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Type I diabetes is caused by a loss or malfunction of the insulin producing cells, called pancreatic beta cells. Damage to pancreatic beta cells results in an absence or insufficient production of insulin produced by the body. Most cases of type I diabetes have an autoimmune basis, and the immune system mistakenly attacks and destroys beta cells. Since insulin is necessary to sustain life, the missing insulin has to be replaced. The replacement insulin is administered by injection using a syringe or an insulin pump, which delivers the insulin subcutaneously.

From：https://dtc.ucsf.edu/

There are multiple theories about the underlying causes of type I diabetes, including autoimmunity, virus infection, susceptibility genes and environmental factors.

Type I diabetes have two subtypes: type 1A and type 1B. Type 1A diabetes is induced by autoimmune deficiency of pancreatic beta cells. This process generally occurs to individuals with genetic susceptibility, which might be caused by one or a few environmental factors, and usually develops within months or years, during which time the individual might have no symptoms and stay at normal blood sugar levels. Different from type 1A diabetes, type 1B diabetes is an unusual form of phenotypic type I diabetes with almost complete insulin deficiency but no evidence of autoimmunity, and is mainly reported in Africa and Asia.

https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547038/all/Diagnosis_and_Classification_of_Diabetes

You have Type II diabetes if your tissues are resistant to insulin, and also you lack enough insulin to overcome this resistance. Type II diabetes is the most common form of the worldwide diabetes and accounts for 90-95% of cases. Your risk of type II diabetes typically increases when you are being older, being less active physically, and being overweight or obese. Because there is a wide range of genetic causes, there is varies how patients will respond to the treatments. Some may be easily treated with just a change in diet, and others may need multiple types of medication.

From: What is Type 2 Diabetes?

Insulin resistance in type II diabetes means the signal insulin gives to a cell is weakened. This results in less glucose uptake by muscle and fat cells and a reduction in insulin mediated activities inside cells. Besides this problem of resistance, there is additional defect in insulin production and secretion by the insulin producing cells, the pancreatic beta cells.

Although both type I and II diabetes are serious conditions, as high blood glucose levels can lead to serious health complications in either of them, they have different mechanisms and you need to take the right steps for diabetic management.

In terms of Type I diabetes, your body attacks the pancreatic beta cells to completely destroy their insulin production ability, and the symptoms appear more quickly. To manage it, you need to take exogenous insulin for blood sugar control. Currently, there is no cure for Type I diabetes, but research is still going on.

Type II diabetes means an inadequate amount of insulin produced by and an inappropriate way of insulin function in the human body. There are risk factors such as weight and ethnicity that can contribute to the Type II diabetes. Compared to Type I diabetes, Type II diabetes has slower rates of symptom appearance, and you can manage Type II diabetes in more ways than Type I, including medication, exercise and diet. Though also lacking a current possibility of being cured, prevention and remission of Type II diabetes is possible according to recent studies.

From: www.diabetes.org.uk

Chronic complications, i.e. long-term problems with gradual development which can cause serious consequences without being taken care of, include retinopathy (affecting eyesight), foot problems (damaged circulation and slower healing rates of sores and cuts in the feet), heart attack and stroke (damaged blood vessels), nephropathy (as it becomes more difficult to clear extra fluid and waste from your body), and neuropathy (as it becomes more difficult to carry messages between the brain and every part of your body, thus affecting sensation and motion).

There are also acute complications that can happen at any time and may lead to chronic complications, including hyperosmolar hyperglycaemic state (HHS), which is brought on by severe dehydration and very high blood sugars; and diabetic ketoacidosis (DKA), which is a life-threatening emergency as insulin insufficiency and high blood sugars lead to a ketone build-up.

As diabetic complications are affecting every part of your body and are inevitable, you need to reduce your risk of developing complications via good blood sugar, blood pressure and blood fat controls.

From: https://www.diabetes.org.uk/

Overall principle:

Control overall calories uptake and balance multiple nutrition contents.

