During the initial phase of prolonged aerobic exercise (such as walking, running, biking, or swimming), the muscle glycogen is the main source of fuel for contracting muscle.
After 5-10 minutes, blood glucose and fatty acids released (free fatty acids FFA) become more important substrates. However, the levels of glucose in the blood remain virtually unchanged during the first 40 minutes of exercise, due to the release of glucose by the liver from hepatic glycogen breakdown.
Over longer periods, hepatic gluconeogenesis from lactate, glycerol, pyruvate and some amino acids are more and more important and can count for 40-50% of hepatic glucose production. If they continue the exercises, the levels of glucose in the blood begin to drop and begins an energy shift of carbohydrates to FFA. Following exercise, muscle and liver glycogen is restored, a process that takes 24 to 48 hours. During this period, the improved glucose tolerance and lowers insulin requirements. Read the rest of this entry »
Interventions that have shown benefit in preventing diabetic retinopathy are:
- Good control of diabetes
- comprehensive control of hypertension
- laser photocoagulation in patients with early-stage lesions.
Laser photocoagulation has proved effective to significantly reduce severe vision loss and slow the progression of retinopathy. It is a technique that involves destruction of new blood vessels formed in the retina or vitreous hemorrhage by administration of multiple shots of a laser beam. Unfortunately, despite its effectiveness, this technique restores sight loss. Read the rest of this entry »
Involvement of the retina of the eye in patients with diabetes mellitus (diabetic retinopathy) is the most common cause of new blindness among adults 20 to 75 years old. During the first twenty years of the disease, nearly all type 1 diabetic patients and more than 60% of patients with type 2 diabetes develop this serious complication.
In the diabetic group in which the disease appears early (diabetes type 1), 85% of cases of blindness has been attributed to diabetic retinopathy. In diabetes type 2 (in which diabetes appears later, from age 40), one third of cases of legal blindness (even with some level of vision, someone unable to work) has been attributed to diabetic retinopathy. Read the rest of this entry »