Challenges to keeping diabetes control on track
Q: When my mom was first diagnosed with diabetes, she took charge, got in touch with a diabetes educator, kept up with her meds, and her A1Cs came down. But lately she seems to be neglecting herself and is giving me lip service when I ask her about her numbers. What can I do?
Martha K., Alexandria, Virginia
A: Your mom isn't alone. Millions of folks have problems managing diabetes. A Centers for Disease Control and Prevention survey revealed that about 18 percent of folks age 45 to 65 with diabetes skip or delay filling prescriptions and taking their meds to save money. And economics isn't the only reason people let their management of the disease slide. Sometimes diabetes just doesn't seem like such a health threat. One doctor we know of says she wishes it hurt when patients' glucose level spiked, because then people would take steps to control it before they suffered irreversible complications, like blindness or amputations.
Other times, people with diabetes develop diabetes burnout. They become discouraged and exhausted because their blood sugar jackrabbits and they can't seem to get it under control. So here's what we suggest:
Assure your mom that she has support from the family — in whatever form she wants and needs — and remind her that no one expects her to be perfect. The Joslin Diabetes Institute wants her to know this: "You should forgive yourself for the occasional glucose fluctuation; you'll be relieved of the stress associated with trying to achieve perfection, and you'll likely reap more rewards for this kind of approach in the long term."
Help her maintain regular contact with her medical care team, starting with her primary care physician. Disengaging from your health care team is a classic indicator of diabetes denial.
Suggest contacting a diabetes educator again or joining a diabetes support group; it can make getting back on track much easier. If your mom can find a buddy to pair up with, they can help each other stay with the program. With your help, we're sure she'll get back on track!
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Q: I'm afraid to let my kids go swimming when we head down to the west coast of Florida this summer. Is there a real danger of contracting flesh-eating bacteria? Sheila K., Camden, Maine
A: The recent news that four people on the Alabama Gulf Coast have been infected by vibrio have spawned tabloid-style headlines about so-called flesh-eating bacteria. Necrotizing bacterial infections (that's the medical name) are dreadful, but exceedingly rare; there are only around 700 to 1,000 cases a year. In the U.S., various vibrio strains cause about 80,000 illnesses, but only around 100 deaths, annually. (For perspective, falling out of bed kills around 500 people annually.)
Eighty percent of vibrio cases are reported from May to October, as waters along coastlines warm. When it comes from shellfish, vibrio can trigger a few days of watery diarrhea, abdominal cramping, nausea, vomiting, fever and chills. Entering the body through an opening in the skin, vibrio can cause problems with wound healing, and if it gets into the bloodstream it can cause fever, chills, dangerously low blood pressure and blistering skin lesions and, yes, it sometimes can prove fatal.
Risk of infection is greatest for people with liver disease, cancer, diabetes, HIV and anyone receiving immune-suppressing therapy. Risk also is increased for anyone who has had recent stomach surgery or is taking medicine to decrease stomach acid levels — more than 15 million Americans do just that!