03 Feb 2015

Statement from Rauner General Counsel on Issuance of Medical Marijuana Licenses and Permits

By Catherine Kelly

Statement attributable to Jason Barclay, General Counsel, Office of the Governor:

Governor Rauner directed our legal team to conduct a comprehensive review of the evaluation and selection process that the Quinn administration used to recommend applicants for licensure in the State's Medical Cannabis Pilot Program.

His request was threefold.  First, determine whether the process used by the Quinn administration followed the law.  Second, share our findings with the Attorney General and determine what, if any, corrective actions need to be taken for any failures to fully comply with the law.  Finally, recommend a plan of action that corrects any deficiencies and fully adheres to the spirit and letter of the law.

Our recently completed legal review identified four potential problem areas:

1)      The review teams imposed certain arbitrary scoring "cut-offs" that were not expressly contemplated or provided by law that effectively eliminated certain applicants from consideration;

2)     The agencies conducted a character and fitness review of the applicants after the blind scoring process had been completed;

3)     As part of the character and fitness review, several applicants were disqualified without clear procedures and standards for disqualification and without offering the prospective applicants an opportunity to respond to the information that was relied upon to make the disqualification decisions; and

4)     Despite seemingly contradictory language in the rules promulgated by the Illinois Department of Agriculture, the prior administration decided to award no more than one cultivation center license to applicants who were the high point scorers in more than one district.

We concluded that these problem areas create a risk of substantial and costly litigation to the State.  We shared our findings and this conclusion with the Attorney General.  Her staff conducted a prompt review and for that we thank them.

As a result of our consultation with the Attorney General, we have further concluded that there is a significant likelihood that the Quinn Administration's decisions will not be upheld in court.  We have also relied upon the Attorney General's legal guidance and must now take all necessary corrective action to make sure that these licenses and permits are properly issued in compliance with the law.

As a result of these conclusions, we are therefore recommending the following actions:

1)      Licenses and permits will be issued to the highest scorers in each district where the top scorer was not disqualified;

2)     Cultivation center applicants that were high scorers in more than one district will be awarded permits up to the three permit limit that was expressly provided by 8 Illinois Administrative Code (the "IL Department of Agriculture Rules") Section 1000.40(d);

3)     The artificial and subjective scoring "cut-offs" that were imposed by the agencies will be eliminated and licenses and permits will be awarded to the high scorers in those districts regardless of their final point total; and

4)     Any applicant that was recommended for disqualification will be fully informed of the basis for that decision, given an opportunity to respond in writing and/or in-person to the respective licensing agency's director and general counsel to contest the recommendation, and a final written character and fitness decision will be made consistent with the relevant pre-established formal standards established by the IL Department of Agriculture Rules Section 1000.110(j) or 68 Illinois Administrative Code (the "IL Department of Financial and Professional Regulation Rules") Section 1290.70(e) - (f).

These actions may result in some additional minimal delay in a limited number of districts and for that we apologize to the patient community.  The Governor has requested that this process must be deliberate, fair, and fully comply with the law.  In order to accomplish those important objectives, these additional steps are essential to correct the deficiencies of the previous administration's selection process.  Only then can the public have the fullest confidence that the law was followed and these licenses and permits were awarded for the right reasons.

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02 Feb 2015

Type 2 Diabetes and Erectile Dysfunction

By Everyday Health
There is a confirmed link between erectile dysfunction and type 2 diabetes, but the right diabetes treatment could lessen the chance you'll have problems with impotence.

Diabetes doubles or even triples the chance that you'll have erectile dysfunction (ED) and that you could develop it a decade earlier than other men. In fact, the two conditions are so closely linked that some experts believe that for men younger than 45, impotence, or ED, could be an early warning sign of diabetes. The good news is that diabetes treatment, especially if you identify type 2 diabetes early, can also ease ED.

