DIABETES

WHAT IS DIABETES?

It is a chronic disease that affects over 30million people worldwide. Simply put, People with diabetes are unable to utilize the glucose in their diet for energy. The glucose accumulates in their blood stream and can damage the heart, kidney, eyes and nerves. If left untreated, its complications are quite devastating. It is usually irreversible and although patients live a reasonably normal lifestyle, these late complications may result in reduced life expectancy and considerable uptake of health resources.

Much of its care is “Self-Managed”, meaning if you have this condition, you owe it to yourself to take day-to-day responsibility for your own care.

TYPES OF DIABETES

A.  Type  I  (also called juvenile onset or insulin dependent DM). It is an auto immune disease. This means your immune system which fights off infection for you has gone hay wire and is destroying your insulin producing cells. Without insulin, your body can’t use the sugar and fat broken down from food you eat. People with Type I Diabetes depend on external intake of insulin to live.

CHARACTERISTICS/SYMPTOMS

·         Most common in children.

·         Often comes on suddenly and severely with thirst, frequent urination, weight

loss which develops and worsens within weeks.( despite a good appetite and regular eating)

·         Usually no known family history.

·         No major risk factor, but chances are higher in those with a family history.

·         Insulin injection is required to control it.

·         Dry mouth weakness, tiredness and blurry vision.

B.  TYPE II (also called Non Insulin dependent DM or adult onset). It defers from type I in that the body makes some insulin but not enough and the body can’t make use of the small amount produced.

CHARACTERISTICS / SYMPTOMS

·         Most common in adults

·         Cuts or sore throat that heals slowly.

·         Itchy skin and yeast infections, dry mouth and leg pains.

·         Slow onset with thirst, frequent urination, weight loss which worsens over weeks or months.

·         Usually runs in families.

C.  GESTATIONAL DIABETES( PREGNANCY INDUCED)

3% to 5% of all pregnant women get this during mid-pregnancy and it usually ends when the baby is born. However some women go on to develop type II DM late on in life. It does not cause birth defects, but the babies are usually larger than normal and may suffer low blood sugar immediately after birth. Treatment is often diet modification.

WHAT PUTS YOU AT RISK?

·         Obesity

·         Family history.

·         Over weight baby (birth weight greater than 4kg) or a history of gestational DM)

·         High blood pressure greater than 140/90mmhg.

·         Abnormal blood sugar level in a previous testing.

CHECKING YOURSELF FOR DIABETES

Fasting blood sugar is the most common diagnostic test carried out. This is carried out by taking a blood sample from an individual who has not eaten anything for a minimum of 8 hours (i.e. first thing in the morning after an overnight fast where the last meal was before 9pm).

Normal levels are between 70-110mg/dl. So figures above this recorded on two different occasions are diagnostic of DM.

COMPLICATIONS.

 

·         Leading cause of adult blindness.

·         End stage kidney disease.

·         Limb amputations as a result of nerve disease.

·         Coronary heart disease and stroke.

·         65% of diabetics are also hypertensive.

Preventing or delaying its onset is often dependent on diet modification (eat a diet rich in fruits and vegetables as our regular diet is more of the class which puts us at risk). This should be backed up with adequate exercise to prevent obesity.

Early detection is necessary to prevent its devastating late complications.

Dr Ibare-Jones Eyitope

FINDING THE RIGHT CHURCH

"Understanding our lives together as a church". 1 Corinthians 12:25

What should you look for when trying to find a church?  The first is Christ-centered worship, the celebration of God for who He is, and what He has done for us.  A biblical sound church places a high priority on praising God.  Second is quality Bible instruction.  Does the church you are considering believe, honor, and teach God's Word in such a way that you understand the Bible and see how it applies to your life?  Remember, you cannot grow beyond what you know.  A third characteristic of a good church is fellowship - the sharing of the life of Christ among the members.  This goes far beyond Sunday morning attendance or coffee and donuts in the fellowship hall.  True fellowship occurs when we are involved in each other's lives - caring, encouraging, correcting, loving and engaging with one another.  The church should provide us with a meaningful sense of belonging.  Fourth is the church's ministry of outreach.  A church that wants to grow, cannot be ingrown.  There is nothing wrong with being a small church - as long as you are not a small-minded church.  The church you identify with should provide you with opportunities to use your gifts and talents to touch other lives, emphasizing the importance of demonstrating your faith in word and good deeds.  In other words, the church's impact should extend well beyond its walls.

When you find a church where these priorities and experiences are regularly offered in an environment that is saturated in grace and charged with faith, you have found the right church.  Join it!  And do not ask what your church can do for you - ask what you can do for your church!

KNOW YOUR ENEMY - HE KNOWS YOU!

