Diabetes
Judy Bothamley, Maureen Boyle in Medical Conditions Affecting Pregnancy and Childbirth, 2020
Type 1 diabetes is caused by a lack of insulin. The most common reason for Type 1 diabetes is the autoimmune destruction of the beta cells. Genetic and environmental factors are thought to influence susceptibility10. Type 1 diabetes usually develops in a younger age group, and pregnant women with Type 1 diabetes may have managed their condition for a number of years. Symptoms of undiagnosed Type 1 diabetes can be severe and have a sudden onset. Without insulin the cells cannot utilise available glucose, and blood sugar levels rise. High blood glucose levels pass into the kidneys and filter into the urine (glycosuria). Glucose pulls water after it, resulting in polyuria (excess urination) and consequently dehydration and loss of electrolytes. Thirst increases to maintain body fluids. Weight loss occurs as the body tries to mobilise energy from fats and protein. The breakdown of body fat causes an excess production of ketone bodies. These are acidic, and when they accumulate in the blood, the pH drops, causing ketoacidosis11. Diabetes is treated by using insulin injections to control blood glucose levels to within the normal range. Adjustments to doses of insulin are made according to carbohydrate intake and levels of activity. The changes to carbohydrate metabolism in pregnancy present a challenge to women with Type 1 diabetes to maintain their normal blood sugars. There are a number of acute and long-term complications of Type 1 diabetes including the risk of hypoglycaemia, hyperglycaemia (leading to ketoacidosis) and damage to blood vessels.
Diabetes mellitus
Judy Bothamley, Maureen Boyle in Medical Conditions Affecting Pregnancy and Childbirth, 2020
Type 1 diabetes is caused by a lack of insulin. The most common reason for Type 1 diabetes is the autoimmune destruction of the beta cells. Genetic and environmental factors are thought to influence susceptibility (Williams and Pickup, 2004). Type 1 diabetes usually develops in a younger age group and pregnant women with Type 1 diabetes may have managed their condition for a number of years. Symptoms of undiagnosed Type 1 diabetes can be severe and have a sudden onset. Without insulin the cells cannot utilise available glucose and blood sugar levels rise. High blood glucose levels pass into the kidneys and filter into the urine (glycosuria). Glucose pulls water after it, resulting in polyuria and dehydration. Thirst increases to maintain body fluids. Weight loss occurs as the body tries to mobilise energy from fats and protein. The breakdown of body fat causes an excess production of ketone bodies. These are acidic and when they accumulate in the blood, the pH drops, causing ketoacidosis (Waugh and Grant, 2006). Diabetes is treated by using insulin injections to control blood glucose levels to within the normal range and eating a diet containing a controlled amount of carbohydrates. The changes to carbohydrate metabolism in pregnancy present a challenge to women with Type 1 diabetes to maintain their normal blood sugars.
Integrating Homeopathy in Mainstream Medicine: Homeopathy in Cancer Management
Anne George, Snigdha S. Babu, M. P. Ajithkumar, Sabu Thomas in Holistic Healthcare. Volume 2: Possibilities and Challenges, 2019
Takes food in gruel form; due to difficulty in swallowing and choking; no regurgitation of food. Cravings: tea++, warm drinks and food++, but now aggravates pain in throat, ice cream+. Thirst: decreased, takes 1-2 glasses of water in a day. Addictions: heavy smoker but stopped for the last 5 years. Perspiration: nothing significant. Urination: 4-5 times during day, 1 or 2 times at night. Stools: daily evacuation, flatulence, occasional constipation. Chilly: needs thick covering and sleeps with head wrapped; intolerance for draught of air. Dreams of dead relatives and colleagues who used to work in his office; fear of operation; anxiety about disease being incurable, and about the family members mainly wife and daughter; fear of disfigurement and disability; fear of injection needles; fear of injuries; fear of after effects of radiation burns; and after effects of chemotherapy.
