What are the symptoms, causes, and management of various medical conditions including diabetes, kidney diseases, nutritional disorders, gastrointestinal issues, liver conditions, and thyroid disorders?

Diabetes Types, Symptoms, and Causes

Diabetes Mellitus Overview

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. There are several types of diabetes with distinct pathophysiological mechanisms:

Type 1 Diabetes

• Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency 1
• Common symptoms include polyuria, polydipsia, weight loss, fatigue, and blurred vision 1
• Often presents in childhood or adolescence but can occur at any age 1
• Associated with other autoimmune conditions including thyroid disease, celiac disease, and pernicious anemia 1

Type 2 Diabetes

• Characterized by insulin resistance and progressive beta cell dysfunction 1
• Risk factors include obesity, physical inactivity, family history, age, and certain ethnicities 1
• Symptoms may develop gradually and include those of type 1 plus recurrent infections, slow-healing wounds, and numbness/tingling in extremities 1
• Often associated with metabolic syndrome components (hypertension, dyslipidemia, central obesity) 1

Gestational Diabetes

• Glucose intolerance with onset or first recognition during pregnancy 1
• Risk factors include obesity, previous gestational diabetes, family history of diabetes, and advanced maternal age 1
• Usually resolves after delivery but increases risk of developing type 2 diabetes later 1

Other Specific Types

• Monogenic diabetes (MODY, neonatal diabetes) 1
• Secondary diabetes due to pancreatic diseases, endocrinopathies, medications, or genetic syndromes 1

Thyroid-Diabetes Connection

• People with type 1 diabetes should be screened for autoimmune thyroid disease soon after diagnosis and periodically thereafter 1
• Thyroid dysfunction is common in diabetes patients, with hypothyroidism being more prevalent than hyperthyroidism 2
• Thyroid hormones affect glucose metabolism through actions on peripheral tissues including the gastrointestinal tract, liver, skeletal muscles, adipose tissue, and pancreas 2
• Hyperthyroidism can cause hyperglycemia, upregulation of glucose transport, and reduction in glycogen storage 2
• Hypothyroidism has opposite effects but both conditions ultimately result in insulin resistance 2
• Type 2 diabetes can impair conversion of T4 to T3 in peripheral tissues 2

Kidney Functions

The kidneys perform several vital functions:

• Filtration of blood and removal of waste products 1
• Regulation of fluid and electrolyte balance 1
• Acid-base homeostasis 1
• Production of hormones (erythropoietin, renin, active vitamin D) 1
• Glucose reabsorption via SGLT2 transporters (relevant to diabetes treatment) 1

Diabetic Kidney Disease

• Leading cause of chronic kidney disease worldwide 1
• Characterized by albuminuria and/or reduced estimated glomerular filtration rate (eGFR) 1
• SGLT2 inhibitors have shown significant benefits in slowing progression 1

Glomerulonephritis: Symptoms and Causes

Glomerulonephritis refers to inflammation of the glomeruli, the filtering units of the kidneys.

Symptoms

• Hematuria (blood in urine) 1
• Proteinuria (protein in urine) 1
• Edema, particularly in face, legs, and feet 1
• Hypertension 1
• Reduced urine output 1

Causes

• Immune-mediated mechanisms (antibody deposition, immune complex formation) 1
• Post-infectious (following streptococcal infection) 1
• Autoimmune diseases (lupus, IgA nephropathy) 1
• Systemic conditions (diabetes, amyloidosis) 1

Acute Kidney Injury (AKI): Symptoms and Causes

AKI is defined as a sudden decrease in kidney function resulting in retention of waste products.

Symptoms

• Decreased urine output 1
• Fluid retention causing swelling 1
• Shortness of breath 1
• Fatigue, confusion 1
• Nausea, vomiting 1

Causes

• Pre-renal: Decreased blood flow to kidneys (dehydration, heart failure, sepsis) 1
• Intrinsic: Direct damage to kidney tissue (acute tubular necrosis, glomerulonephritis, interstitial nephritis) 1
• Post-renal: Obstruction of urine outflow (kidney stones, enlarged prostate, tumors) 1
• Medication-related: NSAIDs, certain antibiotics, contrast dyes 1
• Metformin can rarely cause lactic acidosis in patients with kidney dysfunction 3

Chronic Kidney Disease (CKD): Symptoms and Causes

CKD is defined as abnormalities of kidney structure or function present for >3 months with implications for health.

