Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. Your immune system attacks certain parts of the body, especially the joints. It is a chronic systemic disease characterized by inflammatory changes in joints and related structures that result in crippling deformities.

Rheumatoid arthritis (RA) affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with RA can damage other parts of the body as well.

The specific cause is unknown. But it is generally believed that the pathological changes in the joints are related to an antigen-antibody reaction that is poorly understood. (Antibodies are part of the body's defense system. Antibodies attach to proteins which they recognize to be foreign. The foreign proteins and chemicals that antibodies attach to are called antigens.)

RA and diabetes are different diseases. Having one may make it more likely to have the other. Nearly half of American adults who have diabetes will also have arthritis.

Risk factors for RA:

• Women are more likely than men to develop RA
• RA can occur at any age, but it most commonly begins at age 40-60
• Family history of RA
• If you have a genetic predisposition for RA, smoking increases your risk
• Diabetes

While new types of medications have improved options, severe RA can still cause physical deformities. RA tends to affect the smaller joints first, particularly the joints in your fingers and toes. It often spreads to the wrist, knees, ankles, elbows, hips and even your shoulders.

Signs and symptoms may include:

• Achy joints
• Redness
• Minor fever
• Unintentional weight loss
• Fatigue
• Joint stiffness that is usually worse in the morning and after inactivity
• Pain
• Formation of nodules (Nodules are solid, elevated areas of tissue or fluid inside or under the skin. Nodules are not normally benign and often painless)

There is no specific therapy. If the condition is severe and painful, bedrest may be required for a short time.

All other pain relief strategies are secondary to controlling inflammation. DMARD (diease modifying anti-rheumatic drugs) are drugs designed to work to suppress the body's overactive immune system response, to prevent joint damage and slow the progression of the disease. They are usually prescribed shortly after a diagnosis in order to prevent as much joint damage as possible. Be careful when DMARD'S are prescribed because they may have a lot of side effects. Always read the pamphlet about the drug your taking. Digestive issues, such as nausea and diarrhea are a few of the most common side effects. Always tell your doctor if you are having any problems when taking these drugs.

Treatments are usually given to relieve pain. There are many drugs that can help so you need to see your doctor or rheumatologist to see what they recommend. For acute pain they may prescribe Aspirin and Ibuprofen as well as celecoxib. They may treat joint pain but research has shown they don't prevent joint damage.

Although some say a certain diet will help, but these "special diets" aren't backed by the medical community. But there is some evidence that omega-3 fatty acids can reduce inflammation and possible loss of joint pain may result from it. Omega-3 can be found in cold-water fish and in fish oil supplements. It could reduce the amount of pain medication needed.

Possible complications of RA:

• Osteoporosis
• Sjogren - very dry eyes and mouth
• RA medications given to combat the disease, can impair the immune system, leading to increased infections.
• When RA affects the wrists, the inflammation can compress the nerve that serves most of your hand and fingers - leading to what is known as carpal tunnel syndrome (Pressure on the median nerve causing pain over the wrists and fingers. This can lead to numbness, tingling, or weakness in the hand or fingers. It can also lead to atrophy of the hand and finger muscles.)
• RA can increase your risks of hardened and blocked arteries, as well as inflammation of the sac that encloses the heart
• People with RA have a greater risk of inflammation and scarring of the lung tissue leading to shortness of breath.

Suggestions that may help:

• Maintain a healthy weight
• Get a light massage to help reduce muscle and joint pain
• Low-impact exercise can actually help - walking, swimming, (especially water aerobics) cycling, yoga - When it comes to exercise ralk to your medical care provider about it first
• Orthoses - mechanical aids of some type
• Some people find acupuncture helps

If you are experiencing more pain than before, or if the pain is interfering with your ability to get things done, don't hesitate to let your health care provider know.

Hepatitis C (Hep C)

Hepatitis C is a viral infection that causes inflammation and infection of the liver. The condition develops after being infected with the hepatitis C virus. Hepatitis can lead to serious liver damage. The liver is the most complex and vital organ in the body.

If you were born between 1945 and 1965, you need to be screened for hepatitis C. Check with your doctor.

