Complications of Diabetes:

Over time, the surge and crash of dissolved glucose and insulin that occurs in diabetes can end up causing irreparable damage to many body organs and systems. We refer to this as "end-organ damage" because it can affect nearly every organ system in the body:
  • Hypertension (High Blood Pressure) and Heart Disease. Hypertension is almost uniformly found in people with Type 2 Diabetes. As the blood glucose level increases our bodies attempt to use various means to lower the concentration of glucose back to "normal" levels.  One way the body attempts to do this is by holding more fluid in the blood vessels.  This extra fluid causes the pressure in the vessels to increase.  Heightened blood pressure, in turn leads to a generalized weakening of the circulatory system. This can eventually lead to blood vessels bursting in some extreme cases (e.g., vascular stroke) or lead to the development of chronic blood flow problems in the limbs and other peripheral parts of the body. Chronically high insulin levels are also associated with early development of atherosclerotic plaques inside blood vessel walls, which lead to further risk of aneurysm, hypertension, stroke, and heart attack.
  • Eye Disease. Untreated diabetes can lead to a variety of eye problems including blindness and reduced vision. Diabetes is the No 1 cause of acquired blindness in people under the age of 65 and is one of the leading causes in older adults. People with diabetes experience damage to blood vessels and nerves in the back of the eye, an area called the retina. This leads to a condition called "Diabetic Retinopathy." Diabetes can also cause abnormal new growth of capillaries inside the retina that degrade blood flow and weaken vision. Once it occurs, damage to vision is permanent. However, when identified early enough, many vision problems associated with diabetes can be repaired or avoided. Individuals with diabetes should have their eyes examined once a year by an eye doctor.  People with diabetes can prevent eye problems by keeping their blood glucose under good control, lowering their blood pressure, and cholesterol levels.
  • Kidney Disease (Nephropathy). The kidneys main job is to filter blood. In those with diabetes, sugar that is filtered from the blood damages the blood vessels in the kidneys over time. This process is called "Diabetic nephropathy." In extreme cases diabetes can lead to kidney failure, necessitating frequent and expensive dialysis (machine filtration of the blood), or risky, expensive, and difficult to obtain kidney transplantation. Diabetes is the number one reason that Indians are on dialysis. Doctors test urine of patients with diabetes to monitor for kidney failure.
  • Nerve Damage (Neuropathy). Sugar in the blood damages the peripheral nervous system (that part of the nervous system that works the arms, legs and other extremities). Affected patients report pain, tingling or buzzing sensations in their hands and/or feet. Complete numbness (loss of sensation) in the limbs is also common. Patients may also lose bladder control, or the ability to walk. Male loss of ability to function sexually (impotence or erectile dysfunction) may also occur.
  • Infections of the Skin. Diabetes can cause a number of skin conditions, including fungal (yeast) and bacterial infections, skin spotting (diabetic dermopathy), and a variety of spots, rashes and bumpy or oddly textured skin patches. Most of these conditions are related to chronically raised blood sugar levels, and become less of a problem once blood sugar is brought under control. Individuals with diabetes are also at increased risk of all types of infection because of impaired immunity (ability to fight infection). For this reason, it is important for people with diabetes to get annual influenza vaccinations and pneumococcal vaccine every five years.
  • Cognitive Issues. As one of the organs most affected by blood sugar fluctuations, the brain is also impacted by diabetes. Chronic uncontrolled diabetes appears to be associated with memory problems and dementia in the elderly, and may increase risk of Alzheimer's disease. In younger patients with Type 1 diabetes, elevated blood sugar levels were found to be associated with increased difficulty performing mental arithmetic and with decreased verbal fluency performance. This slowing of cognitive functions was reversible as sugar levels decreased.
  • Diabetic Foot Problems. Poor blood flow in the limbs combined with nerve damage and reduced or deadened sensation lead to a situation where the extremities (feet, hands) become easily susceptible to damage and disease. In such a case, when there happens damage or injury to the feet, the wound doesn’t heal fast and attracts more infection. When this infectious wound is unattended with a combination of higher blood sugar, it creates a situation called as Diabetic Foot. This condition may even lead to Amputation – Cutting of the affected part. Damage to joints (caused by lack of ability to feel pain properly) and ulcers of the feet are common. In 2004 alone, 91,000 Indians required amputation of a foot or leg because of diabetes. It is imperative that those individuals with diabetes perform self-foot exams on a daily basis and that they undergo a foot exam by a Diabetic Foot Doctor at Lifelline Medicare Hospitals once a year.

Knock Knees | Genu Valgum | Symptoms and Causes

What are the symptoms of knock knees?

A standing child of average weight whose knees touch, but whose ankles do not, is usually considered to have knock knees. An abnormal walking gait can also be a sign of the condition. The condition usually becomes apparent when a child is 2 to 3 years old, and it may increase in severity until about age 4. It usually self-corrects by the time a child is about 7 or 8 years old. But if the condition doesn’t appear until a child is 6 or older, it could be a sign that there is an underlying bone disease.

During early childhood, knock-knees actually help a child to maintain balance, particularly when the child begins to walk, or if the foot rolls inward or turns outward. When a child has knock knees, both knees usually lean inward symmetrically. One knee, however, may "knock" less than the other or may even remain straight.

Occasionally, knock knees persist into adolescence. The condition is slightly more common in girls, although boys can develop it, too.

What causes knock knees?

