#diabetes mellitus and obesity

[mi-bodyhealth]

6 Long Term Complications of Diabetes Mellitus

Living with Diabetes Mellitus comes with many complications which can occur even if your diabetes is well controlled. Back then diabetes was known as an endocrine disorder but these days it is widely accepted that diabetes is a vascular-metabolic disorder. This is because most of the damage done by diabetes is primarily on the small blood vessels of many organs. Complications of Diabetes are…

[aravind09]

symptoms of diabetes type 2 in adults

Diabetes is on the ascent overall and is a serious, deep rooted sickness that can prompt coronary illness, stroke, and enduring nerve, eye, and foot issues. We should examine a couple of kinds of diabetes and their disparities. What is diabetes, and where does it emerge from? Insulin is a chemical that controls how much glucose in your body and is delivered by an organ known as the pancreas. You can foster diabetes, a problem set apart by strangely high blood glucose or sugar levels, when your body produces lacking insulin or when insulin doesn't work as expected in your body.

[surinderbhalla]

Breaking Down the Complex Link Between Diabetes and Heart Disease!

Breaking down the complex link between Diabetes and Heart disease. providing valuable insights

Diabetes and heart disease, two of the most prevalent and intertwined health concerns, present formidable challenges to global well-being. Extensive research has unraveled an intricate and complex relationship between diabetes and heart disease. Brace yourself as we embark on a thrilling journey into the depths of the intricate connection between diabetes and heart disease, illuminating the…

[sweetclinics-diabetologist]

Know About That CAN TYPE 2 DIABETES TURN INTO TYPE 1?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycaemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.

More info at https://sweetclinics.com/can-type-2-diabetes-turn-into-type-1/

[joseywritesng]

Weight-loss drug, approved for adults, shows promise in children

Weight-loss drug, approved for adults, shows promise in children

November 10, 2022 — The prospect of being involved in a research program that could help her lose weight intrigued Emmalea Zummo. At age 15, the confident, energetic teenager from Jeanette, PA, weighed 250 pounds — enough to be considered obese. The trial she heard from her endocrinologist was for a drug called semaglutide. Before participating in the study, Emmalea had exhausted a reservoir of…

[crimsonpublishersobesityjourna]

Overweight and Obesity in Youth with Type 1 Diabetes: What is Known?

Abstract

Obesity is a modifiable risk factor for poor health outcomes including cardiovascular disease (CVD). A trend for elevated body weight in children with type 1 diabetes (T1D) compared to the general population is clearly evident. This trend is pronounced in teenage girls with T1D and increases with age. Teenage boys with T1D more closely resemble the population norms for overweight and obesity. Given that individuals with T1D are at an increased risk of early CVD related morbidity and mortality, early weight management intervention could potentially improve CVD outcomes. Further investigation of mechanisms of weight gain in T1D is required to inform interventions.

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[mcatmemoranda]

Doing review questions.

Hyperkalemia is a known side effect of ACE inhibitors and angiotensin receptor blockers such as olmesartan. The risk of hyperkalemia is increased with chronic kidney disease, diabetes mellitus, moderately severe to severe heart failure, NSAID use, and older adults. Chlorthalidone and hydrochlorothiazide can cause hypokalemia.

In men who are diagnosed with hypogonadism with symptoms of testosterone deficiency and unequivocally and consistently low serum testosterone concentrations, further evaluation with FSH and LH levels is advised as the initial workup to distinguish between primary and secondary hypogonadism. If secondary hypogonadism is indicated by low or inappropriately normal FSH and LH levels, prolactin and serum iron levels and measurement of total iron binding capacity are recommended to determine secondary causes of hypogonadism, with possible further evaluation to include other pituitary hormone levels and MRI of the pituitary. If primary hypogonadism is found, karyotyping may be indicated for Klinefelter’s syndrome.

Daily use of polyethylene glycol (PEG) solution has been found to be more effective than lactulose, senna, or magnesium hydroxide in head-to-head studies. Evidence does not support the use of fiber supplements in the treatment of functional constipation. No adverse effects were reported with PEG therapy at any dosing regimen. Low-dose regimens of PEG are 0.3 g/kg/day and high-dose regimens are up to 1.0–1.5 g/kg/day. Ref: Tabbers MM, DiLorenzo C, Berger MY, et al: Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014;58(2):258-274. 2) Gordon M, MacDonald JK, Parker CE, et al: Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database Syst Rev 2016;(8):CD009118. 3) Lauters R, Saguil A: Laxatives for the management of childhood constipation. Am Fam Physician 2017;96(7):433-434

