10 Facts About Hepatitis

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iStock.com/Hailshadow

Even if you've been vaccinated against it, you may have a lot of unanswered questions about hepatitis. The condition, which is characterized by inflamed liver tissue, can be caused by a variety of factors, including viruses, an overactive immune system, and alcohol abuse. Hepatitis symptoms also vary widely, from a flu-like feeling that clears up in a few weeks to liver failure. Here are some facts worth knowing about every type of hepatitis—including the most common types, hepatitis B and hepatitis C.

1. There are five types of viral hepatitis.

Every case of hepatitis is characterized by inflammation of the liver tissue. When looking at viral hepatitis specifically, the treatments, modes of transmission, and duration of symptoms vary from according to which virus strain is causing it. Hepatitis A is an acute illness that often goes away on its own over time. It spreads primarily via the oral-fecal route, usually when someone ingests food or water contaminated with the hepatitis A virus. The second type, hepatitis B, can be either acute or chronic, and it spreads through bodily fluids like blood and semen. Hepatitis C mainly spreads through blood and is most likely to develop into a chronic condition.

The fourth and fifth types of viral hepatitis are hepatitis D and E, though they aren’t talked about much in the U.S. Like hepatitis A, hepatitis E is mostly spread through oral-fecal contamination. Hepatitis D can only be contracted if the patient has already had hepatitis B. Both types are less common in the U.S. compared to countries that lack access to clean drinking water.

2. Non-viral hepatitis can be caused by alcohol and other factors.

Catching a virus isn’t the only way to contract hepatitis. Even if you’re up-to-date on your shots and practice good hygiene, you can get it from exposure to toxic chemicals, taking prescriptions or over-the-counter-drugs, or abusing alcohol. All of these conditions are known as toxic hepatitis. There’s also autoimmune hepatitis, which occurs when the body’s immune system attacks the liver and treats it like a hostile invader. Doctors aren’t entirely sure why this happens, but it’s more common in people with a history of infections or other immune diseases.

3. Chronic hepatitis may not show any symptoms.

Chronic hepatitis is diagnosed when the condition lasts longer than six months. Sometimes it develops following a bout of acute hepatitis, but more often it’s asymptomatic. Vague signs of this form of hepatitis may include malaise, fatigue, and nonspecific upper abdominal discomfort. It’s under-diagnosed, but if patients suspect they have hepatitis symptoms, they can get a liver function test, a viral serologic test, or other blood work done to confirm it’s there.

4. Yellow eyes and skin are common symptoms of acute hepatitis.

Unlike chronic hepatitis, acute hepatitis quickly presents clear signs. These include pale stool, dark urine, fatigue, loss of appetite, and flu-like symptoms. One of the tell-tale symptoms of hepatitis is jaundice, which is characterized by yellowish skin or eyes. This occurs when bilirubin, an orange-colored waste material produced by the normal breakdown of red blood cells, builds up in the blood because the liver isn’t functioning properly.

5. Some types of hepatitis can be prevented with vaccines.

Hepatitis types A and B can both be protected against with vaccines. The hepatitis A vaccine is administered in two doses six to 18 months apart and the hepatitis vaccine is doled out in three shots over six months. Cases of hepatitis B in the U.S. have dropped by as much as 73 percent since the vaccine was first introduced in the 1980s and hepatitis A cases have declined by 95 percent in the same time period.

6. There's no vaccine for Hepatitis C—but doctors are working on it.

Hepatitis C is the most common form of viral hepatitis, but there's still no vaccine for it. Scientists have identified at least six genetically distinct types of the virus, and about 50 different subtypes. This makes it difficult to develop a one-size-fits-all vaccine for hepatitis C, but medical experts have been working on one since the disease was first detected 25 years ago.

7. Some types of hepatitis can be cured.

There’s no specific therapy for hepatitis A once you contract it, but treating it is simple: With plenty of bed rest and hydration, the symptoms should clear up on their own within a few weeks or months. Hepatitis B, on the other hand, has a cure. Pegylated interferon-alphaA, a weekly shot administered over six months, eradicates hepatitis B in 25 percent of people. When it doesn’t work, patients can take oral medications, like amivudine and adefovir, that suppress symptoms. People with hepatitis C can take a combination of pegylated interferon and ribavirin tablets to recover from the condition, but this treatment doesn’t always work and can cause harsh side effects that are hard for some patients to tolerate.