Viral infections are a lot different than bacterial infections. Viruses are not really alive. Viruses reproduce by affecting the mechanism of a living cell. They may be broken down into two groups, according to whether they contain DNA or RNA. (DNA functions as the heredity molecule and is responsible for passing the traits of one generation on to the next. RNA keeps the DNA and genetic code protected from damage.) A virus particle consists of a outer covering wrapped around a strand of DNA or RNA. The outer covering has chemical feelers that can bond to the outside of a human cell. Once bonded to the cell, the virus injects its DNA (or RNA, depending on the virus) into the cell, leaving the outer covering on the outside of the cell. Enzymes (which are proteins) that the viral DNA creates are able to create a new viral covering. It is amazing how fast a virus can reproduce and infect other cells.

Certain foreign substances that enter your body trigger your immune system to make antibodies. Antibodies will only fight the foreign substance that they were created to fight. If you're infected with hepatitis C, your body will make antibodies that only fight hepatitis C.

Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms.

Chronic hepatitis symptoms develop over a period of months and may or may not be apparent at first. The majority of people with hepatitis C don't have symptoms. If you do develop symptoms related to hepatitis C they are generally mild and flu-like and may include: feeling very tired, nausea, poor appetite, sore muscles, joint pain, stomach pain, itchy skin, dark urine, and/or fever.

Hepatitis C is transmitted through blood contact with someone infected with hepatitis C. Hepatitis C is contagious but it is unlikely you can get it through casual contact.

Diabetics have a high risk of being infected because of all the complications associated with diabetes. Diabetics should have a test run for hepatitis C - especially if you have been in contact with someone who has hepatitis C or were born between 1945 and 1965.

How do you get hepatitis C?

• Through blood transfusion's before 1992
• Received clotting factor concentrates or other blood products before 1987
• Received hemodialysis treatment for a long period of time
• Organ transplants
• Child birth (from a mother with hepatitis C to her baby)
• Sharing items such as razors or toothbrushes, etc.
• Be cautious about body piercing and tattooing
• Sharing needles that have been used before
• Sexual contact if blood is exchanged

There are complications of hepatitis C that affect the liver. A large percentage of people develop chronic infection. Some people will develop chronic liver disease. Some with chronic hepatitis C will develop cirrhosis over a 20-30 year period. Cirrhosis involves loss of liver cells and irreversible scaring of the liver. Cirrhosis can become very serious.

There can also be a range of complications outside of the liver like dermatologic (skin) and/or musculoskeletal (joint and muscle) pain

There aren't any guidelines on how to manage your hepatitis C other than those your doctor gives you. There are many medications given to help treat hepatitis C. These include interferons and antivirals. Interferons are a type of cytokine that can change the way our immune system works. Cytokines are a brod and loose category of small proteins that are important in cell signaling. Their release has an affect on the behavior of cells around them.

There are several hepatitis C virus genotypes and not all hepatitis  medications treat all HCV infections. Once your doctor knows your hepatitis genotype, (a genotype is usually used when telling about the genetics of a particular trait) they have a better idea of what medication will work best for you.

There are some things you can do yourself like changing your lifestyle and dietary changes. Your best option is to take steps to help prevent becoming infected.

People with hepatitis C don't need to follow a special diet. The foods that an average, healthy person gets works just as well for people with hepatitis .

General dietary advice:

• Eat regular, balanced meals
• Maintain healthy calorie intake
• Eat whole-grain cereals, breads, and grains
• Eat lots of fruits and vegetables, especially fresh
• Get adequate protein
• Go easy on fatty, salty, and sugary foods
• Drink enough fluids
• Reach and maintain a healthy weight

Weighing too much or too little can allow hepatitis C to progress faster in your body. Overweight people are more likely to develop fatty deposits in the liver (called fatty liver) and will have abnormal tests results. Fatty liver can cause long-term problems with people who have chronic hepatitis C, it may make your hepatitis C treatment less effective.

You need to avoid alcohol and be careful with dietary supplements.

