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the Heart and Diabetes
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sada09 posted:
Hello, I have a question regarding any complications one can develop with ones heart when he has had diabetes for over 20 years.
My husband has never taken a real active role in controlling his diabetes, I am the one that went to the meetings, dietitians etc for him and for 20 years we have managed to keep his average bloodsugar under 130. He is only using metformin and on occasion (rarely) 1/2 of a glimipiride. Lately he has been feeling poorly, and his bloodsugar consistantly show it to be between 85 and 110, so why does he feel bad then ? Is it his heart ? getting him to the doctor so far has proven to be impossible, his excuse is "I cant say whats wrong with me, all I know is I dont feel good, no pains or anything, so why go to the doctor ?
Why all of a sudden is his medication lowering his bloodsugar so much, one would expect it to be less effective as the years roll on, but not in his case.
What should l look for ???
Thanks
Don's wife
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DavidHueben responded:
Sada:

There are many cardiovascular complications that can arise from poorly managed diabetes. Among them are heart disease, stroke, and loss of limbs due to poor circulation.

The only person that can take responsibility for their diabetes management is the diabetic themselves. That is not a task that can or should be shrugged off to a spouse, friend, or family member.

He is the one who should have been going to meetings, seeing the dietitian, and regularly monitoring his blood glucose levels.

Every diagnosed diabetic, regardless of how good their glycemic control is, should be seeing their doctor at least a couple of times per year for routine exams and lab work.

David
Red meat is not bad for you. Now blue-green meat, that's bad for you! -Tommy Smothers
 
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sada09 replied to DavidHueben's response:
David Hueben
Thanks for your reply, and of course you are right it is his responsibility, however he's the love of my life and it's hard to imagine life without him, therefore I am the "doc" in the house.
He does go to the doctor twice yearly, always have labs before and all labs are good. The doc listen to his lungs and heart, says everything sounds fine, and we are out of there within 10 minutes. His last appt. was in april 2010 and all labs were good, less than a week later he started the "I don't feel good" today syndrome, and each time I check his log I see the blood sugar is normal, usually between 80 and 95, he does look paler than usual and he does not sleep well anymore, does have other healthissues, worn out knees and back pains. His doctor just sent us a note he was leaving our clinic, that makes matters even worse as we need to find a new doctor for him, or rather I guess I need to find him a new doctor because I want him around for a long time.
I guess I was looking for symptoms of heart disease, and thought someone could tell me.
I do wish he'd take the responsibility for his diabetes, but until he does, I will carry it for him.
Sada
PS: it took 12 years before I was able to convice him we needed to check his bloodsugar, funny enough I only did it once for him, then he decided he could handle that job all by himself, and has done that part ever since.
 
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MrsCora01 responded:
Has he brought up the fact that he doesn't feel well with the doc? It could be so many things aside from heart issues. It could be kidney related, or even some sort of neuropathy. Gastroparesis could cause him to eat less, lower his blood sugar, and make him feel weak. I'm sorry to say that it could be many things and it should be pursued. I wish you both the best of luck.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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krhudson responded:
Sada, his Lab work seems good and his blood sugars are in line and that is good that he is testing them often. Seems like he is participating in his own health right their with you and he is your number 1 so I can see where you want to help him.

I would see if the current Dr. is referring to a new Dr. Sometimes when they leave a clinic they have other Dr.s either remaining in the same practice or they know of others to refer their patients to for Diabetes. Call there and ask about that. Then sign a records release with all labs etc... to another Dr. and let that Dr. review the whole record and start from scratch on this new problem.

All your husband has to say is that he just plain does not feel good. I do know now that my blood sugars are even more normal than before, I feel a little different. the blood sugars are very good at his current levels. The new Dr. can order tests that are needed such a treadmill and Echo Cardiogram and blood work for kidney function and all this can get ruled out hopefully and both of you will know. I hope his blood pressure is good. He can test that himself at most grocery store pharmacys and other pharmacies. I do it all the time.