Connecting Erectile Dysfunction and Type 2 Diabetes

At first glance, it's not obvious why higher than normal levels of blood sugar would cause erectile dysfunction. However, the relationship is undeniable: Somewhere between 20 and 75 percent of men with diabetes also have erectile dysfunction.

The problem is that uncontrolled high blood sugar damages the blood vessels, big and small, throughout your body. The blood vessels in the penis are already very tiny, so when uncontrolled diabetes starts to undermine your blood vessels, your penis may experience the consequences early on.

And diabetes affects more than the blood system. "Diabetes also results in nerve dysfunction and, in the penile shaft, [eventually] the muscle starts to atrophy and is replaced by scar tissue or collagen rather than smooth muscle. That's the ultimate end result in men," explains urologist Ajay Nehra, MD, professor of urology at the Mayo Clinic in Rochester, Minn. That scenario ? damage to all the tissues that support your penis ? is what could happen if you do not get and keep your diabetes under control.

Are You at Risk for Impotence?

Knowing your risk factors will help you make the best health decisions. Men who are most at risk for erectile dysfunction related to type 2 diabetes:

  • Have high blood sugar (glucose)
  • Know they have diabetes, but are not meeting the goals for their A1C, or average glucose results
  • Have high cholesterol
  • Have high blood pressure
  • Have low testosterone
  • Are overweight or obese
  • Are 40 or older
  • Smoke cigarettes
  • Do not exercise

Breaking the Erectile Dysfunction-Type 2 Diabetes Link

Having diabetes doesn't mean you have to live with erectile dysfunction. The right diabetes treatment can help. Follow these guidelines:

  • Get your diabetes under control. According to Dr. Nehra, the most important number you need to stay on top of is your A1C, which is a blood test that lets you know how well your blood sugar has been controlled for the past few months. Lifestyle changes can help and so can medications. Diabetes medications do not add to your risk for erectile dysfunction, says Nehra.
  • Maintain a healthy lifestyle. Eating a well-balanced, nutritious diet and getting enough exercise will help both your diabetes and your erectile dysfunction.
  • If you smoke, quit.
  • Maintain a healthy weight. If you're overweight or obese, losing even a small percent of your body weight will help control diabetes. Obese men might also benefit from gastric bypass surgery, which has been shown to relieve both erectile dysfunction and diabetes in some patients.
  • Seek treatment for erectile dysfunction. There are many ways to treat erectile dysfunction, including pills, injections, vacuum pumps, and surgery. Talk to your urologist about what you can do for erectile dysfunction even while you are working to control your diabetes.
  • Get heart disease risk factors under control. Work with your doctor to lower blood pressure and high cholesterol, both of which can contribute to erectile dysfunction.

The connection between impotence and diabetes is undeniable, but that doesn't mean you have to accept this outcome. Taking steps to control your diabetes and reduce erectile dysfunction will improve your quality of life.

 

02 Feb 2015

6 Healthy Habits To Implement In February, American Heart Month.

By Ginny Grimsley
Misconceptions Are Among The Greatest Obstacles
For Heart Health, Says One of the 'Best Doctors in America'*

Despite decades of medical research and public campaigns to ease the problem, heart disease is the No. 1 killer in the United States and throughout the Western world.

One of the problems driving heart disease is the messaging, says Robert Thompson, M.D., an integrative medicine specialist deemed by his peers to be in the top 5 percent of U.S. physicians. While there's plenty of good research to indicate good advice, the general public, and many of his peers in the medical community, are stuck with faulty conclusions, he says.

"Perhaps the biggest misconception is that an overabundance of calcium, which may include supplements, is very good for people, especially women, but that's simply not true," says Thompson, author of "The Calcium Lie II: What Your Doctor Still Doesn't Know," (calciumliebook.com), a new book that details the roles minerals play in overall health and how to identify and correct deficiencies and imbalances.

Calcium is just one of 12 substances, as well as traces of 64 other minerals, that make up our bones. Excessive amounts of calcium hurt our bodies in many ways, especially the heart and the brain, he says. We cannot possibly replace minerals with just calcium, which hardens concrete and makes bones more brittle.

