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People With Diabetes Less Likely to Notice Symptoms of Atrial Fibrillation – Everyday Health

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Findings may indicate the need for afib screening in older adults with diabetes, experts say.
People with type 1 or type 2 diabetes are less likely to notice symptoms of atrial fibrillation (afib) such as rapid heartbeat, according to new research. Having diabetes and afib was also associated with a poorer quality of life and additional heart conditions, per the findings, published November 11 in the Journal of the American Heart Association, an open access journal of the American Heart Association (AHA).
“It is remarkable to find that patients with diabetes had a reduced recognition of atrial fibrillation symptoms,” said study author Tobias Reichlin, MD, professor of cardiology at Bern University Hospital at the University of Bern in Switzerland, in a release from the AHA.
The heart rate in afib can range between 100 to 175 beats a minute; the normal range for a heart rate is typically 60 to 100 beats a minute, according to Mayo Clinic.
“The reduced perception of atrial fibrillation symptoms may result in a delayed diagnosis of atrial fibrillation, and, consequently, more complications such as stroke,” said Dr. Reichlin.
Atrial fibrillation can lead to stroke, blood clots, heart failure, and other heart-related conditions, according to the AHA. It’s estimated that at least 2.7 million Americans have afib, which is a quivering or irregular heartbeat (arrhythmia), though the true number may be higher than that, according to Chirag Barbhaiya, MD, cardiac electrophysiologist and researcher at NYU Langone Health in New York City. Dr. Barbhaiya was not involved in this research.
“It’s hard to get a good estimate of the actual number of people with atrial fibrillation because there are so many people that have it and don’t know it,” he says. An additional challenge is that the definition of afib can also vary, says Barbhaiya. “We find that the more closely we are able to monitor people’s heartbeat, the more often we see these very short episodes of atrial fibrillation; it’s not well established how long an episode of afib has to last before you should be put in a category such that you should treated for it,” he explains.
There are many risk factors associated with developing afib, including age, genetics, race, smoking, obesity, and diabetes. People with diabetes have a 40 percent higher risk for developing afib compared with people without diabetes, according to research published in the Journal of General Internal Medicine.
Studying the relationship between these two groups is important because both diabetes and atrial fibrillation are problems that are becoming more prevalent in the population, says Barbhaiya.
Sometimes people have afib and don’t know it because they don’t have any symptoms, or they don’t recognize them, per the AHA. Common symptoms include being tired and weak, rapid and irregular heartbeat or fluttering in the chest, and shortness of breath and anxiety.
Because diabetes is a major risk factor for afib, investigators aimed to find out whether people with diabetes had different symptoms and complications for atrial fibrillation compared with people without diabetes.
The study participants were 2,411 patients diagnosed with atrial fibrillation who were enrolled at 14 healthcare centers in Switzerland from 2014 to 2017 as part of the Swiss-AF (Swiss Atrial Fibrillation) Study. The average age of the subjects was 73.2, and 27.4 percent were women.
At the onset of the study, each participant had a medical exam, which included blood sampling, cognitive assessment, quality of life assessment, and five-minute resting ECG (electrocardiogram).
A total of 17.4 percent of the participants either took diabetes medication or had a diagnosis of diabetes in their medical records. Researchers then compared afib symptoms, quality of life outcomes, cardiac comorbidities, and neurological comorbidities between the groups with and without diabetes.
In quality of life measures, investigators found that that afib adversely impacted mobility, self-care and normal activities more for people with diabetes.
These findings show that people with diabetes who also had afib were less likely to experience any symptom related to afib, despite having more coexisting health conditions related to the heart, said Prakash Deedwania, MD, professor of medicine at the University of California in San Francisco School of Medicine and a member of the scientific advisory board for Know Diabetes By Heart (KDBH), a joint initiative of the AHA and the American Diabetes Association, in the release.
“Keeping these new observations in mind, along with the serious consequences of failing to recognize afib in time, it seems prudent to consider screening older patients with diabetes for afib so that treatment may be initiated when appropriate,” he said.
It may take a study that proves that screening for afib in people with diabetes improves outcomes, such as fewer strokes, before guidelines are changed, says Barbhaiya. “The take-home message here is that the symptoms that patients often develop from atrial fibrillation can be less severe or different if present at all in patients with diabetes,” he says. “If someone with diabetes is having symptoms that are otherwise not well explained — for example, if they are having shortness of breath or feeling more fatigued that usual — then as a provider, I would have a very low threshold for screening for afib,” says Barbhaiya.
The authors acknowledge limitations to the study were limitations to the study. Data wasn’t available on how long the participants had been living with diabetes or how well their diabetes was controlled. Because the study only included residents of Switzerland, the findings may not be generalizable to other populations or ethnic groups.
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ChalleNGe Academy graduate prepares for West Point journey – West Virginia MetroNews

