Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin. Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases. This article looks at the early […]
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Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of […]
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Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin. Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases. This article looks at the early […]
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Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of […]
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Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin.
Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases.
This article looks at the early signs and symptoms of type 2 diabetes, the risk factors, and potential complications.
What is type 2 diabetes?
People with type 2 diabetes do not make or use insulin correctly.
Insulin is a hormone that regulates the movement of blood glucose, or sugar, into cells, which use it as energy.
When sugar cannot enter cells, this means:
too much glucose collects in the blood
the body’s cells cannot use it for energy
A doctor may diagnose diabetes if a person’s blood sugar levels are 126 milligrams per deciliter (mg/dl) or above after fasting for 8 hours.
Symptoms
The symptoms of high blood sugar in type 2 diabetes tend to appear gradually. Not everyone with type 2 diabetes will notice symptoms in the early stages.
If a person does experience symptoms, they may notice the following:
Frequent urination and increased thirst: When excess glucose builds up in the bloodstream, the body will extract fluid from tissues. This can lead to excessive thirst and the need to drink and urinate more.
Increased hunger: In type 2 diabetes, the cells are not able to access glucose for energy. The muscles and organs will be low on energy, and the person may feel more hungry than usual.
Weight loss: When there is too little insulin, the body may start burning fat and muscle for energy. This causes weight loss.
Fatigue: When cells lack glucose, the body becomes tired. Fatigue can interfere with daily life when a person has type 2 diabetes.
Blurred vision: High blood glucose can cause fluid to be pulled from the lenses of the eyes, resulting in swelling, leading to temporarily blurred vision.
Infections and sores: It takes longer to recover from infections and sores because blood circulation is poor and there may be other nutritional deficits.
If people notice these symptoms, they should see a doctor. Diabetes can lead to a number of serious complications. The sooner a person starts to manage their glucose levels, the better chance they have of preventing complications.
Symptoms in children and teens
Type 2 diabetes is more likely to appear after the age of 45 years, but it can affect children and teens who:
have excess weight
do not do much physical activity
have high blood pressure
have a family history of type 2 diabetes
have an African American, Asian American, Hispanic American, or American Indian background
The following symptoms may occur:
weight loss, despite increased appetite and hunger
extreme thirst and dry mouth
frequent urination and urinary tract infections
fatigue
blurred vision
slow healing of cuts or wounds
numbness or tingling in hands and feet
itchy skin
If caregivers notice these symptoms, they should take the child to see a doctor. These are also symptoms of type 1 diabetes. Type 1 is less common but more likely to affect children and teenagers than adults. However, type 2 diabetes is becoming more common in young people than it was in the past.
Symptoms in older adults
At least 25.2 percent of people aged 65 and above have type 2 diabetes in the United States. They may have some or all the classic symptoms of type 2 diabetes.
They may also experience one or more of the following:
flu-like fatigue, which includes feeling lethargic and chronically weak
urinary tract infections
numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage
dental problems, including infections of the mouth and red, inflamed gums
Early signs
Most people do not experience symptoms in the early stages, and they may not have symptoms for many years.
A possible early sign of type 2 diabetes is darkened skin on certain areas of the body, including:
the neck
the elbows
the knees
the knuckles
This is known as acanthosis nigricans.
Other early symptoms include:
frequent bladder, kidney, or skin infections
cuts that take longer to heal
fatigue
extreme hunger
increased thirst
urinary frequency
blurred vision
A person may have mild or subtle symptoms for many years, but these can become in time. Further health problems can develop.
Prediabetes and diabetes prevention
A person with blood sugar levels of 100–125 mg/dl will receive a diagnosis of prediabetes. This means that their blood sugar levels are high, but they do not have diabetes. Taking action at this stage can prevent diabetes from developing.
According to a 2016 report published in The Journal of the American Board of Family Medicine, 33.6 percent of people aged 45 years and older had prediabetes in 2012.
The CDC estimate that around 84 million
Complications
Diabetes may cause a number of health complications if people do not manage it properly. Many of these are chronic, or long-term, but they can become life-threatening. Others need immediate medical attention as soon as they appear.
