We’re all trained to recognize the signs of high and low blood sugar. But do you know the signs of a serious complication?
On the surface, managing type 2 diabetes seems like a numbers game. Checking blood glucose numbers, going to the lab for bloodwork, and dealing with the daily highs and lows of this condition are all part of the job description.
As patients, we put a lot of pressure on ourselves to “perform” in terms of our numbers, so we tend to focus on our glucose management in the immediate moment and not put much attention on the long-term effects of diabetes until we have something to worry about.
This means the symptoms of high and low blood sugar are more commonly known and recognized as warning signs.
Signs of high blood sugar:
Signs of low blood sugar:
But what about complications beyond the highs and lows? How do we know when something more serious is brewing?
Here are five symptoms you shouldn’t ignore if you’re living with type 2 diabetes.
Typically, when we think of neuropathy associated with type 2 diabetes, we think of tingling in our feet, described as pins and needles. Neuropathy is nerve damage caused by long-term high blood glucose.
Though it commonly begins in the feet, neuropathy can also affect the arms, hands, and legs. Neuropathy also causes numbness, which means you may not notice a cut or sore on your foot until it is already infected.
It’s important to get into a consistent foot care routine that involves daily self-checks at home, as well as having a foot examination at every doctor’s appointment.
Diabetes can have a serious impact on your vision, even causing blindness. Diabetic retinopathy, a condition where the retina’s blood vessels are damaged by high blood glucose levels, is one of the most common causes of blindness in adults.
In the early stage of diabetic retinopathy, there may be no obvious symptoms. As the condition advances, the retina begins to grow new blood vessels that aren’t as strong, and these vessels may bleed, causing the dark spots in your vision.
Since there may not be any noticeable symptoms in the early stage of diabetic retinopathy, it’s imperative to keep up with annual visits to the eye doctor to detect any possible problems.
People with diabetes are 1.5 times more likely to have a stroke than people without diabetes. A stroke happens when the blood supply to the brain is temporarily blocked.
Other signs of stroke include:
Every small step you take toward increasing your physical activity and incorporating heathy eating is a step in the right direction toward risk reduction. These improvements, along with keeping your blood pressure, cholesterol, and blood sugar in range, can help prevent a stroke.
What’s the link between diabetes and hearing? Blood sugar that is consistently high or consistently low can cause damage to blood vessels in various areas of the body, including the ears. This damage can cause hearing loss.
Hearing loss is twice as common in people with diabetes as it is in their peers without diabetes. It’s important to note that even people diagnosed with prediabetes are at a 30 percent higher rate of hearing loss than those with blood sugar levels that are in range.
Signs of hearing loss can include:
If you notice a difference in your hearing, be sure to mention it to your doctor.
Loss of interest in your favorite activities
It may surprise you that there is a strong link between diabetes and depression. Depression is a medical condition that causes sadness and a loss of interest in daily life activities, even your favorites. It can influence how you function in the community, at work, and how you take care of yourself and your diabetes.
People with diabetes are 2 to 3 times more likely to be diagnosed with depression as those without diabetes.
Other signs of depression include:
If you feel you might have depression, please reach out to your doctor as soon as possible to get help with treatment options.
As you can see, type 2 diabetes management is about so much more than the numbers. Paying attention to your body’s signals, scheduling and keeping doctors’ appointments, and staying consistent with healthy habits is equally important.
By making yourself a priority now, you can greatly reduce your risk of diabetes complications later.
Mary Van Doorn lives in Georgia with her husband, their two kids, three dogs, and three cats. She’s a type 2 diabetes advocate and the founder of Sugar Mama Strong and Sugar Mama Strong Diabetes Support. When she’s not taking care of the kids, the house, or the zoo, you can find her binge-watching her favorite shows: “Grey’s Anatomy,” “This is Us,” and “A Million Little Things.”
Last medically reviewed on September 15, 2021
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UF celebrates the construction of a new Student Health Care Center – WCJB
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GAINESVILLE, Fla. (WCJB) – UF Health officials held a beam-signing event today to celebrate the construction of the new Student Health Care Center.
With the current facility being about 100 years old, officials with UF Health, said they’re thrilled to get a new building.
“Our current building was designed for in-patient infirmary, people stayed overnight there, and that’s not the way a modern medical office building for outpatient care is done,” said Dr. Ronald Berry, the Director of the Student Health Care Center.
Now, the new facility is being built with all the same services as the current one, and more.
