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difficulty controlling blood sugar after stroke - 1/2/2012 9:15:39 AM   
defiantbadgirl


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Status: offline 		One of my family members had a stroke last year. Before the stroke, he had no problem controlling his blood sugar with medication and a sugar free low carb diet and he had lots of energy. Insurance stopped paying for the medication he was on because it was too expensive so he was switched to a cheaper medication. The new medication tremendously zapped his energy. Then he had a minor stroke that affected his vision and was unable to drive for months. Ever since the stroke, he is having a hard time controlling his blood sugar even with the one injection he now has to take. He is now taking blood thinner because his blood is too thick, and he has even less energy. Is this common after a stroke? I'm not sure which medication he was switched to in place of the one that worked, but I can't help wondering if it caused the whole thing. Can cheap diabetic meds cause blood thickening, strokes, and energy loss? Can insurance be persuaded in certain cases to cover the more expensive meds? How can he get his energy back? I'd appreciate any and all ideas. Thanks.


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RE: difficulty controlling blood sugar after stroke - 1/2/2012 9:48:39 AM   
Rule


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quote:

ORIGINAL: defiantbadgirl
I can't help wondering if it caused the whole thing

Indeed, there appears to be and may be a causality.

I am sorry for your relative. I think that the best option - which will not help him - is to sue the party responsible for the switch in the medication.


< Message edited by Rule -- 1/2/2012 9:49:14 AM >

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 10:12:35 AM   
defiantbadgirl


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Status: offline 		I thought the insurance company might have to start paying for the more expensive drug again but I had no idea this might be grounds for a lawsuit. Sounds like I should advise him to consult an attorney. Hopefully someone will have some advice on how he can regain his energy. I'm very worried about him.


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RE: difficulty controlling blood sugar after stroke - 1/2/2012 10:44:31 AM   
Rule


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Status: offline 		The problem will be proving causality. So the law suit likely will be lost. However, even so the law suit may cause the other party to be aware that something may be wrong with the cheap medicine for particular people. Also, if later causality in other cases is proven, there will be a court record that might be used to sue again for damages and charges as manslaughter.

The best that can be hoped for is that the court - or the agency that approves medicines - orders investigations into the causality.

Of course the cause of the diabetes is also a factor: is it type I or type II. Is whatever triggered the diabetes still resident in the body and is it stimulated by the cheap medication but not by the more expensive one; or perhaps did the medication have no influence, but did the disease causing agent for some reason become more active? There are numerous such questions that may be asked, and it is for that reason also that causality will be difficult to prove.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 10:51:54 AM   
tazzygirl


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Status: offline 		Nefore you begin the lawsuit phase, keep in mind that hyperglycemia is common after a stroke. Coupled with the fact that he already suffered with that problem only increases the effect.

Study author Askiel Bruno, M.D., associate professor of neurology at Indiana University (IU) School of Medicine, says finding high glucose levels, or hyperglycemia, in stroke patients was not surprising. "Glucose levels tend to rise during acute stress, especially in people with diabetes," says Bruno.

http://www.ninds.nih.gov/news_and_events/news_articles/news_article_stroke_hyperglycemia.htm

I can only assume this is what they mean by "thick blood"...

Ketoacidosis surprisingly occurs almost as often in Type 2 diabetes as it does in Type 1. However, people with Type 2 diabetes also encounter another dangerous condition called hyperglycemic hyperosmolar syndrome, which is roughly translated as thick blood due to very high blood sugars. Here, coma and death can occur simply because the blood sugar is so high. The blood will have ketones at higher levels but does not become acidotic. HHS usually occurs with blood sugar readings above 700 mg/dl (40 mmol) as the brain and other functions begin to shut down.

http://www.diabetesnet.com/diabetes-control/high-blood-sugars

My Dr has me on a baby aspirin a day for just this reason.

Unfortunately, to me, without seeing his chart, it sounds like he was poorly controlled diabetic. My suggestion, a long talk with the Drs about both the condition and why certain medications are being used, and why others are not. Perhaps a change in Drs may be in order.

Just, for example...

Currently I am on
Lantus 40 Units.
Novolog 10Units with meals
Baby Aspirin 1 daily
Lisinopril 10 mg for slightly elevated BP (was 130/82, now down to 118/68)
Metformin 1000 mg twice a day
Simvastatin 40 mg for cholesterol

All of this is directly related to be diabetes.

My bp is a concern because of the potential for strokes in diabetics, so they want it on the low side of normal, along with my cholesterol (which has dropped by half already). And the aspirin keeps the blood from being "sticky". Blood clots and plaque are a high risk as well.

Would these work for him? Again, I cannot say. Only his Drs can. If you dont like the answers they give, or they wont answer, its time for a new Doctor.

quote:

Can cheap diabetic meds


Im not sure which meds you are referring too.

As far as the lack of energy... yes yes yes.. a stroke will cause that All I can say is that each patient is different, there is no set time limit. Is he getting stroke rehab?

< Message edited by tazzygirl -- 1/2/2012 10:56:28 AM >

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 11:18:57 AM   
defiantbadgirl


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Status: offline 		He's a type 2 diabetic diagnosed in the last 5 years.  I'm certain hyperglycemic hyperosmolar syndrome didn't cause it. He's too careful. Ever since his diagnosis, he has been very careful about his blood sugar and checks it frequently. He's seen people with their legs cut off because of diabetes so fear of that has always made him cautious. 

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 11:41:16 AM   
barelynangel


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Status: offline 		All meds have side-effects, you can usually look up side-effects online of specific drugs.   A person getting side-effects doesn't mean a medical provider or insurance company has done something wrong, it simply means that they may need to do some experimentation until they find drugs that don't give them the side effects.  My mom was on various statins due to horrid leg craps until she finally found one that she isn't having same with.

