Diabetic Seniors » Complications and Risks

Weight Loss Surgery Staves Off Prediabetes

DiabeticSeniors.com — Thu, 08 Oct 2009 18:54:08 +0000

Restrictive weight loss surgery, such as gastric bypass, involves limiting the stomach size, ultimately causes the patient to eat less. In contrast, with malabsorptive operations, such as biliopancreatic diversion, the intestines are rearranged in such a way that the patient absorbs less of what is eaten.

The new findings indicate that with restrictive operations, the improvement in insulin sensitivity depends on the degree of weight loss. With malabsorptive operations, however, normal insulin sensitivity is restored more rapidly and is not dependent on the amount of weight loss.

The findings, which appear in The American Journal of Medicine, are based on a study of 18 patients with severe obesity and 20 lean comparison subjects who underwent insulin sensitivity testing. The obese patients were treated with either gastric bypass or biliopancreatic diversion and then reevaluated 5 to 6 months and 16 to 24 months postoperatively.

Compared with lean subjects, the obese patients had very poor insulin sensitivity when the study began, senior author Dr. Ele Ferrannini, from the University of Pisa in Italy, and colleagues note.

With each procedure, weight loss averaged more than 100 pounds and occurred over roughly the same time course. However, as noted, the operations differed in their effects on insulin sensitivity.

During follow-up, a steady improvement in insulin sensitivity was seen in the gastric bypass group, but even at 16 months the sensitivity scores were still much lower than those of lean subjects.

In the biliopancreatic diversion group, by contrast, insulin sensitivity normalized by 6 months and actually exceeded that of lean subjects at 24-month follow-up, even though the subjects were still obese.

While the results suggest that biliopancreatic diversion restores insulin sensitivity more rapidly than gastric bypass, the authors note that each procedure has pros and cons and that doctors should decide which to use for a particular patient on an individual basis.

Obesity Gene Identified in Mice

DiabeticSeniors.com — Thu, 08 Oct 2009 18:30:37 +0000

“Our findings suggest that differences in lipin levels may play a role in why some people are more prone to weight gain than others who consume the same calories,” Dr. Karen Reue indicates in a UCLA press statement. The gene’s effects on blood-sugar levels and insulin “may point to new therapies for diabetes,” she suggests.

Dr. Jack Phan and Reue previously showed that lipin deficiency impairs fat cell development, making them more resistant to the effects of insulin.

For their current research, published in the journal Cell Metabolism, they created mice that had increased levels of lipin in muscle or fat tissue.

While on a normal diet, those with excess lipin in muscle exhibited accelerated body weight gain and elevated insulin levels, although food intake was not altered. On the same diet, sugar levels were significantly reduced while weight remained normal in mice with excess lipin in fat tissue.

When lipin was abundant in muscle, metabolism was repressed. The mice consumed less oxygen and energy expenditure was reduced.

When lipin was abundant in fat tissue, there was no difference in energy expenditure and only a trend toward slightly reduced oxygen consumption.

Lipin “may be a novel…target for the treatment of obesity,” the authors write.

High Cholesterol in Diabetes May Harm Vision

DiabeticSeniors.com — Thu, 08 Oct 2009 17:54:51 +0000

Harvard researchers found that individuals with the highest levels of low-density lipoprotein (LDL), the “bad” cholesterol, had twice the risk of developing a visual problem called macular edema, or fluid in the macula of the eye, compared with those with the lowest LDL levels. Subjects with the highest ratio of total cholesterol to high-density lipoprotein (HDL), the “good” cholesterol had a fourfold increased risk of this eye disorder.

Clinically significant macular edema is the leading cause of vision loss in diabetics, Dr. Debra A. Schaumberg of Brigham and Women’s Hospital and colleagues note. While high blood sugar has been tied to the development and progression of disease of the retina, the relationship between blood glucose control and clinically significant macular edema is not as clear.

Schaumberg and her colleagues analyzed data from the Diabetes Control and Complications Trial, which included 1,441 patients with Type 1 diabetes followed for an average of 6.5 years. Study participants’ cholesterol levels were checked annually.

The study, published in the medical journal Diabetes, is the largest investigation of its kind to-date to evaluate the relationship between clinically significant macular edema and blood cholesterol levels.

Patients in the top quarter of total-to-HDL cholesterol ratio had 3.84 times the risk of clinically significant macular edema compared with those in the lowest quarter. Those with the highest LDL levels were 1.95 more times likely to develop clinically significant macular edema.

