Treatment Of Diabetes In The Elderly – Part 3 of 3
And “We are getting more and more disturbed about the complications that occur in older adults with ongoing treatment,” said Dr Gisele Wolf-Klein, director of geriatric education at the North Shore-LIJ Health System in New Hyde Park, NY Wolf-Klein, who has conscious rates of hypoglycemia in nursing home residents, says it’s an underappreciated problem. “We need to understand that older diabetics may be continuing to document the same medication they always took, but they’ve completely changed their lifestyle,” said Wolf-Klein.
For example, many seniors struggle to get enough to eat during the day, something doctors may not think to ask about. Metabolism also slows with age, Wolf-Klein said, making drugs that belittle blood sugar especially potent in this population look at this. “We have to remember that because people are living much longer, the way you treat diabetes in a 40-year-old is usual to be very different than the way you treat diabetes in an older patient.
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Treatment Of Diabetes In The Elderly – Part 2 of 3
For every 1000 seniors followed for a year, there were about eight cases of insensitivity disease diagnosed in those under age 70, about 11 cases in those in their 70s, and roughly 15 cases for those aged 80 and older. Among those aged 80 or older who’d had diabetes for more than a decade, there were 24 cases of nub disease for every 1000 people who were followed for a year. That’s a big drop from just a decade ago, when a prior study found rates of heart disease in elderly diabetics to be about seven times higher – 182 cases for every 1000 mobile vulgus followed for a year.
Heart disease isn’t the only complication to see drastic declines. Dangerous episodes of high blood sugar have plunged about 10-fold since 2002, while amputations appear to be about three times lower. Things are so much better, in fact, that it’s the healing itself that’s now become one of the major reasons seniors with diabetes get sick. Hypoglycemia due to plummeting blood sugar – characterized by weakness, quintessence palpitations, trembling, sweating, trouble speaking and anxiety – is now the third most common nonfatal complication of diabetes in long-term diabetics age-old 70 and older, the researchers found.
So “Hypoglycemia is a side effect of therapy and it’s not a good thing. It’s now more common than kidney failure or amputation. That means the side effects of curing are now more common than the things we’re trying to prevent. An expert who wasn’t involved with the study praised its focus on older adults, who make up about half of those living with diabetes in the United States.
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Treatment Of Diabetes In The Elderly – Part 1 of 3
Treatment Of Diabetes In The Elderly. Better diabetes remedying has slashed rates of complications such as heart attacks, strokes and amputations in older adults, a unfledged study shows. “All the event rates, if you look at them, everything is a lot better than it was in the 1990s, dramatically better,” said study author Dr Elbert Huang, an associate professor of c physic at the University of Chicago. The study also found that hypoglycemia, or low blood sugar – a side effect of medications that control diabetes – has become one of the top problems seen in seniors, suggesting that doctors may require to rethink drug regimens as patients age.
The findings, published online Dec 9, 2013 in JAMA Internal Medicine, are based on more than 72000 adults aged 60 and older with group 2 diabetes. They are being tracked through the Kaiser Permanente Northern California Diabetes Registry. Researchers tallied diabetic complications by age and length of time with the disease. People with archetype 2 diabetes, the most common form of the disease, have too much sugar in the blood.
It’s estimated that roughly 23 million people have type 2 diabetes in the United States, about half of them older than 60. Many more are expected to bring out diabetes in coming years. In general, complications of diabetes tended to worsen as people got older, the study found. They were also more relentless in people who’d lived with the disease longer. Heart disease was the chief complication seen in seniors who’d lived with the disease for less than 10 years.
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Post-Traumatic Stress Disorder And Type 2 Diabetes – Part 3 of 3
Studies need to be done in men in the generalized population, but based on these data we would expect findings to be similar”. Doctors should pay more attention to the possible causes of diabetes. “Physicians in general don’t ask enough questions, but when they do, they forget to implore questions about psychological factors that potentially contribute to medical problems”. The study appears in the Jan 7, 2015 issue of JAMA Psychiatry blueprint.
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Post-Traumatic Stress Disorder And Type 2 Diabetes – Part 2 of 3
Over the track of the study, more than 3000 of the nurses, or 6 percent, developed type 2 diabetes, which is linked to being overweight and sedentary. Those with the most PTSD symptoms were almost twice as credible to develop diabetes as those without PTSD, said study co-author Karestan Koenen, professor of epidemiology at Columbia University Mailman School of Public Health in New York City. The examine doesn’t prove that PTSD directly causes diabetes, although Koenen said the study’s design allows the researchers to “know that PTSD came before type 2 diabetes”.
Since PTSD disrupts various systems in the body, such as those that administer stress hormones, “it may be that something about PTSD changes women’s biology and increases risk” of diabetes. Use of antidepressants and higher body weight accounted for almost half the increased risk. “The antidepressant pronouncement was surprising because as far as we know, no one has shown it before. Much more research needs to be done to determine what the finding means”.
Obesity explains some, but not all, of the relationship. There could be a relation from PTSD to overeating to diabetes, but he believes the situation is more complex than it sounds. “Many PTSD patients are on the overweight end of the spectrum, and that’s true for both men and women. We don’t twig this link”. Some factor, perhaps genetic, could make people more prone to both conditions. What about men? “Our findings are consistent with findings for male veterans.
