September 9, 2006
Diagnosis and Symptoms
Question from Washington, D.C., USA:
My 70 year old father suffered a “silent” heart attack during the week of June 19, we think. He went in for triple bypass surgery on June 23 and had extreme respiratory complications. He just came home on September 1 after being in the hospital and two weeks of rehabilitation. He was down to 108 pounds from 145 pounds and was extremely week. After the surgery, the doctors started him on Lantus, we were told, as a precautionary treatment, to keep the risk of infection down. He currently takes eight units of Lantus a day. Apparently, they now believe that the trauma from the heart attack could have done damage to his pancreas, but no one seems to know if this is permanent or temporary. He never had problems with diabetes before his heart attack and surgery and type 2 diabetes does not run in our family, although my daughter has a type 1 diabetes. Is this common and, if so, does it usually correct itself?
Answer:
I cannot say for sure what the status of his diabetes or blood sugar management should be without reviewing the specific blood sugars. However, you should know that the stress of going through a heart attack very often brings out a tendency for people to have high blood sugars. This is likely to be type 2 diabetes. It is not usually damage the pancreas, but it is an increase in insulin resistance that makes the blood sugars higher after such an event. It is also known that good blood sugar management after the heart attack is very important to the healing of the heart. It is important that your father be given the proper education regarding diabetes. He should know how to test his blood sugar. He should know what his treatments goals are. He should know how to treat low blood sugars. There should be a plan for future management of blood sugars, including an office follow-up visit to make sure things are going well.
JTL