One study, published in the British Medical Journal in 2008, was meant to assess the effect of calcium on bone density and fractures in postmenopausal women. Researchers found that participating women were significantly more likely to suffer heart attacks while taking calcium supplements.

"This is far from an isolated study - there are others, including 15 studies combined into a meta-analysis yielding similar heart-health results, which show an increased risk of heart disease by at least 30 percent," says Thompson, who offers practical recommendations for what individuals can start doing for better overall health in recognition of American Heart Month, celebrated in February.

•  Drink at least 64 ounces of water a day. As a general rule, we need to drink half of our bodyweight in ounces of water daily. For a 150-pound individual, that's 75 ounces of water. Those who are overweight, or are heavy exercisers or live in warm climates may need more. Take care to drink quality water. Get a quality filtration system at home, which can range from $200 to $3,000.

•  Take ionic sea salt-derived minerals. We all need a diverse range of minerals and virtually none of us get enough. Ionic minerals are the only ones that are completely available for our bodies to use because they are water-soluble and they naturally carry an electrical charge that allows them to be carried through the cell membranes. All sea salt-derived trace mineral products are recommended - at least three grams per day.

•  Use only vitamin supplements made from 100 percent organic whole foods that have been vine-ripened. Almost all of us need supplements because contemporary food supplies lack adequate amounts of vitamins and minerals, thanks to soil depletion. Most store-bought vitamins include just one component of the many complex molecular elements contained in the naturally occurring vitamin source. You need all of the nutrient components to get the full benefits.

•  Get your fill of essential fatty acids; raw nuts and/or seeds are a good source. In 2003, the Food and Drug Administration approved the following health claim for seven kinds of nuts: "Scientific evidence suggests but does not prove that eating 1.5 oz. per day of most raw nuts as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease." Omega-3 and Omega-6 are considered essential because humans can't manufacture them within our bodies. Research has now shown that plant-derived Omega 6, and not fish oil, is the best oil for humans.

•  Eat high-quality proteins. Seafood, eggs, beans, chicken, game meat, duck and turkey are excellent sources of essential amino acids that are the building blocks of every protein molecule, hormone, neurotransmitter, cell membranes and immune molecules. Proteins can also be obtained from grains, sprouted grains, raw nuts and raw seeds. Vegetarians and vegans need to play close attention to combine protein sources to get the full complement of amino acids.

•  Walk at least 30 minutes every day. This activity has a huge effect on relieving the physiologic effects of stress on the human physiology. Exercise is good, but walking is amazing. No other single activity will more significantly or more rapidly affect the adrenal stress response in humans than walking, which probably works so well because it slows us down. And, it is an incredible way to build relationships.

"Also, I recommend ingesting essential monosaccharides, which is new and unknown territory for most people," he says. "They are the simplest form of carbohydrate molecules found in the body, are essential for protein molecules and can be found in maple syrup, sweet potatoes, parsnips, beets and onions."

*Robert Thompson, M.D., was added to the peer-reviewed directory, "Best Doctors in America," in 1996.

About Robert Thompson, M.D.

Dr. Robert Thompson is a board-certified obstetrician and gynecologist, and a nutrition specialist who helps patients get long-term relief from chronic disease, including obesity, diabetes, hypothyroidism and adrenal fatigue. His newest book, "The Calcium Lie II," is available for free at calciumliebook.com. Dr. Thompson received his medical training at the University of Kentucky and has been a leader in medical advances for more than 30 years.

02 Feb 2015

5 Ways to Prevent Diabetes Complications

By Karen Appold
Controlling blood sugar is key to managing diabetes and preventing diabetes complications. Get tips to protect your health and reduce health risks.

Having diabetes can result in many other complications, such as damage to the heart, nerves, kidneys, feet, eyes, and skin. If you have diabetes, you may also have a greater risk for osteoporosis, cancer, and Alzheimer's disease. Some diabetes complications are related to high or low blood sugar, while others are related to how long you've had diabetes.

