Hello, it was about
2000 years ago that the
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ancients recognized
that there were some
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people, not
everybody, but some people had
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sweet urine. They
recognized this because
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if the urine spilled
on the ground the ants
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were attracted to it.
They called the disease
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as diabetes mellitus.
Diabetes because that's
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the Greek word for
fountain and mellitus
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because that's the
Latin word for sweet or
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honey. So, its honey
fountain or we call it
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diabetes mellitus or
sugar disease. So, if
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you would like to
learn something about this
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sugar disease we
will be talking about this
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during this program
and we hope you'll join us.
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Welcome to Help
Yourself to Health with
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Dr. Agatha Thrash of
Uchee Pines Institute.
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And, now here is
your host, Dr. Thrash.
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Now, diabetes is
actually two separate
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diseases. One, we call
it type I diabetes and the
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other we call type
II diabetes. Those we
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used to say, we used
to call them juvenile
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diabetes and the
adult onset diabetes. Now,
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we don't actually
refer to them anymore by
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those terms because
we recognize now that
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some adults can get
that what we used to call
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juvenile diabetes
and now with overweight
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being so prevalent
among children we're
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now seeing the
type II diabetes very
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frequently in small
children. And, so we
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now refer to them
as type I and type II,
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but there are two
separate diseases and
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have totally
different ways, so they express
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themselves in the
blood test. Now, in order for
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us to fully understand
about this, we of course
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would like to know
something about how
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the blood sugar is
handled in the body.
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And, just what we
can do to make the body
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better able to
handle sugar. When sugar
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builds up in the
bloodstream that causes
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an irritative problem
to blood vessels. Sugar
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itself is what we
might call an irritant in the
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blood. And insulin
while it's essential to
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life as sugar is
also. While insulin is
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essential to life, we
cannot function without
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it. If we get too much
then we can look at it in
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lay terms as an irritant.
And, it causes a number
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of problems for the
body. One of which is
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overweight that's one
reason for that is, that
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it's a very good appetite
stimulant. So, as it goes
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higher in the
bloodstream, the person
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has more-and-more
appetite. So, if they see
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something they like
and they don't have habits
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that are very strict and
make it so that they will
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not eat at certain
times and will not eat certain
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things that they know
to be unhealthful. They
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don't have those
habits well ingrained then
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because of the surge
of appetite that comes
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with the high
insulin levels they tend to
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overeat and to eat
too frequently. And to be
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willing to eat foods
that are very sweet, they
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tend to have a very
good appetite for foods
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that are very sugary or
very salty or very fatty
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and all of those tend
to promote more appetite
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and also tend to
promote overweight.
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So, there are some
ways that we can help
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ourselves by dietary
restrictions, but if we
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know some of the
complications that can
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occur from diabetes
that too is a deterrent or
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an inspiration or a
motivating factor to
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help us to learn
about these diseases and to
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get so that we are not
ravaged by the diseases
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and the complications.
So, I have some pictures
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to show you of some of
those problems that can
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occur on the skin.
And the first one that I
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would like to show
you is a diabetic ulcer.
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Now, the usual diabetic
ulcer is just as you see
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here with a little
pus and dead material down
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in the active part of
the ulcer. The edges are
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little raised and a
little reddened and if the
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usual leg will be a
little different from this
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because it is usually
quite a lot larger and it
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is quite a lot more
swollen. Because of the
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swelling of it, it
makes the skin tense. And that
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tends to draw the edges
apart more and to retard
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healing. So, one of the
things that we can do to
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improve the healing
is to put on a type of
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bandage that will make
the, the leg, the skin on
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the leg to pull
together more, so that the, the
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tissue can grow, can
spread over, the skin
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surfaces can
spread over the wound and
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heal it in that way.
Now, another thing that
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we need to do with this
ulcer is to clear up the
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pus and the dead
material down in the
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active part of the
ulcer. And, there is a rigid
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bandage, which we
call the Unna boot, which I
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would like to show to you now.