When the patients’ blood sugar levels were considered, the relationship between cholesterol levels and clinically significant macular edema was weaker, although the association remained significant.

However, no relationship was seen between cholesterol levels and the progression or development of diabetic retinopathy.

The results indicate that high cholesterol, especially the total-to-HDL cholesterol ratio, are risk factors for clinically significant macular edema, Schaumberg and her colleagues conclude. The findings may also lend further support to current treatment guidelines that recommend aggressive lowering of high cholesterol in diabetic patients, they add.

Diabetic Senior Foot Care

DiabeticSeniors.com — Thu, 08 Oct 2009 17:37:19 +0000

As a diabetic, you stand a greater chance for foot infections. This can be a result of elevated blood glucose, lack of exercise, or an undetected foot injury. However, with proper care, the senior diabetic can avoid excessive and extreme foot and leg problems.—especially those of a neuropathic nature.

The three types of neuropathy for diabetics are peripheral,, focal, and autonomic. The peripheral is the form most likely to affect the feet. Consequently, an understanding of foot care for senior diabetics as well as treatments for neuropathy related problems is beneficial.

Basic Foot Care for the Senior Diabetic:

Daily self-examination for ulcers, corns, calluses, etc. if you are unable to do it yourself, ask someone to do it for you or use a mirror to see the bottom of your feet.
Keep feet clean and dry. Wash with a mild soap. Be sure that the skin between your toes is completely dry. If the skin is excessively dry, apply lotion.
Never go barefoot—especially important for foot care for the senior diabetic who has lost the feeling in their feet.
Always cut your toenails straight across.
Wear comfortable, properly fitting shoes–as much as possible, buy shoes made from leather as it allows your foot to “breathe”.
Never attempt to perform amateur surgery on your feet. See a doctor for calluses, corns, planter’s warts, etc.
See your doctor for Diabetes senior foot care and concerns like:

An open sore/ulcer on your foot
Any infection in a cut or blister
A red, tender toe or an ingrown toenail
Any change in how your foot feels—pain, tingling, numbing, burning, or no feeling at all
Any type of puncture wound (nails, splinters, tack, etc.)

An additional step you can make in diabetic senior foot care and treatment is to become friendly with your pharmacist. The pharmacy industry stays aware of new methods and treatments. In addition, if your pharmacist is aware of your medical history and physical situation they can assist you with over the counter items for colds, congestion, foot care and other physical ailments. Diabetic senior foot treatment should never involve, unless ordered by a doctor, the use of strong antiseptics like iodine, Epsom salts, creosol, or Mercurochrome. In diabetic senior foot care you should not use adhesive such as Band-Aids as they may damage the skin when removed. Rather, use sterile, dry bandages and fasten the dressing to itself with paper tape or gauze for better diabetic senior foot treatment.

In diabetic senior foot care, one of the greatest risks is a foot ulcer. Since an ulcer is painless (in most cases) it may go unnoticed for some time. However, once the ulcer is discovered, you should see your doctor immediately to begin diabetic senior foot treatment options like:

Using a cream with 10-25% urea for dry skin
Working with your doctor’s plan for treating the ulcer
Quite often, your doctor will check your circulation to see what the best recourse will be.

Diabetes senior foot care may be daunting but it is worth it. By taking consistent steps in foot care, you can continue to stride into the future.

DDI and Diabetic Neuropathy

DiabeticSeniors.com — Wed, 07 Oct 2009 21:22:32 +0000

DDI (Diabetics Detection, Inc.) has developed advanced technology that provides physicians with a new way to detect diabetic neuropathy — a condition in which the extremities lose sensation and become more susceptible to ulceration and infection.

This complication ultimately impacts an estimated one-half of all diabetic patients. But diagnosing diabetic neuropathy in its early stages can help reduce amputations resulting from infections in diabetes patients.

In the past, healthcare professionals relied on cumbersome (and often inaccurate) tuning forks to detect diabetic neuropathy. By sending vibrations into a patient’s extremities, a physician was able to determine if the patient could sense the vibrations.

DDI Technology

The founders of DDI have created a device that integrates with cell phones, pagers and PDAs — which many physicians already carry — to detect and monitor neuropathy. DDI’s Vibrameter allows a health care professional to perform a quick and accurate test to determine diabetic neuropathy in patients. The DDI device produces instant results, allowing the health care professional to refer the subject for further diagnostic evaluation, thereby assisting in the early detection of diabetes.

