Carbohydrates are one of the three major nutrients present in foods apart from proteins and fats. Carbohydrates are mainly made up of carbon, hydrogen, and oxygen apart from many other compounds. They are present in vegetables, starchy foods, grains, cereals, and animal foods. Carbohydrates are a major source of energy and they contain starches, sugars, and fibers. They are also known as saccharides. They consist of monosaccharides, and disaccharides, and polysaccharides. Carbohydrates contain sugars like glucose, galactose, fructose, sucrose, lactose, maltose, sorbitol, and mannitol. They also contain amylose, modified starches, cellulose, and other components that are essential for metabolism. Metabolized carbohydrates are used as fuel and are stored in cells. Carbohydrates are a major form of nutrition and are made of simple and complex carbohydrates. Simple carbohydrates contain sugars and are an immediate source of energy; however, some simple carbohydrates have a tendency to spike the blood sugar levels in people with diabetes. Complex carbohydrates are contained in whole grains, vegetables, legumes, and starchy vegetables. While starchy vegetables are known to raise the blood sugar levels quickly, other complex carbohydrates take time to digest and release glucose into the bloodstream relatively slowly due to the fiber content and lower glycemic content. Complex carbohydrates contain minerals, vitamins, and fiber and so are better suited for people with diabetes. People with diabetes have to count their carbohydrates for glycemic control. This can be done by controlling the portion sizes of each meal and by using the food labels that mention the nutritional value of each food. By controlling the number of grams of carbohydrates in each meal and matching it with physical exercise, one can achieve better glycemic control. Consuming excess amount of carbohydrates leads to high blood sugar levels and weight gain and consuming lesser amounts of carbohydrates can lead to ketosis.

Carbon monoxide is a poisonous gas. Carbon monoxide is a colorless, tasteless, and odorless gas. Though carbon monoxide is produced in certain metabolic activities, it is present in very low levels. It functions as a signaling molecule or a vasodilator; however, it is also known to be the cause of certain diseases when its levels increase. Diseases like degeneration of nerves, heart failure, and high blood pressure are related to levels of carbon monoxide. Added to that, levels of carbon monoxide are also known to effect inflammatory responses. While the influence on inflammatory response can be an ill effect, its efficacy to treat certain conditions like ischemia, cardiac xenograft rejection, asthma, reperfusion injury, and others are being studied. This is because carbon monoxide has the ability to regulate production of cytokines, regulate movement of leukocytes, and create immunomodulatory responses. Higher levels of carbon monoxide in the body is known to create carbon monoxide poisoning. Carbon monoxide poisoning creates symptoms like headache, dizziness, chest pain, weakness, and confusion. It can cause irregular heartbeats, loss of consciousness, and even death. It is mainly caused due to inhalation of fumes from vehicles, burning material, and others. Levels of carbon monoxide are measured with a blood test called carboxyhemoglobin. Treatment is provided by infusing hyperbaric oxygen. Carbon monoxide poisoning can cause a rare complication called diabetes insipidus. After the episode of carbon monoxide poisoning, symptoms of diabetes crop up along with neurological complications and possibly hypernatremia. People with type 1 diabetes are prone to ketoacidosis. In people with diabetic ketoacidosis, some studies suggest that there is apparent carbon monoxide poisoning in the arterial blood gases. A reason for this is attributed to high blood sugar levels and lactic acidosis. A research studying relation between oxidative stress and exhalation of carbon monoxide found that levels of carbon monoxide exhaled by people with diabetes are higher. The efficacy of carbon monoxide to control diabetes-related gastroparesis is also under study.