Primary hyperaldosteronism should be suspected as a cause for hypertension if a patient has a spontaneously low potassium level or persistent hypertension despite the use of three or more antihypertensive medications, including a diuretic. This can be evaluated by checking a serum renin activity level and a serum aldosterone concentration and determining the aldosterone/renin ratio. Primary hyperaldosteronism typically presents with a very low serum renin activity level and an elevated serum aldosterone concentration. A 24-hour urine collection for 5-hydroxyindoleacetic acid (5-HIAA) would be used to evaluate for a neuroendocrine tumor, which can present as chronic flushing and diarrhea. Cortisol levels can be checked if Cushing syndrome is suspected. Hypertension can be present in Cushing syndrome, but it is typically associated with other signs such as obesity and an elevated blood glucose level due to insulin resistance.

Psychogenic tremor is characterized by an abrupt onset, spontaneous remission, changing characteristics, and extinction with distraction. Cerebellar tremor is an intention tremor with ipsilateral involvement on the side of the lesion. Neurologic testing will reveal past-pointing on finger-to-nose testing. CT or MRI of the head is the diagnostic test of choice. Parkinsonian tremor is noted at rest, is asymmetric, and decreases with voluntary movement. Bradykinesia, rigidity, and postural instability are generally noted. For atypical presentations a single-photon emission CT or positron emission tomography may help with the diagnosis. One of the treatment options is carbidopa/levodopa. Patients who have essential tremor have symmetric, fine tremors that may involve the hands, wrists, head, voice, or lower extremities. This may improve with ingestion of small amounts of alcohol. There is no specific diagnostic test but the tremor is treated with propranolol or primidone. Enhanced physiologic tremor is a postural tremor of low amplitude exacerbated by medication. There is usually a history of caffeine use or anxiety.

Ref: Crawford P, Zimmerman EE: Tremor: Sorting through the differential diagnosis. Am Fam Physician 2018;97(3):180-186.

I got 100% on the first quiz! :)

[another-manganime-lover]

Achieve Your Health And Fitness Goals: Unleash the Power of Muscle Mass Building

""

Are you tired of struggling to see progress in your health and fitness journey? Look no further than the transformative benefits of bodybuilding. Whether you're a physical fitness enthusiast, an athlete, or simply someone seeking to improve their body, including muscular tissue building into your routine can open a world of opportunities. Not just does muscular tissue building improve your physical appearance, but it also assists improve overall strength, endurance, and also mental well-being. In this post, we will certainly delve deeper into the significance of muscle mass structure, exploring the scientific research behind it and giving functional pointers to help you get begun on your trip towards a stronger, healthier you.Muscle structure

, additionally called resistance training or strength training, involves participating in exercises that target details muscle mass groups to promote muscle growth as well as growth. It surpasses simply raising weights; it encompasses a variety of workouts such as bodyweight movements, resistance bands, and gym machines. When you involve in bodybuilding activities, your muscles undertake microscopic damage, which sets off a procedure called muscle mass healthy protein synthesis. This procedure entails the repair work as well as restoring of muscle mass fibers, causing increased muscular tissue mass gradually. Not just does bodybuilding lead to a much more toned body, however it also plays a critical duty in improving general health and wellness. Enhanced muscle mass can aid improve metabolism, control blood sugar degrees, enhance bone density, and even reduce the threat of chronic illness such as obesity, diabetes mellitus, and heart disease. So, whether you're going for that beach-ready body or simply aiming for a much healthier way of living, including muscular tissue structure into your fitness routine is a proven method to accomplish your goals.

Read more here Go to this Link

[aasraw-mary]

5 Best peptides for Weight Loss

1 Best Peptide for Weight Loss: Semaglutide

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs. It mimics the GLP-1 hormone, released in the gut in response to eating. The Semaglutide injection works by slowing down how quickly food leaves your stomach and allows you to feel full for a longer period of time. By reducing hunger, lowering your appetite and increasing feelings of fullness, it will reduce your calorie intake and allow you to lose weight, 1-2 pounds a week.

2 Peptide for Weight Loss: Tirzepatide

Tirzepatide is a novel medication that is FDA approved for the treatment of type 2 diabetes mellitus. Given its potent weight loss properties, tirzepatide be used off-label for obesity treatment. It works as a dual GLP-1 agonist and GIP agonist to maximize similar benefits that are seen with GLP-1 medications such as semaglutide. It is currently implemented as a second-line diabetes medication, similar to GLP-1 medications, and given as a once-a-week subcutaneous injectable.