Emergency complications
Complications can arise quickly if blood sugar rises or falls too far.
Hypoglycemia
If blood glucose dips below 70 mg/dl, this is hypoglycemia, or low blood sugar.
This can happen if a person who uses insulin takes more than they need for a particular time.
A home blood glucose test can check for hypoglycemia.
It is vital to know the early signs of hypoglycemia, as it can progress quickly, resulting in seizures and a coma. In the early stages, however, it is easy to treat.
Symptoms of hypoglycemia include:
confusion
dizziness
feeling faint
heart palpitations
rapid heartbeat
mood changes
loss of consciousness
sweating
clamminess
If symptoms are mild, a person can often resolve low blood sugar levels by consuming:
a few pieces of hard candy
a cup of orange juice
a teaspoon of honey
a glucose tablet
The person should then wait 15 minutes, test their blood sugar, and if it is still low, they should take another glucose tablet or sweet.
When levels return to above 70 mg/dl, the person should eat a meal, to stabilize their glucose levels.
If they remain low for 1 hour or longer, or if symptoms worsen, someone should take the person to the emergency room.
Anyone who has frequent or severe hypoglycemic episodes should speak to their doctor, as they may need to adjust their treatment plan.
Hyperglycemia and diabetic ketoacidosis (DKA)
If blood sugar levels rise too far, hyperglycemia can result. If a person notices increased thirst and urination, they should check their blood sugar levels.
It the level is above the target level that their doctor recomends, they take appropriate action.
Without treatment, high a person with hyperglycemia can develop diabetic ketoacidosis (DKA), which happens when high levels of ketones collect in the blood, making it too acidic. For this reason, the person should also test their ketone levels.
Ketoacidosis can lead to:
difficulty breathing
a fruity smell on the breath
a dry mouth
nausea and vomiting
coma
It can be life-threatening. A person with these signs and symptoms should seek immediate medical attention.
People who regularly experience high blood sugar should speak to their doctor about adjusting their treatment plan.
Blood glucose testing kits and ketone testing kits are available for purchase online. People should check with their doctor how often they need to test.
Long-term complications
Keeping blood glucose within target levels can prevent complications that can become life-threatening and disabling over time.
Some possible complications of diabetes are:
heart and blood vessel diseases
high blood pressure
nerve damage (neuropathy)
foot damage
eye damage and blindness
kidney disease
hearing problems
skin problems
Effective management of blood glucose levels can reduce the risk of complications.
Diagnosis and treatment
A doctor can diagnose type 2 diabetes with blood tests that measure blood glucose levels. Many people discover they have high blood sugar during a routine screening test, but anyone who experiences symptoms should see a doctor.
Treatment aims to keep blood glucose levels stable at a healthy level and prevent complications. The main ways to do this are through lifestyle measures.
These include:
following a healthful diet
reaching and maintaining a healthy weight and body mass index (BMI)
doing physical activity
getting enough sleep
avoiding or quitting smoking
taking medications or insulin as the doctor recommends
Outlook
There is currently no cure for diabetes, but most people with the condition can lead a healthful life by managing their condition properly.
People who maintain a healthy weight, follow a healthful diet, and do regular exercise may not need medication. Taking these steps can help manage blood sugar levels.
Routine screening can alert a person to high blood sugar levels in the early stages, when there is still time to slow, stop, or reverse the progress of diabetes.
Current guidelines recommend regular screening from the age of 45 years, or younger if an individual has other risk factors, such as obesity. A doctor can advise on individual needs.
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Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of melanoma, among others.
Receiving an early diagnosis and getting prompt treatment can improve the outlook for people with melanoma.
For this reason, people should keep track of any changing or growing moles. Using adequate protection against sun exposure can help a person prevent melanoma altogether.
What is melanoma?
Melanoma is a type of skin cancer that occurs when pigment producing cells called melanocytes mutate and begin to divide uncontrollably.
Most pigment cells develop in the skin. Melanomas can develop anywhere on the skin, but certain areas are more at risk than others. In men, it is most likely to affect the chest and back. In women, the legs are the most common site. Other common sites of melanoma include the face.
