During Diabetes Awareness Month, the American Podiatric Medical Association encourages patients to see a podiatrist for regular foot examinations.
Bethesda, MD (Vocus) November 17, 2010
The number of Americans diagnosed with diabetes continues to rise toward record levels, with an estimated one in three adults predicted to have the disease by the year 2050 according to the Centers for Disease Control. Because many serious complications from diabetes present in the lower limbs, proper foot care for those with the disease is a vital step to keeping the disease in check. In fact, a new study on foot care for people with diabetes conducted by Thomson Reuters confirms that care by a podiatrist can drastically reduce the incidence of diabetes-related hospitalizations and amputations.
"During November's Diabetes Awareness Month, it's important to realize that simple lifestyle changes can go a long way toward staying healthy with diabetes. These include eating right, being active, monitoring blood glucose, and checking your feet daily," said Dr. Kathleen Stone, president of the American Podiatric Medical Association (APMA). "Diabetic foot complications are the leading cause of non-traumatic, lower-limb amputation in the U.S. Remembering to 'knock your socks off' at every doctor's visit will help to catch any potential lower limb complications early."
According to preliminary results from the Thomson Reuters study, those with diabetes who received care from a podiatrist had a nearly 29 percent lower risk of lower limb amputation, and 24 percent lower risk of hospitalization, than those who did not. APMA's "Knock Your Socks Off" campaign, running during Diabetes Awareness Month, aims to encourage everyone with diabetes and those at risk for the disease to remove their shoes and socks and inspect their feet and visit a podiatrist for a foot exam.
Feet should be checked regularly for signs and symptoms of diabetes to help prevent serious complications. Symptoms in the feet such as redness, tingling and cuts that are not healing can lead to diabetic ulcers and even possible amputation without prompt medical care.
"The Thomson Reuters study results show that just one visit to a podiatrist can drastically reduce the chance of a tragic diabetes-related amputation. There is now no question that a podiatrist must be a part of everyone's diabetes management team," Dr. Stone said. The APMA-sponsored study was conducted using Thomson Reuters' MarketScan Research Databases, which house fully integrated, de-identified health-care claims data extensively used by researchers to understand health economics and outcomes. Studies based on MarketScan data have been published in more than 130 peer-reviewed articles in the past five years.
Founded in 1912, the American Podiatric Medical Association (APMA) is the nation's leading and recognized professional organization for doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg. The medical education and training of a DPM includes four years of undergraduate education, four years of graduate education at an accredited podiatric medical college and two or three years of hospital residency training. APMA has 53 state component locations across the United States and its territories, with a membership of close to 12,000 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine.
Friday, December 3, 2010
Thursday, December 2, 2010
How Will You Stop Diabetes®? The Future Is in Your Hands.
During the holidays, we joke that our belts are a little tight around the waist. But for PJ, his tight belt was no laughing matter.
"I kept thinking 'I ought to lose weight,'" he shared.
Returning home from a baseball game one day, PJ experienced tingling in his hands and feet. "I thought that was odd. So the next day, I checked my blood glucose and my jaw dropped because it was so high. I checked the next day in disbelief, and it was still elevated."
"Right then and there, I thought 'My toes at 60. There is NO WAY I was going to lose my toes at 60.'"
Once PJ was diagnosed with type 2 diabetes, the tight belt became the focus of his attention. "I sucked it up, started to exercise and eat right and lost 30 pounds over 4 months. My glucose dropped and has remained low for 5 years. I even had to put a new hole in my belt!"
"Now I watch my diet and exercise 4 days a week. Keeping my 30 pounds off is challenging. I hate it, but it works! I do it for my toes. I do it for my brain, heart, kidneys, eyes and ultimately, my family. I thank God for the kick in the butt to check my blood glucose that day."
Developing and maintaining a healthy lifestyle can be a challenge any time of the year, but especially during the holidays. During American Diabetes Month® this November, join the movement to Stop Diabetes® and download your very own Celebrations Survival Guide. Get tips to handle the holidays and avoid tight belts this Thanksgiving season.
"I kept thinking 'I ought to lose weight,'" he shared.
Returning home from a baseball game one day, PJ experienced tingling in his hands and feet. "I thought that was odd. So the next day, I checked my blood glucose and my jaw dropped because it was so high. I checked the next day in disbelief, and it was still elevated."
"Right then and there, I thought 'My toes at 60. There is NO WAY I was going to lose my toes at 60.'"