If you're at higher risk (like age and/or diabetic) of getting hepatitis C than the general public, you should get regular hepatitis screenings. There is no vaccine available, however there are treatment options available and hepatitis C may be cured (or cleared from the body). If you feel you may have hepatitis C, the sooner you know the better chances for successful treatment. It never hurts to ask your doctor about it.

Urinary System Disorders

Urinary system disorders are widespread. Incontinence and overactive bladder are two of the most common urinary system disorders.

The bladder, shaped like a balloon, sits in the pelvis and stores urine until your body is ready to urinate. Bladder nerves send signals to let you know when it is time to urinate.

The urinary system works with other organs to get rid of waste and keep chemicals and water in the body balanced. The amount eliminated will vary depending on the amount of liquid and food consumed as well as how much you might lose through sweating and breathing. Some medications you take can affect the quantity of urine eliminated.

Urine exits the kidneys through two tubes about eight to ten inches long called ureters. These tubes carry the fluid to the bladder where the urine is stored. The ureter muscles tighten and relax to pump urine downward. This process is continuous. If the urine gets stuck in the ureters or backs up, a kidney infection can result.

To keep urine from leaking, circular muscles called sphincters (Muscles that control the passage of liquids and solids.) close tightly around the opening of the bladder. When you decide to urinate, bladder muscles tighten and sphincter muscles relax, and the urine is pushed down the urethra.

Diabetes and urination problems often go hand an hand. According to the National Institute of Health, more than half of the people with diabetes have bladder dysfunction. Those people with diabetes who are at risk of urologic problems include people who have poor glucose (sugar) and blood pressure control, have high levels of cholesterol, are overweight, over the age of forty, that smoke, and lack of physical activity. You can lower the risk of urologic problems some when you control the above mentioned.

Some Disorders

Urinary Incontinence - As you age urinary system muscles usually tend to weaken, leading to increased incidence of urinary tract infections and incontinence (leaking of urine that you can't control). Incontinence arises when the bladder muscle is overactive and contracts involuntarily. You may be coughing or sneezing and feel a small amount of urine leak out - that is usually because of incontinence. It is more devastating to one's quality of life than being a danger. Incontinence is one of the most common problems - especially among women.

Overactive Bladder - occurs when you void more than eight times a day and twice at night (more or less), having a strong urge to void. It affects millions of people, both men and women.

Urinary Retention - is when the bladder fails to empty fully, leading to retained urine. Acute urinary retention results in a sudden inability to urinate, accompanied by pain and discomfort. You need to see the doctor to determine the cause and treatment. The doctor may want you to have a CT scan or MRI. For many of the several disorders tests may be run to determine the problem.

A Cystocele - occurs when the pelvic floor muscles which form the wall between the bladder and vagina, weaken, allowing the bladder to drop into the vagina. This causes discomfort and voiding difficulties, such as urine leakage or incomplete bladder emptying.

Urinary Tract Infections - are usually caused by bacteria from the bowel that lives on the skin near the rectum or near the vagina. It is easy to spread from the bowl to the urethra and travel up the urinary tract into the bladder. If the problem is not treated, the infection could continue to spread to the kidneys. If it enters the bloodstream it can become life-threatening. The first sign is usually a strong urge to urinate. As you release urine, you will feel a burning sensation and little urine is eliminated. It is usually very painful to eliminate the urine. You may have soreness in your lower back, or in the sides of your body. The urine may look cloudy or have a reddish tinge from blood. It may smell foul or strong. You may feel tired and shaky.

Ureter Stones - are among the most painful and common urinary tract disorders. They vary in size and in the amount of pain they cause. Less common are struvite or infection stones, caused by the movement of a stone in the urinary tract. If the stone is too large to pass it causes continuing pain in the muscles in the ureter as they try to squeeze the stone into the bladder. Fever and chills suggest an infection - Call your doctor.

Analgesic Neuropathy - improper us of over-the-counter painkillers or analgesics such as aspirin, acetaminophen, ibuprofen, and naproxen sodium, all of which are safe for most people if taken at recommended dosages.

Hematuria - is a term used for the presence of red blood cells in the urine. Hematuria is not a disease in itself, but a sign of some other condition. The cause could be serious, such as bladder or kidney cancer, but usually the cause is relatively benign. See your doctor If this happens. They may want to run some test to identify the cause.