In people with non-viral hepatitis, avoiding the cause—whether it’s drugs, alcohol, or toxic chemicals in their environment—is the first and most important step toward protecting their liver. Patients with autoimmune hepatitis may need to take drugs like Prednisone that lower their immune activity. If chronic hepatitis has gone untreated for a long time and the liver is severely damaged, a liver transplant may be the only option.

8. Long-term effects of hepatitis can be deadly.

If left untreated for too long, chronic hepatitis can have severe health effects. Even when symptoms aren’t immediately apparent, hepatitis takes its toll on the liver. One of the more dire outcomes of this condition is cirrhosis, a deadly liver disease that occurs when scar tissue starts to overtake healthy tissue inside the liver. This stops the liver from functioning properly and can lead to gallstones, swelling of the legs and feet, increased blood pressure, chronic bruising and bleeding, and poisoning of the brain. Liver cancer is another potential long-term side effect of chronic hepatitis.

9. Baby boomers are more likely than other age groups to have hepatitis C.

Baby boomers, a.k.a. people born between 1945 and 1965, are five times more likely to have hepatitis C than the rest of the population [PDF]. Transmission of hepatitis C reached its peak in the 1960s through the 1980s, before regular screenings for the virus became common, which is when most Boomers living with the disease today likely contracted it. Health experts recommend that everyone in this age group be tested for hepatitis C even if they don’t exhibit symptoms.

10. Viral hepatitis kills more people than malaria.

There are more than 325 million people around the world living with viral hepatitis today—that’s roughly equivalent to 4 percent of Earth's population. Every year, the disease leads to 1.34 million fatalities, which makes it deadlier than HIV, tuberculosis, and malaria. While the death rates associated with those diseases are on the decline, deaths caused by viral hepatitis increased 22 percent between 2000 and 2015. In 2017, Charles Gore, then president of the World Hepatitis Alliance, said the spike can be blamed on a lack of funding and prioritization of hepatitis compared to other global health threats. Lack of awareness is also a problem: Just 5 percent of people with viral hepatitis realize they have it.

Pet Obesity is Causing Big Health Problems, According to a New Report

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iStock/dennisvdw

If you’ve recently picked up your cat and felt your back give out, your furry friend may be among the 60 percent of the feline population that’s overweight. Dogs are also getting chubbier: about 56 percent of pet pooches are obese.

According to Banfield Pet Hospital, America's largest general veterinary practice with more than 1000 hospitals nationwide, those fat cats and chunky puppies are at risk for chronic health issues. In a new report, the hospital finds that osteoarthritis (OA) in pets is on the rise, with a 66 percent increase in dogs and a 150 percent increase in cats over the past 10 years.

Osteoarthritis is a kind of arthritis caused by inflammation or damage in joint tissue. Genetics, injury, or bone abnormalities can all be factors. The disease is chronic and degenerative and can make it difficult for pets to move around as they get older.

Excess weight can both precede OA and make it worse. When a pet is overweight, they can develop chronic pain that leads to stress on joints. If they already have OA, that joint discomfort can prevent them from being active, leading to weight gain. That worsens the condition, and the cycle continues.

A dog is 2.3 times more likely to be diagnosed with OA if it's obese, while cats are 1.2 times more likely. Dogs suffering from the condition tend to display symptoms like putting their weight off to one side when sitting, avoiding stairs, or appearing uninterested in playing. Cats might have loose or matted hair because they can't maneuver to groom certain parts of their body.

Although OA can be seen at any age, it’s often mistaken for old age and a pet slowing down naturally. If you notice your pet is either soft around the middle or moving more slowly, it’s best to see a veterinarian. Pets who are overweight or suffering from OA—or both—can benefit from treatments like special diets.

12 Facts About Diabetes Mellitus

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iStock/mthipsorn

Thirty million Americans—about 9 percent of the country's population—are living with diabetes mellitus, or simply diabetes. This chronic condition is characterized by sustained high blood sugar levels. In many patients, symptoms can be managed with insulin injections and lifestyle changes, but in others, the complications can be deadly. Here's what you need to know about diabetes mellitus.