3 Peptide for Weight Loss: Liraglutide

Liraglutide, is an anti-diabetic medication used to treat type 2 diabetes, and chronic obesity. It is a second line therapy for diabetes following first-line therapy with metformin. Its effects on long-term health outcomes like heart disease and life expectancy are unclear. It is given by injection under the skin.

5 Peptide for Weight Loss: Retatrutide

Retatrutide is an agonist of the glucose-dependent insulin otropic polypeptide, glucagon-like peptide 1, and glucagon receptors. As can be expected, such a significant reduction in body weight in overweight and obese people also resulted in an improvement in blood pressure, cholesterol, and glucose parameters. 

How do Peptides for Weight loss Work?  

Most of the peptides, if not all, work via a common mechanism of action. They increase the release of Growth Hormone from the anterior pituitary gland, which leads to systemic effects. This is primarily seen in peptides used explicitly for muscle growth and endurance.  

As far as weight loss peptides are concerned, it gets pretty interesting!  

Some of these peptides work by increasing growth hormone levels. The growth hormone, in turn, targets specific sites like adipocytes and hepatocytes, causing raised cellular metabolism and fat burning.  

Besides this, most peptides also work by rapidly increasing the process of lipolysis and simultaneously inhibiting excess lipogenesis from occurring. This leads to a net loss of fat.  

A few peptides also work by regulating hormones responsible for glycemic control, like insulin and glucagon. With more insulin, glucose is transported inside the cells for energy expenditure. This subsequently aids in further weight loss.  

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[polypeptide2]

Interesting Dosages of Semaglutide between Three Brands

1. What is Semaglutide?

Semaglutide, sold under the brand names Ozempic, Wegovy and Rybelsus.Semaglutide is a synthetic derivative based on the naturally occurring GLP-1peptide, which is known for its ability to reduce blood sugar levels and enhance insulin secretion. Recent research suggests that Semaglutide may also have positive effects on heart, liver, and lung function. And it could potentially slow down or prevent the progression of Alzheimer’s disease.

2. How does Semaglutide work?

Semaglutide works as a GLP-1 agonist, meaning it mimics the effects of a hormone called glucagon-like peptide-1 (GLP-1) in the body. GLP-1 is naturally released by the intestines in response to food intake and plays a crucial role in regulating blood sugar levels and appetite.

When semaglutide is injected, it binds to and activates GLP-1 receptors on various cells in the body, including pancreatic cells. This activation leads to several beneficial effects. First, semaglutide increases insulin release from the pancreas, which helps lower blood sugar levels by facilitating the uptake of glucose into cells for energy. Increased insulin also helps to reduce the production of glucose by the liver. Second, semaglutide suppresses the release of glucagon, a hormone that raises blood sugar levels. By reducing glucagon levels, semaglutide further contributes to the overall control of blood sugar.

3. Benefits of Semaglutide

Improved blood sugar control. Semaglutide, as a GLP-1 receptor agonist, helps regulate blood sugar levels in individuals with type 2 diabetes. It stimulates insulin release from the pancreas, which leads to better glucose utilization by the body’s cells. By reducing glucagon secretion and slowing down gastric emptying, semaglutide helps lower blood sugar levels and maintain better glycemic control.

Weight loss. Semaglutide has been found to promote weight loss when used for weight management in individuals with obesity or excess weight. By suppressing appetite and inducing a feeling of fullness, it can help reduce calorie intake and contribute to sustainable weight loss when combined with a reduced-calorie diet and exercise.

Cardiovascular risk reduction. In individuals with type 2 diabetes and established cardiovascular disease, semaglutide (specifically Ozempic) has been shown to reduce the risk of major cardiovascular events like heart attack or stroke. This benefit can provide additional protection to individuals with both diabetes and cardiovascular conditions.

Potential benefits in cognition. Semaglutide has shown potential benefits in improving cognitive function, particularly in individuals with mildl cognitive impairment or mild dementia caused by Alzheimer’s disease. It has been found to protect against amyloid-ß plaques, which are associated with cognitive decline in Alzheimer’s disease. Preclinical studies and ongoing clinical trials are evaluating semaglutide’s impact onl cognitive function. Results from these trials will provide more information about semaglutide’s effectiveness in improving cognitive abilities in Alzheimer’s disease.