‘Drink clean, safe water and/or other fluids through-out the day even if you do not feel thirsty’: a food-based dietary guideline for the elderly in South Africa
Published in South African Journal of Clinical Nutrition, 2021
Upasana Mukherjee, Carin Napier, Wilna Oldewage-Theron
Dehydration is very common among the elderly. Mortality rates due to dehydration and hyponatremia among older adults are more than 40% as reported by a systematic review.20 The changes in the physiological and hormonal systems of the body, along with other risk factors like immobility, visual impairment, incontinence and all other age-related comorbidities, like Alzheimer’s disease and osmotic disturbances due to diabetes, make the elderly prone to dehydration.10,21 In addition, total body water and the buffering capacity of the stored water are reduced.2 Various factors affect water intake; for example, impaired mobility can reduce access to water and fluids, especially in elderly individuals living alone. Furthermore, reduced thirst and impaired kidney functions also add to lower intakes of fluids. Drinking or eating in greater amounts may also be difficult for the elderly due to swallowing problems or simply not feeling hungry or thirsty.13 Oropharyngeal dysphagia (OD) may also be the result of the natural ageing process (presbyphagia) and is characterised by an inability or difficulty in swallowing foods and fluids. This may also result in the elderly becoming dehydrated and malnourished due to a lack of fluid and food intake.22
Heat strain in children during unstructured outdoor physical activity in a continental summer climate
Published in Temperature, 2021
Gregory W. McGarr, Samah Saci, Kelli E. King, Serena Topshee, Brodie J. Richards, Mohamed R. Gemae, Emma R. McCourt, Glen P. Kenny
Although most of the children (78%) started testing in a euhydrated state, only 28% remained so by the end of free play. This pattern is consistent with observations in adult workers performing physically demanding jobs (e.g. mining, electric utilities) wherein the majority were severely hypohydrated by the end of a day-long work shift [27]. Elevated hypohydration states are not uncommon in exercising children who do not always adequately replenish fluids during prolonged physical activity in the heat [28]. The children reported mean thirst sensation scores of 5 (“Moderately Thirsty”) and average peak scores of 7 (“Very Thirsty”) during free play, with 44% reporting maximal scores of 9 (“Very, very thirsty”). Although the children clearly perceived elevated levels of thirst, they only drank 61% of the available water on average (200 ml/hr), with only one child drinking the full amount. This may be due to the majority of children not asking for water in the first hour of testing. While some children stated a preference for more water during the latter half of testing, several commented that they did not like the temperature of the water provided (maintained at 37°C to avoid confounding influences on Tco), with some opting not to drink at times for this reason. The observation that some children prioritized palatability over rehydration at times is consistent with prior work showing that adding grape flavoring to water reduced voluntary dehydration in children exercising in the heat over unflavored water, which was further reduced with the addition of carbohydrates and salt [29].
Adequacy of Daily Fluid Intake Volume Can Be Identified From Urinary Frequency and Perceived Thirst in Healthy Adults
Published in Journal of the American College of Nutrition, 2020
Matthew A. Tucker, Aaron R. Caldwell, Matthew S. Ganio
A potential limitation of using thirst in the present study as a method of classifying hydration status from the ROC analysis is that we used an average value of the serial measures collected with each micturition over 24 hours. Thus, within a given day, thirst may fluctuate considerably depending on factors such as dietary intake and physical activity level (24–26), making it more difficult for an individual to identify whether they are thirsty due to inadequate DFI. In addition, previous work has demonstrated the potential for habitual daily fluid intake behavior to influence thirst perception, independent of the volume of fluid consumed (60). Across the four trials, intra-individual coefficients of variation were within a similar range (34% ± 20%, 45% ± 30%, 29% ± 19%, and 32% ± 37%), and also similar to what others have reported for serial measures of other urinary hydration markers such as Uosm and color (45, 61). Given that our study design limited physical activity over the observation period and dietary intake remained consistent for each trial, further studies are needed to clarify the utility of perceived thirst as a method of identifying inadequate DFI and hydration status, particularly with consideration for individuals’ habitual fluid intake.
Related Knowledge Centers
- Dehydration
- Diabetes
- Osmolyte
- Sodium
- Polydipsia
- Polyuria
- Brain
- Kidney
- Drinking
- Fluid Balance