The best way to mange diabetes and avoid diabetes complications is by monitoring your blood sugar (glucose) with a glucose meter, or glucometer. "How often you monitor your blood sugar depends on the type of diabetes you have, if you have diabetes complications, and your diabetes treatment plan," says Amber Taylor, MD, director of diabetes at The Center for Endocrinology of Mercy Hospital in Baltimore, Md.

Tips for Controlling Blood Sugar

Spyros G.E. Mezitis, MD, PhD, an endocrinologist at Lenox Hill Hospital in New York City, suggests these general healthy-lifestyle habits to make controlling your blood sugar easier:

  • Follow a low-fat, low-salt, low-carbohydrate diet.
  • Pass on processed foods.
  • Do at least 20 minutes of aerobic exercise three times a week.
  • Lose weight if you're overweight.
  • Take any and all diabetes medications as prescribed.
  • Following your insulin treatment program if needed.

Work with your own doctor to personalize this general plan. "There isn't a best way to manage diabetes ? the right approach is the one that works well for you," Dr. Taylor says. "Different people with diabetes need different treatment plans, and test results are used to watch for and prevent complications."

There are many diabetes testing and management tools available to you for monitoring your blood sugar, such as glucometers, insulin pumps, and continuous glucose monitors.

At your doctor's office, the A1C test is an important way to measure your average blood sugar control for the prior three months and gauge how good of a job you're doing at home. "The A1C target for most people with diabetes is less than 7 percent, which is the lowest risk for complications from high blood sugar," she says. "Some people, especially younger adults with diabetes, may have an even lower target to help prevent diabetes complications long-term."

The A1C test is used to:

  • Confirm that other test results, such as those done by self-testing or by your doctor, are accurate.
  • Show if your treatment plan is successful.
  • Demonstrate that healthy diet and lifestyle choices can make a difference in controlling your diabetes.

Minimizing Diabetes Complications

The best way to prevent most diabetes complications is to see your doctor regularly, and to call him or her if you experience any new symptoms. Some complications, such as eye disorders, occur after many years of diabetes. "It's essential for people with diabetes to see an eye doctor at least once a year whether they have vision problems or not," Taylor says. "Ophthalmologists have tools to stop retinopathy and other diabetes-related eye disorders from progressing."

Good self-care and immediate medical attention for even a minor symptom are important steps in preventing the type of amputations often associated with diabetes. For instance, you can help to prevent foot ulcers by practicing good foot care, but if an ulcer develops, see your doctor or a foot specialist (podiatrist) immediately. "Even small foot ulcers can grow quickly and lead to infection," Taylor advises. Infections that resist treatment can lead to amputation to stop their spread.

Follow these other steps to better manage your diabetes and help prevent diabetes complications:

  • Make and keep all needed check-ups with your doctors and others on your diabetes team.
  • Keep your immunizations up to date to fight infections.
  • Wear a diabetes tag or ID bracelet so that you receive the right treatment in an emergency.
  • Have a glucagon kit handy in case of a low blood sugar emergency.
  • Take care of your skin and your feet to prevent infections, and check for any signs of infection every day.

"It's easy to become overwhelmed with all this information," Taylor says. "When you think of questions, write them down and bring them to your next visit with your doctor. Advocate for yourself, know your targets for A1C, blood pressure, cholesterol, and weight, and do everything in your power to achieve these goals."

30 Jan 2015

Get Covered Illinois and TPQC will be hosting several Valentine's Pizza and Enrollment Parties in Rock Island County

By Kendra Smith

The Affordable Care Act's Health Insurance Enrollment period is nearing the end. To help Rock Island County residents enroll in health insurance plans by the February 15th deadline, this Saturday, January 31st Get Covered Illinois and TPQC will be hosting several Valentine's Pizza and Enrollment Parties in Rock Island County. Events are scheduled from12:00pm to 3:00pm at the Moline Township Office (620 18th St., Moline, IL), and 12:00 pm to 3:00 pm at the Rock Island Township Office (2827 7th Ave. Rock Island, IL).

