Dipak-001/mistril_dataset huggingface dataset:
user: How to prevent Diagnosis of Diabetes and Prediabetes ?

assistant: A major research study, the Diabetes Prevention Program (DPP), proved that people with prediabetes were able to sharply reduce their risk of developing diabetes during the study by losing 5 to 7 percent of their body weight through dietary changes and increased physical activity.
                
Study participants followed a low-fat, low-calorie diet and engaged in regular physical activity, such as walking briskly five times a week for 30 minutes. These strategies worked well for both men and women in all racial and ethnic groups, but were especially effective for participants age 60 and older. A follow-up study, the Diabetes Prevention Program Outcomes Study (DPPOS), showed losing weight and being physically active provide lasting results. Ten years after the DPP, modest weight loss delayed onset of type 2 diabetes by an average of 4 years.
                
The diabetes medication metformin also lowers the risk of type 2 diabetes in people with prediabetes, especially those who are younger and heavier and women who have had gestational diabetes. The DPPOS showed that metformin delayed type 2 diabetes by 2 years. People at high risk should ask their health care provider if they should take metformin to prevent type 2 diabetes. Metformin is a medication that makes insulin work better and can reduce the risk of type 2 diabetes.
                
More information about insulin resistance, the DPP, or how to lower risk for type 2 diabetes is provided in the NIDDK health topics:
                
- Am I at Risk for Type 2 Diabetes?  - Diabetes Prevention Program (DPP)  - Insulin Resistance and Prediabetes
                
Additional information about the DPP, funded under NIH clinical trial number NCT00004992, and the DPPOS, funded under NIH clinical trial number NCT00038727, can be found at www.bsc.gwu.edu/dpp.
                
As part of its Small Steps, Big Rewards campaign, the National Diabetes Education Program (NDEP) offers several booklets about preventing type 2 diabetes, including information about setting goals, tracking progress, implementing a walking program, and finding additional resources. These materials are available at www.ndep.nih.gov or by calling the NDEP at 1888693NDEP (18886936337).
user: What are the treatments for Diagnosis of Diabetes and Prediabetes ?

assistant: People can manage their diabetes with meal planning, physical activity, and if needed, medications. More information about taking care of type 1 or type 2 diabetes is provided in the NIDDK health topics:
                
- What I need to know about Diabetes Medicines  - What I need to know about Eating and Diabetes  - Your Guide to Diabetes: Type 1 and Type 2
                
These NDIC publications are available at http://www.niddk.nih.gov/health-information/health-topics/Diabetes/Pages/default.aspx or by calling 18008608747.
user: What to do for Diagnosis of Diabetes and Prediabetes ?

assistant: - Tests used for diagnosing diabetes and prediabetes include the A1C testfor type 2 diabetes and prediabetesthe fasting plasma glucose (FPG) test, and the oral glucose tolerance test (OGTT). Another blood test, the random plasma glucose (RPG) test, is sometimes used to diagnose diabetes when symptoms are present during a regular health checkup.  - Anyone age 45 or older should consider getting tested for diabetes or prediabetes. People younger than 45 should consider testing if they are overweight or obese and have one or more additional risk factors for diabetes.  - If results of testing are normal, testing should be repeated at least every 3 years. Health care providers may recommend more frequent testing depending on initial results and risk status.  - People whose test results indicate they have prediabetes may be tested again in 1 year and should take steps to prevent or delay type 2 diabetes.  - Many people with prediabetes develop type 2 diabetes within 10 years.  - Modest weight loss and moderate physical activity can help people with prediabetes delay or prevent type 2 diabetes.
user: What causes Nerve Disease and Bladder Control ?

assistant: Nerves that work poorly can lead to three different kinds of bladder control problems.
                
Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include
                
- urinary frequencydefined as urination eight or more times a day or two or more times at night  - urinary urgencythe sudden, strong need to urinate immediately  - urge incontinenceleakage of urine that follows a sudden, strong urge to urinate
                
Poor control of sphincter muscles. Sphincter muscles surround the urethra and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when you are trying to release urine.
                
