Recently, a friend in the pharmaceuticals business asked me about SGLT-2 Inhibitors. He wanted to know what a nephrologist thought of the drugs, and I expressed strong misgivings about potential complications.
Physical health, mental health, and substance abuse problems often are more apparent in prisons than in the community, and many incarcerated men and women are often only diagnosed with these problems after receiving care from a correctional health provider. Correctional health care is also tasked with providing experienced management, technologically advanced services, and programs that control costs while ensuring quality of patient care.
Unfortunately, yes! Diabetes is the leading cause of new cases of blindness in adults ages 20-74 in the U.S. African Americans are two times more likely to have diabetic eye disease than Caucasian patients. Despite the risk of vision loss, only about half of people with diabetes follow the recommendation to receive a dilated eye exam every year.
Peripheral artery disease is a widespread and vastly underdiagnosed disease, affecting nearly 12 million Americans, mostly those over the age of 50, though the incidence increases with age. The most common symptom of peripheral arterial disease is claudication, which is pain, fatigue or aching in the legs when someone attempts to walk. This is due to the poor blood flow to the muscles in the legs. Beyond simply the discomfort in the legs, we know that having peripheral vascular disease makes one much more likely to have poor cardiovascular outcomes. Among patients with symptomatic peripheral arterial disease, more than 10% will have a stroke, heart attack, or die from a cardiovascular cause within two years. And when we look longer term, the statistics are even more sobering. For patients with symptomatic peripheral arterial disease, their mortality rate is 25% at 5 years and 50% at 10 years. When looking at patients with critical limb ischemia (those who have pain at rest or wounds on their feet), the numbers are even worse: they have a mortality rate of 50% at 5 years and 90% at 10 years.
Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.
Hard-to-heal wounds can be a problem for many people. One way that Medical West is offering treatment is through hyperbaric oxygen therapy at the Advanced Wound Center.
Hyperbaric oxygen therapy is the application of 100% oxygen that is applied to a patient under pressure. The therapy is used for decompression sickness, for infections, air pockets in blood vessels, and for diabetic wounds that won’t heal.
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