Dr Arefadeh

Stresss and Diabetes

Stress is the most important factor to predispose to diabetes.

Many diabetic patients have had a major stress before diabetes in my eperiences.

I have visited many diabetic patients who didn't  have positive diabetic family history,however, they have developed diabetes and they had major stress before diabetes.  

Stress can increase blood sugar and it can lead to bad habits like overeating, which can make diabetes harder to manage. 

Recerntly, some papers were published about this subject.

I strongly recommended to avoid stress and anxiety.

Dr. Alireza Arefzadeh.

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  Short Stature is one of the most important problems in children. 

Etiology:

The European Society for Pediatric Endocrinology (ESPE) classifies the main causes of

• Primary growth disorders, where the condition is intrinsic to the growth plate.
• Secondary growth disorders, where the growth plates change as a consequence of the condition.
• Idiopathic, where there is no identifiable cause of short stature.

Primary growth disorders

• Clinically defined genetic syndromes, such as:
• Down's syndrome
• Prader-Willi syndrome
• Silver- Russell syndrome
• Noonan's syndrome
• Turner syndrome
• Intrauterine growth restriction with failure to catch up:
• Fetomaternal factors
• Prematurity
• Placental dysfunction
• Congenital bone disorders such as:
• Achondroplasia
• Hypochondroplasia
• Osteogenesis imperfecta

Secondary growth disorders

• Endocrine:
• Hypothyroidism.
• Panhypopituitarism.
• Hypothalamic or pituitary lesions (eg, trauma or tumour).
• Laron's syndrome (growth hormone insensitivity).
• Cushing syndrome.
• Growth hormone deficiency or insufficiency.
• Precocious puberty.
• Disorders of the growth hormone insulin-like growth factor I axis.
• Metabolic:
• Mucopolysaccharidoses.
• Glycogen storage diseases.
• Diabetes mellitus (poor control).
• Chronic disease:
• Cardiovascular disease.
• Respiratory disease (eg, cystic fibrosis).
• Haemoglobinopathies.
• Renal disorders disease.
• Malignancy.
• Neurological (eg, hydrocephalus).
• Juvenile arthritis.
• Malnutrition:
• Poverty or neglect.
• Inflammatory bowel disease.
• Coeliac disease.
• Bowel obstruction.
• Enzyme deficiencies.
• Chronic bowel infection.
• Short bowel syndrome.
• Anorexia nervosa.
• Rickets.
• Psychosocial deprivation, including hyperphagic short stature syndrome.
• Medication: steroid therapy.

Although many etiologies have roles in short stature, however, malnutrition is  important factor in short stature.

Malnutrition is the most common cause of growth failure and is usually related to poverty or anarchy. Nutritional deficiencies in developed countries are more often the result of self-restricted diets. Poor weight gain is often more noticeable than short stature.

Nutrition is most important factor specially before puberty.

Parents should check their children and refer to doctor continuously to assess children's stature.

Notice:

After puberty and fusion of the growth plates, doctor can not help to increase height, therefore patients should refer before this time.

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What Is hirsutism?

Hirsutism is excessive hair growth in unusual areas of a woman’s face and body, such as the mustache and beard areal like male. .

Hirsutism in women means that hair follicles are being over-stimulated by testosterone or other androgen hormones. Androgens are the dominant sex hormones in men. Women normally have low levels of androgens. Hirsutism can be caused by abnormally high levels of androgens or abnormal stimulation of hair follicles even when androgen levels are normal.

Causes:

Hirsutism can be caused by:

Polycystic ovary syndrome.
Cushing's syndrome.
Congenital adrenal hyperplasia.

Obesity.

Acromegaly.

Hypothyroidism.

Hyperprolactin.

Stress and Anxiety.
Medications.

Symptoms

 significant growth of hair  on the upper lip, chin, sideburn area, around the nipples or lower abdomen.

Diagnosis

Your doctor will ask you about your medical history with special attention to your menstrual cycles. He or she also will examine you. If you have a normal cyclic pattern of menstrual periods, the hirsutism is most likely genetic (inherited).

Expected Duration

Many women will have a satisfactory response to medical treatment if they continue the therapy for several months or longer. A few causes of hirsutism (such as tumors that produce androgen hormones or tumors in the pituitary gland) can be cured with surgical treatment, radiation or both.

Cosmetic treatments can remove unwanted hair temporarily, and may limit hair regrowth in treated areas.

Treatment

If a specific cause of hirsutism is diagnosed, your doctor may suggest appropriate treatment for that cause. For women who are overweight, losing weight may reduce androgen levels and improve hirsutism.

Diabetes mellitus is very common in Iran.

It is a complex disease and patients need to control four important factors :

1) Reduce stress and sudden emotional behaviour

2)Control of Diet 

3) Excersie 

4) Self monitoring blood glucose 

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