Urine retention. For some people, nerve damage means their bladder muscles do not get the message that it is time to release urine or are too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. Or urine that stays too long may lead to an infection in the kidneys or bladder. Urine retention may also lead to overflow incontinence.
user: What causes Nerve Disease and Bladder Control ?

assistant: Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
                
- vaginal childbirth  - infections of the brain or spinal cord  - diabetes  - stroke  - accidents that injure the brain or spinal cord  - multiple sclerosis  - heavy metal poisoning
                
In addition, some children are born with nerve problems that can keep the bladder from releasing urine, leading to urinary infections or kidney damage.
user: What are the treatments for Nerve Disease and Bladder Control ?

assistant: The job of the sphincter muscles is to hold urine in the bladder by squeezing the urethra shut. If the urethral sphincter fails to stay closed, urine may leak out of the bladder. When nerve signals are coordinated properly, the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to push out urine. If the signals are not coordinated, the bladder and the sphincter may contract at the same time, so urine cannot pass easily.
                
Drug therapy for an uncoordinated bladder and urethra. Scientists have not yet found a drug that works selectively on the urethral sphincter muscles, but drugs used to reduce muscle spasms or tremors are sometimes used to help the sphincter relax. Baclofen (Lioresal) is prescribed for muscle spasms or cramping in patients with multiple sclerosis and spinal injuries. Diazepam (Valium) can be taken as a muscle relaxant or to reduce anxiety. Drugs called alpha-adrenergic blockers can also be used to relax the sphincter. Examples of these drugs are alfuzosin (UroXatral), tamsulosin (Flomax), terazosin (Hytrin), and doxazosin (Cardura). The main side effects are low blood pressure, dizziness, fainting, and nasal congestion. All of these drugs have been used to relax the urethral sphincter in people whose sphincter does not relax well on its own.
                
Botox injection. Botulinum toxin type A (Botox) is best known as a cosmetic treatment for facial wrinkles. Doctors have also found that botulinum toxin is useful in blocking spasms like eye ticks or relaxing muscles in patients with multiple sclerosis. Urologists have found that injecting botulinum toxin into the tissue surrounding the sphincter can help it to relax. Although the FDA has approved botulinum toxin only for facial cosmetic purposes, researchers are studying the safety and effectiveness of botulinum toxin injection into the sphincter for possible FDA approval in the future.
user: What are the treatments for Nerve Disease and Bladder Control ?

assistant: Urine retention may occur either because the bladder wall muscles cannot contract or because the sphincter muscles cannot relax.
                
Catheter. A catheter is a thin tube that can be inserted through the urethra into the bladder to allow urine to flow into a collection bag. If you are able to place the catheter yourself, you can learn to carry out the procedure at regular intervals, a practice called clean intermittent catheterization. Some patients cannot place their own catheters because nerve damage affects their hand coordination as well as their voiding function. These patients need to have a caregiver place the catheter for them at regular intervals. If regular catheter placement is not feasible, the patients may need to have an indwelling catheter that can be changed less often. Indwelling catheters have several risks, including infection, bladder stones, and bladder tumors. However, if the bladder cannot be emptied any other way, then the catheter is the only way to stop the buildup of urine in the bladder that can damage the kidneys.
                
Urethral stent. Stents are small tube-like devices inserted into the urethra and allowed to expand, like a spring, widening the opening for urine to flow out. Stents can help prevent urine backup when the bladder wall and sphincter contract at the same time because of improper nerve signals. However, stents can cause problems if they move or lead to infection.
                
Surgery. Men may consider a surgery that removes the external sphincter-a sphincterotomy-or a piece of it-a sphincter resection-to prevent urinary retention. The surgeon will pass a thin instrument through the urethra to deliver electrical or laser energy that burns away sphincter tissue. Possible complications include bleeding that requires a transfusion and, rarely, problems with erections. This procedure causes loss of urine control and requires the patient to collect urine by wearing an external catheter that fits over the penis like a condom. No external collection device is available for women.
                
Urinary diversion. If other treatments fail and urine regularly backs up and damages the kidneys, the doctor may recommend a urinary diversion, a procedure that may require an outside collection bag attached to a stoma, a surgically created opening where urine passes out of the body. Another form of urinary diversion replaces the bladder with a continent urinary reservoir, an internal pouch made from sections of the bowel or other tissue. This method allows the person to store urine inside the body until a catheter is used to empty it through a stoma.
user: What to do for Kidney Failure: What to Expect ?

assistant: For people who are on dialysis or approaching total kidney failure, adequate nutrition is important for maintaining energy, strength, healthy sleep patterns, bone health, heart health, and good mental health. A persons treatment will dictate the type of diet that should be followed:
                
- People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus.  - In contrast, people on peritoneal dialysisa type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the bodymay be able to eat more potassium-rich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis.  - Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat protein-rich foods such as meat, fish, and eggs.
                