Ultimate goal:

Maintain ideal blood sugar levels; reduce cardiovascular risk factors, such as abnormal blood fat and hypertension; provide diet with balanced nutrition contents; and maintain reasonable body weight.

Detailed methods:

Take more healthy carbohydrates, including fruits, vegetables, whole grains, beans and low-fat milk;

No more than 20g (2 spoons) oil or fat per day;

Limit food of high saturated fatty acids or cholesterol level, such as fatty meat or egg yolk, and less than 300mg cholesterol uptake per day;

Have 2-4 times of fish every week, but fried fish is not suggested;

Limit food of high calories and low nutrition contents.

Daily uptake of salt should be no more than 5-6g, especially for hypertension patients;

Both alcohol and tobacco use should be prevented, especially for pregnant women, children and adolescents.

The cardiovascular system can be thought of as the transport system of the body. This system has three major components: the heart, the blood vessels and the blood. The heart, located in the middle of the chest between the two lungs, is to pump blood around the body. Blood vessels are tubes carrying blood: the veins carry blood back to the heart from the body, and the arteries carry blood out of the heart to the body. Microscopic blood vessels called capillaries connect arteries and veins together, and the heart has a few main blood vessels connecting different chambers.

Reference:

https://healthengine.com.au/info/cardiovascular-system-heart

Cardiovascular diseases are the leading causes of death in the U.S. There are different types of cardiovascular diseases with various causes.

Arrhythmia - abnormal heart rhythms that can bring on an uneven heartbeat or a heartbeat that is either too slow or too fast.

Aorta disease - Aorta is the large artery that leaves your heart and brings oxygen-rich blood to the rest of your body, and can widen or tear, which raises the chance of atherosclerosis (hardened arteries), high blood pressure, connective tissue disorders and injury.

Cardiomyopathy - some people have heart muscle disease and their hearts are unusually big, thick or stiff. Their hearts can’t pump blood as well as they should. Without treatment, cardiomyopathy can lead to heart failure and abnormal heart rhythms.

Coronary artery disease - is the narrowing or blockage of the coronary arteries. Also known as atherosclerosis.

Heart failure - it means your heart doesn’t pump as strongly as it should.

Reference:

https://www.webmd.com/heart-disease/guide/diseases-cardiovascular

Coronary heart disease (CHD): CHD can cause angina, which may be felt as squeezing, pressure, burning, aching and tightening across the chest. CHD can also lead to shortness of breath. If the heart does not receive enough oxygen, any form of exertion can become very tiring.

Stroke: When the heart isn’t working effectively, blood clots are more likely to form in the blood vessels. A stroke occurs when one of these clots lodges in a blood vessel in the brain and cuts off blood flow. If a person doesn’t seek treatment quickly enough, many brain cells may die in the important areas of the brain that control speech, strength, memory, and more.

Peripheral artery disease (PAD): The same narrowing that occurs in coronary artery disease can happen in the arteries that supply blood to the arms and legs. The major symptom of PAD is severe leg pain when walking.

Cardiac arrest: Cardiac arrest occurs when the heart suddenly stops beating. It’s usually caused by an electrical disturbance in the heart. Arrhythmia caused by heart disease can lead to cardiac arrest. This will lead to death if not treated immediately.

Reference:

https://www.medicalnewstoday.com/articles/184130#symptoms

1. “I’m too young to worry about heart diseases.”

As early as childhood and adolescence, plaques can start accumulating in the arteries and later lead to clogged arteries. Even young and middle-aged people can develop heart problems – especially now that obesity, type II diabetes and other risk factors are becoming more common at a younger age.

2. “I’d know if I had high blood pressure because there would be warning signs.”

High blood pressure is called the “silent killer” because you may never experience symptoms. The way to know if you have high blood pressure is to check your numbers with a simple blood pressure test.

3. “I’ll know when I’m having a heart attack because I’ll have chest pain.”

Not necessarily. A heart attack may cause subtle symptoms. These include shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck or back. Even if you’re not sure it’s a heart attack or not, call 911 immediately.

4. “Diabetes won’t threaten my heart as long as I take my medication.”

