Case Study A PreDiabetic Middleaged Man
Around the world today, more than 2billion people are overweight or obese. Our global obesity epidemic has beendescribed as the most significant preventable public healthcrisisrecent history. This 48yearold manager of a constructionfirm found himself fighting an uphill battle against a disease that can effectevery organ systemthe human body. Kevin's wife had convinced him tovisit their local medical , because she was concernedabout his weight, and the joint pain he complainedof every evening after work.
At the , Kevin was told that hisfasting blood sugar was elevated, and that he was prediabetic. His triglycerides, total cholesterol, and LDL cholesterol were also elevated andhis HDL cholesterol was low. Standing 5'7quot; tall and weighing 180pounds with predominant central obesity, Kevin's physician calculated a BMIof 28 kilograms per meter squared. Kevin was informed that he was overweightand suffering from metabolic synome, a collection of biochemical andphysiological abnormalities associated
with the development of cardiovasculardisease and type two diabetes. The physician on duty advised Kevinto make some major lifestyle changes. By eating better, andgetting more exercise. Six months later, Kevin returned tothe weighing nine pounds more than he had at the previous visit. When the new physician on duty asked if he had been able to make any of the lifestylechanges suggested by her colleague. Kevin told a story she had heardfar too many times before.
The first week after hislast 's visit, Kevin had tried eliminating allof his favorite foods and snacks. He skipped breakfast, ank a mealreplacement shake for lunch and ate a calorie reduced frozendinnerthe evening. He had also tried to eliminatethe fathis diet. The first week, Kevin lost four pounds butas the weeks went on he found it impossible to stick tothis planed restrictive diet and he noticed that he was replacinghis favourite high fat foods
like potato chips andpizza with foods that were highsugar. In the evening he would findhimselffront of the television, snacking on multiplepackages of Swedish fish. By the time he went to bed, he wouldalmost always feel he had over eaten. The soda machine at work became hisenemy as he tried unsuccessfully to walk by without buying the cold soda cans thathe ended up inking usually three or four times a day. He and his wife both worked long hours soone of them would usually stops for
take outs on the way andthey would end up sharing a pizza and a two liter of Coke,exhausted from their long days of work. Regular exercise was difficult forKevin because of his joint pain and he often felt that he justdidn't have the energy to move. The physician took notes andasked clarifying questions as Kevin spoke. Identifying major target areas for change. Including specific food and eating behaviors that were contributingto Kevin's uphill battle with his weight.
Social Security Disability and Type II Diabetes
Hi. This is Jonathan Ginsberg. I would liketo talk to you today about how I approach Social Security disability casesinvolving Type II diabetes. Type II is the typically adult onset diabetes.It is not juvenile or Type I diabetes. That's really a separate type ofegory but Type II diabetes. Of course, we're seeing a lot of that becauseof diet, obesity, that type of thing, and so a lot of people have it.Of course, since diabetes is fairly common judges see it a lot. Soturnthey expect more from claimants with diabetes.
So really what I'm looking fora diabetescase or what I think helps win would be several things. One is you shoulddefinitely be compliant with your mediion. Ideally, you'd be on insulin.It's much more difficult to win a case when you're on the blood sugarpills without something else. So typically for a diabetes only case I'm lookingfor an insulin dependent diabetic. Someone who is compliant with takingthe insulin. It's not good enough to say anymore I can't afford my mediionand so I don't take it all the time or I don't like the way I feel.You've got to take the
mediions on time. You've got to be compliantwith who put the diet. Typicallya Type II diabetes case, your will give you a diabetic diet. American Diabetes Association Diet willrestrict your calories and limit your sugar and simple carbohyate intake.Very important to be compliant with that. If I seea medicalrecord that my client is not compliant, that he or she is inking alcoholor is not compliant with the diet, that makes it much more difficult towin. I think judges are looking for cases where there is neuropathy whichis painthe nerve. Typically,
that is that numbness and tingling you'llfeelyour hands or your feet andor blurred vision which is the retinopathywhere the vision is being affected. The capillariesthe eye are beingdamaged by the blood sugar fluctuations. We're also looking for situations where diabeteshas been longlasting. 10 years, 15 years because as you know diabetesis a progressive disease and the damage from the blood sugar fluctuationstends to accumulate. So if you've been diabetic for four or five yearsunless you really didn't know,
you were not compliant, didn't have mediionsand had a lot of damage very quickly, judges typically are lookingfor cases where somebody had diabetes for a number of years. I think someof the other things that judges look for and I've won cases with, peoplewho need to take frequent bathroom breaks. Obviously, diabetes causesa frequent need to urinate, having a lot of bathroom breaksexcessof what is normal which might be twice a day. That can be a real problem ina work environment, especiallyan unskilled work environment.
So that's one of the things that I ask myclients to keep track of. Variations and wild swingsblood sugar.I've had people tell me that low blood sugar is actually more debilitatingthan high blood sugar because it causes confusion and it's more difficult torecover from. So if your blood sugar fluctuates and you cannot keep it ata certain level, that's probably a stronger argument than one where the levelis a little bit high. It's may be a 150 blood sugar 125, but it's worse whenit goes from 40 or 60 to 300 and back and forth and so forth. So that'swhat I look for.