Challenges and Opportunities for an Elderly Diabetic

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by Benny Arce

Diabetes, diabetes mellitus among medical practitioners, is a metabolic disorder afflicting an estimated 23.6 million Americans. That is close to eight percent of the population. This eight percent include the likes of former governor and presidential candidate Mike Huckabee, actresses Halle Berry and Selma Hayek, and CNN’s Larry King.

What is Diabetes?

When food is eaten, most of it is converted into glucose, which is the main source of energy for the cells. From the digestive system, glucose flows into the bloodstream waiting to be used. The cells, however, require insulin for them to absorb glucose. If the pancreas does not produce enough insulin, or if the cells themselves do not respond to insulin, glucose accumulates in the bloodstream until it passes out of the system through urine.

There are three main types of diabetes –Type 1, Type 2, and gestational.

Type 1 diabetes is an autoimmune disease where the body’s own immune system attacks the beta-cells of the pancreas that produce insulin.

Type 2 diabetes is the more common kind, with about 90 to 95 percent of diabetics having it. In this type of diabetes, the body does not respond to insulin, a condition referred to as insulin resistance.

Gestational diabetes occurs only during pregnancy and is similar to Type 2.

Causes and Symptoms

Although it is not known precisely what causes Type 1 diabetes, Type 2 is often associated with advanced age, obesity, lack of exercise, ethnicity, family history, and previous gestational diabetes.

Classic symptoms of diabetes are frequent urination and increased thirst, technically, polyuria and polydipsia respectively. Thirst may lead to frequent drinking but the mouth remains feeling dry. These are often accompanied by huge fluctuations in weight, whether upward or downward. In addition to this, the patient often feels fatigued and nauseated. Blurred vision also occurs as well as slow-healing sores and cuts, and itchy skin, particularly in the groin area.

Managing Diabetes

Discovering that you have diabetes is often upsetting as this implies changes in your lifestyle. You may have to give up some things and take up new ones. This is especially difficult when you are elderly. Habits of a lifetime are most difficult to let go, while adopting new ones can be disorienting.

Your diet may have to change. For the elderly, carbs should be limited to 60 percent of the diet with fats no more than 30 percent. You may need to get up and stretch those muscles. You will need to learn how to monitor you blood glucose levels. This means a ready supply of lancets, test strips, glucose meters, syringes, and ketone strips.

Medicare or your insurance will reimburse you for these expenses but you will need to fill out endless forms. Unless you arrange for your supplies to be delivered to your home, you may also have to stand in long lines at the pharmacy.

Diabetes can cause health complications. You will have to take extra care of your feet, eyes, and kidneys. Your blood pressure has to be kept under control.

You can look at these changes as an aggravation or an opportunity. You can focus on learning new things and become a walking encyclopedia on diabetes. You can also meet new friends while waiting in line or taking a walk in the park. Who knows but you might even run into Huckabee, Berry, Hayek, or King.

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Guest Writer

I’m pleased to bring on guest writer Benny who will be helping me update this website with great news stories and information on the medical and health topics that affect us all. Stay tuned for his posts.!

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Cathether based – non surgical procedure can prevent strokes

3 mg (blue), 5 mg (pink) and 1 mg (brown) warf...
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by Rose Broyles

Last month, physicians at Mt. Sinai Medical Center performed the first procedure in the U.S. using sutures to tie off a left appendage which is the source of blood clots leading to stroke in patients with atrial fibrillation. I wish this had been available for Dad years ago. Unfortunately, Dad has so much going on with him I’d be scared to even let him try something like this because of his other existing pre-conditions. But for others, this looks like a promising breakthrough.

The procedure

The procedure was performed by Vivek Y. Reddy, MD, Professor of Medicine and Director of the Cardiac Arrhythmia Service at Mount Sinai Heart, and Srinivas R. Dukkipati, MD, Director of Mount Sinai’s Experimental Electrophysiology Laboratory. Using general anesthesia, the doctors guided two catheters into the patient’s heart to seal the LAA with a pre-tied suture loop. The technique has been shown to be a safe alternative to drug therapies such as the blood thinner warfarin (Coumadin) that can have serious side effects, as well as open-heart surgery, and more invasive implant surgery.

Compared to a lifetime of medication therapy, or other surgical modalities, a one-time, non-surgical procedure to relieve the complications of AFib offers a whole new paradigm,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Mount Sinai School of Medicine, and Executive Vice President for Academic Affairs, The Mount Sinai Medical Center.

Approximately 6 million U.S. adults have been diagnosed with Atrial Fibrillation– a rapid and irregular heart beat that can cause serious complications, including stroke and early death. Warfarin (Coumadin) is necessary for the prevention of life-threatening blood clots. About a quarter of all strokes are caused by Atrial Fibrillation– this was a reason for my dad’s stroke. Using warfarin is necessary for the prevention of blood clots, however, its levels must be maintained constantly otherwise continuous bleeding can occur if there is bruising or a bad fall. My dad has to get his “INR” checked every month IF his therapeutic levels are between 2.0-2.9. However, any number that falls below or increases above the required levels means an adjustment of medication and a weekly blood test until those levels are achieved.

Dr. Reddy explained that the non-invasive procedure could be a permanent means to stroke prevention for patients who cannot be on long-term anticoagulation therapy.

Doctors place a pre-tied suture loop on the outside of the LAA using an approach similar to what is used in surgery. The difference however, is there are no surgical incisions required, rather they use needle punctures to insert the catheters.

This procedure was aided by the LARIAT Suture Delivery Device, which was developed by SentreHEART, Inc., and approved by the FDA in May.

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