4. Side effects of Semaglutide

Side effects from semaglutide injection might occur. If any of these symptoms are severe or do not go away, let your doctor know right once:

Vomiting

Nausea

Diarrhea

abdominal pain

Constipation

Heartburn

Burping

5. Dosages of Semaglutide (For Type 2 Diabetes Mellitus)

(1) Ozempic (semaglutide injection):

Initial Dose: 0.25 mg subcutaneously once weekly for 4 weeks.

Maintenance Dose: After the initial 4 weeks, increase the dose to 0.5 mg subcutaneously once weekly.

Further Dose Adjustment: If glycemic control is not achieved after at least 4 weeks on the 0.5 mg dose, the dose can be increased to 1 mg once weekly.

Maximum Dose: If needed, the dose can be further increased to 2 mg once weekly, but it should not exceed 2 mg per week.

(2) Rybelsus (oral semaglutide tablets):

Initial Dose: 3 mg orally once daily for 30 days (intended for treatment initiation, not for glycemic control).

Maintenance Dose: After 30 days on the 3 mg dose, increase the dose to 7 mg orally once daily.

Further Dose Adjustment: If additional glycemic control is needed, the dose can be increased to 14 mg orally once daily.

Note: Taking two 7 mg tablets to achieve the 14 mg dose is not recommended.

(3) Switching between Ozempic and Rybelsus:

Switching from Rybelsus to Ozempic: Start with 0.5 mg subcutaneously once weekly on the day after the last Rybelsus dose.

Switching from Ozempic to Rybelsus: Start with 7 mg or 14 mg orally once daily, up to 7 days after the last Ozempic injection. There is no equivalent oral dose for the 1 mg Ozempic dose.

[do-foryou]

Amiclear Review - Does Amiclear Really Work? – CAUTION - Amiclear Review...

✅👉🏻 Official Site: https://cutt.ly/amiclearofficial_2023 ✅👉🏻 Official Site: https://cutt.ly/amiclearofficial_2023 ✅Amiclear Review - Does Amiclear Really Work? – CAUTION - Amiclear Reviews 2023. ✅Amiclear Reviews – (Honest Update!) Is It Legit or Waste of Money? Real Results. Amiclear Reviews – Amiclear is an all-natural blood sugar support formula developed by Jeffrey Mitchell that consists of 8 clinically-proven ingredients to support the health of blood sugar. ✅👉🏻Official Website: https://cutt.ly/amiclearofficial_2023 ✅What is Exactly Amiclear? AmiClear is a new blood sugar-supporting supplement made with carefully taken high-quality ingredients to focus on effectively healthy glucose levels and natural weight loss. ✅Powerful Ingredients present in AmiClear: Amiclear is a natural formula with an excellent variety of 8 clinically-proven ingredients supporting healthy blood sugar and weight loss. Inside every Amiclear drop, you’ll find the qualities of each component listed below: Maca Root: Maca root includes more than 50 phytochemicals, including vitamins and zinc. This extract has a high fiber content that regulates blood sugar and even encourages rapid weight loss. It is also well-recognized for regulating the thyroid, which lowers cholesterol, balances blood sugar, and improves memory. Guarana: Guarana contains abundant Caffeine, which aids in turning blood sugar into energy. This extract encourages balanced metabolic activity, which aids in maintaining overall body management. It lessens the symptoms that lead to diabetes and obesity. Even treating anxiety disorders is one of the many uses for natural extract. Grape Seeds: You can regulate your blood sugar levels by eating grape seeds. As a result, this extract aids in keeping your heart health in better shape. It lessens the amount of insulin your body secretes, which is necessary to keep your sugar levels in check. African Mango: African mango can assist in normalizing erythrocyte membrane ATPase activity and lowering blood glucose levels. It also functions in your body as a fat-burning agent. According to the study, this extraction may aid those with diabetes mellitus lower their glucose and blood sugar levels. Ginseng: Ginseng maintains healthy blood glucose levels by drastically lowering fasting blood glucose. It might improve the function of pancreatic beta cells and others by reducing insulin resistance. This extract raises your immunity, which aids in the battle against sickness. Copper: Copper is essential for preventing insulin resistance and maintaining stable blood sugar levels. It lessens inflammation and encourages slow internal and external healing. Although copper deficiency can cause glucose intolerance, this only happens when glucose or fructose are fed simultaneously. Astragalus: The astragalus root dual-directionally regulates blood sugar levels. It can lower blood glucose and type IV collagen levels while repairing the degenerative kidney damage that results from diabetes. This extract keeps the longevity agent and heart in good condition. ✅👉🏻Official Website: https://cutt.ly/amiclearofficial_2023 ✅How About The Cost? You can purchase this supplement on the official page only; you only need to make a single payment to purchase Amiclear. To take advantage of this product, no additional charges in the future are required. This website has excellent security. To safeguard the confidentiality and security of your information, we employ state-of-the-art technologies (such SSLs). 1 Bottle of AmiClear is just $69 + YOU SAVE $110 3 Bottles of AmiClear are just $59 + YOU SAVE $360 6 Bottles of AmiClear are just $49 + YOU SAVE $780 ✅👉🏻Official Website: https://cutt.ly/amiclearofficial_2023 Amiclear Review - Does Amiclear Really Work? – CAUTION - Amiclear Reviews 2023. Amiclear Review - Does Amiclear Really Work? – CAUTION - Amiclear Reviews 2023. Amiclear Review - Does Amiclear Really Work? – CAUTION - Amiclear Reviews 2023. amiclear,amiclear review,amiclear 2023,amiclear drop,amiclear side effects,buy amiclear,amiclear reviews,amiclear works,amiclear supplement,amiclear drop reviews,amiclear 2022,order amiclear,amiclear drop side effects,amiclear drop review,amiclear result,amiclear honest review,does amiclear work,amiclear is good,amiclear drop cons,amiclear drop price,order amiclear drop,amiclear drop honest reviews,amiclear review 2022,amiclear ingredients diabet,diabet zaharat,consultatii diabet,diabet tip 1,diabet tip 2,consultatii online diabet,dieta diabet,simptome diabet,diabetes,diabetul,alimentatie diabet,#diabetes,şəkərli diabet,tipuri de diabet,diabet nutritie,tratament diabet,cum scap de diabet,vindecare diabet,ce mananc in diabet,vindeca diabetul,diabet alimentatie,diabet zaharat tip 1,diabet zaharat tip 2,complicatii diabet,#diabet,am diabet,ce pot manca in diabet #amiclear #amiclearreview #amiclearreviewsMostrar menos