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The, and for that I
would like to have a
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product, which you
can buy on the market may
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not go by this brand
name, but it will have
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or may have the name
of Unna boot or Unna's
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boot as this one
does. Now, the Unna boot is
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the original and
of course we have used
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the Unna boot for I
suppose 100 years or
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more and it goes on
very nicely, even when
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you use the old fashion
Unna's boot itself. And,
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I've here the ingredients
for the old Unna boot
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that we used to make
up 50 years ago and it
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is zinc oxide, which
you simply measure out
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into a cup and you
get the formula properly
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for it. And at which
you can get online and then
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you use glycerin.
And glycerin can also be
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obtained from a
pharmacy as this one
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was. And the glycerin
is mixed with it along
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with some gelatin,
which you can get from
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a grocery store just
the plain Knox gelatin or
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any kind of clear
gelatin, which you can
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use. I suppose Agar
could also be used in
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the same way, but the
Knox gelatin is by all
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means the best. And
so you can make, you can
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make this yourself,
it needs to be heated
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because of the
gelatin, so the gelatin is
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softened in some
water and heated to dissolve
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it and then the zinc
oxide and the glycerin
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put in. And then the
part of foot and leg and
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the ulcer is wrapped
with gauze such as this
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and then with a
little paint brush the old
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Unna paste is painted
on the first layer of the
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gauze and then a
second layer of gauze is
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wrapped on that and
it's allowed to harden and
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to gel and that makes
the rigid bandage. Now,
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while I have put
on I suppose a hundred
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Unna boots with the
old fashion paste and the
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paint brush. I would
like to show you how to
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use this, this new
variety. This is more
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expensive, but it's
also it's so much more
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convenient. So, I've
asked an assistant and
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that so Arianna
Hartsfield. So, Arianna
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if you will come
here and join me, and I
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would like you to sit
right here and Arianna is
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one of our students
in our church school at
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Uchee Pines and we are
pretending that she has
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a large diabetic ulcer
on her left leg. So, if you
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remove your left
sock, we will proceed to put
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on an Unna boot.
Unna boots are extremely
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successful and they
will both clear up the ulcer.
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It will clear that to
dead an infective material
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up. And also will
make the, the swelling go
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down and heal the
ulcer, you can see it
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from one bandage
change to the next.
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Okay, Arianna if you
let me have your left foot
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and I'll just put
this right up here on my
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knee that's the very
best way that you can put
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this Unna boot on.
And then you just take the
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gel cast that you
have and it would be
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packaged very
tightly because it is, it, it
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should not dry out
and then you can see that
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sort of sticks together
little bit like this and on
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the ulcer we will put
a 4x4, so, let's pretend
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that she has a big
ulcer right here. So, we will
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put this right there
and then we will put this on
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top of that just like so
that will help it to stay
00:10:00.44\00:10:04.23
on. And, then we just
wrap this on, it isn't
00:10:04.26\00:10:08.69
difficult to put it on,
it goes on sort of like a
00:10:08.72\00:10:11.10
little cast. And because
it is made of rather thin
00:10:11.13\00:10:16.69
gauze, it is of
course going to mold a bit to
00:10:16.72\00:10:21.89
her foot and this has
to go down all the way to
00:10:21.92\00:10:24.96
the base of the toes
as you see me doing here.
00:10:24.99\00:10:28.89
The reason for that is
so that the little rigid
00:10:28.92\00:10:33.46
bandage, once it
gets rigid then it will be
00:10:33.49\00:10:37.19
right at the base of
the toes and if you have to
00:10:37.22\00:10:40.58
make it fit then you can
just twist it little bit as
00:10:40.61\00:10:43.91
you see me do there.
And then it goes back
00:10:43.94\00:10:46.56
up and if you will
notice you can see that
00:10:46.59\00:10:51.03
there is some chalky
material that gets on
00:10:51.06\00:10:53.91
my fingers like that.
This chalky material is
00:10:53.94\00:10:57.57
the zinc oxide, which
we had in the original
00:10:57.60\00:11:01.13
Unna paste. The
original Unna paste was
00:11:01.16\00:11:04.27
a very good paste
with zinc oxide. One more
00:11:04.30\00:11:07.62
wrap around the foot
and then it goes up over
00:11:07.65\00:11:11.21
the leg. Now, the
reason that it must go
00:11:11.24\00:11:13.61
up over the leg
is because the, the
00:11:13.64\00:11:18.83
swelling needs to
come down, but we don't, we
00:11:18.86\00:11:21.50
don't make it tight.
