Diabetes Archive

Ask the doctor

Q. I am scheduled for an electrical cardioversion for my atrial fibrillation. What should I expect?

A. Electrical cardioversion is a procedure to convert a fast or irregular heartbeat (such as what happens with atrial fibrillation, or afib) to a normal rhythm. Before the procedure, your cardiologist may recommend a special ultrasound test of your heart to check for blood clots. Cardioversion may dislodge any clots, which can be life-threatening. So if clots are found, the procedure may be delayed for a few weeks, so you can take blood-thinning medications to lower your risk of complications such as stroke.

Adults need an annual flu shot and a Tdap booster every 10 years. People over 60 need a shingles shot, and those over 65 should have two pneumonia vaccines.

Ask the Doctor

Q. I had a colonoscopy recently and it detected hemorrhoids. I don't have any symptoms. Should I be doing something to get rid of them?

A. Like you, approximately 40% of people with hemorrhoids have none of the common symptoms—bleeding, anal itching, and pain. Their hemorrhoids may be found on a routine physical examination or during a test done for other reasons, such as a colonoscopy for colon cancer screening.

For many women, bunions and rigidity are two of the most common—and painful—problems with the big toe. Both are easily treated.

Atrial fibrillation (afib) is affecting far more people than it did 50 years ago, according to a study published July 11, 2015, in The Lancet. Afib is an irregular heartbeat that makes the heart's upper chambers (the atria) quiver, rather than pump steadily. This can lead to the formation of blood clots, which can travel in the blood to the brain and cause a stroke. The Lancet study found that afib cases quadrupled from 1958 to 2007 among 9,500 people. But there is some encouraging news: the study also found that the risk of stroke associated with afib decreased 74% in the last 50 years, and the risk of death decreased 25%.

Why the ups and downs? Researchers point to epidemics of obesity and diabetes as part of the reason, as well as increased awareness of the condition and better detection methods. Meanwhile, improved recognition and treatment of other diseases, such as high blood pressure, may be helping to reduce the cases of stroke and early death linked to afib. So, this study provides further evidence of the importance of maintaining a healthy weight and keeping blood sugar, blood pressure, and cholesterol under control. In addition to reducing the risk of heart disease, stroke, diabetes, and other illnesses, you also reduce the risk of getting afib and developing complications from it.

Repeated nocturnal bathroom calls are bothersome, but self-help steps and targeted treatment offer relief.

Rising blood sugar signals a need for weight loss and more exercise.

Whenever you have routine blood tests at a physical exam, chances are one of the numbers will be a measurement of your glucose, or blood sugar. A normal blood sugar level is less than 100 milligrams per deciliter of blood (mg/dL) after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher. But between those two numbers lie many opportunities for action.

Q. My doctor used to check my liver function once a year after I started taking a statin drug to lower my cholesterol, but he doesn't anymore. Why not?

A. Your doctor appears to be following the latest recommendations from the American Heart Association and the FDA. When statin medications were first approved, doctors did periodic blood tests to check for liver injury. Three decades later, it is clear that serious liver injury from statins is a rare side effect and that routine blood testing does not help identify people at risk for statin-related liver problems. Therefore, routine monitoring is not a good use of money and time.

Boosting your fitness level may help decrease the symptoms of the most common heart rhythm disorder, according to a study published online June 22 by the Journal of the American College of Cardiology. The disorder—atrial fibrillation, or afib—causes an irregular, rapid heartbeat that can lead to shortness of breath, dizziness, and fainting.

The study included 308 people with afib who were also overweight or obese, a condition that raises the risk of afib. The participants answered questions about their afib symptoms and underwent tests to determine their fitness levels, which were described in metabolic equivalents, or METs. (METs measure your level of exertion and are based on how much oxy-gen your body uses during activities; sitting still is 1 MET, and brisk walking is 3.)

Ask the doctor

Q. What's the fastest way to get rid of a cold sore? Is it possible to prevent them?

A. Cold sores, also called fever blisters, are bothersome and painful fluid-filled blisters on or around the lips. They are caused by infection with herpes simplex virus (usually type 1). Cold sores heal on their own in seven to 10 days. However, antiviral medications can modestly shorten the healing period. One-day treatment with the prescription antiviral drugs famciclovir (Famvir) or valacyclovir (Valtrex) shortens cold sore symptoms by one to two days. These oral medications are most effective when taken at the first sign of a cold sore, such as a burning or tingling sensation. Antiviral creams are less effective and need to be applied several times daily for five days.