Showing posts with label Diabetes. Show all posts

Sunday, April 17, 2016

Emergency

Tips for Emergency Preparedness

We have always needed to be ready for emergencies. Wherever you live, there is the chance of something happening to disrupt your daily life, whether it's a hurricane, an earthquake, a tornado, or a blizzard.

Recent concerns about terrorist attacks have simply increased our awareness of the need to be prepared if a disaster strikes.

Have a Plan

Everyone is now advised to have a plan in place in the case of an emergency, and people with diabetes must consider proper diabetes care when they make emergency plans.

Emergency Supplies

Consider storing three days worth of diabetes supplies, which, depending on how you take care of your diabetes, could include oral medication, insulin, delivery supplies, lancets, extra batteries for your meter and/or pump, and a quick-acting source of . You may also want to have an extra emergency kit.

All these items should be kept in an easy-to-identify container, and stored in a location that is easy to get to in an emergency.

Emergency Contacts

Your emergency supply kit should also contain a list of emergency contacts and, if you are a parent of a child in school or daycare, physician's orders that may be on file with your child's school or day care provider. As always, it is a good idea to wear medical identification that will enable colleagues, school staff members, or emergency medical personnel to identify and address your medical needs.

If you are a parent of a child with diabetes, it is important that your child's school has clearly identified the school staff members who will assist your child in the event of an emergency evacuation.

For those who are away from home, consider informing your colleagues, friends, and family members about your diabetes and where your emergency supply kit is kept.

Taking a few minutes right now to gather supplies and inform those around you about your diabetes, may make a world of difference in maintaining control and staying healthy under stressful circumstances.

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a serious condition most frequently seen in older persons. HHNS can happen to people with either type 1 or that is not being controlled properly, but it occurs more often in people with type 2. HHNS is usually brought on by something else, such as an illness or infection.

In HHNS, blood sugar levels rise, and your body tries to get rid of the excess by passing it into your urine. You make lots of urine at first, and you have to go to the bathroom more often. Later you may not have to go to the bathroom as often, and your becomes very dark. Also, you may be very thirsty. Even if you are not thirsty, you need to drink liquids. If you don't drink enough liquids at this point, you can get dehydrated.

If HHNS continues, the severe will lead to seizures, and eventually death. HHNS may take days or even weeks to develop. Know the warning signs of HHNS.

What are the Warning Signs?

· Blood sugar level over 600

· Dry, parched mouth

· Extreme thirst (although this may gradually disappear)

· Warm, dry skin that does not sweat

· High fever (over 101 degrees Fahrenheit, for example)

· Sleepiness or confusion

· Loss of vision

· Hallucinations (seeing or hearing things that are not there)

· Weakness on one side of the body

If you have any of these symptoms, call someone on your health care team.

How Can I Avoid It?

HHNS only occurs when diabetes is uncontrolled. The best way to avoid HHNS is to check your blood sugar regularly. Many people check their blood sugar several times a day, such as before or after meals. Talk with your health care team about when to check and what the numbers mean. You should also talk with your health care team about your target blood sugar range and when to call if your blood sugars are too high, or too low and not in your . When you are sick, you will check your blood sugar more often, and drink a glass of liquid (alcohol-free and caffeine-free) every hour. Work with your team to develop your own sick day plan.

Stroke

What is a stroke?

A stroke happens when the blood supply to part of your brain is suddenly interrupted. Then brain tissue is damaged. Most strokes happen because a blood clot blocks a blood vessel in the brain or neck. A stroke can cause movement problems, pain, numbness and problems with thinking, remembering or speaking. Some people also have emotional problems, such as depression, after a .

What does diabetes have to do with strokes?

If you have diabetes, your chances of having a stroke are 1.5 times higher than in people who don't have diabetes. But you can lower your risk by taking care of your health.

How do I know whether I'm at high risk for a stroke?

Having diabetes raises your risk for stroke. But your risk is even greater if:

· you’re over age 55

· your family background is African American

· you’ve already had a stroke or a transient ischemic (ih-SKEE-mik) attack (also called a TIA or a mini-stroke)

· you have a family history of stroke or TIAs

· you have heart disease

· you have high

· you’re

· you have high LDL (bad) cholesterol and low HDL (good) levels

· you are not physically active

· you smoke

You can't change some of these risk factors. But you can lower your chances of having a stroke by taking care of your diabetes and tackling some of the other risk factors, such as losing weight if you're overweight. It's up to you.