Symptoms

• Often asymptomatic until advanced stages 1
• Fatigue, weakness 1
• Edema 1
• Shortness of breath 1
• Nausea, vomiting, loss of appetite 1
• Pruritus (itching) 1
• Sleep disturbances 1

Causes

• Diabetes mellitus (leading cause) 1
• Hypertension 1
• Glomerulonephritis 1
• Polycystic kidney disease 1
• Recurrent kidney infections 1
• Obstruction 1

Renal Calculi (Kidney Stones): Symptoms, Types, and Causes

Symptoms

• Severe, colicky pain (renal colic) 1
• Hematuria 1
• Nausea and vomiting 1
• Urinary urgency and frequency 1
• Fever and chills if infection present 1

Types

• Calcium stones (calcium oxalate, calcium phosphate) - most common 1
• Struvite stones (associated with infections) 1
• Uric acid stones 1
• Cystine stones (genetic) 1

Causes

• Dehydration 1
• Diet high in salt, animal protein, and oxalate 1
• Family history 1
• Certain medications 1
• Metabolic disorders 1
• Urinary tract infections 1

Carbohydrates: Functions and Types

Functions

• Primary energy source for the body, especially the brain 1
• Structural components in cells 1
• Involved in immune function 1
• Protein sparing (prevents protein breakdown for energy) 1

Types

• Monosaccharides: Glucose, fructose, galactose (simple sugars) 1
• Disaccharides: Sucrose (glucose + fructose), lactose (glucose + galactose), maltose (glucose + glucose) 1
• Polysaccharides: Starch, glycogen, fiber 1

Proteins: Functions and Types

Functions

• Growth and repair of tissues 1
• Enzyme production 1
• Hormone production 1
• Immune function (antibodies) 1
• Transport of substances in blood 1
• Fluid balance 1
• Acid-base balance 1

Types

• Complete proteins (contain all essential amino acids): Animal sources, quinoa, soy 1
• Incomplete proteins (lacking one or more essential amino acids): Most plant sources 1
• Fibrous proteins (structural): Collagen, elastin, keratin 1
• Globular proteins (functional): Enzymes, antibodies, hormones 1

Fats: Types and Functions

Functions

• Energy storage 1
• Insulation and protection of organs 1
• Cell membrane structure 1
• Hormone production 1
• Absorption of fat-soluble vitamins 1

Types

• Saturated fats: Solid at room temperature, found in animal products and tropical oils 1
• Monounsaturated fats: Liquid at room temperature, found in olive oil, avocados 1
• Polyunsaturated fats: Liquid at room temperature, found in vegetable oils, fatty fish 1
  • Omega-3 fatty acids: EPA, DHA, ALA 1
  • Omega-6 fatty acids: Linoleic acid 1
• Trans fats: Industrially produced, found in processed foods 1

Vitamins: Types, Functions, and Examples

Fat-Soluble Vitamins

• Vitamin A: Vision, immune function, cell growth (eggs, liver, orange vegetables) 1
• Vitamin D: Calcium absorption, bone health (sunlight, fatty fish, fortified foods) 1
• Vitamin E: Antioxidant protection (nuts, seeds, vegetable oils) 1
• Vitamin K: Blood clotting, bone health (green leafy vegetables, fermented foods) 1

Water-Soluble Vitamins

• Vitamin C: Collagen synthesis, antioxidant, immune function (citrus fruits, berries, peppers) 1
• B vitamins:
  • B1 (Thiamine): Energy metabolism (whole grains, meat, legumes) 1
  • B2 (Riboflavin): Energy production, cell function (dairy, eggs, green vegetables) 1
  • B3 (Niacin): Energy metabolism, DNA repair (meat, fish, nuts) 1
  • B5 (Pantothenic acid): Energy metabolism (meat, vegetables, whole grains) 1
  • B6 (Pyridoxine): Protein metabolism, cognitive development (meat, fish, potatoes) 1
  • B7 (Biotin): Energy metabolism, hair/skin health (eggs, nuts, seeds) 1
  • B9 (Folate): DNA synthesis, cell division (leafy greens, legumes, fortified foods) 1
  • B12 (Cobalamin): Nerve function, DNA synthesis (animal products only) 1

Minerals: Types, Functions, and Examples

Macrominerals (needed in larger amounts)

• Calcium: Bone health, muscle function, nerve transmission (dairy, fortified foods, leafy greens) 1
• Phosphorus: Bone structure, energy metabolism (dairy, meat, nuts) 1
• Magnesium: Enzyme function, muscle and nerve function (nuts, seeds, whole grains) 1
• Sodium: Fluid balance, nerve function (salt, processed foods) 1
• Potassium: Fluid balance, nerve function (fruits, vegetables, legumes) 1
• Chloride: Fluid balance, digestion (salt, seaweed) 1
• Sulfur: Protein structure (eggs, meat, garlic) 1

