Living with Diabetes Mellitus

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). This is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel.

Lifestyle and Home Remedies

Type 1 diabetes can’t be prevented. However, the same healthy lifestyle choices that help treat pre-diabetes, type 2 diabetes and gestational diabetes can also help prevent them:

Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
Get more physical activity. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can’t fit in a long workout, break it up into smaller sessions spread throughout the day.
Lose excess pounds. If you’re overweight, losing even 7 percent of your body weight — for example, 14 pounds (6.4 kilograms) if you weigh 200 pounds (90.9 kilograms) — can reduce the risk of diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.

Sometimes medication is an option as well. Oral diabetes drugs such as metformin (Glucophage, Glumetza, others) may reduce the risk of type 2 diabetes — but healthy lifestyle choices remain essential.

Have your blood sugar checked at least once a year to check that you haven’t developed type 2 diabetes.

Alternative Medicine for Diabetes

Numerous substances have been shown to improve insulin sensitivity in some studies, while other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, there aren’t any alternative therapies that are currently recommended to help with blood sugar management.

If you decide to try an alternative therapy, don’t stop taking the medications that your doctor has prescribed. Be sure to discuss the use of any of these therapies with your doctor to make sure that they won’t cause adverse reactions or interact with your current therapy.

Additionally, there are no treatments — alternative or conventional — that can cure diabetes, so it’s critical that people who are receiving insulin therapy for diabetes don’t stop using insulin unless directed to do so by their physicians.

Coping and Support

Living with diabetes can be difficult and frustrating. Sometimes, even when you’ve done everything right, your blood sugar levels may rise. But stick with your diabetes management plan, and you’ll likely see a positive difference in your A1C when you visit your doctor.

Because good diabetes management can be time-consuming, and sometimes overwhelming, some people find it helps to talk to someone. Your doctor can probably recommend a mental health professional for you to speak with, or you may want to try a support group. Sharing your frustrations and your triumphs with people who understand what you’re going through can be very helpful. And you may find that others have great tips to share about diabetes management.

Erectile Dysfunction

ED is the inability to get and keep an erection firm enough for sex for an averagely normal period of time. Erectile dysfunction remains a reproductive health concern to men.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems.

Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Symptoms of Erectile Dysfunction

Erectile dysfunction symptoms might include persistent:

Trouble getting an erection

Trouble keeping an erection

Reduced sexual desire

When to see a doctor

A family doctor is a good place to start when you have erectile problems. See your doctor if:

You have concerns about your erections or you’re experiencing other sexual problems such as premature or delayed ejaculation

You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction

You have other symptoms along with erectile dysfunction

Causes of Erectile dysfunction

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

Heart disease

Clogged blood vessels (atherosclerosis)

High cholesterol

High blood pressure

Diabetes

Obesity

Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol

Parkinson’s disease

Multiple sclerosis

Certain prescription medications

Tobacco use

Peyronie’s disease — development of scar tissue inside the penis

Alcoholism and other forms of substance abuse

Sleep disorders

Treatments for prostate cancer or enlarged prostate

Surgeries or injuries that affect the pelvic area or spinal cord

Low testosterone levels

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

Depression, anxiety or other mental health conditions

Stress

Relationship problems due to stress, poor communication or other concerns

Risk factors of Erectile Dysfunction

As you get older,

Various risk factors can contribute to erectile dysfunction, including:

Medical conditions, particularly diabetes or heart conditions

Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction

Being overweight, especially if you’re obese

Certain medical treatments, such as prostate surgery or radiation treatment for cancer

Injuries, particularly if they damage the nerves or arteries that control erections

Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions

Psychological conditions, such as stress, anxiety or depression

Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

An unsatisfactory sex life

Stress or anxiety

Embarrassment or low self-esteem

Relationship problems

The inability to get your partner pregnant

Prevention of Erectile dysfunction

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

Work with your doctor to manage diabetes, heart disease or other chronic health conditions.

See your doctor for regular checkups and medical screening tests.

Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.

Exercise regularly.

Take steps to reduce stress.

Get help for anxiety, depression or other mental health concerns.

Menorrhagia (Heavy Periods)

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don’t experience blood loss severe enough to be defined as menorrhagia.