[drsaggubariatricsurgeon]

Why is Weight Loss Treatment Required?

Weight gain has a direct impact on the heart and respiratory systems. When the heart is forced to pump with more effort and across a broader region, it weakens. This will result in a heart attack at a relatively young age. Cholesterol deposition reduces the lumen of blood arteries, resulting in elevated blood pressure (Hypertension). Because of arterial obstruction in these individuals, the risk of vascular events such as heart attack and stroke is quite significant. When compared to those of normal weight, the need for coronary angioplasty and cardiac bypass is three to four times greater. Obesity also causes sleep abnormalities and respiratory issues known as sleep apnea. Excess fat damages the pancreas and creates insulin resistance. As a consequence, blood sugar levels rise (diabetes mellitus). Increased weight harms joints and bones, resulting in early arthritis and the need for joint replacements. The polycystic ovarian illness affects women who have excess body fat (PCOD). It is a major cause of infertility and is usually reversible if the individual reduces weight. Loss of body image is a major component of mental illnesses such as depression. Morbidly obese people find it difficult to move around and use common facilities, commute, and seeing the response of society at the sight of the morbidly obsessed person puts them down.

If you are looking for weight loss, Consult Dr. Sukhvinder Singh Saggu one of the best weight loss surgeon in Delhi.

[joseywritesng]

Genetic 'taste score' could help us eat healthier and reduce disease risk

Genetic ‘taste score’ could help us eat healthier and reduce disease risk

June 29, 2022 – Addicted to cookies? Can’t stand broccoli? You may be able to blame Mom and Dad. That’s because our taste preferences are influenced by our genes. And this may play an important role in shaping our food choices and, in turn, our health, according to early research findings presented at this year’s annual meeting of the American Society for Nutrition. “Our genetic predisposition to…

[crimsonpublishersobesityjourna]

What is the Relationship Between Diabetes and Obesity from an Energy Perspective?