How can I lower my risk of having a stroke?

Lower your risk by keeping your (blood ), blood pressure and cholesterol on target with healthy eating, physical activity, and, if needed, medicine. And if you smoke, quit. Every step you take will help. The closer your numbers are to your targets, the better your chances of preventing a stroke.

What are the warning signs of a stroke?

Typical warning signs of a stroke develop suddenly and can include:

· weakness or numbness on one side of the body

· sudden confusion or trouble understanding

· trouble talking

· dizziness, loss of balance, or trouble walking

· trouble seeing out of one or both eyes

· double vision

· severe headache

If you have warning signs of a stroke, call 9-1-1 right away. Getting treatment as soon as possible after a stroke can help prevent permanent damage to your brain.

Review the symptoms of a stroke with your family and friends. Make sure they know about the importance of calling 9-1-1.

If the blood flow to your brain is blocked for a short time, you might have one or more of the warning signs temporarily, meaning you've had a TIA (mini-stroke). TIAs put you at risk for a stroke in the future.

How is a stroke diagnosed?

A number of tests may be done if a stroke is suspected:

· Your health care provider will check for changes in how your body is working. For example, your provider will check your ability to move your arms and legs. Your health care provider also can check brain functions such as your ability to read or to describe a picture.

· CT and MRI tests use special scans to provide images of the brain.

· An ECG (electrocardiogram) provides information on heart rate and rhythm.

· An ultrasound examination can show problems in the carotid (kuh-ROT-ihd) arteries, which carry blood from the heart to the brain.

· In a cerebral (seh-REEB-rahl) arteriogram (ar-TEER-ee-oh-), a small tube is inserted into an artery and positioned in the neck. The health care provider injects dye into the . Then the provider takes X-rays to look for narrowed or blocked arteries.

What are the treatments for stroke?

Treatment you need right away
"Clot-busting" drugs must be given within hours after a stroke to minimize damage. That's why it's important to call 9-1-1 if you're having symptoms.

Surgical treatments you may need
Several options for surgical treatment of blocked are available. These include:

· Carotid artery surgery, also called carotid endarterectomy (en-dar-tuh-REK-tuh-mee) removes buildups of inside the artery and restores blood flow to the brain.

· Carotid stenting can remove a blockage in a blood vessel to the brain. A small tube with a balloon attached is threaded into the narrowed or blocked blood vessel. Then the balloon is inflated, opening the narrowed artery. A wire tube, or stent, may be left in place to help keep the artery open.

Other treatments
The way you are cared for following a stroke includes treatments and exercises to restore function or help people relearn skills. Physical, occupational and speech therapy may be included, as well as psychological counseling. Steps to prevent future problems should include quitting smoking, healthy eating, physical activity, to manage blood , blood pressure and cholesterol levels.

High Blood Pressure (Hypertension)

Nearly 1 in 3 American adults has high blood pressure and 2 in 3 people with diabetes report having high blood pressure or take prescription medications to lower their blood pressure. Your heart has to work harder when is high, and your risk for heart disease, and other problems goes up.

High blood pressure won’t go away without treatment. That could include lifestyle changes and, if your doctor prescribes it, medicine.

What Is Blood Pressure?

Blood pressure is the force of blood flow inside your . Your doctor records your blood pressure as two numbers, such as 120/80, which you may hear them say as "120 over 80." Both numbers are important.

The first number is the pressure as your heart beats and pushes blood through the blood vessels. Health care providers call this the "systolic" pressure. The second number is the pressure when the vessels relax between heartbeats. It's called the "diastolic" pressure.

Here's what the numbers mean:

· Healthy blood pressure: below 120/80

· Early high blood pressure: between 120/80 and 140/90

· High blood pressure: 140/90 or higher

The lower your blood pressure, the better your chances of delaying or preventing a heart attack or a stroke.