Diabetic Neuropathy: What You Need to Know

The highest rates of diabetic neuropathy occur in individuals who have had diabetes for 25 years or more. Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40. The most common type is peripheral neuropathy, also called distal symmetric neuropathy, which affects the arms and legs.

The best thing you can do to prevent diabetic neuropathy is to work with your doctor to keep your blood glucose under tight control. And because injuries and sores on the feet may go unrecognized due to lack of sensation, it’s important to examine your feet and legs daily, and wear properly fitting footwear all the time to prevent foot injury.

6 Reasons Why You Need a Blood Sugar Test

editor — Wed, 19 Aug 2009 15:38:37 +0000

People call diabetes the “silent disease” or the “silent killer.” You might not have any symptoms of diabetes, or the symptoms can be so subtle — thirst, hunger, weight loss — that you don’t notice them or you might think they are normal. If you’re diabetic and your blood sugar has stayed within its target range for a long time without any problems, the disease might lull you into a false sense of security. Or, you might have become so tired of giving yourself a blood sugar test several times a day that you decide to stop. But blood sugar testing is crucial to keeping your diabetes under control for six reasons.

1. To Empower Yourself

Giving yourself a blood sugar test is all about empowerment because the symptoms of diabetes are so subtle, hard to recognize or nonexistent. By testing your blood sugar periodically, you can see what the disease is doing or not doing to your body — and take action, if necessary. You don’t have to be a victim of the disease — blood sugar testing gives you control over your life.

2. To Maintain Your Proper Blood Sugar Target Range

As a diabetic, you have to perform a balancing act based on the results of a blood sugar test performed periodically each day that non-diabetics don’t have to worry about. Why? Because their pancreas maintains a constant flow of insulin, which helps cells in the body absorb sugar. When people eat, exercise or undergo stress, their bodies increase their blood sugar levels. The pancreas, in turn, creates a burst of insulin to help the cells absorb the extra sugar.

Because you’re a diabetic, though, your pancreas can’t produce the insulin your body needs or your cells won’t absorb the insulin your body does produce. Consequently, you have to perform a blood sugar test at different times each day to monitor your blood sugar level and, if the level is too high, take action to keep it within your target range.

Blood sugar testing can tell you that you need to modify your diet or eat different foods than you normally would at your next meal.

3. To Prevent Complications from Developing in the Future

When you don’t perform a blood sugar test several times every day, you can miss the subtle signs your body sends you that your blood sugar is high. If your body maintains the high level for too long, then serious, potentially life-threatening complications can develop such as neuropathy (damage to the nerve ends in your hands and feet), blindness, nerve damage and heart failure.

4. To See How Effective Your Diabetes Medicine Is

Blood sugar testing lets you monitor the effectiveness of the diabetes medicine you are taking. An elevated pattern of blood sugar revealed by blood sugar tests can indicate that your medicine is losing its effectiveness. You can alert your doctor and together, you can decide if your dosage should be increased or if you should change medicines.

5. To See How Your Non-Diabetes Medications Are Affecting Your Diabetes Medicine

You might be taking other medicines besides your diabetes medicine. Or you might start a new medicine for a new ailment. A blood sugar test can tell you how all those medicines are interacting and whether your non-diabetes medications are interfering with your diabetes medicine. If so, you can see your doctor and change to a medication that won’t interfere with your diabetes medicine.

6. Prevent Future Liver and Heart Damage

If you don’t monitor your blood sugar with a blood sugar test throughout the day, diabetes can lead to liver failure and heart attack. Blood sugar testing can help prevent an early death.

Why You Should Watch for Signs of When to Test Blood Sugar

editor — Wed, 19 Aug 2009 14:51:55 +0000

When to test blood sugar is obvious to most diabetics like yourself. After all, you monitor your glucose periodically every day and use the blood sugar test results to adjust your diet appropriately. Sometimes, though, everyday activities and special events can raise your blood sugar without your realizing it. These activities can include:

Changing your diet or not following it
Overeating
Not getting enough exercise
Becoming involved in an emotionally stressful situation such as a divorce, a death in the family, or a conflict in the workplace
Becoming physical ill
Not taking your diabetes medication

Signs of When to Test Blood Sugar

Some of the signs of when to test blood sugar can be so subtle that you might not recognize them. They also might develop so gradually that they seem normal or you might think they are your body’s reaction to a particularly stressful situation you’re going through. Those signs can include:

Sign	Reason
Frequent urination	Because your blood contains too much sugar, some of the sugar goes into your kidneys, taking water with it. Your kidneys convert the sugar and water into urine.
Extreme thirst	When the sugar and water leave your body as urine, you become dehydrated. As a result, you’re thirsty all the time and drink a lot.
Extreme hunger	Sugar is an important fuel for your body. When it leaves your body as you urinate, your body needs more fuel to replace it and signals that need to you as hunger.
Losing weight even though you’re eating a lot	Your body looks for other food sources to replace the sugar that leaves in your urine. But even though you might eat a lot in response to hunger pains, the sugar from those foods still isn’t absorbed by your cells. So to get the food it craves, your body starts consuming fat and muscle tissue, which makes you lose weight.
Feeling weak and tired all the time	Sugar provides energy to your body. Because your cells can’t absorb the sugar in your blood, your body doesn’t get the energy it craves. So you feel weak and tired all the time.
Tingling or numbness in your feet and hands	This sign, called neuropathy, occurs because the high sugar levels in your blood damage the nerves in your feet and hands. This damage is gradual and develops over time.
Blurring of your vision	The high sugar levels make the lenses in your eyes swell and shrink. Although this problem is usually temporary, it can eventually lead to your becoming blind.
Developing yeast and fungal infections	Because yeast and fungus thrive in high-sugar environments, your body plays host to them. Common infections include athlete’s foot, vaginal infections, bladder infections and sore throats.

Not All the Signs Indicate High Blood Sugar

Not all the signs indicate high blood sugar, but some other problem instead. For example, you could feel tired all the time because you have a sleep disorder such as sleep apnea. Or your weight loss could actually signal a thyroid or some other condition. But you should pay attention to the signs of when to test blood sugar. If your blood sugar test results are in the normal range, there’s no harm done. But if they aren’t, you can keep some major non-diabetic problems from developing down the road.

5 Steps for Proper Diabetic Foot Care

DiabeticSeniors.com — Mon, 17 Aug 2009 01:10:00 +0000

It’s a nasty cycle. Diabetic neuropathy, or nerve damage, can cause people with diabetes to not even be aware of minor cuts, blisters or pressure sores on their feet. Poor circulation can also lead to swelling and dryness of the foot.

Without proper diabetic foot care, these minor injuries can lead to complications that may result in ulceration and possibly even amputation.

That’s why proper diabetic foot care is so important. Good diabetic foot care involves making your feet part of your daily routine, including these simple steps:

1. Check your feet every day. Look for cuts, sores, red spots, swelling or infected toenails. Use a mirror or ask a family member for help with your diabetic foot care if you have trouble bending over to see your feet.

2. Wash your feet often. The next step in good diabetic foot care is washing your feet in warm — not hot — water every day. Dry your feet well, especially between your toes, and use talcum powder to keep the skin dry between the toes. Rub a thin coat of skin lotion or cream on the tops and bottoms of the feet. Do not put lotion between your toes, because this might cause infection.

3. Wear shoes and socks at all times. Do not walk barefoot, not even indoors. Always wear seamless socks, stockings, and nylons with your shoes to help avoid the possibility of blisters and sores developing. Always check the insides of your shoes before putting them on.

4. Keep the blood flowing. Put your feet up when you are sitting. Wiggle your toes for five minutes, two or three times a day.

5. Make Liberty part of your diabetic foot care. It may be hard to see the connection, but proper monitoring of your blood sugar can have a direct effect on the health of your feet. And proper monitoring starts with having the right equipment for home testing. Liberty Medical Supply provides reliable, consistent home delivery of diabetes products, including:

Blood glucose meters and batteries
Test strips
Lancing devices and lancets
Control solution
Hemoglobin A1c tests

If you are on Medicare and have diabetes, the cost of your diabetes testing supplies may be covered, whether you use insulin or not. Liberty Medical diabetic supplies can help determine if you are eligible. Call toll-free 1-800-827-2102.

Diabetic Kidney Complications

DiabeticSeniors.com — Thu, 13 Aug 2009 12:13:00 +0000

The kidneys are organs that act as a filtration system for the blood. They utilize a system of millions of blood vessels to remove waste particles from the blood. Without the kidneys, levels of toxic waste products accumulate to dangerous levels and can cause very serious health problems. Diabetes accounts for approximately 44% of kidney failure in the United States. Diabetic kidney complications are the result of unregulated blood sugar levels that over time deteriorate the ability for kidneys to filter waste.

