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Advancing age is increasingly associated with dry mouth, but thus is usually due to medication or disease rather than age per se.
Drugs or medications are the most common cause for example anti-hypertensives, anti-psychotics, anti-depressants, muscle relaxants, anti-histamines and laxatives. An individual with decreased saliva may complain of dry mouth alone or combined with other features, such as dryness of the eyes and other mucosa, with other eye complaints or there may be systemic features.
For people without teeth, denture retention, comfort and ability to chew and speak may become difficult when less saliva is present.
Sialadenitis (inflammation of the salivary glands), which presents with pain and swelling of a major salivary gland and sometimes with pus discharge from the duct.
Salivation may be promoted with sugar-free chewing gums, diabetic sweets or drugs and dry mouth products that stimulate salivation (as advised).
Efforts should be made to avoid factors that may increase dryness, such as dry hot environments, dry foods, drugs, alcohol (including alcohol-based mouthwashes), smoking and beverages that produce increased secretion of urine (coffee and tea). Oral complications, such as tooth decay, should be prevented and treated by avoiding sugary foods or drinks, having regular dental checkups and using fluoridated products.
Maintain a good oral hygiene by tooth-brushing and flossing twice a day and use a fluoridated toothpaste or dry mouth toothpaste like Orajel® and Biotene®. Coronary heart disease is a common form of heart disease and is a major cause of illness and death.
Coronary heart disease begins when hard cholesterol substances (plaques) are deposited within a coronary artery. Watch this slideshow of heart disease covering symptoms to watch for, diagnostic tests, treatments, and prevention strategies. What symptoms prompted you to seek out the doctor who diagnosed you with coronary heart disease?
Intensive control of blood glucose and keeping glycosylated hemoglobin (HbA1c) levels below 7%. Diabetic ketoacidosis (DKA) is a life-threatening complication caused by insulin deficiency. The process is usually triggered in insulin-deficient patients by a stressful event, most often pneumonia or urinary tract infections.
Severely low insulin levels cause excessive amounts of glucose in the bloodstream (hyperglycemia). These fatty acids are converted into chemicals called ketone bodies, which are toxic at high levels. Cerebral edema, or brain swelling, is a rare but very dangerous complication that occurs in 1% of ketoacidosis cases and results in coma, brain damage, or death in many cases. Other serious complications from DKA include aspiration pneumonia and adult respiratory distress syndrome. If the condition persists, coma and eventually death may occur, although over the past 20 years, death from DKA has decreased to about 2% of all cases.
Life-saving treatment uses rapid replacement of fluids with a salt (saline) solution followed by low-dose insulin and potassium replacement. Patients with type 1 diabetes are 10 times more at risk for heart disease than healthy patients.
Both type 1 and 2 diabetes accelerate the progression of atherosclerosis (hardening of the arteries).
In type 1 diabetes, high blood pressure (hypertension) usually develops if the kidneys become damaged.
Impaired nerve function (neuropathy) associated with diabetes also causes heart abnormalities. Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Diabetic nephropathy, the leading cause of end-stage renal disease (ESRD), occurs in about 20 - 40% of patients with diabetes. Diabetes is responsible for more than half of all lower limb amputations performed in the U.S.
People with diabetes who are overweight, smokers, and have a long history of diabetes tend to be at most risk. In general, foot ulcers develop from infections, such as those resulting from blood vessel injury. Charcot foot is initially treated with strict immobilization of the foot and ankle; some centers use a cast that allows the patient to move and still protects the foot. Diabetes accounts for thousands of new cases of blindness annually and is the leading cause of new cases of blindness in adults ages 20 - 74. The early and more common type of this disorder is called nonproliferative or background retinopathy.
If the capillaries become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer. Type 1 diabetes is associated with a slightly reduced bone density, putting patients at risk for osteoporosis and possibly fractures. Women with diabetes should also be aware that certain types of medication can affect their blood glucose levels. It is also important for women to closely monitor their blood sugar levels during pregnancy. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
Blood vessels both large and small can be affected by extended periods of elevated blood sugars.
Extended periods of elevated blood sugars can cause permanent damage to nerves of the extremities.
Latter stages of peripheral neuropathy can be devastating if the feet are not closely monitored. With diabetes comes the decreased ability to fight infections, this can be from the circulation not being able to get where it needs to be or alterations in the white blood cells not being able to fight infections correctly.