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MONTGOMERY, W.Va. – A West Virginia National Guard Mountaineer ChalleNGe Academy graduate is the first graduate to earn an appointment to the U.S. Army’s Military Service Academy, West Point.
William Farkas, 17, of Preston County, said he was has made a lifelong dream a reality.
It’s been something I’ve been dreaming about since elementary school and something I’ve been set on doing since middle school,” Farkas said during a Friday appearance on MetroNews “Talkline.”
He said the training he received at the Mountaineer ChalleNGe Academy-South in Montgomery was key in developing the attitude and work ethic that enabled him to succeed. That level of focus was required to gain admission to one of the most prestigious universities in the country.
“Everybody was encouraging me there. Everybody wanted me to succeed,” Farkas said. “I kept testing on the ACT and I ended up scoring in the 30’s with my composite. I wouldn’t been able to do it without them.”
William Farkas becomes the first Mountaineer Challenge Academy graduate to receive an appointment to West Point. He talks about this next step in his life with @HoppyKercheval. WATCH: https://t.co/yCFQ3nDJuy pic.twitter.com/jJO0mae0Ap
— MetroNews (@WVMetroNews) January 21, 2022

Within a paramilitary structure, cadets are challenged to learn coping skills, how to lead as well as how to follow, citizenship and physical fitness. Farkas said the program is very demanding. He was awarded the Robert C. Byrd Distinguished Cadet Award and Adjutant General’s Award for Academic Excellence as well as the appointment to West Point.
“The first day was a shock and the first night was even more so a shock,” Farkas said. “I went to sleep and asked myself,,’Am I really doing this? Am I really sleeping on a cot in the gym on reception day?’”
Farkas is enjoying this success before the next chapter of West Point preparation begins.
“It was worth it,” Farkas said. “Despite the initial challenges it was worth it.”
The next stop for Farkas is one-station unit training at Fort Leonard Wood, Missouri. He is scheduled to report to West Point in June to begin his college career.

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Sick Day Management for Diabetes: How to Plan Ahead – Healthline

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When you have diabetes, taking care of yourself during an illness has extra importance — even if the condition is as common as the flu or a urinary tract infection.
To avoid complications, it’s a good idea to plan ahead for how you’ll handle sick days, illnesses, and infections.
This article provides some expert guidance on:
When you have diabetes, an illness or infection can deliver a powerful one-two punch to your body. Here’s how.
One reason to plan ahead is because illness or infection can worsen diabetes symptoms.
Your body reacts to them the same way it reacts to stressful events. It produces a surge of hormones, including cortisol. Cortisol is often called the stress hormone.
When your body is flooded with cortisol, your blood sugar can spike for several reasons:
Both of these actions can mean that when your body is dealing with an illness or infection, you may experience a bump in your blood sugar levels.
If you have diabetes, you may have a higher risk of certain kinds of infection or illness.
Research from 2021 shows that people with diabetes are more likely to develop certain kinds of infections, including pneumonia and cystitis (urinary tract infections).
If you do get sick, you may face a higher risk of hospitalization. For example, 2021 research associated diabetes with longer hospital stays, more complications, and a greater risk of death with COVID-19, the disease caused by the novel coronavirus.
That’s why it’s so important to work with your diabetes care team to plan ahead, so you’ll know how to handle an illness, injury, or infection if it happens. Your plan can give you some peace of mind now, and it may protect your health later on.
Advocates at the American Diabetes Association and the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) recommend that your sick-day plan address the following key questions.
Let’s tackle these questions one at a time.
To prepare yourself for the sick days you’re bound to face sooner or later, talk with your diabetes care team about testing, medications, and warning signs.
When you’re sick, your blood sugar may go up for several reasons:
To keep your blood sugar in your target range, keep eating and drinking as close to your usual routine as possible. That may be easier said than done, especially if you have symptoms like nausea, vomiting, or diarrhea.
If you’re having trouble eating and drinking, aim for:
If your blood sugar is too low, you may need to follow the 15-15 rule. That means you’ll need to consume 15 grams of carbs, then test your blood sugar 15 minutes afterward.
Talk with your healthcare team about whether hard candies or glucose tablets would work if you’re not able to keep down food or drink.
The Centers for Disease Control and Prevention (CDC) recommends testing your blood glucose levels every 4 hours whenever you’re feeling unwell.
Keep a notepad nearby so you have an accurate record to share with your doctor. You don’t want to rely on your memory of the readings at a time when your recall could be clouded by lack of sleep or worsening symptoms.
You may also need to test your urine for ketones. Ketones are a sign that your insulin levels are low and your body is using fat for fuel.
Testing for ketones in your urine can tell you if you’re developing a condition called diabetic ketoacidosis. This condition is life threatening, so it’s important to know in advance how to detect these chemicals in your body.
The NIDDK recommends that you test ketones every 4 to 6 hours during an illness.
It’s also important to track your weight, body temperature, and blood pressure. These metrics are important clues that may tell you if:
It’s especially important for people with type 1 diabetes to test their blood glucose more often when they’re sick. Insulin levels can drop sharply as the body fights an illness or infection.
An illness can change how much insulin you need. Talk with your diabetes care team about when and how much to adjust your dosage of insulin and any other medications you take.
It’s important to keep taking insulin, especially long-acting insulin, on the schedule your doctor recommends. It’s also important to continue taking long-acting insulin even if you’re not eating.
Some over-the-counter (OTC) medications — especially those that treat cough, cold, and flu symptoms — contain sugar. Other types of medication can affect the way your diabetes medications work.
Your diabetes care team may be able to give you a list of medications to avoid when you’re feeling unwell with a common condition.
It’s a good idea to stock up on easy-to-prepare foods, sick-day drinks, medications, and diabetes care supplies so you have these items on hand for those days when you’re not feeling well. Here are some items to include in your sick-day kit:
Keep a ready supply of:
Your sick-day kit should also contain:
Make sure your kit is stocked with:
If you’re experiencing any of the following symptoms, contact your doctor or someone on your diabetes care team right away:
Diabetic ketoacidosis is a medical emergency: It can lead to coma or death. Get medical help immediately if you’re experiencing symptoms such as:
If your employer or insurer offers telehealth services, consider downloading the app or keeping contact information in your phone to make it easier to get advice if you’re not feeling well.
Diabetes can damage your immune system, according to 2020 research. For that reason, it’s important to take good care of your health year-round, not just during cold and flu season.
You can do this by:
The CDC recommends that people with diabetes get flu vaccines every year. It’s especially important for children, who may have more severe flu symptoms for a longer period of time than kids who don’t have diabetes.
Diabetes can make an ordinary illness more challenging — and feeling unwell can make it harder to manage your diabetes.
If you have diabetes, talk with your healthcare team to plan how you’ll respond to an illness or infection. Together, you can decide in advance how to manage your blood sugar when you’re feeling sick.
You can also stock up on food, beverages, testing supplies, and medication you might need.
A good sick-day plan includes information on which medications are safe to take, which to avoid, how best to test your blood sugar, and what steps to follow to keep diabetes or another health condition from sidelining you for longer than necessary.
Last medically reviewed on January 21, 2022