Not sure how old you both are but for some reason get us beyond 50 and it seems like things seem to come up. Let's get as many ruled out as possible for your husband. Please check back, now we will all want him to be fine.Tell him it may be a simple thing and a solution in order to get to feeling better. I am sure he wants to feel better.

krhudson
 
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sada09 replied to krhudson's response:
Thanks for responding, I guess thinking it could only be the heart giving him trouble was wrong, there are so many other things that can go wrong with being diabetic. We are both definately way past the 50 year mark, 69 and 75.
His aversion to go to the doctor and saying I dont feel good stems from serious problems he encountered about 6 years ago. We had moved and found a doctor in the new area right away, he decided to add Actos to my husbands diabetic meds, and pretty soon he was not feeling good which the doc dismissed as being caused by him being overweight, later breathing problems popped up, and he was just told to lose weight and it would get better. Well 4-5 doctor visits later we finally were sent to a specialist who found fluid in one lung and in the sac around the heart. Later the lung collapsed, and after 2 surgeries and more fluid removed from the heart sac he was finally on the mend. I happen to read about actos being not so good a choise for many older patients, and insisted he stop the actos. 5-6 months later he was finally back to feeling better, but his experience with telling a doctor "I dont feel good has not worked too well for him, although now he's not seeing the doctor that prescribed him Actos.
Again thanks for your responses, I aprediate it.
Sada09
 
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krhudson replied to sada09's response:
Your welcome. Keep us posted. Your both still quite young at 69 and 75 so stay active and young at heart :-)

krhudson
 
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Michael Dansinger, MD replied to sada09's response:
I agree with the posts above and the advice you've received. I can appreciate what a difficult situation this must be for you. As a doctor, I have seen many patients describe vague symptoms such as "I don't feel good" and often times that is enough to eventually uncover the source of the problem. A doctor will be able to ask questions, do a physical exam, and order tests that will eliminate some causes and point to other potential causes. Most causes are treatable or reversible.

Heart problems are the leading cause of death in people with diabetes (and in people without diabetes). Heart symptoms can be vague, especially in people with diabetes. So you are right to wonder about this. There are hundreds of other potential causes, and most can be diagnosed if he works together with a physician or other clinicians. It is unfortunate that his own doctor is no longer available, but still important to establish a relationship with a new primary care provider.

Keep us posted.

Michael Dansinger, MD
 
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sada09 replied to Michael Dansinger, MD's response:
Thanks again to all that have been so kind and answer my posts it is so much appreciated.
I called our local clinic and got an appointment with a new doctor for next Wednesday, and will let you know how it goes after that. All the docs there are general practitioner, there are no internal medicine docs on the staff. First I was given an appt. with a nurse practitioner, but decided that even though I feel a certain urge to have him checked asap, (his color is just not looking right to me and I have looked at him for 46 years), I could not see a nurse practitioner being able to help much.
I have not sprung the news of the appointment on my husband yet, I am waiting for the right moment, teehee (a time when he mentions again that he is "not feeling so good"), because when I mentioned last week it was a good idea to make one, he said oh, no, I dont need to go until October that will be 6 mo. from last time.
He's still plugging away in the low end of the bloodsugar range, 70, 80, 90. He had foot doctor appt this morning, goes every 3 months, and then one hour after eating lunch it was at 128 and 2 hrs after eating lunch it was 82. He sat down in his recliner and proceeded to take a nap, is still sleeping, and it's now past 9 pm. I woke him up at 7pm, but he was not wanting any supper, said he felt pretty good though, so we decided no more metformin today for him unless he decided to eat. He did not sleep real well last nite, so I guess that is why the long nap today. I am keeping a sharp eye on him though, we do have a small hospital with an emergency clinic just 2 miles away.
Sada 09
 
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sada09 replied to Michael Dansinger, MD's response:
Hello again
We went to the new doctor at the local clinic on Wednesday, and he listened to the changes I see in my husband that concerns me.
He examined him thoroughly, said his heart beat was irregular, said he had read his file, and ordered blood work along with a chest x-ray and an EKG.
There was a mention in his file regarding Congestive heart failure. We had never heard this mentioned before, and upon checking the date and year it turned out to be the Actos caused fluid buildup that happened 2 or 3 years ago, where he had fluid drained twice, then a collapsed lung and 2 surgeries before he was on the mend again. All the treatments and surgeries however was done in a nearby city with plenty of docs and specialists, and the records from that 1 1/2 year span was never added to his records at the local clinic.
We will get a call, hopefully tomorrow about the labs, ekg and x-rays results, and the new doctor said we will go from there, probably a cardioligist next.
The metformin dose was changed from 3 times a day to 2 times a day, and continue the bloodsugar monitoring.
I fell so much better about this, like I left my heavy load with the new doctor, thanks to all of you for responding to my posts.
Sada09
 
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phototaker replied to sada09's response:
Sada, I'm glad you were able to find out what's wrong. What a relief not to be so worried and know your husband is being taken care of...! Thanks for letting us know.


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