Carbamazepine is an anticonvulsant that is prescribed to people with epilepsy and bipolar disorder. It is even prescribed to people with nerve pain, trigeminal neuralgia, and diabetic neuropathy. This medication, like other anticonvulsants, induces drowsiness and can even cause nausea. It is effective in controlling tonic clonic seizures, partial seizures, and mixed seizures. Carbamazepine is also effective in reducing neuropathic pain, allodynia (pain even with normal stimuli), hyperalgesia (increased sensitivity to pain), and trigeminal neuralgia. Though carbamazepine is a potent medication, it does have certain contraindications. People with bone marrow suppression, and allergies to antidepressants should not use this medication. Carbamazepine is an antiepileptic drug that works by blocking the sodium channels. By stabilizing sodium channels in the inactive states, repetitive firing is avoided. Carbamazepine blocks sodium channels during rapid neuronal firing states giving it the antiepileptic properties. However, overdose of Carbamazepine in some cases has been known to lead to dizziness, blurred vision, double vision, and nausea. When it comes to its efficacy in the treatment for painful diabetic neuropathy, Carbamazepine is known to be effective in many studies. Painful diabetic peripheral neuropathy occurs due to damaged nerves. Pain arising from that can cause disturbed sleep, fatigue, impaired range of motion, and reduced functionality. Painful diabetic peripheral neuropathy is a common complication of diabetes and is a chronic condition. There are similarities in treating epilepsies, seizures, and neuropathic pain using sodium channel blockers. Considering the adverse effect profile of antiepileptic drugs and other pain medications, sodium channel blockers might be a good choice for painful diabetic peripheral neuropathy. Having said that, people with kidney and liver disorders might not be suitable for Carbamazepine.

Capsulitis is a condition that is characterized by the inflammation of capsular ligaments. A joint is surrounded by capsular ligaments. These capsular ligaments perform the function of lining up the bones. They put together the two bones comprising the joint and handle stress. However, when there is excess mechanical load or stress, it leads to an inflammatory condition called capsulitis. Capsulitis shows up with symptoms of pain, swelling, redness, stiffness, restricted movement, and deformity. Capsulitis normally occurs in the foot (in the metatarsals), in the second toe, and in the shoulder. Capsulitis in the shoulder is generally called adhesive capsulitis or frozen shoulder. People who wear ill-fitting footwear, people who walk barefoot, and people who play sports are at a risk of getting foot capsulitis. Frozen shoulder or adhesive capsulitis is a condition in which the ligament around the shoulder becomes stiff and has swelling. This is accompanied by pain. People with diabetes are prone to have this condition as uncontrolled diabetes and high blood sugar levels tend to affect the collagen in the shoulder joints. This occurs when there is excess blood sugar in the collagen. Frozen shoulder is characterized by pain, stiffness, and gradual reduction of range of motion. Frozen shoulder or adhesive capsulitis is diagnosed by physical examination, x-rays, MRI, and ultrasound. Treatment includes pain medications, physical therapy, and glycemic control in the case of people with diabetes.

Capsaicin is the active ingredient that is present in capsicum fruit, chili peppers (both green and red), cayenne peppers, jalapeno peppers, and bell peppers. Capsaicin is the highly purified extract and the molecule present in chili peppers that gives it the property of extreme heat, burning sensation, chemical irritation, pressure, pungency, and pain relieving properties. Capsaicin and capsaicinoids present in chili peppers are alkylamides and contain adrenaline receptors, and TRPV1. This gives them a neuropeptide-releasing property that is selective for primary sensory peripheral neurons. This means that when applied topically, they can act on the peripheral nerves and provide relief from peripheral nerve pain. Capsaicin has also been used to relieve mucositis caused due to radiation therapy and chemotherapy. Capsaicin works by cutting down the pain impulses over a period of time. When applied topically, it first gives a burning sensation. It then activates the nerve endings of sensory nerve fibers. This causes some redness and swelling. However, the activation of nerve fibers also causes the release of certain substances like glutamate, substance P, calcitonin gene-related peptide, and others. These lead to sensations of extreme pain and painful to touch. With repeated applications, the nerve fibers are ultimately blocked and there is desensitization by blocking the conduction of the nerves. Capsaicin has been found effective in treating numerous chronic pains such as arthritic pains, cluster headaches, complex regional pain syndrome, neuralgias, and diabetic neuropathy pains. People with diabetes tend to have complications of the nerves due to high blood sugar levels that cause damage to the nerves. This leads to a condition called peripheral diabetic neuropathy. This condition is characterized by chronic pain, numbness, tingling sensation, extreme sensitivity to heat or touch, muscle weakness, and loss of reflexes. Capsaicin is an effective topical cream for people with peripheral diabetic neuropathy for pain relief.