Each location will have Illinois certified In-Person Counselors available to help with questions and concerns about health insurance plans, as well as enrollment and website navigation. Our goal is to help people get enrolled by the February 15th deadline, and with the upcoming tax season, we want make sure that people are informed about penalties and exemptions.

This is an open invitation for all Rock Island County residents to learn more about their expanded options for health insurance coverages. There is no cost for attendees and there will be great give away prizes and snacks for all.

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30 Jan 2015

Senior Star at Elmore Place Hosts Heart Health Presentation

By Christina L. Maggio-Kellerstrass

American Heart Month offers additional educational opportunities for Quad Cities' residents

 

 

DAVENPORT, IA (January 29, 2015) - Senior Star at Elmore Place will host an informative presentation in recognition of American Heart Month at 1 p.m. on Tuesday, February 10 at 4500 Elmore Avenue.

Presented by Diane Heath, representative of the Quad Cities local chapter of the American Heart Association, discussions will focus on ways to make lifestyle changes that reduce the risk of cardiovascular disease and stroke.  Having this information on hand is vital to a healthy lifestyle as, according to the American Heart Association and the American Stroke Association websites, heart disease is the number one leading cause of death in the United States.  Additionally, one of every three deaths in the United States is caused by heart disease and stroke, 56% of adults have been told by a healthcare professional to improve their health and 60% of adults don't know their blood pressure or cholesterol numbers.

"These statistics and a number of other astonishing facts listed on the American Heart Association and American Stoke Association websites shed light to why education is important," said Marc Strohschein, executive director of Senior Star at Elmore Place.  "As a community that's all about education, we strive to provide our residents and our greater Quad City friends with the tools to age well.  Hosting seminars such as this will be part of a year-long healthy aging initiative that brings attention to a proactive approach to living well."

Please RSVP no later than February 9 by calling 563.484.5114.

For more information about Senior Star at Elmore Place or to schedule a tour, call 563.484.5114 or visit the website at www.seniorstar.com.

30 Jan 2015

Heart-Smart Tips for People With Diabetes

By Everyday Health

Heart disease and stroke are the top causes of death and disability in people with diabetes. Heart-attack symptoms may be severe and appear suddenly or they may be subtle, with only mild pain and discomfort.

If you experience any of the following heart-attack warning signs, call 911:

  • Chest discomfort that feels like pressure, squeezing, fullness, or pain in the center of your chest and that lasts for a short time or goes away and returns
  • Pain elsewhere, including the back, jaw, stomach, or neck; or pain in one or both arms
  • Shortness of breath
  • Nausea or lightheadedness

Diabetes, High Blood Pressure, and Stroke

The American Diabetes Association (ADA) reports that as many as two out of three adults with diabetes have high blood pressure. Because of the risks that accompany high blood pressure, the ADA and the National Institutes of Health suggest a lower blood-pressure target for people with diabetes (less than 130/80 mmHg) than they recommend for the general public.

You can control your blood pressure with lifestyle changes, such as diet, exercise, and medication. (Sound familiar?)

Blood pressure ? also called hypertension ? raises your risk for heart attack, stroke, eye problems, and kidney disease. Having your blood pressure checked regularly and taking action to reach your target blood pressure can prevent or delay complications caused by high blood pressure.

