Symptoms and food for diabetes

The symptoms of diabetes mellitus may include:

1. Frequent thirst.

2. Persistent hunger.

3. Increased urination, particularly during the night.

4. Unexplained weight loss.

5. Loss of muscle mass.

6. Frequent fatigue.

7. Blurred vision.

8. Slow-healing wounds.

9. Recurrent infections, such as those affecting the gums, skin, vagina, or urinary tract.

Individuals with diabetes can still include sweet foods in their diet, but it should be done with specific guidelines, such as:

1. Consume sweet treats infrequently and in small portions.

2. Offset sweet food intake with other nutritional elements like vegetables, nuts, and lean proteins such as fish.

3. Opt for fiber-rich foods, such as soybeans, which are not only high in protein but also fiber, promoting prolonged feelings of fullness.

4. Reduce the consumption of high-carbohydrate sources like white rice, refined pasta, white bread, potatoes, and corn.

5. Examine nutrition labels on food packaging to determine the sugar and carbohydrate content.

Living alone with a blood cancer

Living alone with a blood cancer. Living as an independent person is important for many young people, but it may be very challenging to keep the spirits up and continue to be positive, if you are living alone with a blood cancer. You may be someone who normally appreciates your independence; however being unwell may make you feel lonely and isolated.

The possibility of having to sacrifice your current living situation on top of the diagnosis of a blood cancer is all very overwhelming.  There are aspects of living with a blood cancer that can make it difficult to manage everyday life, such as grocery shopping and cleaning.

Some young adults may feel comfortable with temporarily moving home with family or whanau whilst they undergo treatment for their blood cancer. For many young adults this is simply not an option, and for those individuals there is support available to help them through this time and remain living independently.

Ask to speak to your social worker who will be able to help you to remain as independent as possible.

If you are living alone it is important that you:

•  • Put together a list of emergency contacts in case you do unexpectedly become unwell. 
•  • Let friends, family, whanau and neighbours know about what could happen so if you call them in an emergency, they will know what to do and who to call. Your doctors and nurses will also give you a list of 24 hour emergency contact numbers to use in such circumstances.

It is okay to accept help. Family and friends who care about you may want to help in any way they can, and it is sometimes difficult to accept this help when you have previously lived so independently.  Some family, whanau and friends may find it difficult to talk openly about your blood cancer, but would be happy to help in more practical ways, such as doing your shopping or helping with your house cleaning and transporting you to doctors’ appointments.

Accepting support offered may make living alone easier, and therefore enable you to retain your independence. Although you may want to stay independent for as long as possible, remember that it is okay to ask for help when you need it. Being independent is about finding the right balance between acknowledging when you need support and looking after yourself.

Breast cancer molecular alteration

Molecular alterations The most frequently mutated and/or amplified genes in the tumour cells are TP53 (41% of tumours), PIK3CA (30%), MYC (20%), PTEN (16%), CCND1 (16%), ERBB2 (13%), FGFR1 (11%) and GATA3 (10%), as reported in a series of early breast cancers. These genes encode cell-cycle modulators that are either repressed (for example, p53) or activated (for example, cyclin D1), sustaining proliferation and/or inhibiting apoptosis, inhibiting oncogenic pathways that are activated (MYC, HER2 and FGFR1) or inhibiting elements that are no longer repressed (PTEN).

The majority of the mutations affecting 100 putative breast cancer drivers are extremely rare, therefore, most breast cancers are caused by multiple, low-penetrant mutations that act cumulatively. Luminal A tumours have a high prevalence of PIK3CA mutations (49%), whereas a high prevalence of TP53 mutations is a hallmark of basal-like tumours (84%).

For TNBC, different molecular drivers under- line its subtypes. At the metastatic stage, specific predictive alterations, such as PIK3CA mutations, can be easily detected non-invasively in the plasma in circulat- ing tumour DNA rather than on tumour biopsy; never- theless, depending on the technology used, the level of sensitivity may vary. 

Epigenetic alterations are involved in breast carcinogenesis and progression. In breast cancer, genes can be either globally hypomethylated (leading to gene activation, upregulation of oncogenes and chromosomal instability) or, less frequently, focally (locus-specific) hypermethylated (leading to gene repression and genetic instability due to the silencing of DNA repair genes).

Other epigenetic mechanisms involve histone tail modifications by DNA methylation, inducing chromatin structure changes to silence gene expression and nucleosomal remodelling. These changes are reversible, enzyme-mediated and potentially targetable. For example, in luminal-like breast cancer cell lines, inhibition of histone deacetylase with specific inhibitors such as vorinostat or chidamide can reverse resistance to endocrine therapy via inhibition of the resistance pathway driven by epidermal growth factor receptor signalling.

Recently, a phase III trial in metastatic luminal breast cancer showed the superiority of a treatment combining chidamide with endocrine therapy (namely, the aromatase inhibitor exemestane) to exemestane alone.