TREATMENT
• Lifestyle Management The changing of ones lifestyle though may be effective if fully implemented, it may be hard to do. This method involves the change in both diet and exercise.On average, an individual is limited to only 500-1000 kcal per day to achieve this goal for a period of 6-12 months consistently [26,27,28] . In terms of diet, a carbohydrate-restricted diet should be implemented in NAFLD patients [29] . Since NAFLD is connected to carbohydrate intake, it can affect the glucose homeostasis and free fatty acid metabolism in the liver. With every 7-10% reduction in body weight, a person is said to have decrease some of the inflammation in NAFLD [30] .
• Bariatric Surgery Bariatric surgery is a procedure that is done
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Insulin sensitizers
- Since NAFLD has a strong connection with that of insulin resistance, metformin and thiazolidinedione (TZDs); which are insulin sensitizers are commonly used in treating NAFLD patients [32].
- Metformin
- This insulin sensitizer is normally used for treating type 2 diabetes patients through the action and activation of AMPK [33] . As a result, the peripheral glucose intake is improved, the hepatic gluconeogenesis is reduced and the beta oxidation of FFA is increased [34] .
2. Lipid lowering drugs
- Though there is no direct benefit to that of NAFLD management, the cardiovascular risk of NAFLD can be reduced with the usage of statins, fibrates and omega-3 polyunsaturated fatty acids [32] .
• Hyperstension management The common method of reducing hypertension in NAFLD patients is by using Angiotensin II receptor blockers (AIIRB). This blocker functions not only to inhibit proliferation of stellate cells, but also to decrease inflamation and fibrosis [35] .
• Liver Transplantation For patients that have reached a stage where there is liver failure due to NAFLD, the only option that can be done is through liver transplant. Even with this procedure, it is likely that recurrent NASH can develop as a result of metabolic factors as well as the constant usage of immunosuppresion like corticosteroids [36]
Statins are also another type of medication prescribed if you have a high blood cholesterol level, this lowers cholesterol. This medicine blocks the formation of cholesterol and increasing the number of LDL receptors in the liver, which helps remove the LDL cholesterol from your blood. This helps slow the progression of CHD, and will make having a heart attack less likely. However, not everyone is suitable for this medicine.
Based on 2014 hepatic encephalopathy guideline, NA’s hepatic encephalopathy is classified as type C and recurrent due to the cirrhosis and 2 episodes of HE occur with a time interval of 6 months or less. Typical signs and symptoms consistent with his HE includes confusion, forgetfulness, and anxiety. According to the guideline, the goals for the treatment are maintaining two to three bowel movements per day, decreasing elevated ammonia level, prevention of recurrent episodes of HE, and improvement of daily functioning. Lactulose is the first choice for treatment of overt HE. Currently, patient is on lactulose only once a day because of his noncompliance. The dose frequency is incorrect since he does not have at two to three bowel movements per day. Increasing frequency back to three times a day is recommended for the patient. Moreover, rifaximin is an effective add-on therapy to lactulose for prevention of OHE recurrence. Also, counseling the effects of lactulose and rifaximin, importance of adherence, early signs of recurring HE, and actions to be taken if recurrence are also beneficial for the patient.
Metoformin is a medication used to treat Type 2 diabetes. Metformin is classified as a biguanide and antidiabetic medication. Its therapeutic classification is an antihyperglycemic. Metformin, which is the drug’s generic name, is also known under its trade names: Fortamet, Glucophage, Glucophage XR, Glumetza and Riomet. Metformin is an oral hypoglycemic medication and has three main actions: Metofrmin increases the binding of insulin to insulin receptors in skeletal muscles and fat, which works to improve tissue sensitivity to insulin. Through this action, glucose is able to be transported into skeletal muscles and fat and the body is able to use glucose to function properly. Metformin also suppresses gluconeogenesis, which is the production of glucose from non-carbohydrate sources such as fat and protein. Metformin also prevents the liver from converting stored glycogen into glucose. All these actions work together to lower the level of blood sugar and also lower the Hemoglobin A1C value, ensuring diabetics have better control of their blood sugar.
Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while
The FDA has not approved use of this medication with type 1 diabetes. With type 1 or Juvenile diabetes the immune system destroys the cells that release insulin, which will eventually eliminate insulin production from the body. (WebMD, 2014) This medication is also not approved for use in those with decreased kidney function due to the effects on the GFR.
The mainstay of type 2 diabetes medication is Metformin due to the cost, safety of the medication and limitied side effects. Metformin reduces glucose levels through two pathways; it reduces hepatic glucose production and increases the insulin tissue sensitivity. Monotherapy is normal for this medication; however, it can be utilized in combination with other medications. Metformin used in conjunction with Sodium glucose cotransporter provides a greater control over the level of glucose in the body due to the reduction of glucose production, increase in sensitivity, reduction of reabsorption of glucose and the excretion of glucose through the kidneys, basically the glucose control is through 4 different pathways making it a synergetic effect on diabetes type 2. According to Inzucchi et al.(2016), the combination of these medications helped patients reduce their overall A1c (0.5-1.0), lose weight (2kg) and a reduction in their blood
Fish oil suppliments have been renounced by health care professionals as one of the best ways for patients to increase their chances of battling heart disease and hypertension. But until now, these claims have been unproven and untested. The National Institute of Health has stated that they would like to examine the benefits of fish oil suppliments in a larger study of previous examinations of this phenomenon.
Insulin potentiation therapy is celebrated for being both safe and innovative in the field of cancer treatment. Best of all, unlike chemotherapy and other treatment methods, insulin potentiation therapy has minimal side effects and does not make patients feel nauseous, experience liver damage, or suffer from radical hair loss. I
Metformin is a medication that works by decreasing the amount of glucose that the liver
prescribed to improve sensitivity of the body tissues to insulin so that the body uses
Presently, the treatment strategies used are risk factor modification, conventional pharmacology and surgical revascularization. These strategies have hitherto not been of enormous solution as the disease progression still result in recurrent symptoms. This has now led to the exploitation of advances in comprehending the vascular biology of atherogenesis to introduce novel cell and molecular-based therapies. The application of immunomodulation, lipid-lowering agents like statins, gene transfer, antisense technology and so on has resulted in new therapeutic strategies to interrupt cell proliferation and disorder of the vessel wall. In this essay, immunomudulation and lipid-lowering agent shall be discussed.
The Passover Festival is held to commemorate the Exodus from Egypt over 3,000 years ago.
Type 2 Diabetes (T2D) is the most prevalent form of diabetes, accounting for 90%-‐95% cases worldwide. It’s characterized by the decrease in insulin secretion from pancreatic β cells, as well as the decreased
My family and I don’t have any financial burdens or special situations. We’re just the typical American family who has their occasional ups and downs. These ‘ups and downs’ start with my dad’s line of business. My dad works in the oil field and, as we all know, it really has its downsides. The company he works for recently laid off a large amount of its workers, luckily my dad wasn’t one of them. The oil business is really unstable, and that has a direct effect on our financial standings. When oil is up we’re up and when it’s low we are really low, and sometimes struggle on living paycheck to paycheck. My dad is also gone a lot because, he has to travel all over the US to lay new lines or fix leaks. While he is gone my mom and I are all on our own.
One day that changed my life was the day I went into foster care.I will never forget that day. I remember going to school that day i was sitting in class and the S.R.O came and got me from class. I felt like something bad was going to happen. I was right they took me into foster care. They took me from school and then when we were leaving the school they asked me if i knew where my mom and brother were i didn’t know.