Capillary leak syndrome is a rare disease that can sometimes occur in senior people with diabetes. It is a condition in which proteins and fluids leak from the capillaries into the surrounding tissues. This condition is characterized by symptoms of fatigue, abdominal pain, nausea, thirst, and flu-like symptoms. When untreated capillary leak syndrome can lead to conditions like extremely low blood pressure, decreased plasma volume in the blood, hypoalbuminemia. Capillary leak syndrome can be systemic, in which there is a massive leak of plasma into the surrounding tissues. This occurs in rare diseases like Clarkson’s disease. Capillary leak syndrome can be due to unknown causes. It can occur due to sepsis, autoimmune diseases, poisoning, hemorrhagic fevers, and others. This condition is diagnosed by physical examination, lab tests, and the presence of symptoms. Capillary leak syndrome has no cure and hence treatment during an episode aims to provide stabilization from symptoms, life support and protection against severe complications. For someone who has recurrent episodes of capillary leak syndrome, prophylactic treatment is prescribed. In people with diabetes, diabetic ketoacidosis is a serious complication that arises due to a severe shortage of insulin. It can arise in both type 1 and type 2 patients. In this condition, the body has insufficient insulin and so it starts to process fats to produce energy. This results in an unusual buildup of acidic ketones, which is harmful. This condition can lead to cardiogenic and non-cardiogenic pulmonary edema. The buildup of fluid in the lungs due to non-cardiogenic factors is due to a kind of capillary leak syndrome. This is a fatal complication that is caused due to the permeability of the capillaries of the lungs.

In blood circulatory system, the capillaries are the smallest blood vessels. They measure anywhere from 5 to 10 microns in diameter and are essential for microcirculation of nutrients and oxygen. They are located in the tissues of organs and assist in supplying them with oxygenated blood, glucose, and nutrients. Apart from this, cellular waste products, carbon dioxide and others are passed back through the capillaries. They are essential components of the circulatory system that work on the micro level between the arteries and the veins. As oxygenated blood is pumped from the heart through the arteries, they enter the arterioles. From the arterioles, they enter the capillaries and then to the cells. The cells are replenished with nutrients, and then the waste products of the cell are carried to the venules through the capillaries to the veins. Fluid exchange occurs in the capillaries through precapillary sphincters. When the sphincter opens, the fluid is allowed and when the sphincter is closed, the fluid is stopped. By this sphincter action and osmosis, fluids, nutrients, and gases are exchanged to supply the cells with glucose, and oxygen and to remove waste products. There are around 10 to 40 million capillaries in the body. They are abundant in the skin, eyes, spleen, liver, kidneys, thyroid, and other organs. They are generally arranged in networks called capillary beds consisting of true capillaries (those branching from arterioles). The capillary blood pressure is comparatively lesser than arterial and venous pressure due to its size and diameter. In people with diabetes, blood glucose measurements are made with blood drawn from the capillaries and from veins. The values of blood sugar levels often vary with both blood samples. People with diabetes also experience a damage to their capillaries. This is because of the microvascular damage diabetes causes. Diabetes is known to cause vessel wall stenosis, which can lead to capillary closure and a host of complications. In the eyes, it can cause diabetic retinopathy. In the kidneys, it can cause diabetic nephropathy. Capillaries get damaged in diabetes due to stiffening of the collagen and degeneration of the elastin.