We simply make it fit
00:11:21.53\00:11:24.14
because the way
that it's going to be
00:11:24.17\00:11:26.34
functional is
that her walking and
00:11:26.37\00:11:31.57
moving and flexing her
muscles will make it so
00:11:31.60\00:11:35.84
that she will have
the muscles to make the
00:11:35.87\00:11:42.48
fluid go out of her
leg. So, we wanted to go up
00:11:42.51\00:11:46.61
a good way on her
leg just for that very
00:11:46.64\00:11:49.90
purpose. Now, each
roll around leaves about
00:11:49.93\00:11:55.73
one-third of the last
roll exposed. So, that its,
00:11:55.76\00:12:01.97
it's not, don't make
one edge go to the next
00:12:02.00\00:12:06.67
edge just make it
about like this. Now, once it
00:12:06.70\00:12:11.77
gets on before they do
too much walking on it.
00:12:11.80\00:12:15.92
It has to harden
and that takes with this
00:12:15.95\00:12:20.11
commercial form, they
will often tell you how
00:12:20.14\00:12:23.65
long it's going to
take, but it will often take
00:12:23.68\00:12:27.09
maybe a couple of
hours before it gets
00:12:27.12\00:12:29.93
fully hardened, but
it's not a big problem just
00:12:29.96\00:12:34.09
make it, make it fit
and let them have the time
00:12:34.12\00:12:38.97
to have it to gel.
Now, that looks as if it's
00:12:39.00\00:12:43.59
about enough. So,
cut this off right here.
00:12:43.62\00:12:46.40
Now, you can put the
rest of it back in the
00:12:46.43\00:12:49.54
water tight package
and use this for the next
00:12:49.57\00:12:53.31
time you put the
bandage on. Now, at
00:12:53.34\00:12:56.22
this point we need
to assume a couple of
00:12:56.25\00:12:59.45
things. One is
that couple of days have
00:12:59.48\00:13:03.81
gone by and it's time
for a dressing change.
00:13:03.84\00:13:07.18
So, with the
dressing change the way to do
00:13:07.21\00:13:10.51
that, you will notice
now that this looks like
00:13:10.54\00:13:12.59
a cast, looks like
the cast, so that the
00:13:12.62\00:13:16.13
orthopedists put on
for a broken bone. And
00:13:16.16\00:13:19.63
that's good too, you can
give it a little bit of a
00:13:19.66\00:13:21.91
rub, so that makes
it smooth, but when you
00:13:21.94\00:13:25.36
take it off you simply
cut it off away from the
00:13:25.39\00:13:29.86
place, where the
ulcer is. Ulcer is over here
00:13:29.89\00:13:32.32
and you simply cut
it off somewhere away
00:13:32.35\00:13:36.08
from the, the ulcer.
So, as I'm doing now, takes
00:13:36.11\00:13:42.09
a little to do although
it will be once they have
00:13:42.12\00:13:45.27
walked on it for
a couple of days and
00:13:45.30\00:13:48.25
usually the
dressing change is every 2-5
00:13:48.28\00:13:51.96
days depending the
stage, where the ulcer
00:13:51.99\00:13:55.90
is. But let say this
one, this one is ready to
00:13:55.93\00:13:59.91
come off and this is
simply the way that you
00:13:59.94\00:14:02.73
do it. And
sometimes the patient can, can
00:14:02.76\00:14:06.30
help you to get, get
it cut off, but as you can
00:14:06.33\00:14:10.51
see it's takes a little
bit of, of working to get it
00:14:10.54\00:14:14.06
off. Very affective
treatment, I like it very
00:14:14.09\00:14:19.64
much for the diabetic
ulcers and I'm sure that
00:14:19.67\00:14:23.68
anyone who has
experienced with this
00:14:23.71\00:14:26.22
will tell you the
same thing that I've had.
00:14:26.25\00:14:29.22
Now, usually after
a couple of days of
00:14:29.25\00:14:34.03
having the, the
bandage on, the person, the
00:14:34.06\00:14:38.93
bandage will be a little
bit loose on the leg, but
00:14:38.96\00:14:41.99
the leg will be much
smaller then it had been
00:14:42.02\00:14:45.06
when you put the
bandage on. Thank you,
00:14:45.09\00:14:47.71
Arianna. We
appreciate your working with us,
00:14:47.74\00:14:52.60
with this. That's fine.