"I am afraid that just as Eve was deceived by the serpent's cunning, your minds may somehow be led astray." 2 Corinthians 11:3

Temptation begins in your mind.  Satan gave Eve the idea of eating the forbidden fruit.  Eve was not just standing there trying to figure out how to disobey God.  You must understand that the initial thought to do evil, is not from you.  The new nature you have from God would not come up with that.  The devil studies you the way a coach studies the game film of his opponents.  Satan knows your weak spots.  He knows which temptation has the best chance of success against you.  How often have you ended up "I promised God and myself that I did never do that again," yet you did it.  That is because Satan knows what works on you.

But before you feel defenseless and get discouraged, God gives us this assurance: "No temptation has overtaken you but such as is common to man [we are all cut from the same bolt of cloth]; and God is faithful, who will not allow you to be tempted beyond what you are able, but with the temptation will provide the way of escape also, so that you will be able to endure it." 1 Co 10:13.  God builds a back door into every temptation with a lighted "exit" sign over it.  The key word in this Scripture is "with".  The way of escape comes with the temptation.  So while you will never be exempt from temptation, you can be victorious over it.  And the Good News is, when Satan discovers that his strategies against you are not working, he goes looking elsewhere.

KIDNEY OR RENAL FAILURE

What are the Kidneys?

The kidneys are two bean shaped organs each about the size of a fist located in the lower back.  Each person is normally born with two kidneys.

What do the Kidneys do?

The kidneys have many functions but their major function is to clean the blood by removing waste products and regulating the body fluids. They produce urine through which unwanted waste products are eliminated from the body. They also regulate blood pressure, red blood cells and calcium through the production of some hormones.

What is Kidney Failure?

Kidney failure occurs when both kidneys are so damaged that they can no longer clean waste products from the blood. When only one kidney is lost the other one is usually strong enough to do the job. There are 2 types of kidney failure: Acute and Chronic.

A  Acute Kidney (Renal) failure is a sudden decrease in kidney function. It can happen for example with severe infections, severe vomiting and diarrhea with dehydration, intoxications or allergic reactions. With treatment in the hospital, there is almost always return to normal kidney function.

·   

   Chronic Kidney (Renal) Failure is the gradual loss of kidney function because of kidney damage. Sometimes Chronic Kidney disease may be hereditary. Other causes are repeated infections in the kidneys, inflammation of kidney blood vessels or heavy use of certain drugs and medications.

What are the factors that increase the risk of developing Chronic Kidney Failure?

The main risk factors are:

·    

         Family History: Diabetes and High blood pressure are hereditary conditions and they are the major causes of Chronic Kidney Disease.

·         

    Age: The kidneys begin to get smaller at about age 35. At age 80 most people have lost about 30% of their kidney mass.

·         

    Race: Chronic Kidney Failure is commoner in people of African and Native American descent.

·         

     Sex: Men have been found to have a higher risk of developing chronic kidney failure.

What happens when the kidneys fail?

Harmful waste products and excess fluid accumulate in the body. This will result in the affected person having a poor appetite, vomiting, inability to concentrate, getting tired easily, looking pale, bruising, ankle swelling and elevated blood pressure.

How is Kidney failure treated?

At first, the decrease in the ability of the kidney to regulate the body chemistry requires only medications and changes in the diet; Treatment helps to prolong the life of the kidneys. However when the kidney failure becomes severe (usually less than 10-15%of the normal kidney function, it is called end-stage renal disease and treatments that replace the work of healthy kidneys must be started.

What are the treatments for End–stage renal disease?

When the kidneys fail completely there are 2 options available to sustain life: Dialysis or Transplantation.

·     

          DIALYSIS is a process through which the blood is cleaned of waste products and excess fluid is removed. There are two types of Dialysis namely peritoneal dialysis and Hemodialysis. Hemodialysis is the form of dialysis widely practiced here in Nigeria. It involves running the patient’s blood through a dialysis machine which filters out the waste products and excess fluid before returning the blood back into the patient’s body.  It is best performed 3 days a week and usually lasts from 3-6 hours per session in a dialysis centre.

·        

   TRANSPLANTATION- Kidney transplantation refers to a surgical procedure whereby a healthy kidney is removed from one person (a donor) and placed into the patient with the kidney failure (the recipient). The donor may be a living person preferably a family member or a very recently deceased individual who has prior to his /her death given permission to have his/her organs donated. Because the kidney is foreign to the patient’s body he/she will be required to take a number of immunosuppressive medications daily to decrease the chances of transplant rejection. He or she will also need life-long medical check-ups.