If we review what is in the medical literature, most studies say that type 2 diabetes comes from hormonal and metabolic imbalances generated by the obese patient. According to the article written by Nguyen (2010) entitled Relationship Between Obesity and Diabetes in a US Adult Population: Findings from the National Health and Nutrition Examination Survey, 1999-2006, the prevalence of diabetes increases with high weight classes. But only half of the diabetes adults’ patients were considered obese. In this article, he is suggesting that weight loss is an important aim nowadays to reduce the impact of diabetes in the health care system [1]. The author will write this article according to Hippocrates (460 bce - 375 bce), father of Medicine, who said that we should follow older medicines, before current medical practice. So, the doctor will explain this theme according to the teachings of traditional Chinese medicine [2]. If we look at the article written by Huang [3] entitled Why Are Diabetic Patients Still Having Hyperglycemia Despite Diet Regulation, Antiglycemic Medication and Insulin? and if we look at the energy alterations of obese patients, published by Huang [3] in an article entitled Energy Alterations in Obese Patients, if we look at it from the point of view of traditional Chinese medicine, which exists for more than 5,000 years, we can observe that what the two diseases have in common are energy imbalances or deficiencies in the five internal massive organs [4,5]. According to some studies presented by Huang at the Acupuncture Research Conference, that was held at the Harvard Medical School, in Boston, in 2015, the author demonstrates in her study that the treatment of the imbalance of Yin, Yang, Qi and Blood energy (which are the basis of all traditional Chinese medicine reasoning), can treat all of the individual’s physical and emotional pathologies at the same time, even if the doctor does not know that the patient has such a symptom or illness [6].

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[dr-smita-goel-homeopathy-clinic]

*Dr. Smita Goel Homeopathy Clinic*

Hyperhidrosis, also known as polyhidrosis or sudorrhea, is a condition characterized by excessive sweating. The sweating can affect just one specific area or the whole body.

Although not life-threatening, it can be uncomfortable and cause embarrassment and psychological trauma.

In this article, we will look at the causes, symptoms, diagnosis, and treatment of hyperhidrosis.

Fast facts on hyperhidrosis

Here are some key points about hyperhidrosis. More detail and supporting information is in the main article.

• Hyperhidrosis tends to begin during adolescence

• An estimated 15.6 million people have hyperhidrosis

• Most commonly, the feet, hands, face, and armpits are affected

• There are a number of remedies that can reduce symptoms

What is hyperhidrosis?

The excessive sweating associated with hyperhidrosis is normally most active in the hands, feet, armpits, and the groin because of their relatively high concentration of sweat glands.

• Focal hyperhidrosis: When the excessive sweating is localized. For example, palmoplantar hyperhidrosis is excessive sweating of the palms and soles.

• Generalized hyperhidrosis: Excessive sweating affects the entire body.

Hyperhidrosis may be present from birth or might develop later in life. However, most cases of excessive sweating tend to start during a person's teenage years.

The condition can be due to an underlying health condition, or have no apparent cause:

• Primary idiopathic hyperhidrosis: "Idiopathic" means "of unknown cause." In the majority of cases, the hyperhidrosis is localized.

• Secondary hyperhidrosis: The person sweats too much because of an underlying health condition, such as obesity, gout, menopause, a tumor, mercury poisoning, diabetes mellitus, or hyperthyroidism (overactive thyroid gland).

According to the International Hyperhidrosis Association, approximately 2.8 percent of Americans are affected by hyperhidrosis; that's around 7.8 million people.

For some, hyperhidrosis symptoms are so severe that it becomes embarrassing, causing discomfort and anxiety. The patient's career choices, free time activities, personal relationships, self-image, and emotional well-being may be affected.

Fortunately, there are several options which can treat symptoms effectively. The biggest challenge in treating hyperhidrosis is the significant number of people who do not seek medical advice, either due to embarrassment or because they do not know that effective treatment exists.

Symptoms

Hyperhidrosis is defined as sweating that disrupts normal activities. Episodes of excessive sweating occur at least once a week for no clear reason and have an effect on social life or daily activities.

Signs and symptoms of hyperhidrosis may include:

• Clammy or wet palms of the hands

• Clammy or wet soles of the feet

• Frequent sweating

• Noticeable sweating that soaks through clothing

People with hyperhidrosis might experience the following:

• Irritating and painful skin problems, such as fungal or bacterial infections

• Worrying about having stained clothing

• Reluctant to make physical contact

• Self-conscious

• Socially withdrawn, sometimes leading to depression

• Select employment where physical contact or human interaction is not a job requirement

• Spend a large amount of time each day dealing with sweat, such as changing clothes, wiping, placing napkins or pads under the arms, washing, wearing bulky, or dark clothes

• Worry more than other people about body odor

Experts are not certain why, but excessive sweating during sleep is not common for people with primary hyperhidrosis (the type not linked to any underlying medical condition).

Causes of primary hyperhidrosis

People used to think that primary hyperhidrosis was linked to the patient's mental and emotional state, that the condition was psychological and only affected stressed, anxious, or nervous individuals.

However, recent research has demonstrated that individuals with primary hyperhidrosis are no more prone to feelings of anxiety, nervousness, or emotional stress than the rest of the population when exposed to the same triggers.