Kidney Complications and Kidney Disease

The risk of developing a form of kidney disease, known as Chronic Kidney Disease (CKD), is also increased in patients diagnosed with diabetes. The course of kidney disease and eventually kidney failure is a process that takes place over several years. In fact, many people suffering from kidney disease may be completely unaware due to the absence of visible symptoms. Because the ability for the kidneys to filter blood remains relatively unchanged during the inception of kidney disease it is difficult for people suffering from kidney disease to detect these diabetes kidney complications. However, over the course of several years, small amounts of useful proteins accumulate in urine; this is known as microalbuminuria. As CKD progresses, higher amounts of proteins leak into urine while simultaneously the kidney’s filtration abilities worsen. Ultimately the kidneys loose all ability to filter blood and subsequently the patient will require either a kidney transplant or kidney dialysis.

High Blood Pressure

High blood pressure or hypertension is another factor that significantly influences the functionality and health of kidneys. Abnormally high blood pressure, typically classified as blood pressure above 140/90, has the potential to accelerate kidney disease and ultimately lead to kidney failure. Medical researches assert that regulating blood pressure in conjunction with other key metabolic health indicators including blood sugar is essential to treat diabetic kidney complications.

Please keep in mind that this article on Diabetic Kidney Complications is intended solely as an informational document; consult a licensed physician before making any decisions regarding the management of individual cases of diabetes.

Source: National Diabetes Information Clearinghouse (NDIC)
http://kidney.niddk.nih.gov/kudiseases/pubs/kdd/index.htm

Diabetic Neuropathy

DiabeticSeniors.com — Thu, 13 Aug 2009 02:48:00 +0000

Neuropathy is a term that approximately 60% to 70% of patients with diabetes have unfortunately become familiar with. Diabetic neuropathy, an increasingly prevalent complication of diabetes, is characterized by extensive damage to the nervous system in a diabetic. The disease can be isolated to a specific area in the body or, alternatively, has the potential to cause widespread damage.

A combination of numerous health and genetic factors influence the onset of neuropathy in a diabetic. Primarily, metabolic factors including blood sugar and body fat levels determine the probability of developing the disease. Other factors that increase the risks of developing diabetic neuropathy include genetic predispositions to neurovascular diseases and the degree of oxygen and nutrients present in blood flow. Moreover, the risk of developing the disease exponentially increases as the amount of time a person has been diagnosed with diabetes surpasses 25 years.

There are several types of diabetic neuropathies that each affects a particular area of the body. The following are the different classifications of the disease and the respective areas of the body they can potentially affect[1]:

Peripheral Neuropathy

Toes
Feet
Legs
Hands
Arms

Autonomic Neuropathy

Heart and Blood Vessels
Digestive System
Urinary Tract
Sex Organs
Sweat Glands
Eyes
Lungs

Proximal Neuropathy

Thighs
Hips
Buttocks
Legs

Focal Neuropathy

Eyes
Facial Muscles
Ears
Pelvis and Lower Back
Chest
Abdomen
Thighs
Legs
Feet

The symptoms of diabetic neuropathy depend on the severity of nerve damage and the types of nerves that are affected. Nerve damage occurs gradually over a period of time so many diabetics that are suffering from diabetic neuropathy may not even be aware. Typically, the initial symptoms include numbness or tingling in the limbs. However, these initial symptoms can progress into more severe and damaging ones. These include[2]:

Muscular atrophy
Indigestion
Nausea
Vomiting
Diarrhea or constipation
Dizziness or fainting
Urination problems
Erectile dysfunction

Although some of the symptoms do not seem especially severe or life threatening, further complications may arise that have far more severe health implications. The loss of the sensation of pain in limbs, a common side effect of neuropathy, may result in amputation or even death. The loss of pain in feet for example may cause a diabetic to be unaware of minor injuries that might develop. Subsequently, if left untreated, those injuries can develop into infections or ulcers that may become life threatening.

Because diabetic neuropathy is primarily caused by metabolic factors such as high blood glucose levels, effectively maintaining appropriate levels of these health indicators is a must. Systematic and regular blood glucose testing with diabetic testing supplies will reduce the chances of developing high blood sugar levels and its associated complications – including neuropathy. Furthermore, be sure to implement proper diet and exercise along with your blood sugar testing regiment in order to offset the chances of diabetic neuropathy and other complications.

Please keep in mind that this article on Diabetic Neuropathy is intended solely as an informational document; consult a licensed physician before making any decisions regarding the management of individual cases of diabetes.

Source: National Diabetes Information Clearinghouse (NDIC)

[1] “Neuropathy Affects Nerves Throughout the Body”
http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/

[2] “What are the Symptoms of Diabetic Neuropathies?”
http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/