00:14:52.63\00:14:53.60
So, little bit
messy. Now, as you can see
00:14:53.61\00:14:58.08
it's, while it's a
little trouble to put the
00:14:58.11\00:15:01.52
bandage on. I can
assure you that it's quite
00:15:01.55\00:15:04.81
affective for this
problem. Now, I have
00:15:04.84\00:15:08.54
some other pictures
that I would like to show
00:15:08.57\00:15:10.95
you of other
problems that can occur in the
00:15:10.98\00:15:14.74
diabetic. So, at this
point we will take, we
00:15:14.77\00:15:18.05
will look at a toe.
Now, here you can see that
00:15:18.08\00:15:20.88
this toe has a
chronic ulcer on it. This toe
00:15:20.91\00:15:26.19
may progress in the
diabetic with an ulcer
00:15:26.22\00:15:29.92
like that to amputation
either the toe itself has
00:15:29.95\00:15:34.75
to be amputated or
sometimes a portion of
00:15:34.78\00:15:38.10
the foot perhaps
half of the foot or even a
00:15:38.13\00:15:41.47
below the knee
amputation may have to
00:15:41.50\00:15:44.22
occur for such an
ulcer is this. This ulcer
00:15:44.25\00:15:48.23
happened because the,
a heating pad was used
00:15:48.26\00:15:53.85
for the patient and
that got too hot and this
00:15:53.88\00:15:57.88
little ulcer develop.
little blister first, and
00:15:57.91\00:16:01.28
then the ulcer, which
would not heal and that
00:16:01.31\00:16:04.46
points out the fact
that diabetics should not
00:16:04.49\00:16:07.55
have hot things put
on the feet. They can't
00:16:07.58\00:16:11.49
experience the pain
like a normal person can
00:16:11.52\00:16:14.91
and therefore
they've serious problems with
00:16:14.94\00:16:18.57
excessive heat. Hot
foot baths are best avoided.
00:16:18.60\00:16:22.67
A warm foot bath body
temperature is about the
00:16:22.70\00:16:26.43
hottest that a
diabetic should take a hot foot
00:16:26.46\00:16:29.58
bath or a foot bath
not hot foot bath. Now, we
00:16:29.61\00:16:33.19
have another picture
to show you. This picture
00:16:33.22\00:16:35.94
also shows a typical
problem with a diabetic
00:16:35.97\00:16:39.70
on the just behind
the great toe will develop
00:16:39.73\00:16:45.64
an ulcer on the, on the
sole of the foot. It's not
00:16:45.67\00:16:49.48
an uncommon place.
One of the reasons why
00:16:49.51\00:16:52.06
it develops there is
that the, the diabetic cannot
00:16:52.09\00:16:55.36
see on the bottom and
often because of weight
00:16:55.39\00:16:59.49
they may not be able
to reach down and, and
00:16:59.52\00:17:02.04
recognize that something is
00:17:02.07\00:17:04.14
developing different
on the bottom of the foot.
00:17:04.17\00:17:07.27
And because the
nerves are not sensitive
00:17:07.30\00:17:11.13
anymore then the
person develops an
00:17:11.16\00:17:15.20
ulcer before they
know it and it's a serious
00:17:15.23\00:17:18.11
ulcer before they
even know it. Now, the next
00:17:18.14\00:17:21.10
picture that I will
show you is also in a
00:17:21.13\00:17:23.15
diabetic, also illustrates
a typical problem. This
00:17:23.18\00:17:27.82
problem is
Gangrene you will see that
00:17:27.85\00:17:30.39
developing in the right
foot the second toe. See
00:17:30.42\00:17:35.08
the end of that toe is
black that is called dry
00:17:35.11\00:17:39.66
Gangrene, but you will
notice that on the left
00:17:39.69\00:17:43.38
toes there are, there
are three of the left toes
00:17:43.41\00:17:46.33
that have the
purplish red discoloration. If
00:17:46.36\00:17:50.09
you were to press your
thumb into that area of
00:17:50.12\00:17:53.99
the purplish red
discoloration, it might
00:17:54.02\00:17:57.76
take as long as a
minute for the blood to run
00:17:57.79\00:18:02.09
back into the skin at
that point. Where as a
00:18:02.12\00:18:05.32
normal person will
have the, if you press
00:18:05.35\00:18:07.94
on the foot on a toe
the, the normal person will
00:18:07.97\00:18:13.34
have the blood to
run back into the skin in
00:18:13.37\00:18:16.98
maybe one or two
seconds doesn't take
00:18:17.01\00:18:19.88
long at all. So, you
can see by that, that the
00:18:19.91\00:18:22.75
diabetic is having
a serious problem with
00:18:22.78\00:18:25.97
the skin. Now, let's talk a bit
00:18:26.00\00:18:29.28
about how the
diabetic develops an infection
00:18:29.31\00:18:34.78
more frequently and
more easily than the
00:18:34.81\00:18:37.62
average person does.