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Newcastle single mum of three dies suddenly after eating snack with peanuts – Daily Mail

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By Aidan Wondracz For Daily Mail Australia
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A single mother-of-three who was allergic to peanuts died suddenly after unknowingly eating a snack containing the allergen.
Hanna Scigala, 31, suffered a fatal anaphylactic attack after eating the snack at her home in Newcastle, on the NSW coast, on January 4.
Her condition spiralled quickly and she went into cardiac arrest, suffered brain swelling and was declared brain dead before passing away on January 7. 
She leaves behind a 12-year-old, nine-year-old and three-year-old boy who will now be looked after by their grandparents. 
A single mother-of-three who was allergic to peanuts died suddenly after unknowingly eating a snack containing the allergen
Hanna Scigala, 31, suffered a fatal anaphylactic attack after eating the snack at her home in Newcastle, on the NSW coast, on January 4
Her death has come as a complete shock to the family who say the single mother was always careful with the foods she ate.
Ms Scigala had been with her three children at home when she started to feel peckish and she reached for a snack. She had no idea it contained traces of peanuts.
The single mother immediately recognised the signs of an allergic reaction and rushed down the stairs and into the garage for the Epipen she kept in her car.
She administered the dose of adrenaline before calling an ambulance while her horrified nine-year-old son phoned family to come and help.
A neighbour managed to perform CPR until paramedics arrived and wheeled her into an ambulance.
Ms Scigala went into cardiac arrest on the way to hospital but paramedics were successfully able to treat her. 
But her condition continued to deteriorate the following day with the single mother suffering from brain swelling before she was declared brain dead on January 6.
Her devastated sister Stephanie as ‘inspiring’ and ‘very fun to be around’.
She leaves behind a 12-year-old, nine-year-old and three-year-old who will now be looked after by their grandparents
‘As a mum, I think her favorite thing to do was to introduce the kids to new things so they could develop new interests,’ she said.
‘Whatever she could think of or saw that she thought they might like she’d get them involved. She’d put them before anyone else.’
Stephanie has launched a GoFundMe to raise money for her children. The campaign was set up to raise $7,000, but has already drawn in $29,792 in donations. 
‘With their grandfather retired and grandmother working only part time, this go fund me has been made in hopes to help them be able to financially provide for their grandchildren,’ Stephanie wrote.
‘These funds will also go towards funeral arrangements and any other memorial type of function.’
Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group

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