Diabetes Archive

Infections from a drug-resistant fungus have been occurring around the world for the past decade. It's not cause for panic, but it's wise to understand the facts and ways to protect yourself.

Ask the doctor

Q. I think I have heartburn, but I hear that what feels like heartburn is sometimes a more serious condition. How do I know if I have heartburn?

A. You've asked an important question. "Heartburn" describes symptoms caused by the reflux of stomach acid up into the esophagus (the tube that carries food from the mouth down to the stomach). It is a burning sensation. You can feel it high in the abdomen, just below the bottom of the breastbone, or underneath the middle of the breastbone in the chest. In other words, despite the word "heart" in the word "heartburn," real heartburn comes not from the heart, but from the stomach and esophagus.

Arthritis, bunions, and gout can be disabling. Here are common fixes to stay mobile.

Aching hips, knees, and shoulders are common, and over time can lead to immobility. But so can an aching big toe. The joint at the base of the big toe — called the metatarsophalangeal or MTP joint — is the part of the toe that is affected.

What's the MTP joint?

The MTP joint connects the first long bone (metatarsal) in the forefoot to the first bone of the big toe (phalanx). The joint bends with every step you take, so that you can push off and let the other leg move forward. But the MTP joint takes a beating during that process: for a brief moment as you push off, the MTP joint supports half of your body weight.

Research we're watching

A near-daily serving of nuts may lower the risk of cardiovascular disease in people with type 2 diabetes, new research suggests. The study, published online February 19 by Circulation Research, relied on diet surveys from more than 16,000 people before and after they were diagnosed with type 2 diabetes, a condition that elevates the risk of heart disease. Researchers asked them about their nut-eating habits over a period of several years. People who ate five servings of nuts per week had a 17% lower risk of cardiovascular disease compared with those who ate less than a serving per week.

Chock full of unsaturated fat, fiber, and minerals, nuts can help control blood sugar, blood pressure, and cholesterol. Tree nuts, which include walnuts, almonds, and pistachios, seemed to offer the strongest benefits in the study. Peanuts, which aren't technically nuts but legumes, weren't quite as healthy. While this study can't prove cause and effect, eating a small handful of unsalted nuts on most days will likely help your heart, even if you don't have diabetes.

On call

Q. After I have a bowel movement I sometimes get quite weak and have to lie down until the feeling passes. Why does this happen and is it cause for concern?

A. The sensation you are describing is most likely due to a reflex called a "vasovagal reaction." Here's what I mean.

Peripheral artery disease is serious but preventable.

As people get older, they sometimes shrug off painful cramping in their calves when they walk as a sign of age or overexertion. But it can be a symptom of a more serious condition known as peripheral artery disease, or PAD.

PAD is a condition in which fatty deposits collect in arteries outside the heart — most commonly in the legs — and reduce blood flow in that part of the body. Doctors used to think PAD mostly affected men, but when researchers began to include more women in their studies, they learned that the condition is just as common in women, affecting one in every 10 women over age 50 and one in every five over age 60, says Dr. Aruna Pradhan, a cardiologist and assistant professor of medicine at Harvard Medical School.

Research we're watching

Sleep has long been known to help protect you against heart disease, and researchers now think they know at least one reason why. A study published online February 13 by the journal Nature looked at how sleep duration and quality relates to the buildup of damaging plaque in the arteries.

Harvard Medical School researchers found that a lack of good sleep boosts the body's production of inflammatory white blood cells that earlier research has linked to fatty buildup in the arteries. This could help explain why sleep problems can lead to arterial buildup. Poor sleep is linked not only to clogged arteries, but also to a host of chronic health conditions, such as cancer, obesity, and diabetes — all good reasons to make sure you get your z's.

Q. I have read that people who have had their gallbladders removed should take bile salts. My gallbladder was removed many years ago, and no doctor has said I should take bile salts. Should I?

A. Bile salts are produced in the liver, secreted into the bile ducts and gallbladder, and sent from there to the small intestine by way of the common bile duct. In the intestine, bile salts make it easier for your body to absorb and digest the fats and fat-soluble vitamins that you've eaten. Remember, not all fats are bad: there are "good" fats, and they are crucial to our health.

Q. For years, I have had recurrent cold sores and took antiviral drugs to treat the outbreaks. A friend suggested that I take daily lysine.  What's the evidence that it works?

A. Cold sores (sometimes called fever blisters) are painful fluid-filled lesions on or near the lips that are caused by the herpes simplex virus (HSV). There are two kinds of HSV: HSV-1, which causes most cold sores, and HSV-2, which is mostly responsible for genital herpes. HSV-1 infection is very common and easily transmitted by kissing or other contact with saliva. Once you're infected, the virus lays dormant in the nerve cells that supply sensation to the skin. When the virus becomes active, it travels to the skin surface and multiplies, causing an outbreak.

Q. You wrote about weak, brittle fingernails with longitudinal ridges. I have strong nails with horizontal ridges. What causes this, and what can I do about it?

A. You may be referring to Beau's lines, which are grooves that run horizontally across the nail plate. They usually develop when nail plate growth, which begins in the nail matrix (located under the cuticle), is temporarily disrupted. This can occur with direct injury to the nail matrix; an inflammatory condition such as psoriasis; infection around the nail plate; repetitive picking at the nails or cuticles; or even a manicure. Systemic causes include a common side effect of chemotherapy, nutritional deficiencies, illnesses accompanied by high fever, metabolic conditions, and diminished blood flow to the fingers (from Raynaud's phenomenon, for example).