Treating diabetes can help reduce your risk for or delay the development of cardiovascular diseases. But even when blood sugar levels are under control, you’re still at increased risk for heart disease and stroke.

5. “Heart disease runs in my family, so there’s nothing I can do to prevent it.”

Although people with a family history of heart disease are at higher risk, you can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by eating better, controlling cholesterol, blood pressure and blood sugar, maintaining healthy weight, and stop smoking.

6. “I don’t need to have my blood cholesterol checked until I’m middle-aged.”

The American Heart Association recommends you start getting your blood cholesterol checked every 5 years starting at age 20. It’s a good idea to start having a cholesterol test even earlier if your family has a history of heart disease.

7. “I should avoid exercise after having a heart attack.”

Research shows that heart attack survivors who are regularly physically active and make other heart-healthy changes live longer than those who don’t. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. The American Heart Association recommends at least two and a half hours of moderate-intensity physical activity each week for overall cardiovascular health.

Reference:

https://www.heart.org/

A diet low in trans-fats and salt while high in vegetables and lean proteins is great for your heart.

Regulating your diet’s salt and unhealthy fat content reinforces your body’s ability to maintain healthy blood pressure already in the normal range. In addition to being great for your heart, a diet low in unhealthy fats and salts could be your ticket to maintaining a healthy weight.

Here’s a few things you can do. Replace salty foods with whole fruits and vegetables with lots of natural flavor. You’ll also get a lot of important nutrients—like lycopene and vitamin C—that have been shown to support a healthy cardiovascular system. And make sure the fat in your diet largely comes from plant sources—like nuts, olive, and coconut oil.

Keep your body’s engine running smoothly and get your blood pumping with exercise and a healthy diet.

The definition of joints varies a little bit: some define a joint as a point where 2 bones connect. Others suggest it is a point where bones connect for the purpose of moving body parts.

There are three major types of joints:

Synarthroses (immovable). These are fixed or fibrous joints. They’re defined as two or more bones in close contact that have no movement. The bones of the skull are an example. The immovable joints between the plates of the skull are known as sutures.

Amphiarthroses (slightly movable). Also known as cartilaginous joints, these joints are defined as two or more bones held so tightly together that only limited movement can take place. The vertebrae of the spine are good examples.

Diarthroses (freely movable). Also known as synovial joints, these joints have synovial fluid enabling all parts of the joint to smoothly move against each other. These are the most prevalent joints in your body. Examples include joints like the knee and shoulder.

Reference:

https://www.healthline.com

Arthritis is the swelling and tenderness of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

Uric acid crystals, which form when there's too much uric acid in your blood, can cause gout. Infections or underlying disease, such as psoriasis or SLE, can cause other types of arthritis.

Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Reference:

https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

From 2013 to 2015 in the United States

Of people aged 18 to 44 years, 7.1% ever reported doctor-diagnosed arthritis.

Of people aged 45 to 64 years, 29.3% ever reported doctor-diagnosed arthritis.

Of people aged 65 years or older, 49.6% ever reported doctor-diagnosed arthritis.

The risk of arthritis increases with age and arthritis is more common among women than men.

From 2013 to 2015 in the United States, 26% women and 19.1% men ever reported doctor-diagnosed arthritis.

Reference:

https://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm

Occupational therapy:

An occupational therapist (OT) is a specialist who helps people with arthritis, injuries and other conditions maximize their ability to participate in activities safely and enhance their quality of life. The sooner you start working with an occupational therapist, the more you can benefit by making a plan to address your issues.

The plan could include custom-fitting splints or supports that can ease stress on painful joints and help prevent deformity. Occupational therapists also teach people how to protect their joints by performing tasks in different ways than they are used to, such as using both hands or using an assisting device.

People with arthritis really benefit from assisting devices because they help them do more tasks with less pain. Home exercise programs will also help increase their range of motion, flexibility and strength. The goal of occupational therapy is to improve their strength so that they can do certain functional activities, like turning doorknobs, and then continue an exercise plan on their own at home after reaching a certain strength level.