Because of the fact that
00:18:37.65\00:18:41.17
when the blood sugar
rises after a meal, the
00:18:41.20\00:18:45.38
bodies first objective is
to get the, get all of the
00:18:45.41\00:18:53.09
sugar that's excess
above the fasting level
00:18:53.12\00:18:56.89
to get all of that, out
of the bloodstream and put
00:18:56.92\00:19:00.24
into various
places, where sugar can be
00:19:00.27\00:19:04.29
stored. Now, sugar can
be stored in muscles, it
00:19:04.32\00:19:07.97
can be stored in the
kidney, in the liver, and
00:19:08.00\00:19:11.68
in the skin and
various other places. But the
00:19:11.73\00:19:14.81
skin is an important
immediate reservoir for
00:19:14.84\00:19:19.80
sugar. So, sugar
is taken out of the
00:19:19.83\00:19:22.99
bloodstream and
temporarily stored in
00:19:23.02\00:19:26.54
the skin. That makes
the sugar in the skin go
00:19:26.57\00:19:29.87
high. Sugar is a
good culture medium for
00:19:29.90\00:19:33.90
bacteria. So, a
small scratch, a little
00:19:33.93\00:19:36.82
abrasion, can
result in quite a serious
00:19:36.85\00:19:40.14
infection. And I
would like to show you some
00:19:40.17\00:19:44.29
charts that I have that
will illustrate this the
00:19:44.32\00:19:47.87
way that
infection occurs. Let, let's
00:19:47.90\00:19:51.85
take a look here at a
germ itself. This is a
00:19:51.88\00:19:56.62
bacterium one with
flagella, which are little
00:19:56.65\00:20:04.78
threads with which
the bacterium swims, so it
00:20:04.81\00:20:09.79
moves these and
propel themselves along. Also
00:20:09.82\00:20:14.01
you will notice this
on the outside is the
00:20:14.04\00:20:16.84
capsule, then comes
the cell wall and then
00:20:16.87\00:20:20.90
comes the cell
membrane before you
00:20:20.93\00:20:22.96
ever get to the
cytoplasm then the
00:20:22.99\00:20:25.31
nucleus is down
here. You can see by that,
00:20:25.34\00:20:28.77
that the germ is
well armored to invade and
00:20:28.80\00:20:34.16
has good resistance
against us. But, we also
00:20:34.19\00:20:37.38
have very good
advancing substances
00:20:37.41\00:20:44.28
and advancing structure
such as our white blood
00:20:44.31\00:20:47.34
cells and the vast
array of chemical substances
00:20:47.37\00:20:51.61
that the immune
system can produce. An
00:20:51.64\00:20:55.07
amazing array of
substances that are
00:20:55.10\00:20:58.16
powerful to kill
bacteria or to wall them off and
00:20:58.19\00:21:02.90
make them, so that
they cannot move. So
00:21:02.93\00:21:05.61
bacterium maybe one
without flagella, they
00:21:05.64\00:21:09.75
don't all have
flagella most of them in fact do
00:21:09.78\00:21:12.58
not, but as
something happens let us say,
00:21:12.61\00:21:16.33
there you get an
infection somewhere on
00:21:16.36\00:21:20.78
the skin or in the
internal organs and the
00:21:20.81\00:21:24.80
germ gets into the
bloodstream and goes
00:21:24.83\00:21:28.58
to other parts of
the body. You can get a
00:21:28.61\00:21:31.80
meningitis from,
from one, from the germ
00:21:31.83\00:21:36.09
called Neisseria
meningitidis and that is
00:21:36.12\00:21:39.51
the, the germ most
likely to affect the
00:21:39.54\00:21:44.11
meninges then you can
get a streptococcus that
00:21:44.14\00:21:47.55
can infect the number
of places that can get in
00:21:47.58\00:21:50.46
the bloodstream,
can even go to the heart
00:21:50.49\00:21:52.64
valves. You can
get streptococcus
00:21:52.67\00:21:55.27
pneumonia, which can