Once PJ was diagnosed with type 2 diabetes, the tight belt became the focus of his attention. "I sucked it up, started to exercise and eat right and lost 30 pounds over 4 months. My glucose dropped and has remained low for 5 years. I even had to put a new hole in my belt!"
"Now I watch my diet and exercise 4 days a week. Keeping my 30 pounds off is challenging. I hate it, but it works! I do it for my toes. I do it for my brain, heart, kidneys, eyes and ultimately, my family. I thank God for the kick in the butt to check my blood glucose that day."
Developing and maintaining a healthy lifestyle can be a challenge any time of the year, but especially during the holidays. During American Diabetes Month® this November, join the movement to Stop Diabetes® and download your very own Celebrations Survival Guide. Get tips to handle the holidays and avoid tight belts this Thanksgiving season.
Comprehensive Care for Diabetic Neuropathy
Diabetic neuropathy is a common complication of diabetes that can be difficult to treat using oral medications alone. By addressing both the neuropathy and the underlying diabetes, patients experience better overall outcomes.
“The standard treatment for diabetic neuropathy involves medication management using either Neurontin [gabapentin], Lyrica [pregabalin] or Cymbalta [duloxetine],” says Kelly Miller, D.C., FASA, N.M.D., Clinical Director of Waldo Rehabilitation, Health and Wellness in Kansas City, MO. “However, statistically, those medications are only helpful for about 30% of patients suffering from diabetic neuropathy — and they are expensive drugs with many side effects.”
At Waldo Rehabilitation, Health and Wellness, treatment for diabetic neuropathy in patients with type 2 diabetes involves management of the patient’s disease through specialized nutritional services meant to help patients lose weight. This diet helps correct the metabolic syndrome.
“If patients’ blood sugar levels are unstable, their risk for developing other complications, such as retinopathy, kidney failure and nerve damage, is much higher,” says Dr. Miller. “We provide patients with type 2 diabetes education about their diabetes and the options available to help better manage their insulin resistance through lifestyle modifications. We have medical doctors, podiatrists, chiropractors and physical therapists on staff — all under one roof. This cooperative integration of the different disciplines allows us to treat chronic conditions, such as diabetes, in a comprehensive manner that can be challenging for a single provider.”
Diabetic Neuropathy Management
When patients present at Waldo Rehabilitation, Health and Wellness with diabetic neuropathy, a specific regimen of injections is utilized. Immediately following these injections, which are administered by a podiatrist, patients receive electrotherapy and infrared light therapy surrounding the injection site, which helps to not only anesthetize the fibers causing pain, but also increases circulation in the patient’s foot by 3,000%, according to Dr. Miller.
“By administering electrotherapy immediately after the injections have been completed, the medication is able to provide pain relief while also alleviating the numbness patients experience,” says Dr. Miller. “Improved sensory perception of the feet puts patients at decreased risk for wounds, infections and falls, which not only improves their overall well-being, but also reduces the amount of health care dollars spent on wound care. By taking a proactive approach to diabetes and diabetic neuropathy, we are able to reduce the number of patients who suffer from diabetic foot wounds, falls and other related health problems.”
For diabetic patients experiencing other health concerns, such as pain in their hips, knees and shoulders, physical therapy and chiropractic services are provided. Transdermal nutritional formulas are also used for diabetic neuropathy patients to help reverse any nerve damage that has been sustained and help them sleep.
“By utilizing a comprehensive approach that entails stabilizing blood sugar levels, correcting type 2 diabetes and applying specific nutrients — including B vitamins, melatonin, vitamin D and magnesium — patients have better outcomes for diabetic neuropathy,” says Dr. Miller. “In many cases, we can reverse nerve damage that has been sustained, which provides a much higher quality of life for patients.”
“The standard treatment for diabetic neuropathy involves medication management using either Neurontin [gabapentin], Lyrica [pregabalin] or Cymbalta [duloxetine],” says Kelly Miller, D.C., FASA, N.M.D., Clinical Director of Waldo Rehabilitation, Health and Wellness in Kansas City, MO. “However, statistically, those medications are only helpful for about 30% of patients suffering from diabetic neuropathy — and they are expensive drugs with many side effects.”
At Waldo Rehabilitation, Health and Wellness, treatment for diabetic neuropathy in patients with type 2 diabetes involves management of the patient’s disease through specialized nutritional services meant to help patients lose weight. This diet helps correct the metabolic syndrome.