Reference:

https://www.arthritis.org

You may have already tried other treatments for your arthritis, like over-the-counter pain relievers and corticosteroid injections. If you still have significant symptoms, viscosupplementation might be a good choice to help reduce your pain, stiffness, and swelling. This treatment seems to work best in people with mild or moderate arthritis. It may particularly make sense if you are trying to avoid getting surgery on your joint.

Generally, healthcare providers use viscosupplementation to treat osteoarthritis, but the technique may also benefit people with certain other kinds of arthritis, like rheumatoid arthritis. You can talk to your healthcare provider about whether it is a choice for your type of arthritis.

Hyaluronic acid injection is not always an arthritis treatment choice for all types of joints. The knee is the standard injection site, but you might also be able to get it for arthritis in your hip or possibly in another location.

Reference:

https://www.hopkinsmedicine.org

Arthritis is usually a chronic condition and sometimes can lead to disability. However, there are many ways you and your doctor can lessen these problems. One of the ways may be surgery. Joint surgery can offer several benefits, while relief of pain is the most important benefit of joint surgery. Many people with arthritis have constant pain. Some of this pain can be relieved by rest, heat and cold treatments, exercise, splints, and medication. When these therapies don't lessen the pain, surgery should be considered. Improved movement and use of a joint are also important benefits of joint surgery. Continuous inflammation and the wearing away of bone and cartilage can cause joints, tendons, and ligaments to become damaged or pulled out of place. Losing the use of a joint, such as a hip, knee, hand, elbow or shoulder, can seriously hamper a person's activities. When this happens, surgery to replace or stabilize the joint may be suggested. An improvement in the appearance of deformed joints, especially in the hand, can be expected with some types of surgery.

Reference:

https://orthop.washington.edu

Physical therapy (PT) can help you get moving safely and effectively. Physical therapists are licensed professionals with graduate degrees and clinical experience who examine, diagnose and treat or help prevent conditions that limit the body's ability to move and function in daily life, according to the American Physical Therapy Association (APTA).

Physical therapy focuses on the body’s ability to engage in movement. Movement can be anything from getting in and out of chairs to climbing stairs, walking in your neighborhood, playing a sport or doing recreational activities.

The goal of a physical therapy session is to teach you how to do things in your treatment plan – such as performing certain exercises, or how to best use hot and cold compresses – for yourself. The visits are often short – about an hour – and focus on identifying problems with your physical function and giving you strategies for care that you can do at home.

Reference:

https://www.arthritis.org

Patients with inflammatory arthritis are at greater risk for complications associated with surgery than individuals without the disease. In addition to lowered immunity due to drug therapy, the quality of their bones, and deformities of the joint may contribute to poor outcome. Some problems are diagnosis-specific. Patients with SLE, for example, are particularly vulnerable to avascular necrosis (AVN), a condition in which blood supply to the bone is cut off and the bone dies. This may occur due to the high doses of steroids that are required to control their disease. Patients with ankylosing spondylitis have more difficulty regaining motion due to the stiffness of their tissues from the disease.

Most people don’t have any problems from viscosupplementation, but a small percentage of people do. The most common problem you might encounter is a flare-up of your arthritis just after your injection. This might cause additional pain and swelling in the short term. Healthcare providers are still learning about the best techniques to help reduce the chances of this complication.

Less common risks include bleeding, allergic reaction, pain at the injection site, and infection (you should delay your injection if you have any active infection to help prevent this).

There is also a chance that the treatment will not effectively help your symptoms. Talk to your healthcare provider about all your concerns. Your risks may vary according to your medical conditions and where and how often you get injections.

Treatments include hot packs and deep heat machines, such as ultrasound. Patients can feel good on a painful back, shoulder, or knee. They may help relax you before exercise, but there is no proof that they have any lasting effect.

For example, Studies have found that deep-heat ultrasound, added to an exercise program, does not improve arthritis of the knee. As a consequence, many people are afraid to be physically active when they’re in pain. But avoiding movement only makes the problem worse. This can lead to unnecessary medical procedures, such as knee surgery or steroid injections for back pain.

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