“The infectious unit here is probably the first of its kind in a student health,” said Berry.
He said they started the design stage of the infectious care unit during the pandemic, giving the work even more meaning.
“You’ll be able to enter into the waiting area to infectious care, from a door at the front of the building that’s not going to the rest of the building,” said Berry.
The air in this unit does not get recirculated, making it one of the safest areas in the building.
UF Health is also implementing programs that promote a healthy lifestyle.
“There’s going to be the inclusion of the demo kitchen where our dietitian can host interactive cooking lessons for students, for faculty, and staff throughout campus,” said Adeel Markatia, an Assistant Director within the cabinet of health affairs in Student Government.
Markatia said the building will also have a sun terrace where students can study, hangout, or just relax.
“Things like that, like these new features, definitely make this building a great enhancement for our campus,” he said.
Berry said with a new facility, he hopes to provide more learning opportunities for medical students.
The construction is expected to be done around this time next year, and open for students in Spring 2023.
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What Causes Narcolepsy? These Factors May Play a Role | Health.com – Health.com
In many cases, chronic sleepiness is tied to low levels of certain brain chemicals.
When diagnosed with a new condition, the first question is almost always "How?" We naturally want to know exactly what brought us to that moment. This curiosity may be even stronger with something like narcolepsy, a chronic sleep disorder that is both under-recognized and misunderstood, according to the nonprofit Project Sleep.
While scientists have yet to pinpoint the exact cause of narcolepsy, a majority of cases are tied to low levels of a brain chemical involved in regulating our sleep-wake cycle, according to the Cleveland Clinic. And other factors are thought to play a role in triggering the disease process.
Here's how sleep experts explain the causes of narcolepsy.
Before delving into the causes, let's consider what narcolepsy looks like.
Narcolepsy is characterized by excessive daytime sleepiness, hallucinations, sleep paralysis, vivid dreams, and more, says Steven Thau, MD, division chief of the Pulmonary and Sleep Medicine Department and medical director of the Sleep Center at Phelps Hospital/Northwell Health.
It can present at any point in a person's life, but most commonly it initially occurs in a person's teens or 20s, Dr. Thau tells Health.
While each case is different, excessive daytime sleepiness is generally the first symptom to surface. Symptoms such as hallucinations, sleep paralysis, and cataplexy may follow, says Manjamalai Sivaraman, MD, FAASM, a sleep medicine specialist and neurologist at the University of Missouri. The latter may not happen for a few years, if at all.
RELATED: What Are the Types of Narcolepsy? Sleep Experts Explain the Differing Presentations of This Sleep Disorder
There are two main types of narcolepsy: types 1 and 2. There's also a third known as secondary narcolepsy. (More on that one below.)
Narcolepsy type 1 covers anyone who has low levels of hypocretin (a brain chemical that controls wakefulness) and experiences cataplexy (sudden muscle loss), according to the Mayo Clinic. Type 1 makes up about 70% of narcolepsy cases, says Richard Bogan, MD, a medical officer at SleepMed, Inc. and associate clinical professor at the University of South Carolina School of Medicine and the Medical University of South Carolina in Charleston.
People with narcolepsy type 2 may experience all the symptoms of narcolepsy except cataplexy—and their symptoms are often less severe, says the National Institute of Neurological Disorders and Stroke (NINDS). And their hypocretin levels are usually normal.
While there are no known ways to prevent or cure type 1 or type 2 narcolepsy, NINDS notes that lifestyle changes and medications may be helpful for maintaining alertness and managing other symptoms.
RELATED: Is Narcolepsy Genetic? What Sleep Experts Say About Inheriting This Chronic Disorder
While the science is still evolving, here's what's known so far.
People with type 1 narcolepsy have very low levels of brain chemicals called hypocretins. These chemicals, first discovered in 1998, are important for a couple of reasons, per the Division of Sleep Medicine at Harvard Medical School. For one thing, they keep people awake and alert. They also prevent people from drifting off into REM (rapid-eye movement) sleep while they're awake.
In people type 1 narcolepsy, however, the nerve cells that produce hypocretins die off, and the resulting dearth of these chemicals leads to sleepiness and poorly regulated REM sleep, per Harvard's Sleep Medicine Division.
Research by two separate investigative teams suggests that type 1 narcolepsy is caused by a severe loss of neurons that produce these chemicals, per a 2015 review in the New England Journal of Medicine.