“If patients’ blood sugar levels are unstable, their risk for developing other complications, such as retinopathy, kidney failure and nerve damage, is much higher,” says Dr. Miller. “We provide patients with type 2 diabetes education about their diabetes and the options available to help better manage their insulin resistance through lifestyle modifications. We have medical doctors, podiatrists, chiropractors and physical therapists on staff — all under one roof. This cooperative integration of the different disciplines allows us to treat chronic conditions, such as diabetes, in a comprehensive manner that can be challenging for a single provider.”
Diabetic Neuropathy Management
When patients present at Waldo Rehabilitation, Health and Wellness with diabetic neuropathy, a specific regimen of injections is utilized. Immediately following these injections, which are administered by a podiatrist, patients receive electrotherapy and infrared light therapy surrounding the injection site, which helps to not only anesthetize the fibers causing pain, but also increases circulation in the patient’s foot by 3,000%, according to Dr. Miller.
“By administering electrotherapy immediately after the injections have been completed, the medication is able to provide pain relief while also alleviating the numbness patients experience,” says Dr. Miller. “Improved sensory perception of the feet puts patients at decreased risk for wounds, infections and falls, which not only improves their overall well-being, but also reduces the amount of health care dollars spent on wound care. By taking a proactive approach to diabetes and diabetic neuropathy, we are able to reduce the number of patients who suffer from diabetic foot wounds, falls and other related health problems.”
For diabetic patients experiencing other health concerns, such as pain in their hips, knees and shoulders, physical therapy and chiropractic services are provided. Transdermal nutritional formulas are also used for diabetic neuropathy patients to help reverse any nerve damage that has been sustained and help them sleep.
“By utilizing a comprehensive approach that entails stabilizing blood sugar levels, correcting type 2 diabetes and applying specific nutrients — including B vitamins, melatonin, vitamin D and magnesium — patients have better outcomes for diabetic neuropathy,” says Dr. Miller. “In many cases, we can reverse nerve damage that has been sustained, which provides a much higher quality of life for patients.”
Sunday, October 10, 2010
Advice for Hikers and Hunters: Long, Vigorous Hikes Take Toll on Feet, Ankles
As brightly colored leaves dazzle the fall landscape, hikers and hunters nationwide will migrate to mountains, woods and fields, but many, unfortunately, are ill prepared for the beating their feet will take.
Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain. Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts to foot specialists each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters.
Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven’t conditioned properly before hitting the trail. Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting. Many injuries can be avoided by wearing sturdy, well constructed hiking boots.
Hikers and hunters should investment in top-quality hiking boots. Strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. Supportive shanks decrease strain on the arch by allowing the boot to distribute impact as the foot moves forward. If a boot bends in the middle, it may not be well suited for hunting or hiking.
In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Synthetic socks are excellent as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. Wool lets moisture evaporate more readily than cotton, so fewer blisters develop.
What happens if your feet or ankles hurt during a hike or hunt? Pain usually occurs from overuse, even from just walking. If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache. To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting.
Pain is a warning sign that something is wrong. Serious injury risk escalates significantly if you continue hiking in pain. Hiking, like skiing, is an activity in which beginners should take on less difficult trails until they become better conditioned and more confident.
Evaluation by a foot and ankle specialist is recommended if there is persistent pain following a hiking or hunting outing. Ankle instability and strained Achilles tendons are most concerning. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time.
Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain. Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts to foot specialists each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters.
Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven’t conditioned properly before hitting the trail. Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting. Many injuries can be avoided by wearing sturdy, well constructed hiking boots.
Hikers and hunters should investment in top-quality hiking boots. Strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. Supportive shanks decrease strain on the arch by allowing the boot to distribute impact as the foot moves forward. If a boot bends in the middle, it may not be well suited for hunting or hiking.
In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Synthetic socks are excellent as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. Wool lets moisture evaporate more readily than cotton, so fewer blisters develop.
What happens if your feet or ankles hurt during a hike or hunt? Pain usually occurs from overuse, even from just walking. If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache. To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting.
Pain is a warning sign that something is wrong. Serious injury risk escalates significantly if you continue hiking in pain. Hiking, like skiing, is an activity in which beginners should take on less difficult trails until they become better conditioned and more confident.
Evaluation by a foot and ankle specialist is recommended if there is persistent pain following a hiking or hunting outing. Ankle instability and strained Achilles tendons are most concerning. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time.