Cancer is a group of diseases that can occur to numerous organs of the body. It is a metastatic condition in which there is abnormal growth of cells and this growth spreads to numerous parts of the body ultimately leading to death. In cancer, as against normal cell division, there is abnormal cell division and cell growth. When cells of a particular organ or a part start to grow uncontrollably, they might enter the bloodstream or lymphatic system. When this occurs, they can enter other organs or parts of the body. This is called metastasis. Cancer is of numerous types – carcinomas, sarcomas, lymphomas, myeloma, melanoma, leukemia and mixed forms of cancer. While carcinomas begin in the tissues that line the organs and spread, sarcomas develop in the fat, bone, connective tissue, cartilage and muscle and spread. Lymphomas start in the immune system and leukemia starts in the blood and the bone marrow. Cancer of each organ shows up with specific symptoms. Cancer generally comes in stages. In the first stage, cancer is specific to the organ and has not yet spread to any other organ. In this stage, generally, the cancer is treatable and survival rates (5 years) are high. In the second stage, the cancer has grown, but it has not yet spread to the surrounding tissues or organs. In the stage three, cancer cells break free from the malignant area and start moving into the bloodstream and lymphatic system. In the next stage (stage four), cancer has spread to other organs. As the stages of cancer increase, the survival rates reduce. Cancer is generally diagnosed by CT-scans, MRI, and biopsies. It is treated with surgery, radiation therapy, chemotherapy, and palliative therapy. A statistical data established the fact that people with diabetes are at an increased risk of getting cancer, especially of the endometrium, pancreas, kidneys and liver. This might be due to the fact that the genesis of type 2 diabetes and cancer share some common pathways.

Calorie balance is a principle that refers to the balance between the number of calories consumed and the number of calories burned. This is vital for overall wellbeing of a person as the balance between the number of calories consumed and the number of calories burned can determine the BMI of a person. When the calorie intake is equal to the amount of calories burned, the weight of a person is consistent. If the intake exceeds the amount burned, it leads to increase in the weight of a person. If the intake is less than that of the amount burnt, then it leads to weight loss. However, the overall health of a person depends upon the calorie density. Consumption of red meat, and oily and starchy foods can lead to the development of high cholesterol levels. Maintaining a balance between plant-based foods, fruits, and poultry and fish adds to the richness of the food and provides better calorie density. However, calorie balance principle is not totally based on the principles of nutrition. So, people who intend to lose weight have to replenish themselves with nutritious foods. They have to reduce salt intake, restrict carbohydrate intake, get physical exercise, and consume more dietary fiber. For some people with type 2 diabetes, it is very important to lose weight and maintain calorie balance. Since most people with type 2 diabetes have a higher BMI, reducing weight can improve glycemic control and improve their blood sugar levels. However, maintaining calorie balance has to be done with caution. Along with managing a diabetes diet plan and getting physical exercise, they have to be vary of episodes of hypoglycemia.

Calorie is a unit of heat or energy contained in a substance. All foods consumed contain calories and the calories burned are converted into chemical energy for the body to consume and store. A calorie is defined as the energy required to increase the temperature of water by one degree centigrade. However, in the nutritional context, calories have a different meaning. Calorie is a unit of energy that is measured in kilocalories. In order to measure the nutritional value of foods, the calories per serving is measured. When food is ingested, proteins, lipids, and polysaccharides are digested by the action of enzymes and digestive juices. This results in the formation of amino acids, sugars, fatty acids, and glycerol. These are then oxidized in the cells. Then, in the process of catabolism, glucose is converted into pyruvate, ATP, and NADH. By the production of ATP, the energy of sugars and fats are converted into chemical energy to be consumed or stored. Calories are required for all the basic functions of a body including respiration, heartbeat, blood circulation, and functioning of vital organs. It is also required for all the activities. The basal metabolic rate is the number of calories required by a person every day. It is measured as:
Men:
(9.99 X Weight of a person in Kg) + (6.25 X Height of a person in cm) – (4.92 X Age of a person) + 5
Women:
(9.99 X Weight of a person in Kg) + (6.25 X Height of a person in cm) – (4.92 X Age of a person) – 161
Calorie requirement varies from person to person depending upon the age, gender, physical activity, overall wellbeing, height, and other factors. People with diabetes however have to be cautious about their calorie intake. Excess amounts of calories can lead to high blood sugar levels due to a higher amounts of carbohydrate content in the food. A higher amount of protein content can put pressure on the kidneys and cause proteinuria. Consuming excess fats can increase the cholesterol levels increasing the risk of cardiovascular diseases. A balance of carbohydrates, fats, and protein is a must for people with diabetes.