go to the lungs and a
00:21:55.30\00:21:58.26
streptococcus
aureus, which can involve the
00:21:58.29\00:22:02.21
skin and the pseudomonas, which
00:22:02.24\00:22:04.38
can involve the
prostate and the salmonella,
00:22:04.41\00:22:06.97
which can involve that
the colon of course and
00:22:07.00\00:22:10.80
we are familiar with
that from reports that
00:22:10.83\00:22:14.34
we have out of
people, who have eaten
00:22:14.37\00:22:16.44
infected meat or eggs
or chicken and this has
00:22:16.47\00:22:20.61
caused them to get
a salmonella infection
00:22:20.64\00:22:23.21
in the colon. So, of
course with these germs
00:22:23.24\00:22:28.35
that can go all over
the body, one can certainly
00:22:28.38\00:22:31.62
see how these germs
could either originate in
00:22:31.65\00:22:34.57
the skin or could go
from the blood into the
00:22:34.60\00:22:37.90
skin. Now, let's take
a moment for an anatomy
00:22:37.93\00:22:42.57
lesson, if you will
indulge me. This is a
00:22:42.60\00:22:44.90
most wonderful
illustration of the grand
00:22:44.93\00:22:49.72
design of the human
body. We have in bone
00:22:49.75\00:22:53.96
marrow and before we
are born these cells,
00:22:53.99\00:22:58.63
which is called
here hemocytoblast or a
00:22:58.66\00:23:01.52
stem cell, you may
have heard of stem cell
00:23:01.55\00:23:04.29
transplants. Well, here
is a stem cell, we will say
00:23:04.32\00:23:08.06
that this is a bone
marrow and this is the
00:23:08.09\00:23:10.98
red bone marrow and
this is the cortical bone.
00:23:11.01\00:23:14.07
The red bone marrow
such as in ribs and in
00:23:14.10\00:23:17.64
the breast bone that
kind or and other flat
00:23:17.67\00:23:21.63
bones, the skull, the
hip bones. These are, this
00:23:21.66\00:23:26.57
red bone marrow is
the place where these
00:23:26.60\00:23:29.36
grow. Then over here
we have the line that
00:23:29.39\00:23:32.98
will form red blood
cells. And here is a
00:23:33.01\00:23:35.83
mature red blood cell
right here in this area.
00:23:35.86\00:23:39.99
Then we have what is
called the granulocytes
00:23:40.02\00:23:43.24
and they develop from
a stem cell, which can
00:23:43.27\00:23:46.09
develop in anyone
of our blood cells. The
00:23:46.12\00:23:48.75
stem cell, this is
a myeloblast and then
00:23:48.78\00:23:51.21
we have over here
the neutrophils, the
00:23:51.24\00:23:53.58
eosinophils and the
basophils. Eosinophils
00:23:53.61\00:23:58.62
are increased in
number when we have allergies,
00:23:58.65\00:24:02.83
intestinal parasites
very common thing to cause
00:24:02.86\00:24:07.12
a very high eosinophil
count. Certain collagen
00:24:07.15\00:24:12.65
diseases can also cause
a high eosinophil count.
00:24:12.68\00:24:16.66
The neutrophils are
our first line of attacking
00:24:16.69\00:24:21.92
soldiers. They
attack any germ that comes
00:24:21.95\00:24:26.41
into the body, any
bacterium that comes into
00:24:26.44\00:24:28.72
the body and will
also move into any kind of
00:24:28.75\00:24:31.97
inflammatory
position. Then the basophils, we
00:24:32.00\00:24:36.40
don't know as much as
we would certainly like
00:24:36.43\00:24:38.58
to know about
basophils, but one of
00:24:38.61\00:24:41.10
the things that we
have recognized in the
00:24:41.13\00:24:43.26
basophil line is
that, when there is a cancer
00:24:43.29\00:24:46.73
in the body somewhere
basophils can increase
00:24:46.76\00:24:51.06
in number. Then
here are the monocytes.