Thursday, September 30, 2010
Diabetes Differences, Demystified
Understanding the Types of Diabetes
Diabetes management varies, depending on what type of diabetes you have. This guide will help you understand the many different types of diabetes.
By Krisha McCoy, MS
Medically reviewed by Pat F. Bass III, MD, MPH Print Email If you have diabetes, your body has problems producing or effectively using insulin, which can cause your blood glucose levels to be out of control. There are several different causes of insulin problems, and your treatment plan will depend on which type of diabetes you have.
Type 1 Diabetes: An Autoimmune Disease
With type 1 diabetes, which used to be called juvenile diabetes, your body does not produce insulin or produces very little. Type 1 diabetes is known as an autoimmune disease because it occurs when your immune system mistakenly attacks the insulin-producing cells in your pancreas.
Type 1 diabetes usually develops in children and young adults and accounts for 5 to 10 percent of diabetes cases in the United States. Symptoms may include thirst, frequent urination, increased hunger, unexplained weight loss, blurry vision, and fatigue.
People who have type 1 diabetes need to take insulin injections daily to make up for what their pancreas can’t produce.
Type 2 Diabetes: The Lifestyle Connection
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Type 2 diabetes, which used to be called adult-onset diabetes, is the most common form of diabetes, accounting for 90 to 95 percent of diabetes cases. While most people who develop type 2 diabetes are older, the prevalence of type 2 diabetes in children is on the rise.
The exact cause of type 2 diabetes is largely unknown, but the disease tends to develop in people who are obese and physically inactive. People who have a family history of diabetes or a personal history of gestational diabetes are also at increased risk of developing type 2 diabetes.
Symptoms of type 2 diabetes usually develop gradually, and are similar to symptoms of type 1 diabetes.
Treatment for type 2 diabetes usually includes dietary changes, regular physical activity, and oral diabetes medications to help control blood glucose. If left untreated, serious health conditions such as heart disease or stroke can develop.
Gestational Diabetes: A Pregnancy Concern
Gestational diabetes is a condition that occurs in 3 to 8 percent of pregnant women during late pregnancy. Its cause is thought to be pregnancy-related hormonal fluctuations and a shortage of insulin that often occurs during pregnancy.
Many women with gestational diabetes have no symptoms, so it is important to get screened for this condition during pregnancy. Gestational diabetes can lead to problems such as high-birth-weight babies, breathing problems in the baby, and high blood pressure in the mother during pregnancy. Gestational diabetes is usually treated with dietary changes and exercise, and sometimes insulin injections.
Women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years after their pregnancy.
Other Types of Diabetes
Latent autoimmune diabetes in adults, or LADA, is a less common form of diabetes that usually affects people over the age of 30. In LADA, what looks like type 2 diabetes at first eventually develops into a condition more closely resembling type 1 diabetes.
People with LADA make enough insulin at first, but their immune system later begins making antibodies against insulin-producing cells of the pancreas. Patients will usually require insulin injections as part of their treatment. It is estimated that up to 10 percent of people with type 2 diabetes have LADA.
"Double diabetes" occurs when someone with type 1 diabetes develops resistance to the insulin they are taking, a hallmark of type 2 diabetes. This condition is more and more frequently seen in children, especially those who are overweight or obese.
All types of diabetes require attention to keep blood glucose in check, but the medical plan differs by diabetes type. Getting the right diagnosis is the first step.
Diabetes management varies, depending on what type of diabetes you have. This guide will help you understand the many different types of diabetes.
By Krisha McCoy, MS
Medically reviewed by Pat F. Bass III, MD, MPH Print Email If you have diabetes, your body has problems producing or effectively using insulin, which can cause your blood glucose levels to be out of control. There are several different causes of insulin problems, and your treatment plan will depend on which type of diabetes you have.
Type 1 Diabetes: An Autoimmune Disease
With type 1 diabetes, which used to be called juvenile diabetes, your body does not produce insulin or produces very little. Type 1 diabetes is known as an autoimmune disease because it occurs when your immune system mistakenly attacks the insulin-producing cells in your pancreas.
Type 1 diabetes usually develops in children and young adults and accounts for 5 to 10 percent of diabetes cases in the United States. Symptoms may include thirst, frequent urination, increased hunger, unexplained weight loss, blurry vision, and fatigue.