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Post-Traumatic Stress Disorder And Type 2 Diabetes – Part 1 of 3
Post-Traumatic Stress Disorder And Type 2 Diabetes. Women with post-traumatic burden disorder seem more likely than others to develop type 2 diabetes, with severe PTSD almost doubling the risk, a strange study suggests. The research “brings to attention an unrecognized problem,” said Dr Alexander Neumeister, director of the molecular imaging program for disquiet and mood disorders at New York University School of Medicine. It’s crucial to treat both PTSD and diabetes when they’re interconnected in women. Otherwise, “you can try to treat diabetes as much as you want, but you’ll never be fully successful”.
PTSD is an desire disorder that develops after living through or witnessing a dangerous event. People with the disorder may feel intense stress, suffer from flashbacks or experience a “fight or flight” answer when there’s no apparent danger. It’s estimated that one in 10 US women will develop PTSD in their lifetime, with potentially severe effects, according to the study. “In the past few years, there has been an increasing acclaim to PTSD as not only a mental disorder but one that also has very profound effects on brain and body function who wasn’t involved in the new study.
Among other things, PTSD sufferers gain more weight and have an increased chance of cardiac disease compared to other people. The new study followed 49,739 female nurses from 1989 to 2008 – aged 24 to 42 at the beginning – and tracked weight, smoking, uncovering to trauma, PTSD symptoms and type 2 diabetes. People with type 2 diabetes have higher than normal blood sugar levels. Untreated, the disease can cause serious problems such as blindness or kidney damage.
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Effect Of Anesthesia In Surgery Of Prostate Cancer – Part 3 of 3
In the end, having mongrel anesthesia alone was linked to a nearly threefold higher risk of a cancer turning up in distant sites in the body over the next 15 years. Still, only 3 percent to 5 percent of the men had a cancer recurrence. And the endanger is generally low with a skilled surgeon. He suggested that patients be more concerned about their surgeon’s experience than the type of anesthesia.
Studies have found that prostate cancer patients treated by more au fait surgeons tend to have a lower risk of recurrence. They also have lower rates of lasting side effects, such as erectile dysfunction and incontinence. “It’s not the robot. It’s the knowledge of the surgeon”. To prove that regional anesthesia directly affects cancer patients’ prognosis, “controlled” studies are needed. That means randomly assigning some surgery patients to have general anesthesia only, while others get regional anesthesia as well hgh weight loss cycle. For now the resolve about whether to use a spinal painkiller during surgery should be based on other factors, such as its potential to limit post-surgery pain.
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Effect Of Anesthesia In Surgery Of Prostate Cancer – Part 2 of 3
The study, reported online Dec 17, 2013 in the British Journal of Anaesthesia, is not the blue ribbon to see a link between regional anesthesia and a lower risk of cancer recurrence or progression. Some past studies have seen a nearly the same pattern in patients having surgery for breast, ovarian or colon cancer. But those studies, like the current one, point only to a correlation, not a cause-and-effect link. Dr David Samadi, supervisor of urology at Lenox Hill Hospital in New York City, agreed.
And “We have to be very careful about how we interpret these results,” said Samadi, who was not involved in the new study. One noteworthy issue is that the men in this study all had open surgery to remove their prostate gland. But these days, the surgery is almost always done laparoscopically – a minimally invasive approach in which surgeons make a few inconsequential incisions. In the United States most of these procedures are done with the aid of robotic “arms”. Compared with traditional open surgery, laparoscopic surgery is quicker and causes less stress, blood loss and post-surgery pain. And in his judgement patients’ need for opioids after surgery is low.
Sprung agreed that it’s not clear whether the current findings extend to men having laparoscopic surgery. The findings are based on the records of nearly 3300 men who had prostate cancer surgery between 1991 and 2005 at the Mayo Clinic. Half had been given only catholic anesthesia, while the other half had received regional anesthesia as well. In 83 percent of the cases, that meant a spinal hindrance containing morphine. The researchers weighed other factors, such as the stage of the cancer and whether a man received radiation or hormone therapy after surgery.
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Effect Of Anesthesia In Surgery Of Prostate Cancer – Part 1 of 3
Effect Of Anesthesia In Surgery Of Prostate Cancer. For men having prostate cancer surgery, the sort of anesthesia doctors use might make a balance in the odds of the cancer returning, a new study suggests. Researchers found that of nearly 3300 men who underwent prostate cancer surgery, those who were given both general and regional anesthesia had a lower risk of seeing their cancer move along than men who received only general anesthesia. Over a period of 15 years, about 5 percent of men given only general anesthesia had their cancer recur in their bones or other sites, the researchers said.
That compared with 3 percent of men who also received regional anesthesia, which typically meant a spinal injection of the analgesic morphine, plus a numbing agent. None of that, however, proves that anesthesia choices later affect a prostate cancer patient’s prognosis. “We can’t conclude from this that it’s cause-and-effect,” said senior researcher Dr Juraj Sprung, an anesthesiologist at the Mayo Clinic in Rochester, Minn.
But one theory is that spinal painkillers – peer the opioid morphine – can make a difference because they curb patients’ need for opioid drugs after surgery. Those post-surgery opioids, which feign the whole body, may decrease the immune system’s effectiveness. That’s potentially important because during prostate cancer surgery, some cancer cells usually dodge into the bloodstream – and a fully functioning immune response might be needed to kill them off. “If you avoid opioids after surgery, you may be increasing your ability to fight off these cancer cells.
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