It's also important to recognize the symptoms of a stroke. As with a heart attack, immediate emergency treatment can mean the difference between life and death. Call 911 if you suddenly experience any of the following stroke symptoms:

  • Sudden numbness or weakness in the face, arm, or leg, especially if it occurs on one side of the body
  • Feeling confused
  • Difficulty walking and talking and a lack of coordination
  • Developing a severe headache for no apparent reason

Next step: Nerve Damage and Infection

30 Jan 2015

LCS and CareSouth Strengthen Partnership

By Jeri Uhlmansiek
DES MOINES, Iowa, Jan. 29, 2015 (GLOBE NEWSWIRE) -- LCS(R) announced that CareSouth exercised its option to increase its ownership interest to 70 percent of the Health at Home(TM) joint venture partnership, one year ahead of the deadline which was set for the end of the year, 2015.

"CareSouth and Health at Home are now full-fledged members of the LCS communities," says Ed Kenny, chairman and CEO of LCS. "Health at Home clients are afforded access to a wealth of knowledge and expertise that will serve our communities well in the years to come. A strong commitment to quality care and superior training ensure that our clients receive the best care possible. We are extremely pleased and fortunate to have the opportunity to partner with CareSouth."

In July 2013, CareSouth entered into a joint venture with LCS. As part of this joint venture arrangement, CareSouth jointly owned the homecare division of LCS (Health at Home), with LCS owning the larger portion. CareSouth, however, has been responsible for all of the day-to-day operations of Health at Home in LCS senior living communities.

"Our first year with LCS and Health at Home has been a tremendous success," says Rick Griffin, president and CEO of CareSouth. "In addition to providing additional services to the 17 existing Health at Home locations operating at the time of our initial partnership, we have further expanded in Dallas and Fort Worth, Texas,  serving six additional LCS communities. We attribute this success to the true partnership of Health at Home and the LCS communities and to the strategic implementation of the CareSouth Advantage through Health at Home. Our investment is a commitment to LCS and to the communities. We did not want to wait another year to make a total commitment to this partnership and to the residents of the LCS communities we serve."

The CareSouth Advantage is a disciplined approach to the development and growth of synergy within every part of the CareSouth organization using consistent processes and practices. It includes the execution of a client-first service excellence program, ongoing development of and training for advanced clinical programs and services, combining clinical in-home services with the latest in technological advances in health care and development, and implementation of documented strategies of best practices within each department, agency and branch.

About CareSouth

CareSouth holds the position of 12th largest market share in the US among all providers of Medicare certified home health and also provides other non-acute health services. The company has been providing quality, compassionate in-home care services for more than 20 years. Its home health agencies consistently rank in Home Care Elite(TM) among the top 25 percent of home health agencies in the country. In addition to almost 60 CareSouth locations across the mid-Atlantic and Southeastern regions, including home health, hospice and private duty care, the company maintains joint ventures and partnerships in more than 20 locations across the country. For more information about CareSouth, visit caresouth.com.

About LCS

Based in Des Moines, Iowa, and established in 1971, LCS is a leading provider of high-quality senior lifestyle products and services. The LCS Family of Companies provide development, management, marketing and sales, and strategic planning for continuing care retirement communities (CCRCs), stand-alone assisted living, memory care, and rental communities nationwide. The company also provides in-home care, insurance, and national purchasing consulting services. LCS companies serve 33,000 seniors. Life Care Services(TM), An LCS Company is the nation's third largest management company. LCS is an equal opportunity employer hiring skilled and professional employees to better serve the customer. For more information, visit LCSnet.com.
30 Jan 2015

Nursing Home And Assisted-Living Expenses Can Decimate Retirement Savings

By Ginny Grimsley
Seniors Need To Educate Themselves About Ways To
Protect Their Nest Eggs, Financial Advisor Says

People pondering their retirement years often conjure images of spending more time on a favorite pastime or traveling around the country or the world.

Health concerns can intrude on those idyllic scenes, though, not only affecting enjoyment of life but also punching a heavy dent in retirement savings.

"As we age, usually our medical or long-term care expenses increase, sometimes depleting our assets to a level of crisis," says financial advisor Jake Lowrey, president of Lowrey Financial Group, (www.lowreyfinancial.com).

"It's important for retirees, and anyone planning for retirement, to become educated about what the pitfalls are and what they need to do to avoid losing their life savings."