People who have type 1 diabetes need to take insulin injections daily to make up for what their pancreas can’t produce.
Type 2 Diabetes: The Lifestyle Connection
There's more content below this advertisement. Jump to the content.
Type 2 diabetes, which used to be called adult-onset diabetes, is the most common form of diabetes, accounting for 90 to 95 percent of diabetes cases. While most people who develop type 2 diabetes are older, the prevalence of type 2 diabetes in children is on the rise.
The exact cause of type 2 diabetes is largely unknown, but the disease tends to develop in people who are obese and physically inactive. People who have a family history of diabetes or a personal history of gestational diabetes are also at increased risk of developing type 2 diabetes.
Symptoms of type 2 diabetes usually develop gradually, and are similar to symptoms of type 1 diabetes.
Treatment for type 2 diabetes usually includes dietary changes, regular physical activity, and oral diabetes medications to help control blood glucose. If left untreated, serious health conditions such as heart disease or stroke can develop.
Gestational Diabetes: A Pregnancy Concern
Gestational diabetes is a condition that occurs in 3 to 8 percent of pregnant women during late pregnancy. Its cause is thought to be pregnancy-related hormonal fluctuations and a shortage of insulin that often occurs during pregnancy.
Many women with gestational diabetes have no symptoms, so it is important to get screened for this condition during pregnancy. Gestational diabetes can lead to problems such as high-birth-weight babies, breathing problems in the baby, and high blood pressure in the mother during pregnancy. Gestational diabetes is usually treated with dietary changes and exercise, and sometimes insulin injections.
Women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years after their pregnancy.
Other Types of Diabetes
Latent autoimmune diabetes in adults, or LADA, is a less common form of diabetes that usually affects people over the age of 30. In LADA, what looks like type 2 diabetes at first eventually develops into a condition more closely resembling type 1 diabetes.
People with LADA make enough insulin at first, but their immune system later begins making antibodies against insulin-producing cells of the pancreas. Patients will usually require insulin injections as part of their treatment. It is estimated that up to 10 percent of people with type 2 diabetes have LADA.
"Double diabetes" occurs when someone with type 1 diabetes develops resistance to the insulin they are taking, a hallmark of type 2 diabetes. This condition is more and more frequently seen in children, especially those who are overweight or obese.
All types of diabetes require attention to keep blood glucose in check, but the medical plan differs by diabetes type. Getting the right diagnosis is the first step.
Sunday, September 26, 2010
Ease leg pain, improve appearance
When warm weather came, Angela Snodgrass shunned wearing shorts. Only capris. They covered up the unattractive veins in her legs.
As a physical therapist and mother of two young children, she's on her feet a lot. Since her first pregnancy seven years ago, she had itching, ankle swelling and dull, aching pains in her legs.
At work, she took breaks from standing by sitting on a stool. At home, she couldn't stand up after showering to finish getting ready for work due to pain in her calves.
"It just got progressively worse," said Snodgrass, 32, of Connersville, Ind.
"The varicose veins bothered one leg during my first pregnancy and then the other, too, during my second pregnancy. I also noticed more spider veins," she said, while getting injection treatments at the Decatur Vein Clinic in Greenwood.
Last month, she started to get relief at the clinic. As she nears the end of her treatments, which included endovenous laser procedures and injections, her pain and unsightly veins are almost gone.
Like Snodgrass, many women - and some men - are getting help from a number of minimally invasive procedures available to help aching, painful legs and enlarged veins that can appear twisted and bulging.
"All you have to do is spend a day at the pool and you see how many people it affects," said Dr. William Finkelmeier, a vascular surgeon with VeinSolutions. "It's really a significant problem."
About 50 percent to 55 percent of women and 40 percent to 45 percent of men in the U.S. suffer from some type of vein problem, the Office on Women's Health in the U.S. Department of Health and Human Services says. Young women also are affected, particularly because of pregnancy.
Vein-clinic doctors say public education about treatments is improving, and varicose vein research has advanced in the past 15 years.
This month, a new injectable liquid drug, Asclera, approved by the Food and Drug Administration in April, became available in the United States. It primarily can be used to treat tiny, spider veins or small varicose veins.
With deeper varicose veins, clinics normally first use laser or radiofrequency endovenous techniques. They involve putting a small tube into a vein, inserting a probe with a device at the tip that heats up the inside of the vein and closes it off.
The problem is that many people delay or don't seek treatment.