As for what causes type 2 narcolepsy? It's possible that people who have this form of the disorder may sustain less injury to their neurons than those with type 1, according to that same review, which references a 2009 Sleep study. But data on the disease process involved in type 2 narcolepsy "are quite limited," notes the New England Journal.
Bottom line: Scientists don't fully understand what triggers the loss of hypocretin-producing cells, although it appears that one or more of the following factors may be involved:
Most people with narcolepsy, especially type 1, have a gene variation known as HLA-DQB1*06:02. It is a variation of the HLA-DQB1 gene, which "provides instructions for making part of a protein that plays an important role in the immune system," according the US National Library of Medicine. The risk of narcolepsy associated with this variation and related genes is unclear to researchers at this time.
That same gene variation is found in 50% of people with narcolepsy type 2, but only 12-30% of the general population, according to the New England Journal.
Speaking of risk factors, narcolepsy isn't a disorder that tends to run in the family. According to NINDS, just up to 10% of people with type 1 narcolepsy have a close family member who presents with similar symptoms. If a parent has narcolepsy, the odds of passing it down to a child is only about 1%, says Mayo Clinic.
People with the HLA-DQB1*06:02 gene variation may be at increased risk of developing narcolepsy after being exposed to a trigger, such as an infection, says NINDS. That's based on studies of people after they developed narcolepsy.
Upper airway infections such as streptococcus pyogenes and influenza A (including H1N1) are strongly associated with narcolepsy, per a 2011 study in the Annals of Neurology, especially in cases where it begins in childhood, notes Dr. Sivaraman.
We know that people with narcolepsy type 1 have low hypocretin levels—but why? A leading theory considers narcolepsy to be an autoimmune disorder.
"There are supporting evidences for autoimmune destruction—the immune system in one's body attacking its own healthy cells—of hypocretin neurons in the hypothalamus of the brain," says Dr. Sivaraman. To break it down, if this theory is true, then a person's own immune system is responsible for the brain lacking in hypocretin.
As Dr. Thau puts it, in this case, "the cells that control wakefulness are damaged."
Currently, researchers are working on using immunotherapy to reverse this loss, Dr. Bogan tells Health. According to a 2020 review published in Current Treatment Options in Neurology, small studies have shown an improvement in symptoms for narcolepsy patients after using immunotherapy treatment, especially those who recently presented with the disease. However, the experiments were uncontrolled and did not have clear endpoints, requiring more research to achieve any definitive answer on the treatment's benefits.
RELATED: 7 Narcolepsy Symptoms to Know, According to Sleep Specialists
Unlike narcolepsy types 1 and 2, doctors do know the "why" behind secondary narcolepsy. This form of narcolepsy occurs when the brain's hypothalamus region gets damaged, according to Harvard's Division of Sleep Medicine.
These people can experience all of the same symptoms as those with types 1 and 2. However, they might also have severe neurological problems and require a large amount of sleep—typically 10 hours or more.
"In rare cases, brain lesions or diseases such as tumors, vascular malformations, strokes or inflammatory diseases of the brain can result in the destruction of the signaling pathways that increase brain activity and promote wakefulness," says Dr. Thau.
According to the National Health Service, secondary narcolepsy causes include:
As Dr. Thau notes, "a healthy lifestyle and avoiding smoking or the use of illicit drugs decrease the risk of some of the disorders that cause secondary narcolepsy."
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Mount Laurel police asks public's help in finding child – Courier Post
MOUNT LAUREL – Police are asking the public’s help in finding a 6-year-old girl who was allegedly abducted by her non-custodial mother.
The girl, Grace Craytor of Pennsauken, was last seen around 7:10 p.m. Monday with her mother, Kristina Maletteri, at Lifetime Fitness in Mount Laurel, according to township police.
The girl’s father, who has a full custody order for Grace, had invited Maletteri to swim with the child during a supervised visit at the facility at Church and Fellowship roads, said a police account.
“At some point, Ms. Maletteri is said to have taken her daughter and left the area without consent,” the account said.
Maletteri is known to drive a 2017 silver Audi Q3 with New Jersey license plates “S64MPY.”
The missing child is 46 inches tall, 70 pounds, with blonde hair and hazel eyes, police said.
Anyone with information is asked to call Mount Laurel police at 856-234-8300 or the confidential tip line 856-234-1414, extension 1599.
Tips can also be emailed to Lamaro@mountlaurelpd.org.
Jim Walsh covers public safety, economic development and other beats for the Courier-Post, Burlington County Times and The Daily Journal.
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