DEAR DOCTOR. ROACH: I’m a 90-year-old man who takes glipizide for sort 2 diabetes and finasteride for an enlarged prostate. I take every day walks and observe a cautious however not strict food plan.
Currently, my urination frequency has elevated to each two hours through the day and evening. Is a medicine change indicated? —CH
ANSWER: A radical analysis is indicated. There are three potentialities that I see instantly, however a number of others are additionally price contemplating. Anybody with diabetes who notices elevated urination ought to be evaluated for prime blood sugar ranges.
Glipizide alone could also be remedy for you, however we hardly ever begin remedy with our sufferers anymore as a result of different medicines have been proven to be higher. Glipizide works by forcing the pancreas to provide extra insulin, however because the drawback with sort 2 diabetes is insulin resistance, extra insulin isn’t perfect.
Many individuals handled with glipizide for years ultimately fail and their blood sugar stage additionally rises. A really excessive blood sugar stage exceeds the kidney’s capacity to reabsorb sugar, so the kidney loses giant quantities of sugar and water. A urine and blood sugar check can consider this risk, and an A1C check can present how your blood sugar management has been. If he urinates so much each two hours, that will help this risk. Most individuals additionally produce other signs, equivalent to blurred imaginative and prescient or feeling thirsty on a regular basis.
You’re additionally taking treatment for an enlarged prostate, however regardless of remedy, your prostate should still be so enlarged that it would not really feel utterly empty. For those who solely urinate a small quantity each two hours and really feel like you have not utterly emptied your bladder, that will help this speculation. An ultrasound after urinating can verify this assumption, however even an examination may point out a full bladder.
Older males with prostate issues can also endure from urinary infections. Irregular urine coloration or odor helps this and is confirmed by a urinalysis and tradition check. There are various different much less doubtless potentialities, however these are the primary theories that come to thoughts as a main care physician.
DEAR DOCTOR. ROACH: I’m a 62-year-old girl who has by no means smoked, however my members of the family have. I used to be just lately recognized with a sort of lung most cancers known as lepidic-predominant adenocarcinoma. Is that this the identical as regular lung most cancers? They are saying they caught it early. How harmful is it? – vp
ANSWER: There are greater than 30 various kinds of lung most cancers, though adenocarcinoma is the commonest, accounting for about half of all lung cancers. Nonetheless, there are completely different pathological subtypes of lung adenocarcinoma relying on the looks of the tumor. Considered one of them is lepidic-predominant adenocarcinoma, which tends to develop extra slowly than different sorts of adenocarcinoma.
Though smoking is by far the most important threat issue for lung most cancers, roughly 19% of ladies with lung most cancers had been by no means people who smoke. Secondhand smoke is a threat for girls with extended publicity to smoke in maturity.
As a normal rule, in an individual with lung most cancers that’s confined to 1 space of the lung with out proof of unfold, surgical procedure stays the primary remedy choice if the particular person can tolerate it and the tumor is in a location conducive to removing. surgical. .
EDITOR’S NOTE: Dr. Roach regrets that he can not reply to particular person letters, however will incorporate them into the column each time doable. Readers can e-mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.