      How long can a person live with chronic Kidney Failure

    Many people think that if their kidneys fail, they will die immediately. This used to be true 40-50 years ago when there were not enough dialysis machines to go around and medical knowledge about kidney disease was limited. Today however the life span of a patient with kidney failure varies depending on their age, other health problems and how involved they are in their care. Today we have better drugs, know better about how to slow down kidney failure and have technically advanced dialysis machines. The most important factor is the individual who has the disease because research shows that patients who take a more active role in their own care live longer , so patients should ask questions and explore with their doctor what is the best way to manage their disease.

     How good will my life be with Chronic Kidney Failure?

     This depends on the patient, in the early stages; the symptoms may be so subtle the patient often does not notice them. In later stages fatigue, loss of appetite, itching and the other symptoms mentioned above can reduce the patient’s quality of life if he/she does not act fast because all these symptoms can be treated. The patient should talk to his/her doctor about signs and symptoms to look out for. Taking medications on time can also slow down the progression of kidney disease.

     How do I prevent Chronic Kidney Failure

   Chronic kidney disease may sometimes be prevented by controlling the other diseases or factors that can contribute to kidney disease. Because chronic kidney disease is often caused by high blood pressure and diabetes, keeping your blood pressure and sugar levels near normal can help prevent damage to the kidneys. Others steps that may help reduce the chances of developing chronic kidney failure include eating a diet low in protein and fat, and also avoiding the long term use or dependence on medicines that can damage the kidneys such as some pain relievers and antibiotics.

     

    

     Dr. Olukayode Williams

FAMILY SECRETS

"He is not ashamed to call them his brothers and sisters."  Hebrews 2:11

Most families like to keep their family secrets a secret.  Yet amazingly, you have barely dipped a toe into Matthew's gospel when you realize that Jesus hails from a less-than-perfect family.  Rahab was a Jericho harlot.  Grandpa Jacob was slippery enough to warrant an electric ankle bracelet.  David had a personality as irregular as a Picasso painting - one day writing Psalms, another day seducing his captain's wife.  But did Jesus erase their names from the list?  Not at all.  Why did He hang His family's dirty laundry on the neighborhood clothesline?  This is because your family has secrets too.  A cousin with a prison record.  A dad who left and never came home.  A grand-parent who ran away with a co-worker.  If your family tree has damaged fruit, Jesus wants you to know "I have been there".  The phrase "I have been there" is Christ's theme song.  

To the lonely He whispers "I have been there".  To the discouraged, He nods His head and sighs "I have been there".  The absence of Joseph in the adult life of Jesus suggests that Mary may have raised Him and the rest of their children alone.  Jesus was not reluctant to call His ancestors His family - and He is not ashamed of you either!  Jesus, who makes people holy, and those who are made holy, are from the same family.  "He is not ashamed to call them his brothers and sisters."  That means He is not ashamed of you; nor is He confused by you.  Your actions do not bewilder Him.  Your family secrets do not trouble Him.  So come to Him.  After all, you are part of the family.

THE REIGNING WORKMAN

Introduction

Reigning means the possession or exercise of supreme political, power, sovereignty or dominion while a workman is referred to as an artisan, mechanic who possesses peculiar skills.

In our context, a reigning workman can be described as one who possesses some peculiar skills.  May the Lord give us a better understanding as we study in Jesus name, amen.

1.       Who Is A Reigning Workman?

In the house of God, such a person is a carrier of the holy spirit, whom God has called and bestowed upon him wisdom, understanding, knowledge and creative skills.  Exodus 31:1 – 5, Exodus 35:31 – 32.

2.       What Does The Work Entail?

The work entails good works on our part.  These are the works that cannot be hidden and men will see such works and glorify God in heaven.  1 Tim. 5:25, Acts 9:36, John 10:32.

3.       How Is He To Prepare For The Work?

You should work by faith and not by sight.  A workman is worthy of his wages.  Our God will meet all your needs.  Matthew 10:10, Phil. 4:19, Gal. 3:11, Heb. 10:38.

4.       What Are The Benefits of Such Good Works?

The benefits are numerous.  The blessings of God such as healings, deliverance, abundant grace, will abound towards you.  The blessings of God maketh rich and addeth no sorrow.  Acts 9:37 – 42, Proverbs 10:22.

5.       As Believers, What Are We Expected To Do?

We should always meditate on the Word of God by spending our time wisely in His presence and avoid profane/vain issues that will lead us to ungodliness.  It will profit us to do so and pride ourselves about the knowledge of it.  1 Tim. 4:15, 2 Tim. 2:15 – 16, Eph. 2:10.

HEMORRHOIDS (PART 2)

Diagnosis of Hemorrhoids

Diagnosis of hemorrhoids is usually made by history and physical examination by the doctor. Depending upon the situation, past medical history, medications and stability of the patient, treatment may follow with no further testing.

