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Mahantesh.I.B
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A: Thanks for this very important question. Foot problems are always a concern for diabetics because they can develop temporary or permanent damage to their nerves (diabetic neuropathy). Diabetics are prone to elevated blood glucose (sugar) levels and poor circulation, both of which can lead to nerve damage, especially of nerves which are fed by very small blood vessels, such as those in the feet. When nerve damage occurs in the feet, you may experience sensations of foot tingling, numbness, burning, cramping and even weakness. Nerve damage can occur in other areas of the body as well, such as the eyes, stomach, intestines, bladder, penis, eyelids, etc. This can lead to vision problems, nausea and vomiting, indigestion, urinary incontinence, erectile dysfunction, eyelid drooping, and more. About 50% of diabetics will develop nerve damage and, on average, these symptoms will develop 10 to 20 years after the diagnosis of diabetes has been made. One of the most important ways to prevent nerve damage is to control your blood glucose level. The latest guidelines dictate that a person has diabetes when their hemoglobin A1C (a measure of your average blood glucose level over the most recent 2-3 month period) level is 6.4 or higher. Therefore, Lorenzo, keep up the good work because your A1C level is very good and, hopefully, that will reduce your risk of future nerve problems.
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More studies are needed to see if any of these triggers can directly cause a stroke to occur. But, for now, they are just associations which have been noted to have some form of association with stroke.
A new study published online in the current New England Journal of Medicine suggests that oral medications used to control asthma can be just as effective as inhaled medicines. The researchers studied over 650 patients over a two year period and found that the oral asthma medications Singular (montelukast) and Accolate (zafirlukast) performed just as well as inhaled steroids in controlling asthma, but only in the first two months of the study. After two years, asthma control between oral and inhaled medications was almost equivalent, but inhaled medications held a very slight advantage. What the researchers chose to focus on, however, is that patients are more likely to adhere to a medication regimen when given oral pills, compared to inhaled medicines. This is especially important when it comes to chronic diseases such as asthma, and certainly should be taken into consideration for patients who cannot adhere to inhaled medications for whatever reason. It should be noted that the study and its authors have associations with Merck and AstraZeneca pharmaceuticals, the two companies that produce the two oral asthma medications
Dear Sir / Madam
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