Microminerals/Trace Minerals (needed in smaller amounts)

• Iron: Oxygen transport, energy production (meat, legumes, fortified cereals) 1
• Zinc: Immune function, wound healing, DNA synthesis (meat, shellfish, legumes) 1
• Copper: Iron metabolism, connective tissue formation (shellfish, nuts, seeds) 1
• Manganese: Bone formation, metabolism (nuts, whole grains, leafy vegetables) 1
• Iodine: Thyroid hormone production (iodized salt, seafood, dairy) 1
• Selenium: Antioxidant function, thyroid metabolism (Brazil nuts, seafood, meat) 1
• Fluoride: Bone and tooth structure (fluoridated water, tea, marine fish) 1
• Chromium: Glucose metabolism (whole grains, meat, fruits) 1
• Molybdenum: Enzyme function (legumes, grains, nuts) 1

Nephrotic Syndrome: Symptoms and Causes

Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

Symptoms

• Severe edema, especially around eyes and in lower extremities 1
• Foamy urine (due to protein) 1
• Weight gain due to fluid retention 1
• Fatigue 1
• Increased susceptibility to infections 1
• Loss of appetite 1

Causes

• Minimal change disease (most common in children) 1
• Focal segmental glomerulosclerosis 1
• Membranous nephropathy 1
• Diabetic nephropathy 1
• Systemic diseases (lupus, amyloidosis) 1
• Infections (HIV, hepatitis B and C) 1
• Medications (NSAIDs, gold, penicillamine) 1

Nephritic Syndrome: Symptoms and Causes

Nephritic syndrome is characterized by hematuria, proteinuria, hypertension, and reduced GFR.

Symptoms

• Hematuria (blood in urine) 1
• Oliguria (reduced urine output) 1
• Edema 1
• Hypertension 1
• Proteinuria (usually less severe than in nephrotic syndrome) 1

Causes

• Post-streptococcal glomerulonephritis 1
• IgA nephropathy 1
• Lupus nephritis 1
• ANCA-associated vasculitis 1
• Goodpasture syndrome 1
• Membranoproliferative glomerulonephritis 1

Dialysis: Types, Functions, and Causes

Dialysis is a treatment that filters waste products from the blood when the kidneys can no longer do so.

Types

• Hemodialysis: Blood is pumped through an artificial kidney machine 1
• Peritoneal dialysis: Uses the peritoneal membrane as a filter 1

Functions

• Removal of waste products (urea, creatinine) 1
• Correction of electrolyte imbalances 1
• Removal of excess fluid 1
• Acid-base balance regulation 1

Indications (Causes for Needing Dialysis)

• End-stage renal disease (ESRD) 1
• Acute kidney injury with severe uremia 1
• Severe electrolyte disturbances 1
• Fluid overload unresponsive to diuretics 1
• Certain poisonings or drug overdoses 1

Gastroesophageal Reflux Disease (GERD): Symptoms and Causes

Symptoms

• Heartburn (burning sensation in chest) 4
• Regurgitation of food/sour liquid 4
• Difficulty swallowing 4
• Sensation of a lump in the throat 4
• Chronic cough, laryngitis 4
• Disrupted sleep 4

Causes

• Lower esophageal sphincter dysfunction 4
• Hiatal hernia 4
• Obesity 4
• Pregnancy 4
• Smoking 4
• Certain foods and beverages (caffeine, alcohol, fatty foods) 4
• Medications (calcium channel blockers, antihistamines) 4
• Diabetes (can cause esophageal dysmotility) 4

Irritable Bowel Syndrome (IBS): Symptoms and Causes

Symptoms

• Abdominal pain or cramping 4
• Bloating and gas 4
• Diarrhea, constipation, or alternating between both 4
• Mucus in stool 4
• Symptoms often worsen with stress 4

Causes

• Abnormal gastrointestinal motility 4
• Visceral hypersensitivity 4
• Post-infectious (following gastroenteritis) 4
• Altered gut microbiota 4
• Food sensitivities 4
• Psychological factors (stress, anxiety) 4

Peptic Ulcer: Symptoms and Causes

Symptoms

• Burning stomach pain 4
• Feeling of fullness, bloating 4
• Intolerance to fatty foods 4
• Heartburn 4
• Nausea 4
• In severe cases: vomiting blood, dark stools, severe pain 4

