Managing Diabetes, Angina, Asthma, Hyperlipidemia, Hypertension, and Hyperthyroidism
Non-Pharmacological Management
- Increasingly sedentary lifestyles and poor eating habits have contributed to the simultaneous escalation of diabetes and obesity, which some have called the diabesity epidemic.
- Avoid any type of injury.
- Make a diet plan because, in diabetes conditions, sugar level maintenance is the major task.
- More hunger and thirst are common conditions in diabetes, so the availability of things is very important.
- Exercise and yoga are regularly required because they help in the metabolism (BMR) process of the body and maintain the glucose level.
- Try to avoid stress and depression and visit places where we feel happy and pleasant.
- We also take ayurvedic/natural remedies and avoid allopathic medications.
Miscellaneous Drugs
- Aldose reductase inhibitors – Ex: Epalrestat.
- Alpha Glucosidase Inhibitors – Ex: Acabose, Miglitol, Voglibose.
- Amylin Analogue – Ex: Pramlintide.
- Dopamine D2 Agonist – Ex: Bromocriptine.
- Sodium glucose Co-transport-2 A. Enhance insulin secretion.
- Dipeptidyl peptidase-4 inhibitors. Ex: Alogliptin, Linagliptin, Saxagliptin, Sitagliptin, Teneligliptin, Vidagliptin.
- Glucagon-like peptide-1 agonists. Ex: Albiglutide, Dulaglitide, Exenatide, Liraglutide, Lixisenatide, Semaglutide.
- K-ATP channel blockers.
- Sulphonyl ureas. Ex: Chlorpropamide, Glibenclamide.
B. Overcome Insulin Resistance
- Biguanides – Ex: Buformin, Metformin, Phenformin.
- Dual peroxisome Proliferator-activator receptor agonists – Ex
Angina Pectoris
Any obstruction in the coronary artery of the heart due to deposition or blockage leads to chest pain or any discomfort and ischemia in the heart muscles, called angina pectoris. It is mainly three types:
- Stable angina – Deposition of fatty material in the inner wall of the coronary artery (atherosclerosis).
- Unstable angina – Any damage in the coronary arteries, causing blood clots and partial blockage (atherosclerosis with clot).
- Variant angina – Variation in the coronary artery diameter by any condition leads to variant angina, also called coronary spasm. Also known as Prinzmetal’s variant angina or Angina inversa. It is usually rare and typically occurs in younger patients who have other pre-existing heart conditions.
Asthma
Etiopathogenesis
It is arising due to the hyper-responsiveness of the immune system causing variable and reversible airflow obstruction. Many factors for the hyperactivity include:
- Allergens (pollen, animal dander, dust, etc.)
- Upper respiratory tract infections (URTIs).
- Air pollution, cigarette smoke, other chemicals.
- Drugs (aspirin, NSAIDs, Beta-blockers).
- Food allergens, cold air, and other, etc.
- Genetic factors include HLA gene mutations, defects in bronchial airway epithelium.
In other ways, helper T cells and activated mast cells also secrete cytokines and stimulate the maturation of the granular WBCs (eosinophils, basophils, neutrophils). Finally, these cells migrate into other passages like airways (leads to bronchial contraction), eyes (conjunctivitis), nose (rhinitis), etc.
Repeated procedures lead to the Asthma condition.
Clinical manifestations:
- Wheezing.
- Dyspnea.
- Cough.
- Chest tightness/pain.
- Expiration may prolong.
- Thick, gelatinous sputum/mucus.
Non-Pharmacological Management
- Avoid the allergen responsible for the allergic condition.
- Avoid smoking, drinking, chewing, and risk factors responsible for other disease manifestations.
- Regular use of home remedies and natural products in daily life.
- Follow/do regular pranayama, yoga, exercise, etc., to increase lung capacity or health.
Pharmacological Managements
For the management of COPD, general bronchodilators and fixed combination drugs are used.
Oral and intravenous corticosteroids.
These medications — which include prednisone (Prednisone Intensol, Rayos) and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol) — relieve airway inflammation caused by severe asthma.
Hyperlipidaemia
Definition – Lipids are important nutritional components required in optimum measures for our diet. When the lipids or fats (such as cholesterol and triglycerides) level increases from the optimum level, then it accumulates in the blood vessels and increases the viscosity of blood and leads to many organ blockages (mainly hearts) like diseases. Cholesterol is the organic molecule, a type of lipid, which is an essential component for the cell. When their levels increase in the blood, then it accumulates or passively flows in the blood vessel depending upon their density.
Etiopathogenesis
- Primary/familial/hereditary hyperlipidemia – It is genetically present in the child. Hereditary disorders in lipid metabolism include Tay-Sachs disease, Gaucher disease, metachromatic leucodystrophy, Fabry disease, Refsum disease, etc. It further divides into many classes.
