In case your blood pressure subsides well below the aforementioned ratio, say in the region of 90/60mmHg, but you don’t exhibit any symptoms normally associated with low pressure, then there is no cause for concern.

Possible Symptoms and Indications

On the other hand, if you experience vertigo, and feel lightheaded more often than not, then it could mean that you’re suffering from chronic hypotension. Those registering a low BP reading fairly consistently are said to be hypotensive and the diagnosis could potentially indicate a serious underlying issue linked with the endocrine system or the heart.

Additionally, low blood pressure could also be indicative of a grave neurological disorder. Normal blood supply to the brain and cardiac (heart) muscles are compromised with ultimately depriving both the organs of the much-needed nutrients and oxygen. As you grow older, plaque builds up in the blood vessels adversely affecting the supply of blood to the upper extremities including the heart and the brain (2).

Low Blood Pressure Facts

• Nearly 10-20% of the populace aged over 65 is beset with chronic hypotension.
• If you’re diagnosed with low blood pressure, your physician may recommended you to make specific lifestyle changes, change your current medications, and/or prescribed medicines for treating hypotension.
• He or she may suggest some low blood pressure diet and exercise.
• You may have to take more low blood pressure diet foods like whole grains, vegetables, fruits, fishes rich in omega-3 fatty acids, and increasing your table salt intake.

Essential Tips

1. Stick to a healthy and wholesome diet: Your body needs nutrients on a regular basis, and more so as you grow older. Since the organs in your body are not able to function with the same efficiency as they did when you were younger, you’d need to offset or make up for this insufficiency by consuming fresh and natural food items. In order words, you’d have to eat more homemade food items prepared from whole grains like rice, wheat, maize, barley, and millets (3).
   1. Include more fresh vegetables and fruits in your diet including but not limited to green peas, French beans, tomatoes, ridge gourds, striped gourds, salad veggies, leafy veggies, apples, oranges, grapes, bananas, blueberries, and mangoes. Feast on dry fruits that include a variety of nuts, take meals cooked from lentils, pulses, and seeds like kidney beans, sesame seeds, black beans, and so on. Eat foods rich in proteins like chicken, eggs, quails, and different types of fish including salmon, sardine, tuna, trout, cod, halibut, and a variety of anchovies.
   2. In case you’re a vegetarian to the boot, you’ll be more prone or susceptible to be beset with low blood pressure. This is so because a completely vegan diet means that your body is not getting its routine dose of animal proteins and fats which in turn may lead to your BP plummeting abnormally.
   3. Even if you don’t experience dizziness or feel weak despite having low pressure, you should incorporate lean meats into your diets and take fresh dairy products like low-fat cheese, yogurt, cottage cheese, and skimmed milk (4).
   4. Potassium is one mineral that can be extremely effective in normalizing your blood pressure. In any case, you’d have to increase the uptake of foods abounding in potassium as you age for the sake of your cardiovascular health. Foods that essentially contain a high proportion of potassium are chia seeds, bananas, legumes, some particular types of vegetables, and citrus foods. Seek the recommendations of your doctor with regards to low blood pressure diet recipes.
2. Reduce your alcohol consumption and stay well hydrated

Another effective tip that can go a long way in enabling you to keep your BP under control and prevent the same from plunging abnormally is to reduce alcohol intake if you’ve been drinking quite heavily. Alcohol has a numbing effect on your nerves and can interfere with your cognitive or memory skills. Significantly enough, alcohol can make you inordinately dehydrated that in effect, can lead to an anomalous drop in systemic blood pressure.

So, it doesn’t need to be emphasized that you’d have to curb alcohol consumption and limit yourself to a couple of drinks per week. On the other hand, augmenting water uptake will not only check dehydration but also help maintain the normal range of blood pressure. Drink nothing less than 2 liters of water every day as well as take other nutritious fluids and liquid supplements (5).

1. Have more sodium chloride or salt

Generally, we’re advised are cut back on consumption of sodium chloride or table salt as it is hygroscopic in nature absorbing moisture from the body, and excessive intake of the same can cause dehydration. One can either cook foods by adding more salt to the meals or taking salt during partaking of breakfast, lunch or dinner. Nevertheless, you should always consult with your physician regarding the exact amount of additional salt uptake.