1. There are three types of diabetes.

In healthy people, the pancreas produces enough of the hormone insulin to metabolize sugars into glucose and move the glucose into cells, where it's used for energy.

But people with type 2 diabetes—the most common form of the disease, accounting for about 95 percent of cases—either can't produce enough insulin to transport the sugars, or their cells have become insulin-resistant. The result is a buildup of glucose in the blood (a.k.a. high blood sugar or hyperglycemia). Type 2 diabetes typically develops in adults.

Type 1 diabetes, also known as juvenile diabetes, makes up the remaining 5 percent of chronic cases and most often develops in children and young adults. With this condition, the initial problem isn’t blood sugar levels, but insulin production: The pancreas can’t make enough insulin to process even normal amounts of glucose. The sugar builds up as a result, leading to dangerous concentrations in the bloodstream.

The third form, gestational diabetes, only afflicts pregnant people who weren’t diabetic before their pregnancy. The mother's blood glucose levels usually spike around the 24th week of pregnancy, but with a healthy diet, exercise, and insulin shots in some cases, diabetes symptoms usually can be managed. Blood sugar levels tend to return to normal in patients following their pregnancies.

2. The mellitus in diabetes mellitus means "honey sweet."

Around 3000 years ago, ancient Egyptians described a condition with diabetes-like symptoms, though it wasn't called diabetes yet. It took a few hundred years before the Greek physician Araetus of Cappodocia came up with the name diabetes based on the Greek word for "passing through" (as in passing a lot of urine, a common diabetes symptom). English doctor Thomas Willis tacked on the word mellitus, meaning "honey sweet," in 1675, building on previous physicians' observations that diabetic patients had sweet urine. Finally, in 1776, another English physician named Matthew Dobson confirmed that both the blood and urine of diabetes patients were made sweeter by high levels of glucose in their blood.

3. The cause of one type of diabetes is well understood; the other, not so much.

A person’s lifestyle is a key predictor of developing type 2 diabetes. Factors like being overweight or obese, consuming a high-calorie diet, smoking, and seldom exercising contribute to the risk. Foods and drinks that are high in sugar—soda, candy, ice cream, dessert— may contribute to hyperglycemia, but any food that’s high in calories, even if it's not sweet, can raise blood sugar levels.

In contrast to these well-established factors, medical experts aren’t entirely sure what causes type 1 diabetes. We do know that type 1 is an autoimmune disease that develops when the body attacks and damages insulin-producing cells in the pancreas. Some scientists think that environmental factors, like viruses, may trigger this immune response.

4. Family history also plays a role in diabetes risk.

If a parent or sibling has type 2 diabetes, you are predisposed to developing pre-diabetes and type 2 diabetes. Lifestyle habits explain some of these incidences, since family members may share similar diets and exercise habits. Genetics also play a role, but just because one close relative has diabetes does not mean you're destined to. Research conducted on identical twins, which share identical genes, showed that the pairs have discordant risk. Among twins in which one has type 1 diabetes, the other has only a 50 percent chance of developing it; for type 2, the risk for the second twin is 75 percent at most.

5. Racial minorities are at a higher risk for developing diabetes.

Many racial minority groups in the U.S. have a higher chance of developing type 2 diabetes. Black Americans, Latino Americans, Native Americans, Pacific Islanders, and some groups of Asian Americans are more likely to have pre-diabetes and type 2 diabetes than white Americans. This can be partly explained by the fact that some of these groups also have higher rates of obesity, which is one of the primary risk factors of type 2 diabetes. Socioeconomics may also play a role: One study shows that people with diabetes living in poverty are less likely to visit diabetes clinics and receive proper testing than their middle-income counterparts. According to another study, diabetic people without health insurance have higher blood sugar, blood pressure, and cholesterol rates than insured diabetics. Genetics, on the other hand, don’t appear to contribute to these trends.

6. Diabetes is one of the world's deadliest diseases.

With proper management, people with diabetes can live long, comfortable lives. But if the disease isn’t treated, it can have dire consequences. Diabetics make up the majority of people who develop chronic kidney disease, have adult-onset blindness, and need lower-limb amputations. In the most serious cases, diabetes leads to death. The condition is one of the deadliest diseases in the world, killing more people than breast cancer and AIDS combined.

