University Health System Weblog

Dr. Dan Spogen answers the question: “I’ve smoked for more than 20 years. Recently I’ve had more difficulty breathing. Do I have COPD?”

COPD, or chronic obstructive pulmonary disease, is a lung disease that makes it hard to breathe. It’s caused by damage to the lungs due to time or environmental factors, such as smoking, which is the primary cause of the disease. It’s often characterized by shortness of breath, the inability to take a deep breath, and a lingering cough that brings up mucus. (More on COPD signs and symptoms.)

While some people eventually get COPD due to advanced age, smokers are the largest segment of society that contract the disease because the damage done to the air sacs in the lungs is accelerated to the point that many smokers start to feel the effects of COPD by age 50. The damage to the lungs due to smoking gets worse over time and cannot be cured, but future damage is stopped immediately if one quits using cigarettes. Exposure to second-hand smoke or smoking illegal substances also affects lung capacity and can lead to COPD.

The disease usually presents itself in one of two ways—inflammation of the airways, which also causes bronchospasm, that take air to the lungs due to the buildup of mucus, or damage to the air sacs in the lungs, making for a less efficient transfer of oxygen to the blood.

Medications, often in the form of an inhaler, are available to treat both conditions. Your family physician or internist can diagnose COPD and recommend an appropriate course of treatment.

Daniel Spogen, M.D. was named chair of the family and community medicine department at the University of Nevada School of Medicine in Reno, Nevada in October 2006. Before joining the medical school’s faculty, Dr. Spogen was in private practice for more than 20 years in northern Nevada. He helped launch fellowship programs in obstetrics and sports medicine at the medical school as well as serves as assistant student clerkship director.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. Daniel Spogen answers the question: “How can I manage my type 2 diabetes?”

Type 2 diabetes is a chronic condition that affects how your body metabolizes sugar, or glucose, your body’s main source of fuel. Type 2 diabetes afflict many people in Nevada and the number of new cases is reaching epidemic proportions according to the Centers for Disease Control. The good news is that, in most cases, the disease is preventable.

But what if your family physician or internist diagnosed you with type 2 diabetes? It means your body is resistant to the effects of insulin. Insulin is a hormone that regulates how sugar is absorb into your cells. Having type 2 diabetes means your body doesn’t produce enough insulin to maintain normal glucose levels. There’s no cure, but if you’re diagnosed with type 2 diabetes, it can be managed. Eating healthy foods, engaging in regular physical activity and maintaining a healthy weight are key.

Our nutritionists in Las Vegas or Reno are experts who can work with you to develop a personalized diet that works for you. Generally speaking, an ideal diet is one that consists of two thirds fruits, vegetables and grains. The remaining third can be most anything else, although avoiding simple sugars like certain fruit juices and candies, pasta, alcohol and animal fats is highly recommended. Making these simple changes will improve your type 2 diabetes, while helping you lose weight as well. As I tell my patients, it’s not how much you eat but what you eat that’s important. Daily physical activity like walking, jogging, biking and swimming, is also critical to control your type 2 diabetes. Following general exercise guidelines works well.

Your family physician or internist will want to manage and monitor several things after your diagnosis of type 2 diabetes, such as blood pressure, cholesterol levels and triglycerides. Your kidney function is also monitored to ensure its working properly. Blood pressure monitor is especially critical to managing type 2 diabetes. Type 2 diabetics don’t usually die of blood sugar but usually die from microvascular or macrovascular disease, the most common being a heart attack. The correlation’s so great that the risk of having a heart attack in someone with diabetes is the same as if you’ve already had a heart attack. So instead of aiming for a blood pressure reading of less than 140/90, the typical goal for the diabetic patient is a blood pressure reading of less than 130/80. Most doctors will start with a diuretic as the first line of defense in blood pressure control.

Cholesterol levels should be less than 200 mg/dL, with LDL, or low-density lipoprotien, levels less than 100 mg/dL. Some medical sources even suggest an LDL level of less than 70 mg/dL. Improving HDL, or high-density lipoprotein, levels, or what’s popularly called “good cholesterol,” is also important, but hard to do. HDL levels is most affected by a consistant exercise regiment.

Remember, a good, healthy diet and regular, daily exercise are the most important factors in controlling type 2 diabetes and the disease’s destructive effects on your body.

Daniel Spogen, M.D. was named chair of the family and community medicine department at the University of Nevada School of Medicine in Reno, Nevada in October 2006. Before joining the medical school’s faculty, Dr. Spogen was in private practice for more than 20 years in northern Nevada. He helped launch fellowship programs in obstetrics and sports medicine at the medical school as well as serves as assistant student clerkship director.

Have a question? University Health System doctors answer select questions from readers like you.