All dialysis centers and transplant clinics have a renal dietitian who specializes in helping people with kidney failure. People who are on dialysis or have a kidney transplant should talk with their clinics renal dietitian to develop a meal plan that will enhance the effectiveness of their treatment.
                
For more information about nutrition for people with advanced CKD or who are on dialysis, see NIDDK health topics, Nutrition for Advanced Chronic Kidney Disease in Adults or Kidney Failure: Eat Right to Feel Right on Hemodialysis.
user: What to do for Kidney Failure: What to Expect ?

assistant: - Kidney failure can affect a persons health in several ways.  - When the kidneys stop working, waste products build up in the blood, a condition known as uremia.  - People with kidney failure can avoid most of the problems of uremia by having regular dialysis treatments and limiting foods that contain sodium, potassium, and phosphorus.  - Anemia is common in people with chronic kidney disease (CKD), as well as those on dialysis, because the damaged kidneys slow the produc-tion of the hormone erythropoietin (EPO), which helps the bone marrow make red blood cells.  - People with kidney failure, particularly dialysis patients, have far higher rates of heart and blood vessel problems than people without kidney problems.  - People who have uremia often lose their appetite.  - Many people treated with hemodialysis complain of itchy skin.  - Kidney failure weakens the bones due to a condition called chronic kidney disease-mineral and bone disorder.  - Kidney failure can cause pain, stiffness, and fluid in the joints. These symptoms result from amyloidosis, a condition in which an abnormal protein in the blood called amyloid is deposited in tissues and organs, including the joints and tendons.  - People on dialysis often have insomnia, sleep apnea syndrome, and restless legs syndrome.  - People who have kidney failure and depression should tell their health care provider because depression can often be treated with adjustments to the diet and dialysis dose, medications, counseling, and cognitive behavioral therapy.  - For people who are on dialysis or approaching total kidney failure, adequate nutrition is important for maintaining energy, strength, healthy sleep patterns, bone health, heart health, and good mental health.  - All dialysis centers and transplant clinics have a renal dietitian who specializes in helping people with kidney failure. People who are on dialysis or have a kidney transplant should talk with their clinics renal dietitian to develop a meal plan that will enhance the effectiveness of their treatment.
user: What is (are) What I need to know about Hepatitis A ?

assistant: Hepatitis* A is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other.
                
Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly.
user: What is (are) What I need to know about Hepatitis A ?

assistant: The liver is an organ that does many important things. You cannot live without a liver.
                
*See the Pronunciation Guide for tips on how to say the words in bold type.
                
The liver
                
- removes harmful chemicals from your blood  - fights infection  - helps digest food  - stores nutrients and vitamins  - stores energy
user: Who is at risk for What I need to know about Hepatitis A? ?

assistant: Anyone can get hepatitis A, but those more likely to are people who
                
- travel to developing countries  - live with someone who currently has an active hepatitis A infection  - use illegal drugs, including noninjection drugs  - have unprotected sex with an infected person  - provide child care
                
Also, men who have sex with men are more likely to get hepatitis A.
user: What are the symptoms of What I need to know about Hepatitis A ?

assistant: Most people do not have any symptoms of hepatitis A. If symptoms of hepatitis A occur, they include
                
- feeling tired  - muscle soreness  - upset stomach  - fever  - loss of appetite  - stomach pain  - diarrhea  - dark-yellow urine  - light-colored stools  - yellowish eyes and skin, called jaundice
                
Symptoms of hepatitis A can occur 2 to 7 weeks after coming into contact with the virus. Children younger than age 6 may have no symptoms. Older children and adults often get mild, flulike symptoms. See a doctor right away if you or a child in your care has symptoms of hepatitis A.
user: How to diagnose What I need to know about Hepatitis A ?

assistant: A blood test will show if you have hepatitis A. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis A.
user: What are the treatments for What I need to know about Hepatitis A ?

assistant: Hepatitis A usually gets better in a few weeks without treatment. However, some people can have symptoms for up to 6 months. Your doctor may suggest medicines to help relieve your symptoms. Talk with your doctor before taking prescription and over-the-counter medicines.
                