"Most of our folks have been dealing with symptoms - legs aching, throbbing, heaviness - for five to 10 years before coming in," said Dr. Jeffery Schoonover, regional medical director for Vein Clinics of America
BARB BERGGOETZ • THE INDIANAPOLIS STAR • JULY 6, 2010
As a physical therapist and mother of two young children, she's on her feet a lot. Since her first pregnancy seven years ago, she had itching, ankle swelling and dull, aching pains in her legs.
At work, she took breaks from standing by sitting on a stool. At home, she couldn't stand up after showering to finish getting ready for work due to pain in her calves.
"It just got progressively worse," said Snodgrass, 32, of Connersville, Ind.
"The varicose veins bothered one leg during my first pregnancy and then the other, too, during my second pregnancy. I also noticed more spider veins," she said, while getting injection treatments at the Decatur Vein Clinic in Greenwood.
Last month, she started to get relief at the clinic. As she nears the end of her treatments, which included endovenous laser procedures and injections, her pain and unsightly veins are almost gone.
Like Snodgrass, many women - and some men - are getting help from a number of minimally invasive procedures available to help aching, painful legs and enlarged veins that can appear twisted and bulging.
"All you have to do is spend a day at the pool and you see how many people it affects," said Dr. William Finkelmeier, a vascular surgeon with VeinSolutions. "It's really a significant problem."
About 50 percent to 55 percent of women and 40 percent to 45 percent of men in the U.S. suffer from some type of vein problem, the Office on Women's Health in the U.S. Department of Health and Human Services says. Young women also are affected, particularly because of pregnancy.
Vein-clinic doctors say public education about treatments is improving, and varicose vein research has advanced in the past 15 years.
This month, a new injectable liquid drug, Asclera, approved by the Food and Drug Administration in April, became available in the United States. It primarily can be used to treat tiny, spider veins or small varicose veins.
With deeper varicose veins, clinics normally first use laser or radiofrequency endovenous techniques. They involve putting a small tube into a vein, inserting a probe with a device at the tip that heats up the inside of the vein and closes it off.
The problem is that many people delay or don't seek treatment.
"Most of our folks have been dealing with symptoms - legs aching, throbbing, heaviness - for five to 10 years before coming in," said Dr. Jeffery Schoonover, regional medical director for Vein Clinics of America
BARB BERGGOETZ • THE INDIANAPOLIS STAR • JULY 6, 2010
Saturday, September 25, 2010
Using Insulin with Type II Diabetes
Although most people with Type II diabetes are on oral medications, some may need insulin to control their blood sugar levels.
By Marijke Vroomen-Durning, RN
Medically reviewed by Pat F. Bass III, MD, MPH
Type II diabetes, previously known as adult-onset or non-insulin-dependent diabetes, is becoming more common in North America. As more people are diagnosed with type 2 diabetes, more research is being done into better ways to manage the disease.
Type II Diabetes: Medications
Type II diabetes is usually treated with oral medications that stimulate insulin production in the pancreas. Insulin, used in type 1 diabetes, was generally only given in Type II diabetes as a last resort if the oral medications weren’t working.
Gerald Bernstein, MD, associate professor of medicine at Albert Einstein College of Medicine in Bronx, N.Y., and a past president of the American Diabetes Association, says that the idea of going on to insulin is often seen as a threat: “If you don’t lose weight, you’ll wind up on insulin.” But, over time, researchers and doctors are learning that it may be in a patient’s best interest to begin insulin treatment earlier for type 2 diabetes, rather than later.
It’s important to understand the goal of treating diabetes. The treatment of diabetes is, of course, meant to lower blood sugar levels, but this is the short-term goal. The long-term goal of diabetes treatment is to slow the progression of the disease and, therefore, delay or prevent complications.
Vincent Woo, MD, chair of the clinical and scientific section of the Canadian Diabetes Association, says “this is a big topic,” and refers to the association’s guidelines, which say:
• If after two to three months of lifestyle changes, blood sugar control hasn't improved, it’s time to start medications. This could include insulin in combination with oral medications.
• If blood sugar levels aren’t under control after a trial period of oral medications alone, insulin may be added if appropriate. Insulin is normally administered under the skin several times per day, either by injection or via an insulin pump. Several years ago an inhaled insulin was marketed in the United States, but it was discontinued due to poor sales.
