-sugar diet primarily acts in white adipose tissue by driving microbiota-related damage to the energy synthesis process, leading to systemic insulin resistance," said Morgun, associate professor of pharmaceutical sciences in the OSU College of Pharmacy. "Treatments that modify a patient's microbiota in ways that target insulin resistance in adipose tissue macrophage cells could be a new therapeutic strategy for Type 2 diabetes," he added. The human gut microbiome features more than 10 trillion microbial cells from about 1,000 different bacterial species. "The so-called 'western diet', high in saturated fats and refined sugars, is one of the primary factors. But gut bacteria have an important role to play in mediating the effects of diet," Shulzhenko said. Experiments in mice, looking at the intestine, liver, muscle and white adipose tissue, the team found "adipose tissue has a predominant role in systemic insulin resistance". Further they "discovered that the Oscillibacter microbe, enriched by a western diet, causes an increase of the insulin-resistant adipose tissue macrophage". The researchers add, however, that Oscillibacter is likely not the only microbial regulator for expression of the key gene they identified, Mmp12, and that the Mmp12 pathway, while clearly instrumental, is probably not the only important pathway, depending on which gut microbes are present. Previously studies have shown that another microbial species "Romboutsia ilealis worsens glucose tolerance by inhibiting insulin levels, which may be relevant to more advanced stages of Type 2 diabetes", Shulzhenko said. (Agency) Read More► Women Should Exercise in The Morning, Men in Evening: Study

Tokyo: Daily vitamin D supplements do not seem to prevent the development of Type 2 diabetes in people already at high risk of the condition, finds a study. Type 2 diabetes affects around 480 million people worldwide, and is predicted to increase to 700 million by 2045. Another half a billion people have impaired glucose tolerance or pre-diabetes, or higher than normal blood sugar levels that, if left untreated, can develop into Type 2 diabetes. Some studies have shown that Vitamin D deficiency is associated with an increased risk of future diabetes, but trials of Vitamin D supplements for preventing the condition have shown inconsistent results. The new study, published by The BMJ, shows that supplements had no clinically meaningful effect in high risk adults, but suggest there may be a benefit for people with insufficient insulin secretion, although this finding remains unclear. In the study, the team assessed whether eldecalcitol - an active form of vitamin D used to treat osteoporosis in Japan - could reduce the risk of developing Type 2 diabetes among people with impaired glucose tolerance. They analysed 1,256 Japanese adults with impaired glucose tolerance recruited from three hospitals in Japan and were divided into two groups: a standard daily dose of eldecalcitol (630 participants) or placebo (626 participants). They were assessed for diabetes every three months over a three-year follow-up period. During this period, the researchers found no meaningful differences between groups in those who developed diabetes (12.5 per cent in the eldecalcitol group and 14 per cent in the placebo group) or whose blood sugar levels returned to normal (23 per cent in the eldecalcitol group and 20 per cent in the placebo group). The team did, however, find a significant increase in both lower back and hip bone mineral densities among those taking eldecalcitol compared with placebo. "Although treatment with eldecalcitol did not significantly reduce the incidence of diabetes among people with pre-diabetes, the results suggested the potential for a beneficial effect of eldecalcitol on people with insufficient insulin secretion," said researchers, calling for further study to determine whether vitamin D is beneficial to people with pre-diabetes. (Agency) Read More► B12 Deficiency in Children is Huge Yet Overlooked Problem: Study

New York: Scientists have demonstrated that normal brain ageing is accelerated by approximately 26 per cent in people with progressive Type 2 diabetes compared with individuals without the disease, according to a study. There is already strong evidence linking Type 2 diabetes with cognitive decline, yet few patients currently undergo a comprehensive cognitive assessment as part of their clinical care. The results, published today in eLife, suggest that by the time Type 2 diabetes is formally diagnosed, there may already be significant structural damage to the brain. The findings also suggest that the patterns of Type 2 diabetes-related neurodegeneration strongly overlap with those of normal ageing, but that neurodegeneration is accelerated. Sensitive ways to detect diabetes-associated changes to the brain are therefore urgently needed. "Routine clinical assessments for diagnosing diabetes typically focus on blood glucose, insulin levels and body mass percentage," said Botond Antal, a doctoral student at the Department of Biomedical Engineering, Stony Brook University, US. "However, the neurological effects of Type 2 diabetes may reveal themselves many years before they can be detected by standard measures, so by the time Type 2 diabetes is diagnosed by conventional tests, patients may have already sustained irreversible brain damage," Antal added. The team evaluated the relationship between typical brain ageing and that seen in Type 2 diabetes from a dataset, which includes brain scans and brain function measurements, of 20,000 people aged 50 to 80 years old. The results were then compared with a meta-analysis of nearly 100 other studies. Their analysis showed that both ageing and Type 2 diabetes cause changes in executive functions such as working memory, learning and flexible thinking, and changes in brain processing speed. However, people with diabetes had a further 13.1 per cent decrease in executive function beyond age-related effects, and their processing speed decreased by a further 6.7 per cent compared to people of the same age without diabetes. Further, MRI scans of people with and without diabetes showed that people with diabetes had even more pronounced decreases in gray matter beyond the typical age-related effects -- a further 6.2 per cent decrease in grey matter in the ventral striatum, but also loss of grey matter in other regions, compared with normal ageing. "Our findings suggest that Type 2 diabetes and its progression may be associated with accelerated brain ageing, potentially due to compromised energy availability causing significant changes to brain structure and function," said Lilianne Mujica-Parodi, at the varsity's Director of the Laboratory for Computational Neurodiagnostics. "By the time diabetes is formally diagnosed, this damage may already have occurred. Our results underscore the need for research into brain-based biomarkers for Type 2 diabetes and treatment strategies that specifically target its neurocognitive effects," Mujica-Parodi noted. (Agency) Read More► Does Vitamin D Affect Fertility?