DEAR DR. ROACH: I’m 70 years outdated and had a kidney transplant 18 years in the past. I developed diabetes, nevertheless it was managed via oral medicine. I just lately went into the hospital for pneumonia and was given giant doses of steroids and injections of insulin. Now I’m unable to carry my sugar down with the capsules I used to be taking. Could the trigger be the insulin I used to be given? Your reply would actually be appreciated. — P.I.
ANSWER: The main trigger for diabetes in older folks is resistance to insulin. Being chubby is a contributing issue to Type 2 diabetes, however some folks might be insulin resistant even with a traditional weight.
Steroids (I imply glucocorticoids, like cortisone or prednisone) act in opposition to the motion of insulin, and are inclined to make insulin resistance worse. This can precipitate or worsen diabetes. Any type of critical sickness, particularly an infection however even one thing like a coronary heart assault, also can worsen diabetes. Between the upper dose of steroids and the pneumonia, it’s not stunning your diabetes went uncontrolled and you required insulin.
The insulin you bought within the hospital was not the reason for the issue controlling your diabetes now. In truth, it may have helped: The pancreas regularly loses the power to answer excessive blood sugar with extended excessive blood sugar ranges, a situation often called glucose toxicity. Keeping the blood sugar close to regular, utilizing insulin if vital, helps shield the insulin-secreting cells within the pancreas from injury. Current care is to attempt to get the blood sugar right into a near-normal vary as quickly as attainable after analysis whereas being cautious of the chance of dangerously low blood sugars.
Type 2 diabetes tends to worsen over time, and many individuals require extra medicine as time goes on. This is very the case if folks achieve weight, one other widespread drawback with high-dose steroids. Still, getting the blood sugars again beneath management now, with weight reduction (if acceptable), cautious food regimen and common train, and extra oral medicines or insulin if vital continues to be the easiest way of defending you from worsening diabetes over time. Diabetes care is ideally managed by a crew, together with a nutritionist, diabetes educator and skilled physician.
DEAR DR. ROACH: I have COPD and I’m on oxygen. My cat was chewing on my oxygen tubing, and I assumed I might have to surrender my pet. A pal recommended I get half-inch cut up conduit tubing at an automotive retailer. It’s used to wrap wiring within the engine to maintain squirrels and different animals from chewing on the wires. You slip the oxygen tubing into the conduit tube, and your pet will not chew on it. I hope this helps another person to have the ability to hold their pets. — C.C.S.
ANSWER: I thank C.C.S. for writing. It’s an answer to an issue I didn’t know existed, and I additionally hope anyone finds it helpful. Pets are extraordinarily essential social helps for many individuals.