Causes

• Helicobacter pylori infection (most common) 4
• NSAIDs use 4
• Excessive alcohol consumption 4
• Smoking 4
• Stress (as an exacerbating factor) 4
• Zollinger-Ellison syndrome (rare) 4

Constipation: Symptoms and Causes

Symptoms

• Infrequent bowel movements (less than three per week) 4
• Hard, dry stools 4
• Straining during bowel movements 4
• Sensation of incomplete evacuation 4
• Abdominal discomfort 4

Causes

• Inadequate fiber intake 4
• Dehydration 4
• Physical inactivity 4
• Medications (opioids, antidepressants, iron supplements) 4
• Irritable bowel syndrome 4
• Neurological conditions (Parkinson's, multiple sclerosis) 4
• Metabolic disorders (diabetes, hypothyroidism) 4
• Structural abnormalities (strictures, tumors) 4

Indigestion (Dyspepsia): Symptoms and Causes

Symptoms

• Upper abdominal pain or discomfort 4
• Bloating 4
• Early satiety (feeling full quickly) 4
• Nausea 4
• Belching 4

Causes

• Overeating 4
• Eating too quickly 4
• Fatty or spicy foods 4
• Excessive alcohol or caffeine 4
• Smoking 4
• Anxiety and stress 4
• Medications (NSAIDs, antibiotics) 4
• Underlying conditions (GERD, peptic ulcer, gastritis) 4

Diarrhea: Symptoms and Causes

Symptoms

• Loose, watery stools 4
• Abdominal cramps 4
• Abdominal pain 4
• Urgency 4
• Nausea 4
• In severe cases: fever, blood in stool, dehydration 4

Causes

• Infections (viral, bacterial, parasitic) 4
• Food intolerances (lactose, fructose) 4
• Medications (antibiotics, magnesium-containing antacids) 4
• Irritable bowel syndrome 4
• Inflammatory bowel disease 4
• Malabsorption syndromes 4
• Endocrine disorders (hyperthyroidism, diabetes) 4

Ulcerative Colitis: Symptoms and Causes

Symptoms

• Diarrhea, often with blood or pus 4
• Abdominal pain and cramping 4
• Rectal pain and bleeding 4
• Urgency to defecate 4
• Weight loss 4
• Fatigue 4
• Fever 4

Causes

• Autoimmune reaction (immune system attacks digestive tract) 4
• Genetic factors 4
• Environmental triggers 4
• Altered gut microbiome 4

Liver Functions and Pathophysiology

Functions

• Metabolism of carbohydrates, proteins, and fats 5, 6
• Detoxification of harmful substances 5
• Production of bile for fat digestion 5
• Storage of vitamins and minerals 5
• Synthesis of plasma proteins 5
• Activation of vitamin D 5
• Regulation of blood clotting 5

Pathophysiology

• Inflammation: Release of inflammatory mediators 5
• Necrosis: Cell death due to toxins, viruses, or ischemia 5
• Fibrosis: Excessive collagen deposition 5
• Regeneration: Liver's ability to regenerate after injury 5
• Portal hypertension: Increased pressure in portal vein 5

Cirrhosis: Types/Stages, Pathophysiology, Symptoms, and Causes

Types/Stages

• Compensated: Liver still functions despite scarring 1
• Decompensated: Liver function is significantly impaired 1

Pathophysiology

• Progressive fibrosis replacing normal liver tissue 5
• Distortion of hepatic architecture 5
• Development of regenerative nodules 5
• Portal hypertension 5

Symptoms

• Early stages often asymptomatic 5
• Fatigue, weakness 5
• Jaundice 5
• Ascites (fluid in abdomen) 5
• Edema in legs 5
• Bruising and bleeding easily 5
• Confusion, drowsiness (hepatic encephalopathy) 5

Causes

• Chronic alcohol abuse (most common in developed countries) 5
• Chronic viral hepatitis (B and C) 5
• Nonalcoholic fatty liver disease 5
• Autoimmune hepatitis 5
• Biliary diseases (primary biliary cholangitis, primary sclerosing cholangitis) 5
• Genetic disorders (hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency) 5

Hepatitis: Types, Stages, Symptoms, and Causes

Types

• Viral: Hepatitis A, B, C, D, E 5
• Autoimmune hepatitis 5
• Alcoholic hepatitis 5
• Drug-induced hepatitis 5
• Nonalcoholic steatohepatitis (NASH) 5

Stages

• Acute: Short-term inflammation 1
• Chronic: Inflammation lasting more than 6 months 1
• Fulminant: Severe, rapid-onset liver failure 5

