Gary Edward Sander, MD, PhD, FACC, FAHA, FACP, FASH is a member of the following medical societies: Alpha Omega Alpha, American Chemical Society, American College of Cardiology, American College of Chest Physicians, American College of Physicians, American Federation for Clinical Research, American Federation for Medical Research, American Heart Association, American Society for Pharmacology and Experimental Therapeutics, American Society of Hypertension, American Thoracic Society, Heart Failure Society of America, National Lipid Association, Southern Society for Clinical Investigation
Kidney damage from diabetes is called diabetic nephropathy. The onset of kidney disease and its progression is extremely variable. Initially, diseased small blood vessels in the kidneys cause the leakage of protein in the urine. Later on, the kidneys lose their ability to cleanse and filter blood. The accumulation of toxic waste products in the blood leads to the need for dialysis. Dialysis involves using a machine that serves the function of the kidney by filtering and cleaning the blood. In patients who do not want to undergo chronic dialysis, kidney transplantation can be considered.
Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Teens with hypertension should not smoke because it can make the long-term associated heart problems worse.
Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension. J Am Coll Cardiol. 2011 May 17. 57(20):2037-114. [Medline].
People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.[80][81]

^ Jump up to: a b Petzold A, Solimena M, Knoch KP (October 2015). "Mechanisms of Beta Cell Dysfunction Associated With Viral Infection". Current Diabetes Reports (Review). 15 (10): 73. doi:10.1007/s11892-015-0654-x. PMC 4539350. PMID 26280364. So far, none of the hypotheses accounting for virus-induced beta cell autoimmunity has been supported by stringent evidence in humans, and the involvement of several mechanisms rather than just one is also plausible. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/bennyquote.png
In people aged 18 years or older hypertension is defined as either a systolic or a diastolic blood pressure measurement consistently higher than an accepted normal value (this is above 129 or 139 mmHg systolic, 89 mmHg diastolic depending on the guideline).[5][7] Other thresholds are used (135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour ambulatory or home monitoring.[79] Recent international hypertension guidelines have also created categories below the hypertensive range to indicate a continuum of risk with higher blood pressures in the normal range. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) published in 2003[27] uses the term prehypertension for blood pressure in the range 120–139 mmHg systolic or 80–89 mmHg diastolic, while European Society of Hypertension Guidelines (2007)[86] and British Hypertension Society (BHS) IV (2004)[87] use optimal, normal and high normal categories to subdivide pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.[27] The ESH-ESC Guidelines (2007)[86] and BHS IV (2004)[87] additionally define a third stage (stage III hypertension) for people with systolic blood pressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels.[27] In November 2017, the American Heart Association and American College of Cardiology published a joint guideline which updates the recommendations of the JNC7 report.[88]

In hypertensive emergency, there is evidence of direct damage to one or more organs.[27][28] The most affected organs include the brain, kidney, heart and lungs, producing symptoms which may include confusion, drowsiness, chest pain and breathlessness.[26] In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage,[26] however, there is a lack of randomized controlled trial evidence for this approach.[28]
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In a meta-analysis of pooled data from 19 prospective cohort studies involving 762,393 patients, Huang et al reported that, after adjustment for multiple cardiovascular risk factors, prehypertension was associated with a 66% increased risk for stroke, compared with an optimal blood pressure (< 120/80 mm Hg). [41, 42] Patients in the high range of prehypertension (130-139/85-89 mm Hg) had a 95% increased risk of stroke, compared with a 44% increased risk for those in the low range of prehypertension (120-129/80-84 mm Hg). [41, 42]
The device being used is known as a “sphygmomanometer”, which uses an air-filled cuff wrapped around the upper arm, to obstruct the bloodflow into the arm. By releasing the air pumped into the cuff in small, incremental quantities, eventually blood is permitted to flow back into the arm, at which point, the pressure inside the cuff is measured, and which will equate to the pressure inside the arteries. This pressure, known as the systolic pressure, represents the pressure in the arteries during contraction of the heart. When the heart relaxes between beats the pressure drops, and is known as the diastolic pressure. Together, these two pressures are written as a ratio, and represents ones “blood pressure”.
Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.

Hypertension is the most important preventable risk factor for premature death worldwide.[149] It increases the risk of ischemic heart disease,[150] strokes,[23] peripheral vascular disease,[151] and other cardiovascular diseases, including heart failure, aortic aneurysms, diffuse atherosclerosis, chronic kidney disease, atrial fibrillation, and pulmonary embolism.[11][23] Hypertension is also a risk factor for cognitive impairment and dementia.[23] Other complications include hypertensive retinopathy and hypertensive nephropathy.[27]
People with type 2 diabetes have insulin resistance, which means the body cannot use insulin properly to help glucose get into the cells. In people with type 2 diabetes, insulin doesn’t work well in muscle, fat, and other tissues, so your pancreas (the organ that makes insulin) starts to put out a lot more of it to try and compensate. "This results in high insulin levels in the body,” says Fernando Ovalle, MD, director of the multidisciplinary diabetes clinic at the University of Alabama in Birmingham. This insulin level sends signals to the brain that your body is hungry.
Maddy Arnstein has lived with T1D for over 50 years. She became involved with JDRF when she saw the dramatic difference technologies like the insulin pump could have on her life. Maddy was quickly drawn to advocacy—initially to help secure continued renewal of funding for the Special Diabetes Program (SDP). But once she started using a continuous glucose monitor, she dedicated herself to fighting for Medicare coverage.