In fact, it is the other way round - the emotional and mental feelings experienced by many patients with hyperhidrosis are because of the excessive sweating.

Studies have also shown that certain genes play a role in hyperhidrosis, making it look more likely that it could be inherited. The majority of patients with primary hyperhidrosis have a sibling or parent with the condition.

Causes of secondary hyperhidrosis

• Spinal cord injury

• Alcohol abuse

• Anxiety

• Diabetes

• Gout

• Heart disease

• Hyperthyroidism - an overactive thyroid gland

• Obesity

• Parkinson's disease

• Pregnancy

• Respiratory failure

• Shingles

• Some cancers, such as Hodgkin's disease

• Some infections - HIV, malaria, TB (tuberculosis)

• Some medications, including some antidepressants, anticholinesterases (for Alzheimer's disease), pilocarpine (for glaucoma), propranolol (for high blood pressure)

• Substance abuse

Natural remedies

Some alterations in daily activity and lifestyle may help improve symptoms:

• Antiperspirants - deodorants do not stop sweating, but antiperspirants sprays do. Some prescription antiperspirants include aluminum chloride, which plugs the sweat glands.

• Armpit shields - pads worn in the armpit to protect a garment from perspiration.

• Clothing - certain synthetic fibers, such as nylon, may worsen symptoms. Loose clothing is better.

• Shoes - synthetic materials are more likely to worsen symptoms. Natural materials, such as leather, are recommended.

• Socks - some socks are better at absorbing moisture, such as thick, soft ones made of natural fibers.

If these measures are not effective, medical treatment may help.

Antiperspirants and armpit shields are available to purchase online.

Complications

If hyperhidrosis is not treated, it can lead to complications.

• Nail infections: Especially toenail infections.

• Warts: Skin growths caused by the HPV (human papillomavirus).

• Bacterial infections: Especially around hair follicles and between the toes.

• Heat rash (prickly heat, miliaria): An itchy, red skin rash that often causes a stinging or prickling sensation. Heat rash develops when sweat ducts become blocked and perspiration is trapped under the skin.

• Psychological impact: Excessive sweating can affect the patient's self-confidence, job, and relationships. Some individuals may become anxious, emotionally stressed, socially withdrawn, and even depressed.

On average, a person with hyperhidrosis seeks medical help after living with the condition for 9 years. It is important to spread the word that the symptoms of excessive sweating can be effectively treated.

[mcatmemoranda]

Patient is a [ ] yo male/female presenting to the clinic for a preoperative evaluation.

Procedure [ ]

Scheduled date of procedure [ ]

Surgeon performing procedure requesting consultation for preop is [ ] and can be contacted at [ ]

This patient is/is not medically optimized for the planned surgery, see below for details.

EKG collected in office, interpreted personally and under the direct supervision of attending physician as follows- sinus rate and rhythm, no evidence of ischemia or ST abnormalities, no blocks, normal QTc interval.

The following labs are to be completed prior to surgery, and will be evaluated upon completion. Procedure is to be performed as scheduled barring any extraordinary laboratory derangements of concern.

Current medication list has been thoroughly reviewed and should not interfere with surgery as written.

Patient has no prior history of adverse reactions to anesthesia, problems with airway management, difficult IV access, prolonged emergence, or postoperative nausea/vomiting.

Airway Mallampati score: This patient is a Grade based on the criteria listed below

-Grade I Tonsillar pillars, soft palate, entire uvula

-Grade II Tonsillar pillars, soft palate, part of uvula

-Grade III Soft palate, base of uvula

-Grade IV Hard palate only, no uvula visualized

Patient is a low/medium/high risk for this low/medium/high risk surgical procedure.

Will send documentation of this preoperative visit to surgeon [ ].

**** ADDITIONAL INFORMATION****

Patient Risk for Elective Surgical Procedure as Determined with the Criteria Below:

1- Very Low Risk

No known medical problems

2- Low Risk

Hypertension

Hyperlipidemia

Asthma

Other chronic, stable medical condition without significant functional impairment

3- Intermediate Risk

Age 70 or older

Non-insulin dependent diabetes

History of treated, stable CAD

Morbid obesity (BMI > 30)

Anemia (hemoglobin < 10)