7. Millions of Americans are pre-diabetic.

According to the CDC, 84 million adults living in the U.S. are pre-diabetic: Their blood sugar is higher than what’s considered safe, but hasn't yet reached diabetic level. In pre-diabetic patients, blood glucose levels after eight hours of fasting fall between 100 and 125 milligrams per deciliter, and diabetic levels are anything above that. People with pre-diabetes are not just at a greater risk for type 2 diabetes, but also for heart disease and stroke. Fortunately, people who are diagnosed with pre-diabetes can take steps to eat a healthier diet, increase physical activity, and test their blood glucose level several times a day to control the condition. In some cases, doctors will prescribe drugs like metformin that make the body more receptive to the insulin it produces.

8. After climbing for decades, rates of diabetes incidence are declining.

In the U.S., the rate of new diagnoses skyrocketed 382 percent between 1988 and 2014. Globally, 108 million people had diabetes in 1980, but by 2014 that number was 422 million.

But thanks to nationwide education and prevention efforts, the trend has reversed in the U.S., according to the CDC. Since peaking in 2009, the number of new diabetes cases in America has dropped by 35 percent. In that same timeframe, the number of people living with diagnosed diabetes in the U.S. has plateaued, suggesting people with the condition are living longer.

9. The first successful treatment for type 1 diabetes occurred in 1922.

Prior to the 20th century, type 1 diabetes was usually fatal. Diabetic ketoacidosis—a toxic buildup of chemicals called ketones, which arise when the body can no longer use glucose and instead breaks down other tissues for energy—killed most patients within a year or two of diagnosis. In searching for way to save children with juvenile (type 1) diabetes, Canadian physician Frederick Banting and medical student Charles Best built on the work of earlier researchers, who had demonstrated that removing the pancreas from a dog immediately caused diabetes symptoms in the animal. Banting and Best extracted insulin from dog pancreases in University of Toronto professor J.J.R. Macleod's lab. After injecting the insulin back into dogs whose pancreases had been removed, they realized the hormone regulated blood sugar levels. On January 11, 1922, they administered insulin to a human patient, and further refined the extract to reduce side effects. In 1923, Banting and Macleod received the Nobel Prize in Medicine for their work.

10. A pioneering physicist discovered the difference between type and and type 1 diabetes.

In the 1950s, physicist Rosalyn Yalow and her research partner Solomon Berson developed a method for measuring minute amounts of substances in blood. Inspired by Yalow's husband's struggle with diabetes, Yalow focused her research on insulin. Their "radioimmunoassay" technology revealed that some diabetes patients were still able to produce their own insulin, leading them to create two separate categories for the disease: “insulin-dependent” (type 1) and “non-insulin-dependent” (type 2). Prior to that discovery in 1959, there was no distinction between the two types. In 1977, Yalow won the 1977 Nobel Prize in Medicine for the radioimmunoassay, one of only 12 female Nobel laureates in medicine.

11. Making one insulin dose once required tons of pig parts.

Insulin is relatively easy to make today. Most of what's used in injections comes from a special non-disease-producing laboratory strain of E. coli bacteria that's been genetically modified to produce insulin, but that wasn't always the case. Until about 40 years ago, 2 tons of pig pancreases were required to produce just 8 ounces of pure insulin. The pig parts were typically recycled from pork farms.

12. A quarter of diabetes patients don’t know they have it.

The symptoms of type 2 diabetes can develop for years before patients think to ask their doctor about them. These include frequent urination, unexplained thirst, numbness in the extremities, dry skin, blurry vision, fatigue, and sores that are slow to heal—signs that may not be a cause for concern on their own, but together can indicate a more serious problem. Patients with type 1 diabetes may also experience nausea, vomiting, and stomach pain.

While serious, the symptoms of diabetes are sometimes easy to overlook. That’s why 25 percent of people with the illness, 7.2 million in the U.S., are undiagnosed. And that number doesn’t even cover the majority of people with pre-diabetes who aren’t aware they’re on their way to becoming diabetic.

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