Wear white socks when ever possible, not because they are the most stylish-because bleeding and other drainage are easy to see,.


If anything looks differently, do not wait, call your podiatrist, yes you need a podiatrist on speed dial. Make regular visits to a podiatrist for examinations, at least every 6 months, more often for palliative foot care if you are suffering from complications of diabetes in your feet. Stroke is a “brain attack” cutting off vital blood and oxygen to the brain cells that control everything we do from speaking, to walking, to breathing.
Every year, stroke strikes approximately 795,000 Americans – killing 144,000 and forever changing the lives of many who survive. SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
This information is important to your healthcare provider and can affect treatment decisions.
Previous stroke, previous episode of transient ischemic attack or “TIA,” high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease. Smoking, being overweight and drinking too much alcohol.You can control these lifestyle risk factors by quitting smoking, exercising regularly, watching what and how much you eat and limiting alcohol consumption. Having dry mouth at night, dry mouth in the morning or dry mouth while sleeping may occur as the saliva flow is naturally reduced at night or it can also be due to sleeping with your mouth open or breathing through your mouth. Generally, dry mouth treatment consists of managing the medical condition causing the dry mouth, increasing saliva flow and preventing tooth decay. The lips may become dry, weaken and susceptible to cracking and thus should be kept moist using a moist-based lubricant or a lanolin-based product rather than one containing petroleum-derived lubricants. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. A similar term, arteriosclerosis which means hardening or stiffening of the arteries is sometimes interchanged with atherosclerosis by some authors. This approach can help prevent complications due to vascular (blood vessel) abnormalities and nerve damage (neuropathy) that can cause major damage to organs, including the eyes, kidneys, and heart. Blood glucose control helps the heart, but it is also very important that people with diabetes control blood pressure, cholesterol levels, and other factors associated with heart disease. Other triggers include alcohol abuse, physical injury, pulmonary embolism, heart attacks, or other illnesses. Among young patients, the youngest children and boys of any age are at higher risk for hypoglycemia. Hypoglycemia unawareness is a condition in which people become accustomed to hypoglycemic symptoms. Mild symptoms usually occur at moderately low and easily correctable levels of blood glucose. Heart attacks account for 60% of deaths in patients with diabetes, while strokes account for 25% of such deaths.
Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain.
With this condition, the tiny filters in the kidney (called glomeruli) become damaged and leak protein into the urine. Patients with ESRD have 13 times the risk of death compared to other patients with type 1 diabetes.
It is a common complication that affects nearly half of people with type 1 or type 2 diabetes after 25 years. Studies show that tight control of blood glucose levels delays the onset and slows progression of neuropathy. People who have the disease for more than 20 years and are insulin-dependent are at the highest risk.
Numbness from nerve damage, which is common in diabetes, compounds the danger since the patient may not be aware of injuries. Charcot foot or Charcot joint (medically referred to as neuropathic arthropathy) occurs in up to 2.5% of people with diabetes. When the acute phase has passed, patients usually need lifelong protection of the foot using a brace initially and custom footwear. Patients with no signs of retinal damage or low risk factors for retinopathy may only require screening every 2 - 3 years. People with diabetes face a higher risk for influenza and its complications, including pneumonia, possibly because the disorder neutralizes the effects of protective proteins on the surface of the lungs.
Women with diabetes face a significantly higher risk for urinary tract infections, which are likely to be more complicated and difficult to treat than in the general population.
Depression, in turn, may increase the risk for hyperglycemia and complications of diabetes. The changes in estrogen and other hormonal levels that occur during perimenopause can cause major fluctuations in blood glucose levels.
Up to a third of young women with type 1 diabetes have eating disorders and under-use insulin to lose weight. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Most strokes occur when arteries are blocked by blood clots or by the gradual build-up of plaque and other fatty deposits. If given within three hours of the first symptom, there is an FDA-approved clot-buster medication that may reduce long-term disability for the most common type of stroke. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. The plaques narrow the internal diameter of the arteries (Figure1) which may cause a tiny clot to form which can obstruct the flow of blood to the heart muscle (Figure 2). It may also occur in a person with type 1 diabetes who is not consistent with insulin therapy, or who has an acute illness or infection that makes their diabetes difficult to control. The most serious consequences of neuropathy occur in the legs and feet and pose a risk for ulcers and, in unusually severe cases, amputation. Patients with diabetes should be aware of other warning signs of a heart attack, including sudden fatigue, sweating, shortness of breath, nausea, and vomiting.