My curiosity is what does his doctor say to all this?  What does his stroke rehabilitation tell him regarding his energy and blood sugar etc. 

I would say yes, that could very well be common after a stroke, i mean a stroke is a MAJOR brain injury and requires years to recover from.  His NEW meds could very well be having an affect on his body, but that isn't necessarily his doctor's fault or his insurance company's fault -- it could be that his whole system had a change due to a stroke and it's working hard to regulate itself and heal.

What does his policy say about what they will pay for and when they will pay for brandnames versus generics?    I would say that his policy will have the answers to the questions you are posing about what an insurance company will need to pay for.

What did his doctor say as to what they believe was the cause of the stroke?

Personally, i think he needs to sit down with his medical providers and explain his dilemma.  Is his not taking the old meds due to he can't afford the meds or he just wanted to pay less?  There is a difference and maybe he may want to consider asking the doctor for some samples of his other med to see if these symptoms he is having goes away. 

I take Janovia which is a Class B drug for my insurance company.   My doc gave me over 3 month supply he had in samples.  He said he forgets to give people samples.  This was 7 months after i had already been taking it.

So his doctor may have some samples for him of the other drug to see if he does feel better on it rather than the generic.


Also, as far as expense, has he looked on line for deals -- i.e., Janovia had a great deal wherein my perscription cost $15 bucks instead of 25 due to the year long deal i got on the internet at their website.

Also, there are a lot of diabetes groups out there that some research may help him pay for drugs he can't afford etc.   But it takes research and time to find the deals.

angel
angel

< Message edited by barelynangel -- 1/2/2012 11:44:23 AM >

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 11:47:22 AM   
Rule


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quote:

ORIGINAL: defiantbadgirl
He's a type 2 diabetic diagnosed in the last 5 years.  I'm certain hyperglycemic hyperosmolar syndrome didn't cause it. He's too careful. Ever since his diagnosis, he has been very careful about his blood sugar and checks it frequently. He's seen people with their legs cut off because of diabetes so fear of that has always made him cautious. 

Then it becomes more likely that the cheap medication affected his biochemistry adversely, causing a clot or a torn blood vessel.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 11:53:10 AM   
barelynangel


Posts: 6233
Status: offline 		To me, someone who was very good at controlling their diabetes through diet and exercise wouldn't be spending 5 years on meds, especially more expensive ones.    Could it be he wasn't controlling it as well as he wanted you to believe he was?

Also, how old is he, what are his other health issues outside of the stroke etc.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 11:55:21 AM   
tazzygirl


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Status: offline 		Sort of what I was thinking, angel. Without looking at his lab work, its hard to tell. I would love to know what his A1c was for the past year leading up to his stroke

_____________________________

Telling me to take Midol wont help your butthurt.
RIP, my demon-child 5-16-11
Duchess of Dissent 1
Dont judge me because I sin differently than you.
If you want it sugar coated, dont ask me what i think! It would violate TOS.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 12:08:56 PM   
barelynangel


Posts: 6233
Status: offline 		Yeah, i mean to me if he had great A1Cs for the past year and a good average blood sugar readings daily, it's hard for me to believe he would have to be on such expensive diabetes meds continuously.


I mean a no sugar free low carb diet is great but if that is really what he is doing for 5 years and now, there may be more going on.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 12:20:41 PM   
defiantbadgirl


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Status: offline 		I'll ask him what his A1C was like before the medication switch the next time I talk to him and try to find out all the meds he is on.


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Only in the United States is the health of the people secondary to making money. If this is what "capitalism" is about, I'll take socialism any day of the week.


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RE: difficulty controlling blood sugar after stroke - 1/2/2012 1:51:36 PM   
hausboy


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Status: offline 		defiantbadgirl--
I've sent you CMail.

save your money and time on a lawsuit. 

People with diabetes are considered at greater risk of stroke---patients with elevated blood sugar are more likely to also have hypertension, high cholesterol and other risk factors.  There are so many factors in controlling high blood sugar--sometimes it's just a matter of the right dose of the right medication (for the right patient).  There may be some serious issues with your family member post-stroke that is affecting his/her metabolism and affecting the ability to regulate blood glucose levels. 

If you are seeing spikes and drops and can't get it to level off, the solution is to meet with the primary physician to re-evaluate the treatment plan.  It may require switching meds, or they may need to run some more conclusive tests to rule out other medical issues that may be occurring. 

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 2:01:20 PM   
angelikaJ


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Status: offline 		If someone can not afford a medication that is working for them, very often the drug companies have programs that will subsidize some or all of the cost.

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RE: difficulty controlling blood sugar after stroke - 1/2/2012 2:12:31 PM   
hausboy


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quote:

ORIGINAL: angelikaJ

If someone can not afford a medication that is working for them, very often the drug companies have programs that will subsidize some or all of the cost.

Absolutely.
There are also programs for low-income folks, seniors and minorities (usually grant funded) through the local health dept to help with Rx med costs.  They don't go out and actively seek clients--you usually have to contact them.  There are also some national programs available to help with prescription drugs  I have actually hosted the "Help is Here" bus  locally--it's a lifesaver for folks who quality--www.pparx.org/

edited to add: the Partnership for Prescription Assistance has a big tour bus called the "Help Is Here" bus where they can actually process applications live.  Some of you may remember this from Montel Williams, who promoted the bus tour.  The bus travels all over the US but you can register via phone or web.



< Message edited by hausboy -- 1/2/2012 2:15:40 PM >

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