However, melanoma can also occur in the eyes and other parts of the body, including — on very rare occasions — the intestines.
Melanoma is relatively rare in people with darker skin.
Stages
The stage of a cancer at diagnosis will indicate how far it has already spread and what kind of treatment will be suitable.
One method of assigning a stage to melanoma describes the cancer in five stages, from 0 to 4:
Stage 0: The cancer is only present in the outermost layer of skin. Doctors refer to this stage as “melanoma in situ.”
Stage 1: The cancer is up to 2 millimeters (mm) thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated.
Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.
Stage 3: The cancer has spread to one or more lymph nodes or nearby lymphatic channels but not distant sites. The original cancer may no longer be visible. If it is visible, it may be thicker than 4 mm and also ulcerated.
Stage 4: The cancer has spread to distant lymph nodes or organs, such as the brain, lungs, or liver.
The more advanced a cancer is, the harder it is to treat and the worse the outlook becomes.
Types
There are four types of melanoma. Learn more about each type in the sections below.
Superficial spreading melanoma
This is the most common type of melanoma, and it often appears on the trunk or limbs. The cells tend to grow slowly at first before spreading across the surface of the skin.
Nodular melanoma
This is the second most common type of melanoma, appearing on the trunk, head, or neck. It tends to grow quicker than other types, and it may appear as a reddish or blue-black color.
Lentigo maligna melanoma
This is less common and tends to develop in older adults, especially in parts of the body that have had excessive sun exposure over several years, such as the face.
It starts as a Hutchinson’s freckle, or lentigo maligna, which looks like a stain on the skin. It usually grows slowly and is less dangerous than other types of melanoma.
Acral lentiginous melanoma
This is the rarest kind of melanoma. It appears on the palms of the hands, soles of the feet, or under the nails.
Since people with darker skin do not typically get other types of melanoma, these tend to be the most common type of melanoma in those with darker skin types.
Risk factors
Research into the exact causes of melanoma is ongoing.
However, scientists do know that people with certain skin types are more prone to developing melanoma.
The following factors may also contribute to an increased risk of skin cancer:
a high density of freckles or a tendency to develop freckles following exposure to the sun
a high number of moles
five or more atypical moles
the presence of actinic lentigines, also known as liver spots or age spots
giant congenital melanocytic nevi, a type of brown birthmark
pale skin that does not tan easily and tends to burn
light eyes
red or light hair
high sun exposure, particularly if it produces blistering sunburn, and if sun exposure is intermittent rather than regular
older age
a family or personal history of melanoma
a previous organ transplant
Of these risk factors, only sun exposure and sunburn are avoidable. Avoiding overexposure to the sun and preventing sunburn can significantly lower the risk of skin cancer. Tanning beds are also a source of damaging ultraviolet (UV) rays.
Being able to tell the difference between normal moles or freckles and those that indicate skin cancer can support an early diagnosis.
Superficial spreading melanoma
Nodular melanoma
Lentigo maligna melanoma
Acral lentiginous melanoma
Skin changes due to cancer
Normal mole
Symptoms
In its early stages, melanoma can be difficult to detect. It is important to check the skin for any signs of change.
Alterations in the appearance of the skin are vital indicators of melanoma. Doctors use them in the diagnostic process.
The Melanoma Research Foundation offer pictures of melanomas and normal moles to help a person learn how to tell the difference.
They also list some symptoms that should prompt a person to visit the doctor, including:
any skin changes, such as a new spot or mole or a change in the color, shape, or size of an existing spot or mole
a skin sore that fails to heal
a spot or sore that becomes painful, itchy, or tender
a spot or sore that starts to bleed
a spot or lump that looks shiny, waxy, smooth, or pale
a firm, red lump that bleeds or looks ulcerated or crusty
a flat, red spot that is rough, dry, or scaly
ABCDE examination
The ABCDE examination of moles is an important method for revealing potentially cancerous lesions. It describes five simple characteristics to check for in a mole that can help a person either confirm or rule out melanoma:
Asymmetric: Noncancerous moles tend to be round and symmetrical, whereas one side of a cancerous mole is likely to look different to the other side.
Border: This is likely to be irregular rather than smooth and may appear ragged, notched, or blurred.