Callus or calluses (plural) are thickened areas of skin that become hard over a period of time due to pressure and friction. Calluses occur when the outermost layer of the skin are subject to excess pressure and friction either due to stress or rubbing. Calluses generally occur on the feet, on the fingers, and on the hands. They are painless. They occur due to occupational stresses, ill-fitting shoes, and many other causes. Calluses occur when the skin accumulates keratinocytes. The cells present in the calluses are dead cells. People who have fragile skin tend to have calluses on their feet. Also, people with diabetes who have poor blood circulation have calluses on their feet. People with diabetes have complex mechanisms like compromised immunity, peripheral neuropathy, damage to blood vessels and capillaries, and reduced blood circulation. Poor circulation leads to starvation of the skin, which in turn leads to the thickening of the skin. This leads to the increased risk of calluses and hammer toe. Due to compromised immunity and reduced sensation as a result of damaged nerves, there is a risk of diabetic foot ulcers. Moreover, when the callus gets thickened, the pressure of the callus leads to the tearing of the adjoining capillaries leading to bleeding. High blood sugar levels, and uncontrolled diabetes further increase the risk. The hyperkeratotic tissue can lead to improper walking, diabetic foot, and diabetic foot ulcer and can even lead to foot amputation. Glycemic control, foot hygiene, usage of orthotics, and reduced friction reduces the risk significantly.

Caesarean section or C-section refers to giving birth to babies by the method of operation as against natural birth. A natural method of giving birth is called the vaginal delivery in which the baby is delivered through the vagina (generally after the full term of the pregnancy). The vaginal delivery can be spontaneous, assisted, induced and normal. However, in the case of caesarean deliveries, the baby is delivered by surgery. In this surgery, the abdomen is incised to open the uterus and the womb to deliver the baby. This operation is conducted either with local or epidural anesthesia; however, some complex deliveries are known to occur under general anesthesia. Caesarean section delivery is performed in numerous instances. It is performed when the baby is in transverse position (when the baby is sideways), when the baby is in breech position (bottom first instead of head), when the position of baby is unstable, and when the pregnant woman has low-lying placenta. Women can also have caesarean section deliveries when they have an infection that can be passed on to the baby. In some cases, caesarean section can be performed as an emergency operation when the water breaks unexpectedly and the pregnant woman goes into labor, when the labor movements are sluggish or slow, and if there is a complication during the pregnancy. Women with gestational diabetes are prone to the risk of caesarean section deliveries and macrosomia of the baby. Gestational diabetes occurs in women due to a family history of diabetes, high BMI, and hormonal changes during pregnancy that make them insulin resistant. Women PCOS are also at a risk of getting gestational diabetes. Though the chances of vaginal deliveries are slim, with proper management of gestational diabetes, women can avoid the risk of stillbirths, infections, and preterm births.

