Page 11 - Diabetes

NEWS&
NOTES

Diabetes Diabetic

[definitions] Neuropathies
on the Rise
MERCI Doctors may treat CHD with coronary angio-
An acronym for Mechanical Embolus Removal in plasty, in which a thin, flexible tube with a tiny iabetic neuropathy is a type of
Cerebral Ischemia, a medical device designed to balloon on the end is threaded through a blood Dnerve damage caused by diabe-
treat ischemic strokes. The most common form of vessel to the narrowed or blocked coronary tes. The most common symptoms are
strokes, ischemic strokes occur when the artery artery. Once placed, the balloon is temporarily tingling, numbness or pain in the
that feeds blood to the brain becomes blocked, inflated to compress the plaque and restore hands, arms, feet and legs. But there
typically by a blood clot. When treating a stroke, blood flow through the artery. are other less common types of dia-
time is of the essence to prevent permanent brain In some cases, a stent is placed in the artery betic neuropathy, and a new study
damage. In the past, the only treatment available during the procedure. The stent keeps the finds that two rare types of diabetic
for acute ischemic strokes was recombinant tis- artery open and dramatically decreases the
sue plasminogen activator (tPA), a protein that likelihood that the artery will become narrowed neuropathy—small fiber neuropathy
dissolves clots. However, tPA may take as long or blocked again. and autonomic neuropathy—are on
as two hours to work. Unfortunately, using stents in coronary artery the rise in the United States.
Mechanical procedures can remove clots in a disease doesn’t necessarily translate into better Both occur when diabetes damages
matter of minutes. These include carotid endarter- outcomes for most patients. Large studies have the small blood vessels that supply the
ectomy, in which the surgeon cuts open the carotid found that stents do not prevent heart attacks nerves. When that happens, the nerves
artery and removes the clot, and carotid artery or death from heart attacks or ease chest pain. begin to die due to lack of oxygen and
angioplasty, in which a tiny balloon is threaded Although cardiac stents may still have a role in
into the clogged artery and inflated to widen the treating heart disease, including a heart attack in nutrients. In small fiber neuropathy,
area and allow blood to flow more freely. progress, some cardiologists suggest that the clini- the damaged nerves are the ones that
In MERCI, first developed by doctors at UCLA cal guidelines for using stents should be changed. control sensations of pain and temper-
in 1996, a thin tube called a catheter with a ballon ature. People who have this condition
at the end of it is threaded through the femoral DASH DIET often feel pain in their feet—a pain
artery (an artery in the leg) and into the affected A diet that has been scientifically proven to that eventually moves up their legs or
vessel. The balloon is then inflated to block blood reduce blood pressure. The DASH diet empha- develops in their hands. Autonomic
flow, which could hinder the procedure. A long, sizes fruit, vegetables, and fat-free or low-fat
thin wire called a retriever, with a coil at the end milk and milk products, and is low in saturated neuropathy commonly affects involun-
of it, is threaded through the catheter. The coil fat, cholesterol and total fat. It also includes tary body functions such as digestion,
wraps around the clot, and the clot is removed. whole-grain products, fish, poultry and nuts. sexual function, urination and sweat.
Studies have shown that MERCI can achieve It limits the intake of red meats, sweets, added It also affects blood pressure, which
better results than tPA. sugars and sugar-sweetened beverages. Fur- means that its most common symptom
thermore, it is rich in potassium, magnesium,
calcium, protein and fiber. is lightheadedness, especially when
The DASH eating plan was developed one stands up. According to Divpreet
and tested in a large study funded by the Kaur, MD, a neurologist at Penn State
National Institutes of Health called the Dietary Health Milton S. Hershey Medical
Approaches to Stop Hypertension (DASH) study. Center, “The blood pressure drops
In the study, 412 participants were randomly so much when they stand up that they
assigned to consume a typical American diet feel like they are going to pass out.”
or a DASH diet. Those who followed the DASH
diet had lower blood pressure than those who These two neuropathies are uncom-
followed a typical American diet. The DASH mon, so patients don’t know about them
V diet also lowered their levels of low-density or aren’t able to recognize the symptoms.
CARDIAC STENT lipoprotein (LDL) cholesterol. Kaur explains that not everyone with
The DASH diet is tailored to the individual’s
A small mesh tube used to treat narrow or weak caloric needs. A 2,000-calorie-a-day diet, for these symptoms necessarily has diabetic
coronary arteries. People with diabetes are espe- example, would include 6-8 servings of grains, 6 neuropathy, but anyone with diabetes or
cially prone to atherosclerosis, a condition in which or fewer servings of meats, poultry and fish, 4-5 prediabetes who does experience them
plaque, a waxy substance, builds up inside the servings of vegetables, 4-5 servings of fruit, 2-3 should tell their doctor. Once other
arteries. When atherosclerosis affects the coronary servings of low-fat or no-fat dairy products, 2-3 causes have been ruled out, patients “can
arteries—the arteries that supply oxygen-rich servings of fats and oils, and 2,300 mg of sodium. be referred to the neuromuscular clinic
blood to the heart muscle—coronary heart disease To find out more about the DASH diet, talk with for consultation or to the autonomic
(CHD) may occur. Symptoms of CHD include your doctor or dietitian. † laboratory for further testing.” †
Shutterstock/crystal light buildup of plaque also makes it more likely that Robert Dinsmoor, a medical writer and editor, is a Joseph Gustaitis is a freelance writer and editor
chest pain or discomfort, known as angina. The
blood clots will develop in the coronary arteries,
based in the Chicago area.
contributing editor of Diabetes Self-Management.
blocking them and causing a heart attack.
DiabetesSelfManagement.com 9