1. Individuals having afflicted with low blood pressure are advised by their GPs to incorporate extra helpings of salt in their diets as patients with low BP are usually salt-deficient.
2. Taking processed foods laced with salt or gulping down salt tablets to compensate for the deficit.
1. Have more small portions and eat lesser high-carbohydrate foods

Taking a heavy breakfast or lunch can cause your blood pressure to fall sharply. The solution lies in meals frequently that are broken down into smaller portions.

1. To put it simply, instead of having a heavy breakfast or brunch at one go break down the repast into small portions and take these on a piecemeal basis spread over the entire day.
2. Go slow on consumption of food items that are rich in carbohydrates like potatoes, yams, rice, processed breads, and pasta. Partaking of small dishes frequently can aid in the prevention of postprandial hypotension (5).

Concluding Remarks

To say the last but not the least, make it a point to discuss with your GP about low blood pressure diet and treatment. Alternatively, he or she can help you out with drawing a low blood pressure diet chart or low blood pressure diet plan where you can see at a glance the kind of foods that you’ll be able to eat.

References:

1. http://naturimedica.com
2. http://timesofindia.indiatimes.com
3. http://www.webmd.com
4. http://www.nhs.uk
5. http://www.mayoclinic.org

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Acanthosis nigricans is a condition where there is an occurrence of discoloration in the skin. This discoloration normally occurs in areas where there are folds, such as the folds in the side of the neck as well as the posterior folds. Moreover, it has been recognized that indeed, the condition highly predisposes children to develop diabetes.

As an added tidbit of information, the first recorded incident of acanthosis nigricans is dated back in the late 1880s in Germany. It was first observed by Unna and Pollitzer. Although in the earlier part of 1880s, a suspected case of acanthosis nigricans was discovered by Addison; however, he misdiagnosed it as a case of Addison’s disease. Moreover, in the early part of the 1900s, about fifty individuals were identified to have been affected by the disease with a tendency to develop internal cancerous growth.

Epidemiology

To date, the precise incident rate of acanthosis nigricans is still not known. However, the cancerous variation of the condition has a fewer incidence than the benign ones. Moreover, acanthosis nigricans has been found to be more common in individuals with darker pigments of their skin; however, the cancerous variation of the condition has no known partiality to any skin color or race.

Also, the condition (both the benign and cancerous ones) has no known partiality to gender as it occurs equally among both sexes. Acanthosis nigricans also has no specific age at which it occurs. The condition can appear at any stage of an individual’s life span; although, it is usually observed in the adulthood stage.

Causes of Acanthosis Nigricans

The exact cause of acanthosis nigricans has not yet been fully elucidated to date. The condition usually occurs at a young age, usually before an individual reaches the fourth decade of life. Moreover, the condition is highly linked with obesity or the condition where there is excessive accumulation of fat in the body that may pose significant health risks to an individual.

Other than that, acanthosis nigricans may also be a hereditary condition. In addition, the condition is also said to be caused by problems in the endocrine system such as Cushing’s syndrome, Acromegaly, Hyperthyroidism, Hypothyroidism and Diabetes Mellitus.

The most frequent etiologic factor associated with acanthosis nigricans is insulin resistance. When there is insulin resistance, the levels of insulin floating around the body will consequently increase. Due to this phenomenon, the excess insulin may accumulate in the skin resulting to skin hyperplasia or the anomalous augmentation of growth.

Pathophysiology

Basically, acanthosis nigricans may be predisposed by the factors mainly responsible for the propagation or increase in production of keratinocytes (main cell types of the epidermis) and fibroblasts in the dermis. Below, the pathophysiology of benign and malignant acanthosis nigricans will be further discussed.

Benign acanthosis nigricans

In the non-cancerous form of acanthosis nigricans, the condition may be instigated by insulin itself or the insulin-like growth factor that initiates the increase in production of cells in the epidermis. Other key players are receptors such as the fibroblast growth factor as well as the epidermal growth factor. In patients having excessive fats in the body, the insulin-like growth factor 1 has a very high tendency to increase, as a result the insulin’s capability to produce accelerated cell growth as well as cell differentiation, is also higher. This is because; the insulin’s high affinity to the insulin-like growth factor causes the increase in the growth of the cell and its differentiation.