CT-scan or CAT scan is an abbreviation for computerized axial tomography. It is a diagnostic tool that can provide cross sectional images of organs of the body. CT-scans provide high resolution images that are not possible with x-rays. With the help of CT-scans, images of slices of organs can be obtained. CT-scans are generally performed for the head, lungs, pelvis, abdomen, the extremities, and for angiography. A coronary CT angiography is done for patients who are suspected to have coronary artery diseases. CT pulmonary angiography is performed for those who are suspected of having pulmonary embolism. As against other imaging techniques used in diagnostics like x-rays, CT-scan offers numerous advantages. Since it can offer slice images of any organ, the issue of superimposition is eliminated. Due to its high contrast resolution, the differences in the tissues can be visualized to a good degree. The scope to view images in different planes makes it a better diagnostic tool. However, since it is a procedure that is done with medium to high radiation, there is risk of a person being exposed to radiation during the procedure. Added to that, contrast agents injected to patients undergoing CT-scans can also cause reactions. These can be mild, which include nausea, vomiting, and other allergic reactions. Since these contrast agents have to be flushed out of the body via the urinary system, there is a risk of nephropathy. This condition is called contrast-induced nephropathy. To eliminate this condition, a patient undergoing a contrast CT-scan is asked to undergo a serum creatinine test prior to the CT-scan. This is especially advised for people with diabetes.

The immune system of the body is designed to respond to two different ways. One is the humoral response that corresponds to antibody-mediated response. This is response of the immune system to bacteria, viruses, foreign substances, and antigens that freely circulate in the body. Humoral immunity response, involving the B cells of the immune system, recognizes pathogens and antigens moving freely in the body fluids such as blood. Cell-mediated immunity on the other hand is the activity of the T cells of the immune system. It involves the activation of phagocytes, release of cytokines, and antigen-specific cytotoxic T-lymphocytes. The T cells of the cell-mediated immunity develop in the thymus (located behind the breastbone). Then, they move between the bloodstream and the lymphoid organ till they encounter a specific antigen they were made for. When a T cell encounters its antigen, it turns from a naïve T cell to a T cell capable of destroying infected cells or tumor cells with the help of cytotoxic T cells. This is done by cell-mediated immunity. Type 1 diabetes is an autoimmune disease in which there is destruction of the beta cells of pancreas. Since the beta cells of pancreas produce insulin, there is diabetes mellitus. In people with type 1 diabetes, due to various factors, there is cellular immune reactivity causing beta cell destruction. This process is known to be mediated by T cells. Certain T cells are known to infiltrate the islets of Langerhans (which contains the beta cells) and destroy the beta cells. People with type 2 diabetes are also prone to infections more than non-diabetics. This is due to an innate defect in the immune system and decreased cellular responses including low cytokine response in uncontrolled diabetes. Moreover, there is a decrease in the presence of CD4+ T cells in people with diabetic ketoacidosis. This leads to abnormal metabolic processes and further susceptibility to diabetic ketoacidosis.

Canker sores are small and shallow lesions that appear in the mouth. They might also appear at the base of the gums. Canker sores are also called as aphthous ulcers. They are open, painful sores that might appear white or reddish in color. They are accompanied with inflamed soft tissue and are round or oval in shape. They can appear under the tongue, inside the lips, inside the cheeks, and inside the mucus membranes of the lips. They might even cause swollen lymph nodes. Canker sores might occur due to a variety of causes. They occur due to anxiety, stress, food allergies, and use of certain medications, viral infections, vitamin deficiencies, hormonal fluctuations, and others. They are even known to be caused due to fungal infections like oral thrush. Canker sores generally take around seven to ten days to resolve with the help of mouth rinses, vitamin pills, antibiotics, and dental hygiene. However, recurrent canker sores demand medical attention. People with diabetes have oral manifestations in the form of reduced salivary production. This is witnessed in the form of dry mouth. People with diabetes are prone to tooth decay, periodontal diseases, oral fungal infections, and canker sores. Also, the nerves of the mouth in some people with diabetes are damaged due to a condition called burning mouth syndrome. This leads to a constant scalding sensation in the mouth, lips, and cheeks. This is accompanied by dryness of the mouth, numbness, and tingling sensation. Oral hygiene, periodical dental checkups, and tight glycemic control can avert such complications.