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Question:

From Nottingham, England:

My father - 70 next year - was diagnosed diabetic in his early 20's. He just suffered an occipital lobe stroke which has caused a homonymous field defect and he can no longer drive. He is desperate to find out if this really is irreversible as it is the first real "setback" as a direct result of diabetes. Please can you help? He has Type 1 and takes two injections a day.

Answer:

One of the frustrating aspects of diabetes is the increased risk of complications including strokes (sudden loss of function of part of the brain due to damage to the blood supply to a specific area of the brain). There's no good way to predict which people with diabetes will suffer strokes, nor how fast they may improve after they occur.

However, there are several thoughts for your father to review with his physicians (These same thoughts would apply to prevent future strokes in his case, and to help prevent strokes in other people):

  1. If he has any tendency for high blood pressure (hypertension), he should be on aggressive therapy with antihypertensive medications, probably an "ACE-inhibitor" such as captopril.
  2. He might benefit from starting on aspirin therapy (Warning: some forms of stroke should not have anticoagulant therapy: this must be discussed with the physician!)
  3. If his cholesterol level is very elevated, he should have this treated with meal plan modification, and perhaps with prescription medications.
  4. Tightening up his diabetes control might also be appropriate in general, although there is not much data that it will help in stroke prevention or recovery.

WWQ

Additional Comments from Dr. Lebinger:

I am sorry to hear your father has suffered a stroke. Although certainly 50 years of diabetes increases the risk of stroke, many men of this age suffer strokes without any history of diabetes. Your father certainly must have taken great care of himself to have diabetes almost 50 years with no complications. It must be hard for such a strong man to suffer a stroke with visual loss.

I suggest your father consult with his neurologist or ophthalmologist to get suggestions how to improve his function despite his visual impairment. Sometimes prisms can be inserted into glasses to improve the range of vision with a field loss. There are specialists who deal with such impairments. It is very common to be depressed for a while after such an event, but it sounds like your dad is still well enough to enjoy life and be active and productive.

TGL

Original posting 5 Jan 98

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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