Physical changes: If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues. For example, it’s thought that changes in your kidney function due to aging may upset the body’s natural balance of salts and fluid. This change may cause your body’s blood pressure to increase.
Globally, black adults have among the highest rates of hypertension, with an increasing prevalence. Although white adults also have an increasing incidence of high BP, they develop this condition later in life than black adults and have much lower average BPs. In fact, compared to hypertensive white persons, hypertensive black individuals have a 1.3-fold higher rate of nonfatal stroke, a 1.8-fold higher rate of fatal stroke, a 1.5-fold higher mortality rate due to heart disease, and a 4.2-fold higher rate of end-stage renal disease (ESRD). [38]
Because metabolic syndrome and insulin resistance are closely tied, many healthcare providers believe that insulin resistance may be a cause of metabolic syndrome. But they have not found a direct link between the two conditions. Others believe that hormone changes caused by chronic stress lead to abdominal obesity, insulin resistance, and higher blood lipids (triglycerides and cholesterol).

At the end of the twelve-week study both groups lost weight, but the difference in the amount of muscle vs. fat loss was telling. The aerobic group lost 37 pounds over the course of the study. Ten of those pounds came from muscle. In contrast, the resistance-training group lost 32 pounds. None of the weight they lost came from muscle. When the resting metabolic rate of each group was calculated, the aerobic group was shown to be burning 210 fewer calories per day. The resistance-training group avoided this metabolic decline and instead was burning 63 more calories per day.
In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients' own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.

The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius of Memphis.[108] The disease was considered rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career.[108] This is possibly due to the diet and lifestyle of the ancients, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease "diarrhea of the urine" (diarrhea urinosa).[110]
High blood pressure is a common and dangerous condition. Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be. But you can take steps to control your blood pressure and lower your risk of heart disease and stroke. About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure.1 Only about half (54%) of these people have their high blood pressure under control.1 Many youth are also being diagnosed with high blood pressure.2 This common condition increases the risk for heart disease and stroke, two of the leading causes of death for Americans.3 Get more quick facts about high blood pressure, or learn more about high blood pressure in the United States.
Especially severe cases of hypertension, or hypertensive crises, are defined as a BP of more than 180/120 mm Hg and may be further categorized as hypertensive emergencies or urgencies. Hypertensive emergencies are characterized by evidence of impending or progressive target organ dysfunction, whereas hypertensive urgencies are those situations without progressive target organ dysfunction. [2]
Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified[34] as well as some rare genetic variants with large effects on blood pressure.[35] Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found.[36] Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.[36]
Your doctor may recommend a 24-hour blood pressure monitoring test called ambulatory blood pressure monitoring to confirm if you have high blood pressure. The device used for this test measures your blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over an average day and night. However, these devices aren't available in all medical centers, and they may not be reimbursed.
Lipase inhibitors can play a role. These are foods that have action in decreasing the digestion of fats so they move out of the body instead of getting absorbed. Since the digestive tract is the major place where POPs are both removed from the body and taken into the body, doing what is possible to NOT allow fat soluble compounds reentry is important. Some common lipase inhibitors include green tea, oolong tea, mate tea, and ginger root. https://i.ytimg.com/vi/8AdXhRXuQLU/hqdefault.jpg?sqp

MRUT is just about the best acronym I've heard in awhile. Have to check it out, but I can already say I like it. The other point of note is that I'm putting together a Jenn Sinkler incidence table. By my early estimates I can't get through three hours of my day without running into Jenn's name or mention of her new book. Add that one to the reading list too. At this rate, with all of this content, my workouts are suffering. I'm going to recommend these books move to MP3 formats with good background tunes so we can all listen while we lift. Problem solved. Thanks John. Good stuff.


When there is excess glucose present in the blood, as with type 2 diabetes, the kidneys react by flushing it out of the blood and into the urine. This results in more urine production and the need to urinate more frequently, as well as an increased risk of urinary tract infections (UTIs) in men and women. People with type 2 diabetes are twice as likely to get a UTI as people without the disease, and the risk is higher in women than in men.
The primary problem in metabolic syndrome is insulin resistance. In the body's attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated insulin levels. The elevated insulin levels can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, the insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications.
^ Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F (October 2005). "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement". Circulation. 112 (17): 2735–52. doi:10.1161/CIRCULATIONAHA.105.169404. PMID 16157765.

The prevailing opinion is that all of these markers are signs of insulin resistance, meaning the diminished ability of a given amount of insulin to exert its normal effect. When insulin resistance develops, it can impact metabolic processes in many ways, resulting in the specific markers listed above. However, different individuals respond to insulin resistance in different ways. Also, the time frame in which certain signs develop varies. This variability makes defining—and treating—metabolic syndrome tricky.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and corticosteroids.
* The average person can expect to lose 1-2 lbs. per week. Results may vary. Weight loss is influenced by exercise, food consumed and diet.* FREE 1-3 Day Shipping on Orders Over $99 from Shop.Atkins.com. ©2017 Atkins Nutritionals, Inc.Disclaimer: Nothing contained on this Site is intended to provide health care advice. Should you have any health care-related questions, please call or see your physician or other health care provider. Consult your physician or health care provider before beginning the Atkins Diet as you would any other weight loss or weight maintenance program. The weight loss phases of the Atkins Diet should not be used by persons on dialysis. Individual results may vary.

^ Saiz, Luis Carlos; Gorricho, Javier; Garjón, Javier; Celaya, Mª Concepción; Muruzábal, Lourdes; Malón, Mª del Mar; Montoya, Rodolfo; López, Antonio (2017-10-11). "Blood pressure targets for the treatment of people with hypertension and cardiovascular disease". Cochrane Database of Systematic Reviews. 10: CD010315. doi:10.1002/14651858.cd010315.pub2. PMID 29020435.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/cindygallopquote-426x300.jpg
×