Internal Medicine

Dr. Ankit Vyas

Dr. Ankit Vyas

MBBS, MD (Medicine), Physician

Fellowship Austria Europe

Diabetology Conventry (UK)

Ex-Senior Resident Medanta Hospital, Gurgaon

     

Internal medicine or general medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Internal medicine covers a wide range of conditions affecting the internal organs of the body – the heart, the lungs, the liver and gastro-intestinal tract, the kidneys and urinary tract, the brain, spinal column, nerves, muscles and joints. Although some diseases specifically affect individual organs, the majority of common diseases – arteriosclerosis, diabetes, high blood pressure and cancer may affect many internal organs of the body.

Diabetes

diabetes-img

Diabetes is a group of metabolic diseases characterized by high blood sugar (glucose) levels that result from defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes was first identified as a disease associated with “sweet urine,” and excessive muscle loss in the ancient world. the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty and hungry.

Symptoms of diabetes include:

  • Increased Urine Output
  • Excessive Thirst
  • Weight Loss
  • Hunger
  • Fatigue
  • Skin Problems
  • Slow Healing Wounds
  • Yeast Infection
  • Blurred Vision
  • Tingling or numbness in the feet or toes.

 

Diabetes Diagnostic
Condition 2 hour glucose Fasting glucose HbA1c
Unit mmol/l(mg/dl) mmol/l(mg/dl) mmol/mol DCCT %
Normal <7.8 (<140) <6.1 (<110) <42 <6.0
Impaired Fasting Glycaemia <7.8 (<140) ≥6.1(≥110) & <7.0(<126) 42-46 6.0–6.4
Impaired Glucose Tolerance ≥7.8 (≥140) <7.0 (<126) 42-46 6.0–6.4
Diabetes Mellitus ≥11.1 (≥200) ≥7.0 (≥126) ≥48 ≥6.5

 

Type 1 diabetestype-1-diabetes-img

Type 1 diabetes is usually diagnosed in children and young adults. In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body.

Insulin Therapy

A person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the “key” bringing glucose to the body’s cells.

The challenge with this treatment is that it’s often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

  • Food
  • Exercise
  • Stress
  • Emotions and general health

Type 2 diabetes

The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin. Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight.  Approximately 90% of all cases of diabetes worldwide are of this type

Gestational Diabetes

Gestational Diabetes affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.

The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth.

Hypertensionhypertension-img

Hypertension is a major public health problem. High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history

Hypertension is defined as having a blood pressure higher than 140 over 90 mmHg, with a consensus across medical guideline

The following ranges of blood pressure (in mmHg):

  • Normal blood pressure is below 120systolic and below 80 diastolic
  • Prehypertension is 120-139systolic or 80-89 diastolic
  • Stage 1 high blood pressure (hypertension) is 140-159systolic or 90-99 diastolic
  • Stage 2 high blood pressure (hypertension) is 160or higher systolic or 100 or higher diastolic
  • Hypertensive crisis (a medical emergency) is when blood pressure is above 180systolic or above 110

Rare High Blood Pressure Symptoms

Sometime people with chronic high blood pressure might have symptoms such as:

  • Dull Headaches
  • Dizzy Spells
  • Frequent Nosebleeds

Emergency High Blood Pressure Symptoms

When symptoms do occur, it is usually only when blood pressure spikes suddenly and extremely enough to be considered a medical emergency.

  • Severe Headache
  • Severe Anxiety
  • Shortness of Breath
  • Nosebleed