Dr. Bernstein agrees: “The reality is that all of the new data and the goals of glucose control suggest that insulin would actually be better used if it were started very early in type 2 diabetes.” New guidelines “suggest that insulin should be the earliest medication intervention after the patient is taught lifestyle changes and is placed on metformin,” he says.
Type 2 Diabetes: Using Insulin for a Short Period
Many people with type II diabetes do quite well with oral medications and just need to be vigilant. Unfortunately, diabetes is a complicated illness that gets worse when your body is stressed. The stresses aren’t necessarily things like a serious illness or surgery — they could include stress over an infection or a good stress, like pregnancy. Regardless of the cause, in these situations you may need insulin to get you over the hump.
The idea here is you’re given insulin while your body heals itself from the stress and, if all goes well; the insulin may be reduced or eliminated once the stressor is gone and your body returns to its pre-stress self.
These insulin’s will be either short-acting or longer-acting insulins, or both, depending on what your body needs at that point. But, you should remember that this is most likely a temporary measure and that the hope — and aim — of the treatment is to get you back onto your usual diabetes management plan.
Living with diabetes can be frustrating, especially if you are trying your best to keep your blood sugar levels under control. While using insulin may not have been in your plan or vision of diabetes management, you should keep in mind your long-term goal of slowing down the disease process. And, if insulin is part of that plan, learning how to manage and use the insulin may be exactly what you need.
By Marijke Vroomen-Durning, RN
Medically reviewed by Pat F. Bass III, MD, MPH
Type II diabetes, previously known as adult-onset or non-insulin-dependent diabetes, is becoming more common in North America. As more people are diagnosed with type 2 diabetes, more research is being done into better ways to manage the disease.
Type II Diabetes: Medications
Type II diabetes is usually treated with oral medications that stimulate insulin production in the pancreas. Insulin, used in type 1 diabetes, was generally only given in Type II diabetes as a last resort if the oral medications weren’t working.
Gerald Bernstein, MD, associate professor of medicine at Albert Einstein College of Medicine in Bronx, N.Y., and a past president of the American Diabetes Association, says that the idea of going on to insulin is often seen as a threat: “If you don’t lose weight, you’ll wind up on insulin.” But, over time, researchers and doctors are learning that it may be in a patient’s best interest to begin insulin treatment earlier for type 2 diabetes, rather than later.
It’s important to understand the goal of treating diabetes. The treatment of diabetes is, of course, meant to lower blood sugar levels, but this is the short-term goal. The long-term goal of diabetes treatment is to slow the progression of the disease and, therefore, delay or prevent complications.
Vincent Woo, MD, chair of the clinical and scientific section of the Canadian Diabetes Association, says “this is a big topic,” and refers to the association’s guidelines, which say:
• If after two to three months of lifestyle changes, blood sugar control hasn't improved, it’s time to start medications. This could include insulin in combination with oral medications.
• If blood sugar levels aren’t under control after a trial period of oral medications alone, insulin may be added if appropriate. Insulin is normally administered under the skin several times per day, either by injection or via an insulin pump. Several years ago an inhaled insulin was marketed in the United States, but it was discontinued due to poor sales.
Dr. Bernstein agrees: “The reality is that all of the new data and the goals of glucose control suggest that insulin would actually be better used if it were started very early in type 2 diabetes.” New guidelines “suggest that insulin should be the earliest medication intervention after the patient is taught lifestyle changes and is placed on metformin,” he says.
Type 2 Diabetes: Using Insulin for a Short Period
Many people with type II diabetes do quite well with oral medications and just need to be vigilant. Unfortunately, diabetes is a complicated illness that gets worse when your body is stressed. The stresses aren’t necessarily things like a serious illness or surgery — they could include stress over an infection or a good stress, like pregnancy. Regardless of the cause, in these situations you may need insulin to get you over the hump.
The idea here is you’re given insulin while your body heals itself from the stress and, if all goes well; the insulin may be reduced or eliminated once the stressor is gone and your body returns to its pre-stress self.
These insulin’s will be either short-acting or longer-acting insulins, or both, depending on what your body needs at that point. But, you should remember that this is most likely a temporary measure and that the hope — and aim — of the treatment is to get you back onto your usual diabetes management plan.
Living with diabetes can be frustrating, especially if you are trying your best to keep your blood sugar levels under control. While using insulin may not have been in your plan or vision of diabetes management, you should keep in mind your long-term goal of slowing down the disease process. And, if insulin is part of that plan, learning how to manage and use the insulin may be exactly what you need.
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