Bladder Cancer - Signs and symptoms can include blood in the urine, painful or frequent urination or feeling the urge to urinate even though the bladder is empty.

I didn't list all the problems you could have with the urinary system, but most of them. Always tell your doctor if you feel you are having a problem.

Renal Diseases

The critical regulation of the body's salt, potassium, and acid content is performed by the kidneys. The kidneys also produce hormones that affect the function of other organs. 

The kidneys perform the following functions:

• Remove waste products from the body
• Remove drugs from the body
• Balance the body's fluids
• Release hormones that regulate blood pressure
• Produce an active form of Vitamin D that promote strong, healthy bones
• Control the production of red blood cells

Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems and injuries. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or a close family member with kidney disease.

Other causes of kidney failure:

• Loss of blood flow to the kidneys
• Inflammation of small blood vessels
• Blood clots in the or around the kidneys
• Urine elimination problems
• Overload of toxins from heavy metals
• Uncontrolled diabetes
• Cancer of the plasma cells in bone morrow
• Certain antibiotics
• Some dyes used in imaging tests

Protein and glucose (sugar) are supposed to be retained, not flushed out of the body in the urine. Running high blood sugar and high blood pressure can damage the kidneys. When small blood vessels in the kidneys become clogged, that starts to interfere with the filtering process. When the kidneys have almost stopped filtering waste out of the blood, you will have renal failure. At first, kidney damage may be seen by small amounts of protein, called albumin, in the urine, preventing waste and extra fluid from being removed. You will have Diabetic Neuropathy when kidneys damage becomes renal failure.

The more uncontrolled your blood sugar is the more likely you are to have bladder infections. Diabetes can damage nerves making it difficult to empty the bladder. Pressure that results from a full bladder can back up and injury the kidneys. When urine stays in the bladder too long, it can cause infections because bacteria grow rapidly in urine, especially if there is a high level of sugar in it. When you take care of your diabetes, you take care of your kidneys.

One way to evaluate kidney function is through measurement of serum creatinine. Creatinine is the end product of creatine metabolism, which the kidneys cleanse from the blood. Rising blood creatinine, which is alkaline composition of urine and blood, happens when the kidneys have trouble cleansing the blood. When the kidneys cannot cleanse the blood, toxins in the blood reach a critical level and you may require dialysis or a kidney transplant.

To help delay or possibly prevent kidney disease:

• Control your blood sugar
• Control your blood pressure
• Quickly treat any urinary tract infection
• Avoid medication that may damage the kidneys
• Exercise regularly
• Choose a healthy diet
• Control your weight
• Avoid drinking alcohol
• Have your kidneys checked once a year; more if you are on certain medications

Warning signs of kidney disease:

• Extremely high blood pressure
• Blood and/or protein in the urine
• A creatinine and blood urea  nitrogen (BUN) blood test, outside the normal range
• A glomerular filtration rate (GER) less than 60
• More frequent urination, particularly at night, difficult or painful urination
• Puffiness around eyes, swelling of hands and lower areas

How is kidney failure diagnosed?

• Urinalysis
• Urine volume measurement
• Blood samples
• Imaging
• Kidney tissue sample

If you are having kidney problems, large amounts of ptotein, sodium, and potassium are not healthy. You may be put on a low-sodium diet because salt makes you retain water and raises blood pressure..
Renal disease is usually irreversible when it reaches the last stages. Having diabetes doesn't necessarily mean you will have kidney disease, but you are at greater risk.

Tinnitus

What causes ringing and/or noises in the ear? Usually it's from damage to tiny hairs in your inner ear. That changes the signals they send to your brain that control how you hear sound.

When you look at the ear it looks fairly simple. Wrong! The ear contains three parts; the external, middle, and inner ear. The external ear collects sound and serves to protect the delicate parts inside the ear. The middle ear is a narrow, air-filled space between the ear drum and the  outer wall of the inner ear containing the three tiny bones that transmit sound vibrations. The inner ear maintains balance and contains sensory nerve endings for detecting sound. Once information for detecting sound is  collected it is sent to the brain by the hearing nerves to process events into recognizable sound or hearing.