Currently, there have been two identified classifications of the condition’s manifestations, which are namely the anomaly in the growth factor of the fibroblast and the syndromes associated with insulin resistance. Moreover, the three usual elements associated with the condition are craniosynostosis, hyperinsulinemia and excessive accumulation of fats in the body.

In addition, other causative factors of acanthosis nigricans are friction and perspiration as evidenced by its dominance in areas of the body where there is presence of folds.

Malignant Acanthosis Nigricans

A factor called transforming growth alpha has been cited as the most likely factor to cause the occurrence of cancerous forms of acanthosis nigricans. Evidences like normalization of the said factor’s level in the blood after the elimination or removal of the tumor in the body has supported the idea that indeed it may be the one responsible for the progression of benign acanthosis nigricans to malignant ones.

Extrinsic factors such as medications have also been cited as causative factors for malignant acanthosis nigricans. Medications, especially the ones that utilize parenteral routes may have the tendency to activate insulin-like growth factors in the injection site.

Moreover, there are a lot of disorders that are highly associated with acanthosis nigricans. Examples of these disorders are Acromegaly, Barter syndrome, Bloom syndrome, Dermatomyositis, Phenylketonuria, Pituitary hypogonadism, Rud syndrome, Wilson syndorme as well as Lupus erythomatosus among others.

Signs and Symptoms

Initially, the first clinical manifestation that can be observed in acanthosis nigricans is the darkening of the skin with accompanying thickening of the area. There may be itching and it can then progress to dark macules. Lastly, it may then develop into a very tangible plaque when touched. In malignant forms of acanthosis nigricans, these skin manifestations may appear before, on or after the tumor presentation. Moreover, in malignant acanthosis nigricans, the itching may be considerably higher.

As  stated above, frequent locations of the condition are in areas of the body where there are folds such as the neck, groin and armpit; with the back side of the neck being the most frequent site in children. In addition, lesions of the condition may also develop in moist areas of the body such as the mouth and the mucosa of some parts of the gastrointestinal tract including the esophagus. In other cases, even the areola may be affected.

Types of Acanthosis Nigricans

There are nine known types of acanthosis nigricans, which will each be discussed below.

Obesity-related type

The obesity-related type is the most frequently occuring type of acanthosis nigricans so far. Lesions usually develop in older people than in younger ones. Although, not all may have resistance of insulin, it is usually common in this type and since it is obesity related, the symptoms may consequently disappear as the weight is trimmed down.

Syndromic type

As can be inferred from the name itself, this type of acanthosis nigricans is linked with a syndrome. For instance, there are two types of syndromes that are associated with acanthosis nigricans, which are namely the types A and B. The first type is associated with hereditary links, especially common in young women with abnormally elevated levels of testosterone. The second type, on the other hand, is linked with various conditions such as Hashimoto thyroiditis, Sjogren syndrome, Scleroderma and SLE among others.

Acral type

This type of acanthosis nigricans happens in individuals who are relatively healthy, other than, of course, their acanthosis nigricans condition. This type is mostly common in dark skinned individuals such as the African American race.

Unilateral type

This type of acanthosis nigricans is hereditary and is usually acquired through an autosomal dominant manner. In this type, the lesions may develop in various stages of an individual’s life span, may it be in the infancy or in the adulthood stage. Moreover, these lesions have a tendency to have a continuing growth before it stops to its optimal size.

Generalized type

This type of acanthosis nigricans is uncommon and has no known predisposition to cancerous acanthosis nigricans.

Familial type

This type of acanthosis nigricans is also usually uncommon and just like the unilateral type; it is usually acquired through an autosomal dominant manner. Moreover, the lesions usually develop from early childhood and usually stops during the teenage years.

Drug-related type

This drug-related acanthosis nigricans may be linked to the use of various medications such as corticosteroids, nicotine as well as insulin among others, with the nicotinic acid being the most frequently linked drug to the development of the condition. However, the drug-related acanthosis nigricans along with its associated lesions may disappear after the discontinuation of the related medication.

Malignant type

Obviously, the malignant type is the worst type of acanthosis nigricans that an individual could possibly have. Although there are a lot of possible associations with various carcinomas, the most frequently associated carcinoma is the ones that are in the gastrointestinal tract, especially gastric adenocarcinoma. Moreover, the mouth, including the lips may be severely affected.

