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High A1c, arthritis, How one should go about

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Ulcerative Colitis
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Posted 3/18/2014 9:27 AM (GMT 0)
Hello folks,

This question is related to my mom. She is almost 60, her UC is in remission, without meds for about 20 years now. She has developed a LOT of arthritis issue and I am unable to connect the dots. If this inflammation stems from UC or something else. Her arms and lower back are in CONSTANT pain, esp. the region close to shoulder to elbow. The physicians that she sees give her pain killers and send home.

During last blood check, I noticed her A1C is shot to 7.1, she has become obese too.

I am trying to get her A1c under control, at the same time address arthritis. Swimming is not an option where she lives, but what other options folks here have employed. I thought on following lines
- Get colonoscopy done, so that if there are any bugs responsible for obesity, they will be taken care of. At the same time, I am afraid that she is maintaining her remission, I do not want to disturb that.
- Get diet in check. Her diet is not bad quality at all, still will clean up where possible.
- I am not too sure of exercise part, as sometimes its so difficult for her to move her arm that she breaks into tears. I don't want her to resort to pain killers all the time.

What other strategies folks who have gone through have applied?

Many thanks in advance.
Posted 3/18/2014 12:58 PM (GMT 0)
That A1C likely indicates she needs to be on medication for her diabetes.

Walking is great exercise, if she can do that. If not, perhaps a good physical therapist or personal trainer can help her with an exercise regimen - my wellness center has chair exercise groups and other classes intended for people with limitations.

I have several years on your mother, and I just have to wonder why you consider this your responsibility. If your mom isn't on board with you acting like a parent to her, that stress could be a problem. Your concern is commendable, but be careful not to invalidize her with your interactions.
Posted 3/18/2014 1:45 PM (GMT 0)
Can't comment much because I don't know the full extent of the situation, but just wanted to point you to what the Swedes are doing to curb obesity trends:

Following a literature review of 16,000 studies on diet and obesity, Swedish government advisors at the Council on Health Technology Assessment have suggested that a low-carb, high-fat diet may be the key to reversing obesity and obesity-related illnesses.

It's more or less the Mediterranean diet with strong emphasis on low GI foods.

You are on point about getting her on probiotics, as research is showing there is a microbial component to obesity as well. Our gut bugs regulate everything from metabolism to LDL-B cholesterol levels, so I'd get her on a fermented foods / kefir / probiotic regime right away.

Best.
Posted 3/18/2014 2:19 PM (GMT 0)
Exercise and maintaining a healthy weight are the top two things to help improve arthritis and diabetes both-swimming, stationary biking, or light resistance training (either some weights or resistance bands).

Walking is okay- but it can be hard on your joints if they are hurting, esp if you are on a treadmill.

As far as diet....4-6 small meals a day proteins, veggies should make up the larger percentage of the plate, with whole grains being a small serving.
7.1 is high, but does mean there is room to try improvement with diet and exercise- however it is still high on next follow up- medications would be warranted (usually 3months).

NSAIDs tend to work better for arthritis pain and not narcotics. But obviously those can cause stomach issues/bleeding if over used.
Posted 3/18/2014 5:29 PM (GMT 0)
If she's had UC for 20 years she needs routine screening colonoscopies. Is she going for those?

Sacroiliitis (lower back pain) is commonly associated with IBD. A rheumatologist might be better able to determine if this is RA or osteoarthritis or arthritis associated with IBD. Even if she's in remission with her GI symptoms, if the arthritis pain is autoimmune in nature, something like Humira or Simponi could be really effective for managing her pain.

A1C should be addressed by her PCP, or a referral to an endocrinologist if necessary. An A1C of 7.1 combined with a second A1C reading of >6.5 means that she has diabetes. You should not attempt to manage full blown diabetes without a medical professional on board.
Posted 3/18/2014 5:35 PM (GMT 0)
get her off her butt, then get her off the pain killers - in that order -
Posted 3/18/2014 5:43 PM (GMT 0)
If you would like more information about eating for blood glucose control, please check the diabetes forum here at HealingWell. There's a lot of good information in the sticky posts on that forum.
Posted 3/18/2014 6:21 PM (GMT 0)
Judy,
You are absolutely right, but I am telling her for last 6 to 7 years to do something about it. She says yes, and no action further. I only hear when she is in pain that she can not control. Her pain tolerance is pretty high, so when she complains, it is REALLY painful. And if 'I' do not address it now, it is going to come and bite my rear end eventually. So I am following 'stitch in time, saves nine'.

Plus, she has lot other family responsibilities, and its really difficult for her to find any time for herself. Hence, I am looking for something that will sort of give me lot of bang for her time. I will check diabetes section.

Liz,
I think, she is on some meds already, but I don't know if her PCP officially diagnosed her as diabetic. There is some confusion about a clot behind her ear. She is unable to explain me properly, so I am going to check the records when I visit her in a month. I need to study that before, I suggest anything.
The sarcoilitis is not (probably) what she has. I remember suggesting her to ask her physician, still good point to look at again.

Nursemb,
Walking is NOT easy for her. The lower back pain that I mentioned is pretty troublesome at a times, and hence she can not walk longer distance.

Stealth,
Diet is getting in check, but thanks for the link.
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