"Anaemia, a common but often unrecognized risk in diabetic patients: A review" - Diabetes Metab. 2014

Anemia “is a frequent clinical finding” in diabetes:

Potential causes in type 2 diabetes:
-renal insufficiency
- medicines (oral antidiabetic drugs, ACE inhibitors & ARBs)

Potential causes in type 1 diabetes (comorbidities):
-Addison’s
-Celiac
-Hashimoto’s thyroiditis
-Autoimmune gastritis, pernicious anaemia,

Rare causes “in young patients or when the classical causes are excluded”
-G6PD deficiency
-microangiopathic haemolytic anaemia
-thiamine-responsive megaloblastic anaemia
(Angelousi & Larger)

Some people want to win, to prove they are right. Others just want to do the right thing. Needing to be right and doing the right thing are seldom the same thing.

littlewoosh said: What should a person do when their family doesn't believe that they have a chronic illness? My family thinks I should be "better" by now because it's been 8 years. Many of them think I'm faking it. What's a good way to handle this situation?

cfsfmmcschirps:

Trying to prove yourself to family and friends is emotionally painful and exhausting. Sometimes it helps if you can hand them medical studies that stress the validity of and difficulty in living with your illness. I’ve tagged those posts #proof. Let me know if you can’t find #proof for your illness.

If you are still undiagnosed, you can still go through your medical tests, look for the abnormal results, and find out what they mean so that you can explain them to your family. If you don’t have a doctor willing to run tests, find one who will.

If you can provide your family with a good way for them to explain your illness to others, it may help since parents are often embarrassed when people ask,”What are your kids up to?”

Lastly, try to find something productive you can still do, even if it is just taking one class a semester or being there for younger family members in a way their busy working parents can’t be. Children are wonderful because they don’t see what you aren’t accomplishing, only who you are. Being productive will help take away family members’ excuse to judge you, and it will help you start to rebuild your life.

Take comfort from the ones who support you, and the others will eventually come around, but unfortunately by then, you may no longer need their support. You will have found a way to make a new life within the parameters of your illness.

The current findings support that children’s perception of parenting behavior is associated with anxiety … children diagnosed with a primary anxiety disorder perceived higher parental control… child-reported maternal acceptance was associated with lower symptoms of child anxiety, depression …
Great idea for children facing surgery. . .

Wacky Wednesday,”an environment where employees were dressed in ‘wacky’attire and children and parents were provided with gifts and costume items” reduces pre-surgery anxiety in children. (Berger et al.)

Double Vision (Diplopia)

Some potential causes:
Eyes-dry eye, eye strain, uveitis, wrong glasses/contacts
Sinuses-sinusitis
Headaches
Infections-sinus fungal infections, Lyme disease
Autoimmune conditions- arteritis, diabetes, Graves disease, myasthenia gravis
Medicines - antibiotics (fluoroquinolone), anticonvulsants
More serious causes - aneurism, stroke, TIAs, tumor.

Questions about signs & symptoms:
1) Pain with it?
2) New type of headache or tender scalp?
3) Problems with chewing or other changes in facial sensation or muscle strength?

Tests:
1) Monocular or Binocular?
(Monocular-“sees double with only one eye open” & extra image is usually a ghost. Binocular-“sees double only if both eyes are open” & the problem disappears when covering either eye.)
2) Is pupil reactive to light or sluggish?
3) Eye movement issues?
4) Comitant or Incomitant?
(Comitant-“double vision is the same no matter where the patient turns his head.” Incomitant-“double vision goes away when the patient turns his head to the left but remains bad when turned right.”)

Blood Tests:
1) Sed rate aka erythrocyte sedimentation rate (ESR) for possible autoimmune/inflammatory conditions
2) glucose for possible diabetes

Treatments:
Depending on the cause, sometimes it can be corrected by special glasses or eye muscle exercises

(Always see an ophthalmologist)

http://www.aao.org/publications/eyenet/200911/feature.cfm
http://www.ncbi.nlm.nih.gov/pubmed/12571776

The secret of happiness… It is only after you quit trying to get other people to like you and instead just focus on always trying to do the right thing that something amazing happens; it doesn’t matter so much if other people like you because you really start to like yourself, who you have become.

Anemia

There are many types of anemia. It can be due to decreased production or increased destruction of red blood cells (RBCs). RBCs carry oxygen to tissue.

Potential Signs & Symptoms:
Fatigue, weakness, or shortness of breath, especially upon exertion
Cognitive complaints, headaches, or dizziness
Peripheral neuropathy (in B12 deficiency anemia)

Potential Causes of Anemia:
Autoimmune attacks against RBCs
Cancer
Endocrine diseases (hypothyroidism)
Infections (parasites)
Inherited blood disorders
Renal failure
Thalassemia
Deficiency of iron, folic acid, or vitamin B12 
Medicines (calcium-containing antacids, Methotrexate, … )
(Check #anemia for more causes)