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November 2, 2006

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Question from Oak Ridge, North Carolina, USA:

My husband was diagnosed with type 1 diabetes at the age of 14 and is now 37 years and has no signs of complications. His A1cs average around 7.0, but there were years where he didn't take the best care of his diabetes and didn't even test his sugars. His father died about five years ago from a brain aneurysm and I've read where aneurysm's are more likely to occur if someone in your family had one and that they are easily repaired if they are found BEFOREHAND. Also, I'm concerned about his risk for heart disease and stroke. So, at what age would you recommend that my husband get screened for stroke, heart disease and aneurysm's considering he has already had diabetes for more than 20 years and that they run in his family?

Answer:

I would recommend he have an elective stress test. Most of the strokes and heart attacks in people with type 1 diabetes occur when the individual has kidney complications and marked excretions of albumin in the urine. Other things can be done to screen for stroke, including having his doctor screen him with an exam looking for carotid bruits in his neck. He should probably also be on a baby aspirin as a means of decreasing his risk for stroke and heart attack. His blood pressure should be watched carefully and kept below 130/80. These are all preventive measures. I am not sure what type of screening is indicated for brain aneurysms. You should have him check with his doctor about this.

JTL