The consequences of both poor circulation and peripheral neuropathy make this a common and serious problem for all patients with diabetes. About 85% of amputations start with foot ulcers, which develop in about 12% of people with diabetes. Related conditions that put people at risk include peripheral neuropathy, peripheral artery disease, foot deformities, and a history of ulcers.
Early changes appear similar to an infection, with the foot becoming swollen, red, and warm. People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma. The two primary abnormalities that occur are a weakening of the blood vessels in the retina and the obstruction in the capillaries -- probably from very tiny blood clots. Patients beginning a new or vigorous exercise program should have their eyes examined, as well as all patients planning pregnancy.
Everyone with diabetes should have annual influenza vaccinations and a vaccination against pneumococcal pneumonia. In terms of sexual health, diabetes may cause decreased vaginal lubrication, which can lead to pain or discomfort during intercourse. Long-term use (more than 2 years) of birth control pills may increase the risk of health complications. Studies indicate that high blood sugar levels (hyperglycemia) can affect the developing fetus during the critical first 6 weeks of organ development.
Women with diabetes also face an increased risk of premature menopause, which can lead to higher risk of heart disease. Adolescents with diabetes are at higher risk than adults for ketoacidosis resulting from noncompliance. Anorexia and bulimia pose significant health risks in any young person, but they can be especially dangerous for people with diabetes.
Some strokes can be caused by arteries rupturing when weak spots on the blood vessel wall break. New emergency treatments can help stop the brain damage and disability, if you know the symptoms and get immediate attention.
If you have one of these risk factors, it is even more important that you learn about the lifestyle and medical changes you can make to prevent a stroke.
There are also two other types of stroke treatment available that might help reduce the effects of stroke.
Longer survival rates are probably due to improvements in monitoring and tighter control of blood glucose. Other contributing factors are lack of health insurance and intentionally reducing insulin doses in order to lose weight, which occurs with adolescent girls in an effort to keep weight down. It affects about 25% of patients who use insulin, nearly always people with type 1 diabetes. Urine tests showing microalbuminuria (small amounts of protein in the urine) are important markers for kidney damage.
Symptoms of kidney failure may include swelling in the feet and ankles, itching, fatigue, and pale skin color.
Peripheral neuropathy usually starts in the fingers and toes and moves up to the arms and legs (called a stocking-glove distribution). Lowering triglycerides, losing weight, reducing blood pressure, and quitting smoking may help prevent the onset of neuropathy. If these processes affect the central portion of the retina, swelling may occur, causing reduced or blurred vision. In this more severe condition, new abnormal blood vessels form and grow on the surface of the retina. Therefore, it is important that women with pre-existing diabetes (both type 1 and type 2) who are planning on becoming pregnant strive to maintain good glucose control for 3 - 6 months before pregnancy. Young people who do not control glucose are also at high risk for permanent damage in small vessels, such as those in the eyes.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Usually the condition is manageable, but, occasionally, it can be severe or even life threatening, particularly if the patient fails to recognize the symptoms, especially while continuing to take insulin or other hypoglycemic drugs.
In such cases, hypoglycemia appears suddenly, without warning, and can escalate to a severe level.
The outlook of end-stage renal disease has greatly improved during the last four decades for patients with type 1 diabetes, and fewer people with type 1 diabetes are developing ESRD. The bones may crack, splinter, and erode, and the joints may shift, change shape, and become unstable. Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode. It typically develops in people who have neuropathy to the extent that they cannot feel sensation in the foot and are not aware of an existing injury. Major hemorrhage or retinal detachment can result, causing severe visual loss or blindness. Any duplication or distribution of the information contained herein is strictly prohibited.
With vigilant monitoring and by rigorously avoiding low blood glucose levels, patients can often regain the ability to sense the symptoms. Instead of resting an injured foot or seeking medical help, the patient often continues normal activity, causing further damage. However, even very careful testing may fail to detect a problem, particularly one that occurs during sleep.



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