Symptoms

• Jaundice 5
• Fatigue 5
• Abdominal pain 5
• Nausea and vomiting 5
• Loss of appetite 5
• Dark urine 5
• Clay-colored stools 5
• Fever 5

Causes

• Viral infections (hepatitis viruses) 5
• Alcohol abuse 5
• Medications (acetaminophen overdose, certain antibiotics) 5
• Toxins 5
• Autoimmune disorders 5

Hepatic Coma (Hepatic Encephalopathy): Symptoms and Causes

Symptoms

• Confusion, disorientation 5
• Personality changes 5
• Slurred speech 5
• Asterixis (flapping tremor of hands) 5
• Lethargy progressing to stupor and coma 5
• Fetor hepaticus (sweet, musty breath odor) 5

Causes

• Accumulation of toxins (especially ammonia) due to liver's inability to detoxify 5
• Precipitating factors:
  • Gastrointestinal bleeding 5
  • Infection 5
  • Electrolyte disturbances 5
  • Constipation 5
  • Medications (sedatives, diuretics) 5
  • Dehydration 5

Malabsorption Syndrome

Symptoms

• Weight loss despite adequate food intake 4
• Diarrhea 4
• Steatorrhea (fatty, foul-smelling stools) 4
• Bloating and gas 4
• Edema 4
• Anemia 4
• Muscle cramps 4
• Easy bruising 4

Causes

• Celiac disease 4
• Crohn's disease 4
• Pancreatic insufficiency 4
• Bile acid deficiency 4
• Bacterial overgrowth 4
• Parasitic infections 4
• Short bowel syndrome 4
• Medications 4

Cholelithiasis (Gallstones): Types, Symptoms, and Causes

Types

• Cholesterol stones (most common in Western countries) 1
• Pigment stones (black or brown) 1
• Mixed stones 1

Symptoms

• Often asymptomatic 1
• Right upper quadrant pain, especially after fatty meals 1
• Referred pain to right shoulder or back 1
• Nausea and vomiting 1
• Fever and chills if infection present 1
• Jaundice if bile duct obstruction occurs 1

Causes

• Female gender 1
• Obesity 1
• Rapid weight loss 1
• Pregnancy 1
• Certain medications (estrogen, fibrates) 1
• Genetic factors 1
• Certain medical conditions (diabetes, cirrhosis, Crohn's disease) 1

Pancreatitis: Symptoms and Causes

Symptoms

• Severe upper abdominal pain radiating to the back 1
• Nausea and vomiting 1
• Fever 1
• Rapid pulse 1
• Tender, swollen abdomen 1
• In severe cases: hypotension, shock 1

Causes

Acute Pancreatitis

• Gallstones (most common) 1
• Alcohol abuse 1
• Medications (certain antibiotics, immunosuppressants) 1
• Hypertriglyceridemia 1
• Post-ERCP (endoscopic retrograde cholangiopancreatography) 1
• Trauma 1
• Infections 1

Chronic Pancreatitis

• Alcohol abuse (most common) 1
• Genetic factors 1
• Autoimmune disorders 1
• Obstruction of pancreatic duct 1
• Hypertriglyceridemia 1
• Medications 1

Thyroid Disorders: Symptoms and Causes

Hyperthyroidism

• Symptoms: Weight loss despite increased appetite, heat intolerance, tremors, anxiety, rapid heartbeat, insomnia, frequent bowel movements 7, 2
• Causes: Graves' disease (autoimmune), toxic nodular goiter, thyroiditis, excessive iodine intake, medications 7

Hypothyroidism

• Symptoms: Fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, depression, menstrual irregularities 7, 2
• Causes: Hashimoto's thyroiditis (autoimmune), iodine deficiency, surgical removal of thyroid, radiation therapy, medications 7

Thyroid Nodules

• Symptoms: Often asymptomatic, visible swelling in neck, difficulty swallowing or breathing if large 7
• Causes: Iodine deficiency, Hashimoto's thyroiditis, overgrowth of normal thyroid tissue, cysts, thyroid cancer 7

Thyroiditis

• Symptoms: Vary by type, may include pain in the thyroid, symptoms of hyper- or hypothyroidism 7
• Causes: Autoimmune disorders, viral infections, pregnancy, medications 7

Thyroid-Diabetes Connection

• Thyroid disorders are common in diabetes patients 2
• Hypothyroidism is more common than hyperthyroidism in diabetic patients 2
• Both conditions can affect glucose metabolism and insulin sensitivity 2
• Poorly managed diabetes may contribute to thyroid tissue proliferation and nodule formation 2