Long-term care especially can burn a hole in savings accounts. In 2012, for example, nursing home care averaged $74,800 a year, according to a report by the Henry J. Kaiser Family Foundation.

Meanwhile, assisted living facilities averaged $39,500 per year, and home-health services averaged $21 per hour.

More than 10 million Americans need some sort of long-term care, the Kaiser report said. That number covers all ages, even children, but about half are people 65 and older.

"Those older Americans had looked forward to enjoying their golden years," Lowrey says. "They should be able to have actual golden years instead of what can end up being scary years, both personally and financially."

Certainly, being able to maintain good health is a key factor in protecting savings and making retirement enjoyable and satisfying, he says.

But life doesn't always work out that way. Fortunately, there are strategies seniors can use to lessen the impact of expenses brought on by long-term care needs. Lowrey says some of those include :

•  VA benefits. Military veterans may be able to offset nursing home or assisted-living expenses through benefits provided by the U.S. Department of Veteran Affairs. A veteran's eligibility for long-term care services would be determined based on his or her need for ongoing treatment, personal care and assistance, as well as the availability of the service in the area where the person lives, according to the Department of Veteran Affairs.

Other factors, such as financial eligibility, a service-connected disability, insurance coverage, and/or ability to pay may also come into play.

•  Medicaid compliant SPIAs. A SPIA is a single-premium immediate annuity. Typically, a SPIA is a contract with an insurance company where you pay the company a sum of money up front (the premium), and the company promises to pay you a certain amount of money periodically for the rest of your life.

A Medicaid compliant SPIA is a specially designed annuity that pays out over the person's "life expectancy" and has other specific characteristics. A couple who put money in a Medicaid annuity are able to avoid having the income from that annuity count against the financial assistance a spouse receives for nursing home care.

•  Setting up a trust. Trusts can help shelter wealth from the look-back periods in Medicaid requirements and assist in qualifying for VA programs, among other advantages, Lowrey says.

About Jake Lowrey

Jake Lowrey is a financial consultant and president of Lowery Financial Group, (www.lowreyfinancial.com), an ethical and professional firm that guides clients to retirement success, including planning for long-term care needs. As a relationship-driven organization, Lowrey and his team educate clients about the newest, most progressive retirement and long-term care planning strategies to assure a brighter financial future.

30 Jan 2015

Avoid These Diabetes Risks Common in Older Adults

By Everyday Health

What are some of the most common health concerns among aging type 2 diabetics, and how can they be managed?

By Dr. Sanjay Gupta

Type 2 diabetes can lead to serious health complications, and older people with the disease are especially vulnerable. The American Diabetes Association (ADA) estimates roughly 27 percent of people 65 years of age and older have diabetes, and studies have shown that the highest rates of diabetes-related heart attacks, kidney failure, and amputations are among older adults.

According to a 2012 report published by the ADA and the American Geriatrics Society, "diabetes in older adults is linked to higher mortality, reduced functional status, and increased risk of institutionalization." But many complications can be delayed or even prevented with treatment and lifestyle changes. Here are some of the most common health concerns among aging type 2 diabetics.

Limited Mobility

Everyone knows physical activity is key to overall health, especially for people with diabetes. Exercise helps regulate weight, improve cardiovascular health, and strengthen bones and muscle. A recent study in New Zealand suggests that short bursts of exercise before  main meals may help control blood sugar levels. But aging can often limit mobility and physical activity, even for people accustomed to exercising.

Sam Penceal, 69, was diagnosed with diabetes almost 15 years ago. A former college basketball player, he was able to quickly jumpstart his fitness routine to help manage the disease. Though he still exercises three to five times a week, Penceal admits he now needs more time for his body to rest.

"I realize that I have to give my body more time to recoup," said Penceal, who sits on the executive committee of the ADA's Step Out Walk NYC and is captain of his Step Out Walk team. "If I exercise heavily two days in a row, it's important I give my body a day of rest."