Color: Melanomas tend to contain uneven shades and colors, including black, brown, and tan. They may even contain white or blue pigmentation.
Diameter: Melanoma can cause a change in the size of a mole. For example, if a mole becomes larger than one-quarter of an inch in diameter, it might be cancerous.
Evolving: A change in a mole’s appearance over weeks or months can be a sign of skin cancer.
Treatment
The treatment of skin cancer is similar to that of other cancers. However, unlike many cancers inside the body, it is easier to access the cancerous tissue and remove it completely. For this reason, surgery is the standard treatment option for melanoma.
Surgery involves removing the lesion and some of the noncancerous tissue around it. When the surgeon removes the lesion, they send it to pathology to determine the extent of the involvement of the cancer, and to make sure that they have removed all of it.
If melanoma covers a large area of skin, a skin graft may be necessary.
If there is a risk that the cancer has spread to the lymph nodes, a doctor may request a lymph node biopsy.
They may also recommend radiation therapy for treating melanoma, especially in the later stages.
Melanoma may metastasize to other organs. If this happens, a doctor will request treatments depending on where the melanoma has spread, including:
chemotherapy, in which a doctor uses medications that target the cancer cells
immunotherapy, in which a doctor administers drugs that work with the immune system to help fight the cancer
targeted therapy, which uses medications that identify and target particular genes or proteins specific to melanoma
Prevention
Avoiding excessive exposure to UV radiation can reduce the risk of skin cancer. People can achieve this by:
avoiding sunburn
wearing clothes that protect the body from the sun
using broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30, preferably a physical blocker such as zinc oxide or titanium dioxide
liberally applying sunscreen about half an hour before going outside in the sun
reapplying sunscreen every 2 hours and after swimming or sweating to maintain adequate protection
avoiding the highest sun intensity by finding shade between the hours of 10 a.m. and 4 p.m.
keeping children in the shade as much as possible, having them wear protective clothing, and applying SPF 50+ sunscreen
]keeping infants out of direct sunlight
Wearing sunscreen is not a reason to spend longer in the sun. People should still take steps to limit sun exposure where possible.
Those who work outdoors should also take precautions to minimize exposure.
Doctors recommend avoiding tanning booths, lamps, and sunbeds.
What about vitamin D?
The American Academy of Dermatology (AAD) do not currently recommend sun exposure (or tanning) for the purpose of obtaining vitamin D.
Instead, they suggest “getting vitamin D from a [healthful] diet that includes foods naturally rich in vitamin D, foods and beverages fortified with vitamin D, and/or vitamin D supplements”
Diagnosis
Most cases of melanoma affect the skin. They usually produce changes in existing moles.
A person can detect the early signs of melanoma themselves by regularly examining existing moles and other colored blemishes and freckles. People should have their backs checked regularly, as it may be harder to see moles in this area.
A partner, family member, friend, or doctor can help check the back and other areas that are hard to see without assistance.
Any changes in the skin’s appearance require further examination by a doctor.
Some apps claim to help a person identify and track changing moles. However, many are not reliable.
Clinical tests
Doctors may use microscopic or photographic tools to examine a lesion in more detail.
If they suspect skin cancer, they will have a dermatologist biopsy the lesion to determine whether or not it is cancerous. A biopsy is a procedure wherein a medical professional takes a sample of a lesion and sends it for examination in the laboratory.
Outlook
Melanoma is an aggressive type of cancer that can be dangerous when it spreads. However, people who identify a lesion early can have a very good outlook.
The ACS have calculated the 5 year relative survival rates for melanoma. These compare the likelihood that a person with melanoma will survive for 5 years with that of a person without cancer.
If a doctor diagnoses and treats melanoma before it spreads, the 5 year relative survival rate is 98%. If it spreads to deeper tissues or nearby lymph nodes, however, the rate drops to 64%.
If it reaches distant organs or tissues, the likelihood of surviving for 5 years reduces to 23%.
For this reason, it is important to monitor any changing moles and seek medical attention for any that are changing, irregular, or growing. Taking preventive steps is also vital when spending long periods of time in the sun.
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