00:24:51.09\00:24:54.84
These are also
called macrophages they can,
00:24:54.87\00:24:58.63
they can also be
called dendritic cells or a
00:24:58.66\00:25:01.66
macrophages, very
excellent fighting cells
00:25:01.69\00:25:05.89
for us. All of these
are good fighting cells.
00:25:05.92\00:25:08.51
Then the lymphocytes
and one of there line
00:25:08.54\00:25:11.38
can make antibodies
and plasma cells, which
00:25:11.41\00:25:16.66
we used to think
didn't have any good reason
00:25:16.69\00:25:19.99
for being. Now, we
know that they are the
00:25:20.02\00:25:22.19
part of the
immune system and very
00:25:22.22\00:25:23.93
important for us.
Then way over here we have
00:25:23.96\00:25:27.63
what is called a
megakaryoblast. And
00:25:27.66\00:25:30.89
the megakaryocyte,
which develops from
00:25:30.92\00:25:33.47
the megakaryoblast
has also platelets. These
00:25:33.50\00:25:37.67
platelets have a
very important part in our
00:25:37.70\00:25:41.99
clotting mechanism and
in abnormal... in times
00:25:42.02\00:25:47.35
when there are
abnormalities in the
00:25:47.38\00:25:49.33
body, an inflammation.
These platelets can
00:25:49.36\00:25:52.37
become sticky and then
they make a clot. If we
00:25:52.40\00:25:56.13
get a cut they
can become sticky and
00:25:56.16\00:25:59.07
make a clot. Now, in
the urinary tract, we
00:25:59.10\00:26:04.72
have some other
problems that can be
00:26:04.75\00:26:07.21
very common in
diabetics. So, now I
00:26:07.24\00:26:09.69
would like to just show
you here is the adrenal,
00:26:09.72\00:26:12.04
here is the kidney,
here is the cut surface of a
00:26:12.07\00:26:16.24
normal kidney and
here is a dilation of the
00:26:16.27\00:26:20.94
kidney pelvis because
of a, of an impaction of
00:26:20.97\00:26:26.03
a stone that has
developed here in the
00:26:26.06\00:26:29.06
kidney pelvis and the
top part of the ureters,
00:26:29.09\00:26:31.88
so this the ureter
gets blocked by a stone and
00:26:31.91\00:26:35.48
we've a dilation of
the ureter there. Here the
00:26:35.51\00:26:40.27
ureter comes down and
empties into the bladder
00:26:40.30\00:26:43.71
and the bladder can
have in the diabetic
00:26:43.74\00:26:47.40
may have cystitis or
may even get a little
00:26:47.43\00:26:51.91
ulceration. Here we
have a jack stone type
00:26:51.94\00:26:57.49
of stone in the
bladder, which is not too
00:26:57.52\00:27:01.89
uncommon. And here
we've stones in the
00:27:01.92\00:27:06.11
kidney. These stones,
these kinds of stones,
00:27:06.14\00:27:10.70
but then this stone
is called a staghorn
00:27:10.73\00:27:15.64
calculus. Now,
staghorn calculus is
00:27:15.67\00:27:18.87
quite to find for the
pathologist and I have
00:27:18.90\00:27:22.32
several in my collection
of stones from various
00:27:22.35\00:27:26.85
parts of the body.
Stones that require
00:27:26.88\00:27:29.85
a special license
for prospecting for them
00:27:29.88\00:27:32.35
and so I try to
hang on to them, they
00:27:32.38\00:27:34.99
are now called
semi- precious stones.
00:27:35.02\00:27:38.08
Diabetics are more
likely to produce stones
00:27:38.11\00:27:41.41
then others and I
hope that by our going into
00:27:41.44\00:27:45.63
these things you
can understand how
00:27:45.66\00:27:48.12
diabetics must
protect themselves in many
00:27:48.15\00:27:50.69
ways, but by
following a good lifestyle they
00:27:50.72\00:27:54.63
too can live normally.
00:27:54.66\00:27:56.13