See your doctor regularly to make sure your body has fully recovered. If symptoms persist after 6 months, then you should see your doctor again.
                
When you recover, your body will have learned to fight off a future hepatitis A infection. However, you can still get other kinds of hepatitis.
user: What to do for What I need to know about Hepatitis A ?

assistant: If you have hepatitis A, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements.
user: What to do for What I need to know about Hepatitis A ?

assistant: - Hepatitis A is a virus, or infection, that causes inflammation of the liver.  - Anyone can get hepatitis A, but some people are more likely to than others.  - You could get hepatitis A through contact with an infected persons stool.  - Most people do not have any symptoms of hepatitis A.  - Children younger than age 6 may have no symptoms of hepatitis A.  - Hepatitis A may cause mild, flulike symptoms in older children and adults.  - See a doctor right away if you or a child in your care has symptoms of hepatitis A.  - A blood test will show if you have hepatitis A.  - Hepatitis A usually gets better in a few weeks without treatment.  - You can avoid getting hepatitis A by receiving the hepatitis A vaccine.  - Tell your doctor and your dentist if you have hepatitis A.  - See your doctor right away if you think you have been in contact with the hepatitis A virus.
user: What is (are) Prevent diabetes problems: Keep your diabetes under control ?

assistant: Diabetes problems are health problems that can happen when you have diabetes. If your diabetes is not under control, you will have too much glucose*, also called sugar, in your blood. Having too much glucose in your blood for a long time can affect many important parts of your body, such as your
                
- blood vessels and heart  - nerves  - kidneys  - mouth  - eyes  - feet
                
You can do a lot to prevent or slow down these health problems if you keep your diabetes under control.
                
This chart shows the body parts that can be affected by diabetes and the resulting health problems you may have.
                
Affected Body Part    Resulting Health Problems You May Have          Blood vessels and heart             - Heart disease      - Heart attack      - Stroke      - High blood pressure      - Poor blood circulation, or flow, throughout your body            Nerves             - Pain, tingling, weakness, or numbness in your hands, arms, feet, or legs      - Problems with your bladder, digestion, having sex, and keeping your heartbeats and blood pressure steady            Kidneys             - Protein loss through your urine      - Buildup of wastes and fluid in your blood            Mouth             - Gum disease and loss of teeth      - Dry mouth      - Thrush, or the growth of too much fungus in the mouth            Eyes             - Loss of vision and blindness            Feet             - Sores      - Infections      - Amputation
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.
user: What is (are) Prevent diabetes problems: Keep your diabetes under control ?

assistant: The A1C test, also called the hemoglobin A1C test, HbA1C, or glycohemoglobin test, is a blood test that reflects the average level of glucose in your blood during the past 3 months. Your A1C test result is given in percents. Your doctor might use the A1C test to help diagnose your diabetes. Your doctor will draw a sample of your blood in the office or send you to a lab to have a sample of your blood drawn for the test. After being diagnosed with diabetes, you should have the A1C test at least twice a year.
                
Your A1C result plus your record of blood glucose numbers show whether your blood glucose is under control.
                
- If your A1C result is too high, you may need to change your diabetes care plan. Your health care team can help you decide what part of your plan to change. For instance, you might need to change your meal plan, your diabetes medicines, or your physical activity plan.  - If your A1C result is on target, then your diabetes treatment plan is working. The lower your A1C is, the lower your chance of having diabetes problems.
                
This chart shows the A1C goals for different types of people with diabetes.
                
Types of People    A1C Goals          Most people with diabetes    below 7%        Women with diabetes who want to get pregnant or who are pregnant    below 6%
                
A1C goals can also depend on
                
- how long you have had diabetes  - whether or not you have other health problems
                
Ask your doctor what goal is right for you.
                

                
This chart shows how your A1C result may match up to your average blood glucose number.
                
What Your A1C Result Means          My A1C Result    My Average Blood Glucose Number        6%    135        7%    170        8%    205        9%    240        10%    275        11%    310        12%    345
user: What to do for Prevent diabetes problems: Keep your diabetes under control ?

assistant: Following a healthy eating plan is a key step in living with diabetes and preventing diabetes problems. Your health care team will help you make a healthy eating plan.
                
More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes or call 18008608747.