My name is Sheila O'shaughnessy and I've been coming to see greenand staff for six months. I saw him on Facebook awesome people liked him so I um made an appointment came I came because I new I was suffering from peripheralneuropathy and I had burning and tinglingmy hands and feet and
heating and burning went up to my elbows and my knees and I knew I had to do something about it and I knew if I didn't take care of it this issue that I would be very I would be immobilized as I got older I also came because I have avery foggy brain lo and behold
up to six months I do not have theburning and tingling up to my knees and elbows t's now onlymy feet and hands I found out I was allergic to gluten I found out I was allergic to lots of foods different foods.I changed my diet I change the way I think about how I need to improve my health I'm off
all mediions except for the supplements that Green has been giving me and I am more than thrilled about the way I feel today and peoplehave noticed the changme. I look forward to continuing on this journey with you and I look forward to continuing thisjourney with green and his staff until I feel like I am completely cured of all my ailments wonderful great
Diabetic nephropathyis one of the most common and serious chronic compliions associated with diabetes mellitus. In this tutorial, let'sdiscuss how the mechanisms underlying diabetic nephropathy correlate with the al presentation as well as the treatment of the disease. Now fortunately the mechanisms
underlying diabetic nephropathy, directly correlate withthe al presentation. And the first alfinding of the disease is somewhat paradoxicallyan increased kidney filtration rate orglomerular filtration rate. So, diabetic nephropathy,if you break down the term into nephro and pathy literally means kidneydisease caused by diabetes.
Now typically kidney disease is marked by a decreased filtration rate, so why is it that the first al stage of diabetic nephropathy is that of an increased glomerularfiltration rate? Well recall that the earliest mechanism contributing to diabetic nephropathy is an increased pressurestate, over hereblue.
And this is due to hypertension and efferent vasoconstriction. So let's use a common garden hose to help illustrate how thisincreased pressure state will ultimately resultan increased glomerular filtration rate. So, imagine you have this garden hose and it has a small holein the middle of it.
So first you're gonna open up the spigot and increase the pressureand flow through the hose. Intuitively, this isgoing to increase the rate at which water is leakingfrom the holethe hose. Next, you partially kink off the end of the hose distal to the hole, and once again this isgonna further increase the rate at which waterleaks from the hose.
This is essentially what'soccurringthe glomerulus with the hypertension representing the opening up of the spigot and increasing the pressurebefore the glomerulus,front of the glomerulus, and the efferent vasoconstriction representing the kinking off of the hose, which causes this back pressure.
One of the most seriouschronic compliions of diabetes mellitus is a condition known as diabetic nephropathy. Which, if you break down the term into nephro and pathy literally means kidney disease that occurssecondary to diabetes. And it's actually pretty common as it eventually affects about20% to 40% of all individuals
with diabetes, includingboth type I and type II. In this tutorial, let'stalk about the mechanism underlying the causeof diabetic nephropathy and how individuals withdiabetes develop the condition. So diabetic nephropathyis a chronic compliion of diabetes mellitus. Meaning, it usually has aslow progression over decades after the initial diagnosis of diabetes.
And to give you anoverview of what happens, an insulin deficiency due to the diabetes resultshyperglycemia, which then causes hypertensionand kidney dysfunction. This kidney function isactually then further worsened by the hypertension. And ultimately, all of thisresultskidney failure, which can have very severeand potentially even
life threateningcompliions, such as anemia, electrolyte imbalances,such as metabolic acidosis, and heart arrhythmias. Now, before we dive into the mechanism of diabetic nephropathy, let'sbriefly the structure of the glomerulusthe kidney, by bringinga diagram here. So, the glomerulus isthe portion of the kidney
where blood is initially filtered. So blood enters the glomerulus over here, through this afferent arterial, and then leaves the glomerulus throughthe efferent arterial. And you can remember this, that it leaves throughthe efferent arterial for E for exit, or efferent. And while the blood iswithin the glomerulus,
there's this advanced filtration system, which we'll talk about morea minute. And the filtered fluidthat exits the blood is known as a filtrate and it collectsBowman's space before it enters into thetubules of the nephron where further reabsorptionand secretion occurs before it exits the kidneyinto the ureters as urine.