WHAT IS DIABETES INSIPIDUS?

The syndrome is caused by heposecretion of anti diuretic hormones. The disease belongs to the category of 'xiao ke' in Acupuncture.

CLINICAL diagnosis resulting from hypothalamus-pituitary lesion. It can also be secondary to other diseases. The state of illness may be mild or severe, transient or permanent.

1. Polyuria, polydipsia and increased water intake are the principle features. If water intake is restricted, severe dehydration may occur.

2. The etiology of primary diabetes insipidus remains indeterminate. Secondary cases may be initiated by tumor, infection or trauma of the hypothalamus-pituitary system or the adjacent tissues.

3. Accessory examination

a) The specific gravity of urine is reduced and usually less than 1.006. The osmotic prnsipidus from psychogenic polydipsia and polyuria.

b) The osmotic pressure of plasma is elevated. There may appear dizziness, dysphoria, tachycardia or disorder of consciousness, the so-called hyperosmotic syndrome.

c) Water-deprivation test and hypertonic saline test are used to distinguish diabetes insipidus from psychogenic polydipsia and polyuria. Water- deprivation test is dangerous, and now is rarely performed.

TYPES OF SYNDROMES

Deficiency of the Kidney-qi. Main Symptoms: Polydipsia, frequent and profuse urination, emaciation, aching pain in the lumbus, lassitude. The case exhibiting more symptoms and signs of deficiency of the kidney-yin is marked as feverish sensation in the palms and soles, restlessness, red tongue with little fur, deep, thread and rapid pulse; while the case presenting more symptoms and signs of deficiency of the kidney-yang is manifested as light color urine, aversion to cold, impotence, pale tongue with whitish fur, and deep, thread and weak pulse.

WHAT IS DIABETES MELLITUS?

Diabetes Mellitus is a common metabolic endocrinopathy resulting from absolute or relative deficiency of insulin and leading to metabolic disturbance of carbohydrate, fat and protein. The disease is frequently followed by water-electrolyte imbalance and acid-base disturbance. According to the age of the patients, clinical manifestations and requirements for insulin, diabetes can be divided into many types. In Acupuncture, this disease is defined as 'xiao ke’, which means diabetes.

CLINICAL DIAGNOSIS

1. The characteristics of a typical case of diabetes mellitus are often polyphagia, polydipsia, polyuria and loss of body weight. Early or asymptomatic patients only show abnormal release of cortical hormone and insuline inside the body. The level of fasting blood sugar is elevated with abnormal glucose tolerance test. Symptomatic patients are frequently complicated by other symptoms of dermal, neural and endocrinous disorders, besides polyphogia, polyuria and loss of body weight.

2. The main complications and concomitant diseases of diabetes mellitus are diabetic ketoacidosis, cardiovascular diseases, diabetic renopathy and peripheral neuropathy. Cardiovascular complications are the chief causes of death.

3. Diabetes mellitus is classified into juvenile and adult types according to the clinical features. The age of onset of the juvenile type is young and has a tendency to inheritance. Blood sugar fluctuates widely and is quite sensitive to insulin. Treatment is difficult and it is often named insulin-depending diabetes or unstable diabetes. The age of onset of adult type is above 40. This type is relatively mild and can be controlled by dietary restriction or oral antidiabetics. Therefore it is also named non- insulin depending diabetes or stable diabetes.

4. Accessory examination

a) Fasting blood-glucose is higher than 130 mg. Blood glucose after meal is more than 160-180 mg. Urine is positive for glucose. If complicated by ketosis, urine is positive for ketone bodies.

b) Glucose tolerance test can be used to diagnose early or suspected cases and is the principle test in diagnosis.

c) New diagnostic techniques such as testing blood insulin levels are quite helpful in understanding the pathological changes of pancreas and in obtaining information concerning treatment.

TYPES OF SYNDROMES

1. Dryness-heat in the Lung and Stomach Main Symptoms: Restlessness, polydipsia, polyphagia with tendency to hunger, dryness of the mouth and tongue, polyuria, red tongue with yellowish fur, slippery and rapid pulse.

2. Deficiency of the Kidney Main Symptoms: Polyuria with turbid discharge, soreness and debility of the lumbus, dryness of the mouth and tongue, dyshopria with feverish sensation in the chest, palms and soles, red tongue, deep, thread and rapid pulse.

Hypoglycaemia (low blood glucose) in diabetic autism patients

Regular blood sugar tests can help you identify when you need to pay extra attention to your blood sugar level.

Causes

Diabetic autism patients, hypoglycaemic episodes (also known as 'hypos') can be caused by too much insulin in the blood, or less insulin is needed.

Too much insulin in the blood

The dose of insulin or antidiabetic tablets is set too high.

The patient has accidentally overdosed or been given too many tablets.