Mixed type

As can be inferred from the name itself, the mixed type of acanthosis nigricans is characterized by a combination of two or more of the above-mentioned types.

Differential Diagnosis

Differential diagnoses should also be done to rule out other similar disorders such as Pellagra, Hemochromatosis and Addison’s disease among others.

Procedures and Tests

It may be helpful to perform tests to measure the level of glycosylated hemoglobin in the individual’s body, as well as, test for glucose tolerance. In some cases, a biopsy performed in the skin may be necessary as the need of it may arise.  Moreover, it may also be necessary to test for the level of plasma insulin in the body to consequently discover or come into light the occurrence of insulin resistance in an individual.

Treatment for Acanthosis Nigricans

Medical Management

To date, there is still no routine treatment regimen for the management of acanthosis nigricans. Usually, the objective of most medical managements is to cure the causal or primary disease condition that leads to the development of acanthosis nigricans, in the first place. Moreover, the accompanying lesions in the condition usually do not pose a significant health risk and its management is solely for cosmetic matters only. However, the following may be helpful in the resolution of acanthosis nigricans:

• As stated above, obesity or the excessive accumulation of fats in the body is one of the main factors to the development of acanthosis nigricans. Hence, a healthy reduction of weight as well as healthy control of glucose intake may be helpful in the resolution of the condition.
• On the other hand, in the case of drug-related acanthosi nigricans, the discontinuation of the causative medications may be necessary in order to resolve the appearance of acanthosis nigricans.
• Experts also suggest the inclusion of fish oil in the diet of the patient, as it may help in the resolution of the generalized type of the condition.
• There are also topical creams that have posed promising results. Examples of these topical creams are keratolytics such as ammonium lactate, as well as depigmenting topical soluctions, usually in triple combination. The use of sunscreen in a daily manner may also help in the resolution of acanthosis nigricans.
• Aside from topical agents, there are also oral medications that posed promising results in the resolution of acanthosis nigricans. Examples of these oral medications are metformin, isotretinoin, as well as etretinate.
• Type A syndromic forms may also be treated with the utilization of metformin and contraceptives taken orally.
• Lesions may also be significantly reduced by using available laser therapies such as dermabrasion among others.
• For malignant acanthosis nigricans however, the first line of treatment is surgical intervention. The tumors are surgically removed. Moreover, cyproheptadine is usually used for the management of malignant types of acanthosis nigricans as it may hamper or hinder the liberation of tumor materials.
• Lastly, the utilization of Psoralen in combination with ultraviolet A may help relieving symptoms of malignant acanthosis nigricans.

Also, as acanthosis nigricans involve various systems in the body, like the endocrine system, a collaborative team effort may be necessary to achieve optimal management of the patient. Because of this, different specialists may be needed such as the family physician, dermatologist for the skin care, geneticist to determine familial or genetic links, oncologist for malignant cases of acanthosis nigricans and the endocrinologist for the management of endocrine signs and symptoms.

Patient Education

An integral part of the medical management for acanthosis nigricans is patient education. The patient should be informed that acanthosis nigricans is not a disease in itself, but a resulting condition of another causative disease. Proper diet and healthy reduction of weight should be included in educating the patient.

Prognosis

The malignant type of acanthosis nigricans have shown poor prognosis, with an estimated life span of two years upon onset of malignant signs and symptoms.

Acanthosis Nigricans Pictures

Picture 1 : Acanthosis Nigricans on axilla (on of the most common sites)

Picture 2 : Acanthosis Nigricans on neck (on of the most common sites)

Picture 3 : Acanthosis Nigricans on body

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Type 1 diabetes, also known as juvenile diabetes, takes a toll on the lives of patients and families and affects every system of the body. There are cures for the disease on the horizon, but to date the only treatment is to manage the disease with frequent insulin injections and lifestyle interventions. The American Diabetes Association is devoted to prevention and finding a cure for type 1 diabetes. A leader in trying to find a cure for type 1 diabetes is the Juvenile Diabetes Research Foundation (JDRF) in Australia.