Mild renal insufficiency

4- High Risk

-Chronic CHF

-Insulin-dependent diabetes mellitus

-Renal insufficiency: creatinine > 2

-Moderate COPD: FEV1 50% to 70%

-Obstructive sleep apnea

-History of stroke or TIA

-Known diagnosis of dementia

-Chronic pain syndrome

5- Very High Risk

-Unstable or severe cardiac disease

-Severe COPD: FEV1 < 50% predicted

-Use of home oxygen

-Pulmonary hypertension

-Severe liver disease

-Severe frailty; physical incapacitation

Surgical Risk Score Determined as Below:

1- Very Low Risk

Procedures that usually require only minimal or moderate sedation and have few physiologic effects

-Eye surgery

-GI endoscopy (without stents)

-Dental procedures

2- Low Risk

Procedures associated with minimal physiologic effect

-Hernia repair

-ENT procedures without planned flap or neck dissection

-Diagnostic cardiac catheterization

-Interventional radiology

-GI endoscopy with stent placement

-Cystoscopy

3- Intermediate Risk

Procedures associated with moderate changes in hemodynamics, risk of blood loss

-Intracranial and spine surgery

-Gynecologic and urologic surgery

-Intra-abdominal surgery without bowel resection

-Intra-thoracic surgery without lung resection

-Cardiac catheterization procedures including electrophysiology studies, ablations, AICD, pacemaker

4- High Risk

Procedures with possible significant effect on hemodynamics, blood loss

-Colorectal surgery with bowel resection

-Kidney transplant

-Major joint replacement (shoulder, knee, and hip)

-Open radical prostatectomy, cystectomy

-Major oncologic general surgery or gynecologic surgery

-Major oncologic head and neck surgery

5- Very High Risk

Procedures with major impact on hemodynamics, fluid shifts, possible major blood loss:

-Aortic surgery

-Cardiac surgery

-Intra-thoracic procedures with lung resection

-Major transplant surgery (heart, lung, liver)

High risk surgery: yes/no

Hx of ischemic heart disease: y/n

Hx of CHF: y/n

Hx of CVA/TIA: y/n

Pre-op tx with insulin: y/n

DM/how are blood sugars?

Pre-op Cr >2mg: y/n

OTHER EVALUATIONS BASED OFF PATIENT HISTORY SEE BELOW:

1. CARDIAC EVALUATION

A. Ischemic Cardiac Risk- Describe any history of cardiovascular disease and list the cardiologist/electrophysiologist. For CAD, report the results of the most recent stress test or cardiac cath, type of procedures or type of stents, date of MI, and recommendations for perioperative management. Include antiplatelet management. Continue baby aspirin for patients with cardiac stents - unless having neurosurgery, then coordinate with surgeon.

B. Ventricular function - include most recent echocardiogram evaluation ideally performed within the past 2 years

C. Valvular heart disease- include most recent echocardiogram, type of prosthetic valve

D. Arrhythmias - include any implanted devices and recent interrogation report, contact electrophysiology about device management during the surgery and include recommendations provided. For A-Fib, include CHA2DS2-VASc score

E. Beta blockade - All patients on chronic beta blockers should have these medications continue throughout the perioperative period unless there is a specifically documented contraindication.

F. Hypertension - Other than for cataract surgery, ACEI inhibitors and ARBs should be held for 24hours prior to surgery and diuretics should be held the morning of surgery

G. Vascular disease - include antiplatelet management and dates of strokes

2. PULMONARY EVALUATION

A. COPD/Asthma - include any recent exacerbations, intubations, chronic O2 use, amount of rescue inhaler use

B. OSA risk - STOPBANG score - address severity of sleep apnea and CPAP use

3. HEMATOLOGIC EVALUATION

A. Bleeding Risk - assess the bleeding risk and history for every patient

B. VTE Prophylaxis/Thrombotic risk - estimate risk and provide recommendations

C. Anticoagulation management - include pre-op and post-op medication instructions

D. Anemia - pre-op treatment plan

D. Oncology - history and treatments

4. ENDOCRINE EVALUATION

A. Diabetes mellitus - include type, medication use, recent A1c, pre-op and post-op management instructions

B. Adrenal insufficiency risk - assess for prolonged steroid use in the last year

5. RENAL EVALUATION

A. CKD - include stage, baseline labs

B. ESRD - include dialysis schedule, type, access, dry weight, location of dialysis. Generally, surgery should not be scheduled on a dialysis day.

C. Electrolyte abnormalities

6. GI EVALUATION

A. Liver disease - including MELD score and Child-Pugh classification

7. OTHER relevant comorbidities or anesthesia considerations

[substance abuse, chronic pain, delirium risk, PONV (post-operative nausea and vomiting) risk, psych disorders, neurologic disorders, infectious disease, etc.]