With menorrhagia, you can’t maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia.

Symptoms of Menorrhagia

Signs and symptoms of menorrhagia may include:

Soaking through one or more sanitary pads or tampons every hour for several consecutive hours

Needing to use double sanitary protection to control your menstrual flow

Needing to wake up to change sanitary protection during the night

Bleeding for longer than a week

Passing blood clots larger than a quarter

Symptoms of anemia, such as tiredness, fatigue or shortness of breath

When to see a doctor

Seek medical help before your next scheduled exam if you experience:

Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours

Bleeding between periods or irregular vaginal bleeding

Any vaginal bleeding after menopause

Causes of Menorrhagia

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

Hormone imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.

A number of conditions can cause hormone imbalances, including polycystic ovary syndrome (PCOS), obesity, insulin resistance and thyroid problems.

Dysfunction of the ovaries. If your ovaries don’t release an egg (ovulate) during a menstrual cycle (anovulation), your body doesn’t produce the hormone progesterone, as it would during a normal menstrual cycle. This leads to hormone imbalance and may result in menorrhagia.

Uterine fibroids. These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.

Polyps. Small, benign growths on the lining of the uterus (uterine polyps) may cause heavy or prolonged menstrual bleeding.

Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful periods.

Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. Your doctor will help you plan for alternative management options.

Pregnancy complications. A single, heavy, late period may be due to a miscarriage. Another cause of heavy bleeding during pregnancy includes an unusual location of the placenta, such as a low-lying placenta or placenta previa.

Cancer. Uterine cancer and cervical cancer can cause excessive menstrual bleeding, especially if you are postmenopausal or have had an abnormal Pap test in the past.

Inherited bleeding disorders. Some bleeding disorders — such as von Willebrand’s disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding.

Medications. Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding.

Other medical conditions. A number of other medical conditions, including liver or kidney disease, may be associated with menorrhagia.

Risk factors

Risk factors vary with age and whether you have other medical conditions that may explain your menorrhagia. In a normal cycle, the release of an egg from the ovaries stimulates the body’s production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.

Menorrhagia in adolescent girls is typically due to anovulation. Adolescent girls are especially prone to anovulatory cycles in the first year after their first menstrual period (menarche).

Menorrhagia in older reproductive-age women is typically due to uterine pathology, including fibroids, polyps and adenomyosis. However, other problems, such as uterine cancer, bleeding disorders, medication side effects and liver or kidney disease could be contributing factors.

Complications

Excessive or prolonged menstrual bleeding can lead to other medical conditions, including:

Anemia. Menorrhagia can cause blood loss anemia by reducing the number of circulating red blood cells. The number of circulating red blood cells is measured by hemoglobin, a protein that enables red blood cells to carry oxygen to tissues.

Iron deficiency anemia occurs as your body attempts to make up for the lost red blood cells by using your iron stores to make more hemoglobin, which can then carry oxygen on red blood cells. Menorrhagia may decrease iron levels enough to increase the risk of iron deficiency anemia.

Signs and symptoms include pale skin, weakness and fatigue. Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods.

Severe pain. Along with heavy menstrual bleeding, you might have painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require medical evaluation.

Treatment of Menorrhagia

Specific treatment for menorrhagia is based on a number of factors, including:

Your overall health and medical history

The cause and severity of the condition

Your tolerance for specific medications, procedures or therapies

The likelihood that your periods will become less heavy soon

Your future childbearing plans

Effects of the condition on your lifestyle

Your opinion or personal preference

Medications

Medical therapy for menorrhagia may include:

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).

Tranexamic acid. Tranexamic acid (Lysteda) helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding.

Oral contraceptives. Aside from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.

Oral progesterone. The hormone progesterone can help correct hormone imbalance and reduce menorrhagia.

Hormonal IUD (Liletta, Mirena). This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.

If you have menorrhagia from taking hormone medication, you and your doctor may be able to treat the condition by changing or stopping your medication.

If you also have anemia due to your menorrhagia, your doctor may recommend that you take iron supplements regularly. If your iron levels are low but you’re not yet anemic, you may be started on iron supplements rather than waiting until you become anemic.