President and CEO, Alan Lewis PhD joined the JDRF in 2009. He has been focused on stem cell research to cure type 1 diabetes. According to Dr. Lewis in an interview found at Future Medicine, “One thing that I am going to focus on is making certain our research considers the patient in a slightly different way: what we refer to as the ‘person centric’ approach. Type 1 diabetes is a disease that affects people from infanthood through to the elderly. This gives us a different constituencies of patients and their loved one: patients who not only want to help their loved ones: patients who not only want to help their child who has diabetes, but also want to know if it can be prevented in their other children; teen-agers or college-aged young adults who want to know how to handle the disease in a social context; and people who have had diabetes for years, in some instances decades who want a cure, but are also concerned about complications .” He adds, “Eventually, we hope to become the go-to organization for information related to type 1 diabetes for everyone involved in this disease…”

Thymoglobulin

Type 1 diabetes is linked to autoimmunity. Scientists, looking for a cure for type 1 diabetes have found a drug that suppresses the immune system to help reverse and possibly cure type 1 diabetes. Type 1 diabetes occurs in children when the body’s immune system attacks the cells in the pancreas that produce the hormone insulin.

Thymoglobulin, manufactured by Tolera is designed to stop the immune system from destroying insulin cells, leading to a cure for type 1 diabetes. The drug could be taken for a short period of time to “reprogram” the immune system and cure type 1 diabetes. The immune suppressing drug is the first to offer a potentially safe cure for type 1 diabetes.

Artificial Pancreas

An artificial pancreas system that includes an insulin pump and monitoring device that tracks blood sugar levels offers a way to keep glucose levels under control. The artificial pancreas device is not a cure for type 1 diabetes but has offered a novel way to help prevent complications of the disease and improve quality of life. The technology frees individuals with type 1 or type 2 diabetes from the constant task of monitoring glucose levels and keeps glucose levels under control, preventing complications of the disease and currently is awaiting FDA approval.

Video about artificial pancreas

BCG Vaccine

Bacillus Calmette-Guerin (BCG) vaccination is a promising treatment that could cure type 1 diabetes. The vaccine could also prevent type 1 diabetes among high risk individuals. BCG vaccine temporarily raises levels of TNF (tumor necrosis factor) in humans and in mice. As of this writing, the vaccine is entering Phase II clinical trials. Bacillus Calmette-Guerin could prevent insulin loss and destruction to the beta cells of the pancreas.

Stem Cell Therapy

Stem cell therapy is being explored as a cure for type 1 diabetes, but there are many safety issues. According to the National Institutes of Health, “A major consideration is whether any precursor or stem-like cells transplanted into the body might revert to a more pluripotent state and induce the formation of tumors. These risks would seemingly be lessened if fully differentiated cells are used in transplantation.” One of the problems with stem cell therapy is finding a replenishable supply of cells that produce insulin, making stem cell transplant therapy a distant hope for curing type 1 diabetes, but nevertheless is being vigorously pursued by scientists.

Researchers are working on several approaches to cure type 1 diabetes. Because the body’s own immune system attacks the cells of the pancreas, a cure for type 1 diabetes may be decades away from becoming a reality. Stem cell therapy may offer the greatest hope for a cure for type 1 diabetes, but many hurdles remain.

References:

• NIH Resource for Stem Cell Research
• Artificial Pancreas
• Thymoglobulin Study
• American Diabetes Association
• JDRF
• Working for a Cure

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Generally kidney defects, diseases, and infections are caused in diabetics due to persistent high levels of blood sugar that pass into urine in order to be secreted out. It can be found in both Type 1 and Type 2 diabetics. In Type1 patients, insulin production is diminished, and in Type2 patients, once called non-insulin diabetes mellitus, or adult onset diabetes results as insulin deficiency or insulin resistance.

Uncontrolled sugar levels however are fatal for both types of diabetics. Cardiovascular diseases, impairment of several body organs, muscle weakness, nephropathy, blindness, memory loss, artery diseases, and most commonly heightened healing defects are some of the defects and ailments caused due to excessive hypoglycemia or hyperglycemia.

Once detected, apart from blood sugar levels, blood pressure and cholesterol levels are a must to be watched closely and maintained. As diabetics with high cholesterol levels are more at risk than other diabetic nephropathics.

When undergoing a kidney disorder it is the biggest concern for diabetics to get hold of the defect or disease at the proper time. Without the knowledge of being encountering nephropathy, a diabetic might lose the chance of recovery for ever. So it is important to notice any unusual body changes that become evident and keeping their track.