Knock knees are usually part of the normal growth and development of the lower extremities. Some cases, especially in a child who’s 6 or older, may be a sign of an underlying bone disease, such as osteomalacia or rickets. Obesity can contribute to knock knees—or can cause gait (walking) problems that resemble, but aren’t actually, knock knees. The condition can occasionally result from an injury to the growth area of the shin bone (tibia), which may result in just one knocked knee. In the course of developing normal alignment of their lower extremities, all young children have knock knees to some degree for a period of time. At the age of 3, more than 20 % of children have at least a 5-centimeter gap between their ankles. By the age of 7, only 1 % of children have this gap.

How is Genu Valgum treated?

Treatment for Genu Valgum depends on the cause and severity of your symptoms. For example, if rickets are causing your knock-knees, Dr. Aniruddh Ambekar at Lifelline Medicare Hospitals may likely prescribe vitamin D and calcium supplements to help restore your levels. He may also prescribe prescription-strength nonsteroidal anti-inflammatory drugs if over-the-counter options, like naproxen (Aleve, Naprosyn), aren’t providing relief.

Some tips from Dr. Aniruddh Ambekar:

Weight loss : Obesity can put added stress on your knees, worsening Genu Valgum. If you’re overweight, he will work with you to develop a healthy weight loss plan.

Exercise : For most people with Genu Valgum, exercise can help realign and stabilize their knees. He with your physical therapist can evaluate your gait and suggest exercises designed to strengthen your leg, hip, and thigh muscles. Specific stretches may also be useful in relieving symptoms. Strengthening exercises can be simple, such as leg raises while seated or lying down. As you progress with an exercise routine, you may add leg weights to make it more effective.

Orthotics : If your legs are of unequal length as a result of Genu Valgum, a heel insert into the shoe on the shorter side can equalize your leg length and help regularize your gait. It may also relieve leg pain. For children whose Genu Valgum doesn’t resolve by age 8, a brace or a splint may help guide bone growth.

Surgery : When Genu Valgum is severe, or when exercise isn’t enough to relieve pain and stabilize your knee, Dr. Aniruddh Ambekar may recommend Surgery. For younger people, a small metal plate inserted in their knee can help direct future bone growth. This minor procedure is called Guided Growth Surgery. The plate is removed when bone growth is corrected. Adults may benefit from an osteotomy. This surgery uses permanent metal plates to keep bones aligned. This can adjust your leg bones and realign your knees. Knee Replacement Surgery is also an option for older adults.


Angioplasty Means

A coronary angioplasty is a procedure used to widen blocked or narrowed coronary arteries (the main blood vessels supplying the heart).

The term "angioplasty" means using a balloon to stretch open a narrowed or blocked artery. However, most modern angioplasty procedures also involve inserting a short wire-mesh tube, called a stent, into the artery during the procedure. The stent is left in place permanently to allow blood to flow more freely. Coronary Angioplasty is sometimes known as Percutaneous Transluminal Coronary Angioplasty (PTCA). The combination of coronary angioplasty with stenting is usually referred to as Percutaneous Coronary Intervention (PCI).

When a coronary angioplasty is used

Like all organs in the body, the heart needs a constant supply of blood. This is supplied by the coronary arteries. In older people, these arteries can become narrowed and hardened (known as atherosclerosis), which can cause coronary heart disease. If the flow of blood to the heart becomes restricted, it can lead to chest pain known as angina which is usually triggered by physical activity or stress. While angina can often be treated with medication, a coronary angioplasty may be required to restore the blood supply to the heart in severe cases where medication is ineffective. Coronary angioplasties are also often used as an emergency treatment after a heart attack.

What are the benefits of a coronary angioplasty?

In most cases, the blood flow through the coronary arteries improves after an Angioplasty. Many people find their symptoms get significantly better and they're able to do more than they could before the procedure. If you've had a heart attack, an angioplasty can increase your chances of surviving more than clot-busting medication (thrombolysis). The procedure can also reduce your chances of having another heart attack in the future.

How a coronary angioplasty is performed

A coronary angioplasty is performed using local anaesthetic, which means you'll be awake while the procedure is carried out and the procedure is completely pain free.

A thin flexible tube called a catheter will be inserted into one of your arteries. This is guided to the affected coronary artery using an X-ray video. When the catheter is in place, a thin wire is guided down the length of the affected coronary artery, delivering a small balloon to the affected section of artery. This is then inflated to widen the artery, squashing fatty deposits against the artery wall so blood can flow through it more freely when the deflated balloon is removed.

If a stent is being used, this will be around the balloon before it's inserted. The stent will expand when the balloon is inflated and remains in place when the balloon is deflated and removed. A coronary angioplasty usually takes between 20 to 30 minutes. If you're being treated for angina, you'll normally be able to go home later the same day or the day after you have the procedure. You'll need to avoid heavy lifting, strenuous activities and driving for at least a week. If you've been admitted to hospital following a heart attack, you may need to stay in hospital for several days after the angioplasty procedure before going home.

How safe is a coronary angioplasty?

Its 100% Safe. A coronary angioplasty is one of the most common types of treatment for the Heart. Coronary angioplasties are most commonly performed in people aged 65 or older, as they're more likely to have heart disease. As the procedure doesn't involve making major incisions in the body, it's usually carried out safely in most people. Doctors refer to this as a minimally invasive form of treatment.

Are there any alternatives?

If many coronary arteries have become blocked and narrowed, or the structure of your arteries is abnormal, a CABG - Coronary Artery Bypass Graft may be considered. This is a type of invasive surgery where sections of healthy blood vessel are taken from other parts of the body and attached to the coronary arteries. Blood is diverted through these vessels, so it bypasses the narrowed or clogged parts of the arteries and reached the required parts of the heart providing blood to the region.

To know more about the procedure contact Lifelline Medicare Hospitals on 9769825566