Pathological evolution and self-monitoring strategies of alcoholic cirrhosis and diabetes

For years, scientists have wondered: what causes cirrhosis-a disease in which organ cells degenerate and die? Even before the time of Hippocrates, physicians questioned how much alcohol was needed to damage the liver. A 1940 study showed that even small amounts of alcohol-so-called social drinking-could lead to fat buildup or “fatty liver”-a common precursor to cirrhosis. Later, it was confirmed that excessive alcohol directly toxicizes the liver. Now, many experts link alcohol abuse to 90-95% of deaths from cirrhosis. However, no one knows exactly how much alcohol is needed to develop cirrhosis. Clearly, the duration of drinking has a greater effect than the amount. Cirrhosis usually develops only after years of consuming large amounts of alcohol. Studies also show that drinking 10 drinks a day for 10 years or more can lead to cirrhosis in about 8% of people and alcoholic hepatitis in about 25%-an acute inflammation of the liver. Fatty liver occurs in almost all heavy drinkers, and they generally don't consider it a serious condition. Some experts have also noted that in a small number of "social drinkers" who consume 2-3 drinks a day, 3-4 years is enough to develop fatty liver. In some cases, two days of heavy drinking is enough to increase liver fat. Alcohol is not the only cause of cirrhosis; abstainers can also develop it, just as those with viral hepatitis, certain genetic diseases, severe drug reactions, and prolonged exposure to environmental toxins can. Cirrhosis can also occur in children with cystic fibrosis and in those with long-term biliary obstruction. The earliest signs of cirrhosis are often difficult to detect. As the disease progresses, symptoms may include weight loss, nausea, vomiting, stomach discomfort, and fat malabsorption. Doctors are often the first to discover an enlarged liver during a physical examination. In some cases, fatty liver protrudes noticeably on the right side of the abdomen. If the liver disease progresses further, the skin and eyes may turn yellowish, and the person will excrete black urine. If heavy drinking continues, it may develop into hepatitis. This stage of alcoholic liver disease can cause the liver to enlarge and soften, and can lead to jaundice. In the third stage, cirrhosis stops digesting food, bile returns to the bloodstream, causing severe jaundice. Spider angiomas appear on the face and neck, the abdomen swells, the palms turn red, blood doesn't clot, gynecomastia occurs in men, impotence develops, and-if alcohol consumption continues-bleeding and liver failure, ultimately leading to death. The treatment for cirrhosis is abstinence from alcohol. Although liver damage is irreversible, it can be slowed or even stopped, depending on the stage of the disease. Cirrhosis patients who abstain from alcohol can survive and improve, maintaining a good condition for more than 5 years. Nearly 100% of cirrhosis patients who continue drinking are already dead or near death by then. Patients who abstain from alcohol in the early stages of fatty liver or hepatitis can fully recover. Long-term exposure to toxic environments can also cause cirrhosis. The American Liver Foundation recommends caution when using chemicals at work, at home, or in the yard: ensure good ventilation. Use strictly according to label instructions. Never mix chemical products. Avoid getting chemicals on your skin; if they do, wash them off immediately before absorption. Avoid inhaling chemicals; wear a protective mask and appropriate clothing when using them. Everyone has sugar in their blood-primarily in the form of glucose. After a large meal, especially one rich in easily digestible simple carbohydrates, blood sugar tends to spike. As a result, the pancreas automatically secretes more insulin-a hormone that prompts the body to convert glucose into energy or store it for later use. When the pancreas cannot secrete enough insulin to bring blood sugar down to normal levels, or when the pancreas can secrete insulin but the body cannot respond, ineffective glucose accumulates in the blood, and blood sugar remains elevated-this is diabetes, a complex disease in which cells cannot obtain enough glucose to function properly. Type 1, or insulin-dependent diabetes-formerly known as juvenile-onset diabetes-usually occurs in children and adolescents, although it can occur at any age. In the United States, 90% of the 10-11 million people with diabetes have type 2, or non-insulin-dependent diabetes. This type of disease was formerly known as adult-onset diabetes because it usually occurs after age 50. However, it can occur at any age. Diabetes is the 10th leading cause of death for men. Besides shortening average lifespan, many people with diabetes experience serious health problems, especially when their condition is left untreated. For example, the abnormal metabolism associated with diabetes can alter tissue development and lead to necrosis of small blood vessels throughout the body, which in turn causes vision loss, kidney and nerve damage, and other life-threatening complications. People with diabetes are 25 times more likely to go blind or experience vision impairment than non-diabetics; 17 times more likely to develop kidney disease; 5 times more likely to develop gangrene requiring amputation; and at least twice as likely to develop coronary heart disease and stroke. Furthermore, people with diabetes often suffer from atherosclerosis, severe periodontal (gingival) disease, infections, depression, and 50-60% of men with diabetes experience erectile dysfunction. Early warning signs of diabetes include: excessive thirst; frequent urination; extreme hunger; rapid weight loss; fatigue, weakness, irritability, and nausea. Further progression of diabetes can cause: frequent gum, skin, or urinary tract infections; vision changes or blurred vision; pain, cramps, or tingling in the legs, feet, or fingers. Wounds and hematomas heal slowly. Intense itching. Drowsiness and fatigue. If you notice any of these symptoms, see a doctor immediately. Four or five million Americans with diabetes are unaware of the disease. Type 1 diabetes, in particular, often presents with few or no symptoms. Many cases are only discovered after complications arise in the heart, kidneys, nerves, or eyes. The only common way to detect diabetes is through periodic blood or glucose tolerance tests. This involves intermittently testing blood sugar levels after the patient drinks a glucose solution. Diabetes is not curable, but it can be managed. People with type 1 diabetes maintain their blood sugar levels as close to normal as possible through a strictly synchronized diet, exercise, and daily insulin injections. They should stick to easily absorbed sugars such as hard candy or fruit juice to prevent insulin from causing a rapid drop in blood glucose. A rapid drop in blood sugar can cause hypoglycemia or, more seriously, insulin shock. The main treatment for type 2 diabetes is weight control through diet and exercise, supplemented by oral hypoglycemic agents when necessary. To control weight, people with diabetes must exercise regularly. They should develop a plan to exercise at least three times a week for at least half an hour each time. Each exercise cycle should include a warm-up and cool-down phase, followed by aerobic exercise such as dancing, cycling, swimming, or walking, raising your heart rate to 75% of your maximum. Exercise reduces the need for medication, helps maintain a healthy weight, and helps prevent heart disease. Despite the recognized benefits of weight management, a healthy diet, and exercise, only 10-20% of people with diabetes successfully maintain this lifestyle long-term. Successfully adjusting your lifestyle requires family support and viewing diabetes treatment as a matter for everyone in the family.