Class Increased lipoprotein
- Type-I (Chylomicronemia) Chylomicrons
- Type-IIa (Hypercholesterolemia) LDL
- Type-IIb (Combined hyperlipidemia) LDL & VLDL
- Type-III (Dysbetalipoproteinemia) LDL
- Type-IV (hypertriglyceridemia) VLDL
- Type-V (mixed hyperlipidemia) VLDL & chylomicrons
- Secondary/acquired hyperlipidemia – It occurs after birth due to any abnormality or disease.
a. Hypercholesterolemia – hypothyroidism, nephrotic syndrome, and drug use.
b. Hypertriglyceridemia – DM, alcohol, gout, chronic renal failure.
Common symptoms:
- Less production of bile juice – lipids or fats are not easily digested by the gastric glands, so bile juice is one of the liver secretions responsible for the absorption of the lipid. Bile juice breaks down the large lipid molecule into smaller particles.
Pharmacological Managements
- (3-hydroxy-3-methyl glutaryl CoA) HMG-CoA reductase inhibitors – lovastatin, simvastatin, atorvastatin, rosuvastatin.
- Bile acid sequestrants – Cholestyramine, colestipol.
- Fibric acid derivatives – fenofibrate, benzafibrate, gemfibrozil.
- Nicotinic acid.
Non-Pharmacological Management
- Follow the proper routine of regular activities (wake up, sleep, natural urges).
- Follow regular exercise and workout (prevents fat deposition and removes excessive fats).
Hypertension
Sympathetic Inhibitors
- Alpha Beta adrenergic blockers – arotinolol, labetalol, carvedilol, bucindolol
- Alpha adrenergic blockers – Prazosin, doxazosin, naftopidil, phenoxybenzamine.
- Beta adrenergic blockers – Atenolol, metoprolol, timolol, oxprenolol, nipradilol.
- Central sympatholytics – methyldopa, reserpine, clonidine.
Non-Pharmacological Management
- Follow the proper routine of regular activities (wake up, sleep, natural urges).
- Follow regular exercise and workout (prevents fat deposition and removes excessive fats).
- Follow yoga and meditation (which maintain the oxygen and carbon dioxide level).
- Make a proper diet chart after consulting a specialist and follow it. (Take green vegetables, natural fruit juice, less fatty substances, and avoid street food items).
- Avoid polluted areas and spend time where fresh air blows.
- Coconut water and green tea help control hypothyroidism and aid in weight loss.
- Avoid allergic-causing substances.
- Try to avoid stress and depression and visit places where we feel happy and pleasant.
- Follow exercise and yoga regularly.
Hyperthyroidism
Definition – Diseases of the thyroid include conditions associated with excessive release of thyroid hormones, called hyperthyroidism. Sometimes, the factors involving it are divided into two:
- Primary hyperthyroidism – It is arising from an intrinsic thyroid abnormality, such as Grave’s disease, an autoimmune disease.
- Secondary hyperthyroidism – It is arising from processes outside of the thyroid, such as a TSH-secreting pituitary tumor.
Etiopathogenesis
Thyrotoxicosis is a hypermetabolic state caused by elevated circulating levels of free T3 and T4. Because it is caused most commonly by hyperfunction of the thyroid gland, it is often referred to as hyperthyroidism. Three most common causes for the hyperfunctioning of the gland include:
- Diffuse hyperplasia of the thyroid associated with Graves’ disease (approximately 85% of cases).
- Hyperfunctional multinodular goiter.
- Hyperfunctional thyroid adenoma.
Hyperthyroidism also caused by:
- Genetic defects in thyroid development.
- Thyroid hormone resistance syndrome.
- Congenital biosynthetic defect.
- Hashimoto thyroiditis.
- Iodine deficiency.
- Hypothalamic/pituitary failure (Rare).
Clinical manifestations:
- Tachycardia
- Tremors.
- Heat intolerance.
- Infertility.
- Polyphagia
- Palpitations
- Fatigue and muscle pain.
- Hair loss.
- Swelling at the base of the neck.
Pharmacological Managements
- Thioamides – Methimazole, Propylthiouracil.
- Iodide salts – Lugol’s solution.
- Iodinated contrast media – Ipodate.
- Beta-blocker – Propranolol, Esmolol.
- Anion inhibitor – Thiocyanate, perchlorate.
Non-Pharmacological Management
- Make a diet plan according to the indication of a physician because iodine level maintenance (low iodine) is the major task during thyroid disorders.
- Take a diet rich in calcium, vitamin D, magnesium, and selenium.
- Avoid intake of sugar, caffeine, alcohol, etc., products.
- Avoid allergic-causing substances.
- Try to avoid stress and depression and visit places where we feel happy and pleasant.
- Follow exercise and yoga regularly.