The primary symptoms such as pain at the back area at point where kidneys reside in body are generally referred to as muscular pains. Regardless of high sugar levels which cause excessive urination, in nephropathy, durations in between urination are prolonged and the quantity of urine decreases. The patient feels it difficult to urine in one go, and has to get rid of it in short intervals. Urine color also changes to some extent with evident foam in urine and somewhat increased bad smell.

Excessive sweating, joint pain, anorexia; loss of appetite, skin itchiness, excess of cold and body shivering, oedema or edema; swollen feet and legs, swollen eye surroundings, excessive feeling of tiredness, nausea or vomiting with a pressure on the head, troubled sleep and fatigue. Other minor symptoms include malaise; general ill feeling, and frequented hiccups.

With all these symptoms a patient should go straight for clinical checkups, examinations and treatments. It should be kept in mind that a primary level of nephropathy is not evident in ultrasounds therefore extensive urine tests are required to evaluate the level of damage the kidneys have encountered.

The amount of protein content secreted in urine; proteinuria, basically determines damage level which microalbuminuria test shows. A routine urinalysis is also effective indicator of prevailing kidney defects and ailments. Along with urine tests, blood tests are also important to keep checks because serum creatinine and BUN may also increase as a result of kidney damage progression. UTI infections are also found in kidney infections, as the urine contains more chemicals than normal urine does.

It is important to control diabetes levels and keep it controlled. In this way not only diabetic nephropathy but many other diabetes side effects and diseases can be prevented.

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In accordance with the normal procedure alimentary canal digest the carbohydrate of food into glucose and absorb into blood. Glucose is the key source of the energy of human body.

After that, the essential organ of the body ‘pancreas’ release hormone called insulin, that get the glucose from blood and provide them to the body cell for proper functioning.

Development of diabetes refer to the state, that either your body in not producing enough protein or your body cells are not recognizing the insulin present in your body, that is why they are not using it in the way they should.

As a result starts to accumulate in the blood, causing diabetes or hyperglycemia. The average reported cases of gestational diabetes are about 200,000 only in U.S.

Diagnosis of gestational diabetes

At the approach of third trimester, pregnant women, who have the risk of gestational diabetes should test their glucose level through their health care provider. If you are at higher risk, your doctor may test you within the first trimester of pregnancy. By the use of oral glucose tolerance test, your doctor will confirm, either you have gestational diabetes or not.

Affects of gestational diabetes on neonate

Women with gestational diabetes, most of the time, give birth to healthy babies. For this purpose such women have to maintain their blood sugar level, eat proper healthy diet, moderate kind of physical exertion and keep body weight in an optimum range.

In few cases gestational diabetes affect the baby in womb. The possible risks are as follow:

• Macrosomia: Delivery of a baby with larger body than normal most of the time through cesarean section.
• Hypoglycemia: Baby with low body sugar.
• Jaundice: Skin color becomes yellow.
• Respiratory Distress Syndrome: Baby faces breathing trouble due to lack of oxygen.

Diet plan during pregnancy

Pregnant women need extra 300 calories each day in the second and third trimesters of pregnancy for the weight gain. This is equivalent to 16 to 17 calories per pound of healthy body weight. Additional ten to twelve grams of protein are required for the normal growth of the baby. You should also classify the calories intake such as; get 45 to 60 percent from carbohydrates, 15 to 25 percent from protein, and 20 to 30 percents from fat.

Eating Plans

• Some pregnant women with gestational diabetes control their sugar level with diet plan alone without the use of external hormones, by eating 3 small servings and 1 to 3 snacks per day.
• You may need a snack, before going to bed to prevent the attack of hypoglycemia at night. Your health care provider will better guide you according to your condition and your blood glucose level.
• Try to make a routine of eating at fix time, never skip a meal. Distribute your recommended diet evenly over the day and make sure you eat short meals after every 2 to 3 hours. Stick to the diet suggested by your physician and do not exceed the amount of food while eating.
• Avoid fast foods and beverages with surplus sugar, molasses, corn syrup etc.

Treatment of gestational diabetes

Women with gestational diabetes normally deliver healthy babies because they strictly follow a treatment plan provided by their doctor.

Sometime use of insulin also gets essential for the management of diabetes. The injected insulin can help lower their blood glucose level.

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