When your blood moves through your vessels with too much force, you have high blood pressure or . Your heart has to work harder when blood pressure is high, and your risk for heart disease and diabetes goes up. High blood pressure raises your risk for heart attack, stroke, eye problems and kidney disease. High blood pressure is a problem that won't go away without treatment and changes to your diet and lifestyle.

You should always have an idea of what your blood pressure is, just as you know your height and weight.

How Will I Know if I Have High Blood Pressure?

High blood pressure is a silent problem — you won't know you have it unless your health care provider checks your blood pressure. Have your blood pressure checked at each regular health care visit, or at least once every two years (people without diabetes or other risk factors for heart disease).

What Can I Do About High Blood Pressure?

Here are some easy tips to help reduce your blood pressure:

· Work with your health care provider to find a treatment plan that's right for you.

· Eat whole-grain breads and cereals.

· Try herbs and spices instead of salt to flavor foods.

· Check food labels and choose foods with less than 400 mg of sodium per serving.

· Lose weight or take steps to prevent weight gain.

· Limit alcohol consumption and consult your health care provider about whether it is safe to drink alcohol at all.

· If you smoke, get help to quit.

· Ask your health care provider about medications to help reduce high blood pressure. Samples of these types of medications include ACE inhibitors, ARBs, beta blockers, calcium channel blockers and diuretics.

Kidney Disease (Nephropathy)

Kidneys are remarkable organs. Inside them are millions of tiny that act as filters. Their job is to remove waste products from the blood.

Sometimes this filtering system breaks down. Diabetes can damage the kidneys and cause them to fail. Failing lose their ability to filter out waste products, resulting in kidney disease.

How Does Diabetes Cause Kidney Disease?

When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the . Useful substances, such as and red blood cells, are too big to pass through the holes in the filter and stay in the blood.

Diabetes can damage this system. High levels of blood make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called .

When kidney disease is diagnosed early, during microalbuminuria, several treatments may keep kidney disease from getting worse. Having larger amounts of protein in the urine is called macroalbuminuria. When kidney disease is caught later during macroalbuminuria, end-stage disease, or ESRD, usually follows.

In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine ().

Who Gets Kidney Disease?

Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and .

The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease.

What are the Symptoms?

The kidneys work hard to make up for the failing capillaries so kidney disease produces no symptoms until almost all function is gone. Also, the symptoms of kidney disease are not specific. The first symptom of kidney disease is often fluid buildup. Other symptoms of kidney disease include loss of sleep, poor appetite, upset stomach, weakness, and difficulty concentrating.

It is vital to see a doctor regularly. The doctor can check blood pressure, urine (for protein), blood (for waste products), and organs for other of diabetes.

How Can I Prevent It?

Diabetic kidney disease can be prevented by keeping blood sugar in your . Research has shown that tight blood sugar control reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight control can reverse microalbuminuria.

Treatments for Kidney Disease

Self-care

Important treatments for kidney disease are tight control of and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen. Four ways to lower your blood pressure are losing weight, eating less salt, avoiding alcohol and tobacco, and getting regular exercise.

Drugs

When these methods fail, certain medicines may be able to lower blood pressure. There are several kinds of blood pressure drugs, however, not all are equally good for people with diabetes. Some raise blood sugar levels or mask some of the symptoms of low blood sugar. Doctors usually prefer people with diabetes to take blood pressure drugs called ACE inhibitors.

ACE inhibitors are recommended for most people with diabetes, high blood pressure and kidney disease. Recent studies suggest that ACE inhibitors, which include captopril and enalapril, slow kidney disease in addition to lowering blood pressure. In fact, these drugs are helpful even in people who do not have high blood pressure.

Diet

Another treatment some doctors use with macroalbuminuria is a low-protein diet. Protein seems to increase how hard the kidneys must work. A low-protein diet can decrease protein loss in the urine and increase protein levels in the blood. Never start a low-protein diet without talking to your health care team.

Kidney Failure

Once kidneys fail, dialysis is necessary. The person must choose whether to continue with dialysis or to get a kidney transplant. This choice should be made as a team effort. The team should include the doctor and , a (kidney doctor), a kidney transplant surgeon, a social worker, and a psychologist.