If a person does not have a history of consistent exercise, precautions should be taken before beginning a new regimen.

"Because the risk of heart disease is higher in diabetic patients, I recommend those in the aging population talk with their physicians or even go through an exercise stress test to make sure their heart is okay for physical activity," said Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic.

Diabetics are at a greater risk for joint and bone disorders, which can impact their ability to exercise. Dr. Hatipoglu recommends working with your doctor to come up with an individualized exercise plan, which should include walking and light weight training to help with balance.

Falls and Fractures

The risk of falls and fractures is a normal part of aging, but mobility problems associated with diabetes raise the risk even higher.

Hypoglycemia, or low blood glucose, can cause symptoms including shakiness, weakness, and lack of coordination. Hyperglycemia, or high blood sugar, can cause dehydration, leg cramps, and imbalance.

Hatipoglu stresses the importance of a safe home environment complete with non-slip rugs, bed rails, and grab-bars in the shower and bathroom.

Vision and Hearing

People living with diabetes have a much higher risk of eye complications, including glaucoma and cataracts, and the risk increases with age. Retinopathy, a disorder of the retina, is also common.

There are treatment options available, but the condition needs to be caught as early as possible. "It's very important for elderly diabetics to have regular checkups with their ophthalmologist, especially if they are driving or working," Hatipoglu said.

Hearing loss is twice as common in people with diabetes as it is in those who don't have the disease. The reason for the increased risk is unclear, though it may be that diabetes damages nerves and blood vessels of the inner ear. If you suspect hearing loss, talk to your doctor.

Mental Health

"The lifestyle modification that comes with type 2 diabetes has definite psychological effects," said Xavier Jimenez, MD, a psychiatrist at the Cleveland Clinic. The stress of diabetes management can take its toll on a patient's mental and emotional well-being. Studies show that people with diabetes have a much greater risk of depression, which can compromise their self-care and commitment to a healthy lifestyle.

Even patients who have been dealing with diabetes for a long time can become demoralized. "It's basically people saying they're sick and tired of being sick and tired," said Dr. Jimenez. "It's a little less severe than depression, but should still be addressed."

Diabetics may feel isolated from family and friends. Penceal emphasizes the importance of having a stable support system to help with the day-to-day challenges. "Find a group of people who are going through the same things you are," he said. "It can be difficult when your family doesn't have to go through the same diet and lifestyle changes you do. Join a support group to discuss those challenges."

Diabetes, especially type 2, may increase a person's risk for Alzheimer's disease or vascular dementia. Evidence suggests diabetes may lead to mild cognitive and memory problems that impact a patient's ability to manage their condition.

"If a patient keeps coming back with uncontrolled high blood sugar, instead of blaming them, we should sit back and ask ourselves, 'Could this be a sign of depression or dementia?' " said Hatipoglu.

Bladder and Bowel Dysfunction

Diabetic neuropathies are disorders that damage nerves all over the body. When the autonomic nervous system ? which controls the bladder, stomach, and intestines ? is affected, patients may experience problems with bladder and bowel function. Symptoms can include constipation, diarrhea, urinary tract infections, and incontinence.

"When you have urinary incontinence, you are at a much higher risk for infection and as a result hyperglycemia, which can cause more urinary leakage," said Hatipoglu. "It's a vicious cycle."

Hatipoglu urges patients to not be embarrassed. Report any changes in digestion and urination to your healthcare provider because early treatment is so important.

Drug Interactions

Older adults with diabetes may be taking several medications to manage multiple conditions, raising the risk for adverse interactions and side effects. Patients can become confused about dosages and what drugs are taken when.

The doctor should review all medications a patient is taking, even over-the counter drugs, at every visit. Hatipoglu suggests caregivers can help as well by writing down clear, easy-to-follow instructions.

"Writing down which medications to take and when in big letters is very helpful," she said. "You have to get creative and simplify things so they can follow the instructions."

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