Most people have ringing in the ears occasionally (Tinnitus). A continual noise in the ear e.g. can be caused by damage to the hair cells of the inner ear. The hair cells are responsible for hearing. There are two types of hair cells; the inner hair cells and the outer hair cells. These cells have hairs that stick out; they are sort of three- dimensional. Sound causes the hair cells to vibrate or bend, which creates electrical signals that are transmitted to auditory nerve fibers just below the hair cells. The auditory nerves pass these signals on to the brain. Tinnitus is not usually serious, but it can become a problem.

Tinnitus is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can very in loudness. Loud noises, certain medications, and some disease can cause loss of hearing. Injury, including perforation of the ear drum, fractured skull or large changes in air pressure can damage hearing.

Tinnitus is often associated with hearing loss, but it does not necessarily cause hearing loss. Sometimes tinnitus can be caused by infections or blockage in the ear. Once it is treated, tinnitus usually disappears.

Take Care of Your Ears:

• Avoid getting water in the ear canal.
• After swimming, tilt the head to drain water from your ears.
• Do not swim in dirty water.
• Use ear plugs.
• Use a shower cap.
• Keep soap and shampoo out of the ears. Dry your ears after bathing.
• Do not take bubble baths!
• Be careful when using hairspray and/or hair dye; it could lead to an infection in the ear. Reduce the risk of ear infections by treating upper respiratory tract infections promptly.
• When removing ear wax from your ears, be careful because you could puncture your eardrum. You might want to see a doctor if you have a problem. They can clean the ear wax out fairly easy. A punctured or ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear. That membrane is made of tissue that resembles skin.
• Do not try to remove all ear wax. You need some wax to protect the ear canal. Do not use cotton balls or try to clean your ears by poking anything pointed into the ear canals. You could injure the delicate skin, or impact earwax.
• Hot and humid weather can produce ear infections.
• Insects, on occasion, can get trapped in the ear, but they can usually be washed out carefully with warm water.
• Be careful if you treat an ear infection or other ear problems yourself because you could make things worse. See a doctor if the pain gets worse or does not get better in twenty-four hours and/or if you experience dizziness or ringing in the ear; infections can spread.
• When using ear drops, warm the drops to room temperature (do not use cold eardrops).

What does this have to do with diabetes? When a diabetic gets an infection, of any kind, it can be very hard to heal and could become serious very quickly.

It is best to leave the ear canal alone. If you have a problem with your ears, it's best to get advice before attempting to handle the situation yourself.

Osteoporosis

Osteoporosis is the most common form of arthritis. It is caused by damage to the joints. It can be brought on by a number of things including joint injury, other forms of arthritis and excess pressure on the joints caused by obesity.

Types of Osteoporosis:

• Primary: depends on the thickness of the bones
• Secondary: occurs as a result of having certain medical conditions, such as hyperthyroidism, hyperparathyroidism, leukemia - it may also occur as a result of taking medicines known to cause bone breakdown
• Ontogenesis: is present at birth and causes bones to break for no apparent reason 
• Idiopathic juvenile: Occurs between ages 8-14 or during times of rapid growth - there is too kittle bone formation or excessive bone loss - increases the risk of fractures

Bone formation and bone destruction run concurrently throughout life. Bone is living tissue. Bone is constantly breaking down and rebuilding itself. As we age bone turnover changes. The rate of growth decreases while removal of old bone continues, which leads to bone loss. During the early adult to middle age years, the rate of formation pretty much equals the rate of destruction. Between the ages of about thirty-five and forty, bone loss exceeds bone gain.

Osteoporosis means "pours bone" and is characterized by a reduction in bone density accompanied by increasing porosity (porosity is defined as being full of tiny holes that water or air can get through) and brittleness associated with loss of calcium from the bones. Osteoporosis is a painful and crippling disease. As you get older, bones become thin and brittle. You may become shorter because the bones in your spine collapse, leaving you with a hump on your back. The causes of osteoporosis may include many years of deficient intake, deficient calcium absorption or both. 