Inspection of the anus and a digital rectal examination are often performed. Sometimes anoscopy may be required where a small, lighted scope is introduced into the anus to examine the inner lining of the anus and rectum. The procedure is often performed in the doctor’s office without sedation. If there is the potential that the bleeding source originated above the rectum from other parts of the colon, tests by a gastroenterologist may be recommended.

Hemorrhoid Treatment

Self-Care at Home

Fortunately, many effective options are available to treat hemorrhoids. Most people can get relief from symptoms using home treatments and lifestyle changes.

1. Warm Sitz Baths

       Sitting in a few inches of warm water (not hot water) three times a day for 15-20 minutes may help decrease the inflammation of the hemorrhoids. It is important to dry off the anal area completely after each Sitz bath to minimize irritation of the skin surrounding the anus.

2. Dietary Changes

       Increased fluid intake and dietary fiber (roughage) will decrease the potential for constipation and lessen the pressure on the rectum and anus during a bowel movement, minimizing further swelling, discomfort, and bleeding. Dietary fiber supplements may also help bulk up the stools.

3. Stool Softeners

       Stool softeners may help but once hemorrhoids are present, liquid stools may cause inflammation and infection of the anus. Your doctor and pharmacist are good resources to discuss their use.

4. Activity Suggestions

       Individuals with hemorrhoids should not sit for long periods of time and may benefit from sitting on an air or rubber donut available at some pharmacies.

Exercise is helpful in relieving constipation and in decreasing pressure on the hemorrhoidal veins. Individuals should be encouraged to have a bowel movement as soon as possible after the urge arises. Once that urge passes, stools can become constipated and straining with a bowel movement may occur.

5. Over-the-Counter Medications

Many creams, ointments, and suppositories are available for symptom relief and may be used for comfort. However, they do not "cure" hemorrhoids. Analgesics like paracetamol may reduce pain. Avoid taking Ibruprofen and aspirin because they may worsen bleeding.

Medical Treatment

·         Prolapsed Internal Hemorrhoids

Most prolapsed internal hemorrhoids can be pushed back into the anus but occasionally your doctor may need to reduce them by gently pushing them with constant pressure.

If the hemorrhoids remain swollen and trapped outside the anus and nothing is done about it, the hemorrhoid tissue may not receive enough blood and can become infected. In such situations, surgery may be required to resolve the problem.

·         Thrombosed Hemorrhoids

Thrombosed external hemorrhoids can be extremely painful and are associated with a hard lump that is felt at the anus and cannot be pushed back inside. Most often the clot within the hemorrhoid will need to be removed with a small incision.

There may be some mild bleeding from the hemorrhoid for a couple of days. Sitz baths and over-the-counter pain medications may be recommended.

Sitting on a rubber or air rubber donut may help relieve the pain as well.

Preventing constipation is also a priority.

Surgical Treatment

A variety of surgical options exist for persistent pain or bleeding.

·         Rubber band ligation: Here the surgeon places a couple of tight rubber bands around the base of the hemorrhoidal vein causing it to lose its blood supply. Rubber band ligation of internal hemorrhoids can be done in the doctor’s office on an outpatient basis.  

·    Sclerotherapy: Sclerotherapy describes a procedure when a chemical is injected into the hemorrhoid causing it to scar.

·         Laser therapy: Laser therapy can be used to scar and harden internal hemorrhoids.

·      Hemorrhoidectomy: Hemorrhoidectomy is a surgical procedure done in the operating room with an anesthetic agent (general, spinal or local with sedation) where the whole hemorrhoid is removed (ectomy=removal). This is the most aggressive approach and there is a markedly decreased chance of the hemorrhoids returning. However, there is also an increase in the complication rate.

·         Stapled hemorrhoidectomy: Stapled hemorrhoidectomy is the newest surgical technique for treating hemorrhoids, and it has rapidly become the treatment of choice for third-degree hemorrhoids. Stapled hemorrhoidectomy is faster than traditional hemorrhoidectomy, taking approximately 30 minutes. It is associated with much less pain than traditional hemorrhoidectomy and patients usually return earlier to work.

Regardless of the surgery, Sitz baths and dietary suggestions for increased roughage are usually recommended.

Prevention of Hemorrhoids

·      Avoid sitting for many hours at a time, take a break and walk around for at least five minutes.

·         Regular exercise will help to keep your weight in check and make constipation less likely and at the same time improve your muscle tone.

·         Drink at least 8 glasses of water each day; more if you lead a very active lifestyle.

·         Watch your salt intake as excess salt may result in fluid retention which causes swelling of veins including hemorrhoids.

·         Eating a high fiber diet especially lots of fruits and vegetables will help prevent constipation.

·         Avoid straining when passing faeces.

·         Avoid toilet paper that is to irritating, try dampening it first or use alcohol free baby wipes.

·         Good anal hygiene is also very important in preventing hemorrhoids.

Dr. Olukayode Williams