Less insulin needed

1.If the patient has eaten less than usual.
2.If there has been physical activity.
3.If the patient has been drinking alcohol.

What happens during a hypoglycemic episode?

paleness
shaking
perspiration
a feeling of weakness
rapid heartbeat
hunger
agitation
difficulty concentrating
irritability
fatigue
blurred vision
temporary loss of consciousness
confusion
convulsions
coma.

Hypoglycemia does not cause any of the above symptoms in some diabetic autism patients. This is especially the case where long-standing diabetes is concerned. In these patients, convulsions and loss of consciousness can occur without warning. To avoid this, they are asked to maintain a higher level of glucose in the blood and to measure it more frequently than is normally required. This is very important.

Hypoglycemic episodes can be categorized as:

1. Mild hypoglycaemia or hypoglycaemic episodes. The patient can manage these episodes alone.

2. Serious hypoglycaemia. The patient will need help from others, either a family member or a doctor.

The are Hundreds of patients that have got total recovery from our intensive treatment.

Blood glucose levels

Blood glucose levels stay within narrow limits throughout the day (4 to 8mmol/l). But they are higher after food and usually lowest in the morning or when you are hungry.

When a person has diabetes, their blood glucose level usually moves outside these limits.

Controlling blood glucose levels:

Stable blood glucose significantly reduces the risk of developing late-stage diabetic omplications. These may start to appear 10 to 15 years after diagnosis with Type 1 diabetes autism and often less than 10 years after diagnosis with Type 2 diabetes.

Complications

Neuropathy (nerve disease)
Retinopathy (eye disease)
Nephropathy (kidney disease)
Cerebrovascular disease, such as stroke
Cardiovascular disease, such as heart attack, hypertension and heart failure.
Gangrene.

The best readings are:

4 to 7mmol/l before meals.
less than 10mmol/l one-and-a-half hours after meals.
around 8mmol/l at bedtime

What is Raynaud’s Disease?

Raynaud's disease is a condition of the circulation that affects blood supply to the skin and causes the extremities of the body to lose feeling and become numb. The symptoms of Raynaud’s are most commonly associated with cold and stress and sufferers of this condition will find their toes and fingers feel very cold or even lose sensation in response to a stressful situation or exposure to cold.

People with Raynaud’s disease may also notice their skin changing color to pale and then to blue when they are cold or stressed - particularly the fingers. They may feel a prickly numbness when cold or stressed and sometimes a stinging pain with throbbing and redness when they begin to relax or warm up as blood returns to the extremities.

Though not completely understood, Raynaud’s seems to be caused by an overreaction of blood vessels in the extremities to temperature and stress. In normal physiology, when a person’s body is exposed to cold the blood vessels in the extremities become narrowed and slow down blood supply to the fingers and toes.

This is to prevent excessive heat loss from these areas and preserve the body’s core temperature. Similarly, in times of stress the evolutionary “flight or fight” response is triggered and blood flow to the fingers and toes is reduced as the body tries to conserve blood for the vital organs and muscles. In people with Raynaud’s these responses are exaggerated - causing troublesome symptoms. The reduced blood flow leaves the extremities looking pale or even blue and cold as no warm blood reaches these areas.

What causes Raynaud’s?

Some people have Raynaud's as a complication of an underlying disorder (Secondary Raynaud’s) though more commonly this disease appears independently and on its own and is known as Primary Raynaud’s. In Primary Raynaud’s the cause of the condition remains unknown.

Conditions that may cause Secondary Raynaud’s include Scleroderma, a condition that causes hardening of connective tissue, Lupus, Rheumatoid Arthritis, Carpal Tunnel Syndrome and other diseases that affect the arteries including atherosclerosis. Smoking, beta blockers, certain Chemotherapy agents and some OTC cold and flu medications can also predispose an individual to Raynaud’s.

Certain factors may also increase an individual’s risk of having Primary Raynaud’s. Women are generally more commonly affected as are people who live in cold places and those who suffer from chronic stress.

Complications

Complications of Raynaud’s are fairly rare and the day-to-day discomfort and inconvenience is the most common complaint amongst sufferers of this condition. In severe cases though, blood supply to the fingers and toes could diminish on a long-term basis causing poor healing of sores, development of ulcers and, in the worst cases, gangrene and amputation. It is important to seek medical assistance immediately if you suffer from Raynaud’s and develop an ulcer or infection on one of any of your fingers or toes.

How is Raynaud’s usually treated?

Conventional treatment of Raynaud’s will include treatment of the underlying condition (in Secondary Raynaud’s) as well as medications to reduce the frequency of attacks and prevent tissue damage. These medications work mostly on the principle of dilating the blood vessels in order to prevent the symptoms of Raynaud’s. In severe cases surgery on the nerves in the hands and feet may be performed.

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