Calcium gives firmness and rigidity to bones and teeth from the gastrointestinal tract. Large quantities of corn, bread, and rice may lead to decreased absorption. The average American diet consists of "junk food" with very little calcium or nutrition in it. You may or may not drink soft drinks, but what about tea and coffee? Many people are on different types of steroids, they get little or no exercise, and/or they are on hormonal therapy. All this and more can affect the utilization of calcium.

Some risks factors for osteoporosis:

• Gender-osteoporosis is much more common in women
• Family history of osteoporosis
• Going through, or having gone through , menopause. Menopause can cause a sharp decline in estrogen
• Smoking and/or drinking alcohol reduces the body's absorption of calcium
• Lack of exercise like walking, jogging, and other forms of exercise subject bones to stress. Bones respond by laying down more collagen, fibers, and mineral salts in the bone matrix. This, in turn, makes bones strong.
• Eating fewer than three servings of dairy foods each day

For proper utilization of the calcium you get from your diet and/or added supplements, you need magnesium, Vitamin D, and zinc (but not in mega amounts). Magnesium is for bone strength and is required to ensure proper calcium utilization. Vitamin D facilitates adequate absorption. Zinc is needed to assist with bone calcification.

A bone scan is used to measure bone density and determine your risk of developing a fracture. A bone scan gives a score that is used to compare the density of your bone to that of a young healthy woman. This is referred to as a t=score. The lower the bone density, the lower the t=score, and the higher the risk of fracture.

A lot of things you see in diabetes you will also see in osteoporosis. While the relationship is complex, osteoarthritis and diabetes may feed into each other in a vicious cycle -- with progression of diabetes contributing to worsening osteoporosis, and vice versa.

Painkillers and corticosteroids may be prescribed to treat painful symptoms. There are non-drug treatments which would include massage, acupuncture, heat or cold compresses, and nutritional supplements. You should check with your doctor to see if they have any newer treatments.

Asthma

Asthma is shortness of breath accompanied by wheezing caused by a spasm of the bronchial tubes or by swelling of the mucous membrane. No age is exempt but asthma occurs most frequently in childhood or early adulthood. The patient may assume a "hunched forward" position in an attempt to get more air. Other allergic disorders may coexist. Recurrence and severity of attacks are mental or physical fatigue, by exposure to fumes, by endocrine changes at various periods in life, and by emotional situations. A continuous asthmatic state may last for hours or days. Asthma can't be cured, but its symptoms can be controlled.

Allergens inhaled in the air or infections of the respiratory may precipitate an attack. Occasionally foods (eggs, shellfish, or chocolate, and a few others) may precipitate an attack. In some cases asthma develops in persons with allergies of unknown etiology. It may be precipitated by infection of the upper or lower respiratory tracts.

Causes

• Airborne substances, such as pollen, dust mites, mold spores, or particles of cockroach waste, dust, and animal dander
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants, such as smoke
• Certain medications, including beta-blockers (Beta-blockers are drugs that block the effects of adrenaline, the hormone that triggers your body's fight-or-flight response when you're stressed), aspirin, Ibuprofen (Advil, Motrin, others) and naproxen (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Complications

• Sign and symptoms that interfere with sleep, work or recreational activities
• Sick days from work or school during asthma flare-ups
• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breath
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

It isn't clear why some people get asthma and others don't. It could be due to a combination of environmental and genetic factors.

People with asthma seem to have a higher risk of getting diabetes than those who do not suffer from asthma. Those with both conditions seem to have a tougher time keeping their blood sugar under control. Diabetics that are poorly controlled are more likely to show dips in lung function over time than those with well-controlled diabetes.

Specific foods you eat might have a direct impact on your asthma. The following foods will also help if you have diabetes.

• Eat plenty of raw fruits and vegetables
• Eat foods with omega-3 fatty acids like salmon, tuna, and sardines
• Avoid Trans fats and omega-6 fatty acids. Look at the labels to make sure foods you eat don't contain these things.
• Keep healthy weights, as overweight people tend to have more trouble controlling asthma and diabetes.