Diabetes Archive

Most people who are suffer from fecal incontinence do so in silence. As a result, the number of people with the condition — which results in the involuntary release of gas or stool — isn't known. But the scant evidence at hand indicates that it usually begins during one's 40s or 50s.

You don't have to live with incontinence — there are treatment options, which include dietary changes and bowel training regimens, and surgery for some people.

Those extra inches around the middle may signal increased fat around abdominal organs and rising health risks.

It's a rare woman over age 50 who has the same waist measurement she had as a teenager. But in the past decade or so, women's waistlines have been expanding regardless of age. A 2014 report from the National Health and Nutrition Examination Survey found that from 1999 to 2012, the average body mass index (BMI) for women age 20 or older held steady. But during the same period, the average female waistline grew slowly and steadily, from 36.2 inches to 37.8 inches. Researchers are still searching for an explanation for this phenomenon, but they do know one thing: increasing waistlines are linked to greater risks for heart disease, diabetes, and osteoporosis.

What's in a waistline?

Regardless of whether your weight has changed over the years, your height is likely to have decreased, the result of declining volume in the intervertebral discs of the spine. As your torso shortens, your abdominal organs have less vertical space to inhabit, so they move horizontally. If you haven't gained weight, an increase of an inch or two around the waist may simply reflect lost height.

This common type of arthritis can show up suddenly and cause debilitating pain.

 Image: © ThamKC/Thinkstock

The great artists Ludwig van Beethoven, Luciano Pavarotti, and Leonardo da Vinci had more than extraordinary talent in common; they were also sufferers of a type of inflammatory arthritis called gout. You may be at risk of joining their ranks if you have any potential triggers for the condition. "Most people are surprised by their initial gout diagnosis, unless they have a strong family history," says Dr. Mark Fisher, a rheumatologist at Harvard-affiliated Massachusetts General Hospital.

About gout

Gout is mostly a man's condition, although women can experience it, too. It's caused by a buildup of uric acid — a waste product from the breakdown of natural chemicals called purines (an essential part of DNA).

Because medications cannot effectively treat aortic stenosis, a stiff, narrowed aortic valve needs to be replaced.

Your aortic valve is the gateway between your heart and body. With every heartbeat, it opens to allow blood to flow to your body, then snaps shut to keep blood from moving back into the heart.

As people age, calcium deposits may collect on the hard-working aortic valve, causing it to stiffen and narrow. Known as aortic stenosis, this condition also can result from a genetic abnormality (see "What is a bicuspid aortic valve?"). But most cases are in older people, often — but not always — those with high blood pressure, high cholesterol, and other risk factors linked to heart disease. In the United States, about three to four of every 100 people ages 75 and older have severe aortic stenosis.

On call

Q. I have had a dandruff problem for years. I have tried selenium and zinc shampoos, as well as ketoconazole shampoo. Nothing has worked. Are there other options?

A. Dandruff, which is a chronic skin condition known as seborrheic dermatitis of the scalp, can range from a minor irritant to a severe rash of the entire scalp.

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

For people with diabetes, eating out — whether at a restaurant, a social function, or a friend's home — can be a challenge. Portions can be hefty and packed with calories and saturated fat. When you eat out, it may help to follow these simple guidelines:

• Ask how entrées are prepared, and avoid fried foods or dishes served in heavy sauces or gravies.
• Choose skinless chicken, fish, or lean meat that's broiled, poached, baked, or grilled.
• Get the server's advice to help you select healthy, low-fat dishes. Restaurants are used to dealing with special diets.
• Don't feel obliged to clean your plate. Eat a reasonable portion, and take the remainder home.
• Choose steamed vegetables and salads to accompany your meals. Request low-calorie dressings and toppings, and if they're not available, ask for all dressings, butter, and sauces to be served on the side so you can use them sparingly.
• If you take insulin and you know your meal will be delayed, time your injection appropriately. You may need to eat a roll or piece of fruit to tide you over.
• If you're craving dessert, have some — but split it with someone else.

For more information on the essentials for a healthy diet and managing type 2 diabetes, buy Healthy Eating for Type 2 Diabetes, a Special Health Report from Harvard Medical School.

Don't be surprised if your doctor doesn't rush you into treatment.

 Image: © iStock

Urinary tract infections (UTIs) can be tricky in older age. They're not always as easy to spot or treat as in youth. And the decades-long approach to treatment is changing. "We've been hasty in using antibiotics, and we're learning there are significant consequences that can range from side effects of medication to infections with antibiotic-resistant bacteria," says Dr. Helen Chen, a geriatrician at Harvard-affiliated Hebrew Rehabilitation Center.

About UTIs

UTIs can occur anywhere in the urinary tract. The most common places are the bladder (where urine is stored) and the urethra (the tube through which you urinate). Less common, but more serious, is infection of the kidneys, which filter waste and extra water from the blood and make urine. Infections may be triggered by sexual activity, catheters, kidney stones, decreased estrogen in the lining of the vagina, or urine that's pooled in the bladder.

News briefs

Red meat is associated with an increased risk for developing cardiovascular disease, diabetes, and some types of cancer. Now, a study published online Jan. 9, 2017, by the journal Gut suggests that eating red meat is associated with an increased risk for developing diverticulitis. This occurs when tiny pouches in the wall of the large intestine become inflamed, potentially causing cramps, diarrhea, constipation, and even rectal bleeding. We don't really know what causes diverticulitis, so researchers explored possible dietary links. They analyzed health and diet information reported by more than 46,000 men (ages 40 to 75) over 26 years. Men who ate the most red meat per week (about 13 servings) were 58% more likely to develop diverticulitis during the study period, compared with men who ate the least red meat per week (1.2 servings). The association was strongest for unprocessed red meat like steak. However, the risk for developing diverticulitis was 20% lower when people in the study substituted poultry or fish for a serving of unprocessed red meat each day. The findings don't prove that red meat causes diverticulitis, but other studies have suggested red meat may be a factor in diverticular disease.

In preliminary research, sucralose and acesulfame potassium increased insulin levels, although more studies are necessary to determine whether they—or other artificial sweeteners—increase the risk of insulin resistance.