INR and diabetes

[lance]

Spuse attends cardiac rehab because of his stent and arrythmia. He's doing well--no concerns.

However, to-day during his class he had the following conversation with a fellow patient suffering from diabetes also on warfarin--stent with arrythmia.

She advised my spoue to be careful when swallowing warfarin washed down by apple juice to eave 4 hours between them. Her INR has been jumping around, her manager says she is taking a very high dose of warfarin considering her size.

She feels the apple juice is interfering with the warfarin causing the problems with remaining stable. Her doctor wants to interview her about the food she is eating.

Does being a diabetic interfere with how warfarin is metabolized? Spouse told her to dose the diet and really didn't want to get involved. Remember the incident at the clinic when the pharmacist said home monitors were highly inaccurate?

I'm just wondering.

 

[Ross]

First alarm bell going off is this statement:

Her INR has been jumping around, her manager says she is taking a very high dose of warfarin considering her size.

Size has nothing to do at all with how much Coumadin a person must take to stay in range. It depends on how fast their body metabolizes the drug.

I really don't think Diabetes has anything to do with it either, but I'm not qualified to answer this one. I'll leave it for Al Lodwick or one of the members with diabetes.

 

[Illinois Al]

I really don't think Diabetes has anything to do with it either, but I'm not qualified to answer this one. I'll leave it for Al Lodwick or one of the members with diabetes.

Well, I am one of the newbie members of the forum and certainly not as knowledgeable as so many of the others.

However I can tell you that I have Type II Diabetes and that in discussing my warfarin dosing with both the cardiologist and my PCP, who is initially managing my INR testing and warfarin dosing, nothing at all was said about my diabetes or diabetes meds, and I was under the distinct impression the two treatments did not have any effect on each other.

 

[ALCapshaw2]

The most common Cause of unstable INR is a Manager who OVERREACTS to (small) out-of-range INR readings.

SMALL Changes in the right direction work best for me and many others.

The only way anyone could tell conclusively is if the patient provided INR readings and a schedule of Doses Taken (and Dose Changes recommended by the manager).

I wonder if that manager also instructed the patient to completely avoid anything containing Vitamin K.

Studies have now confirmed that a 'consistent' daily intake of Vitamin K results in a more stable INR (since any variation will then be only a small percentage of the weekly intake vs. a LARGE increase if Vitamin K is being restricted).

'AL Capshaw'

 

[lance]

The beat goes on ..........

The beat goes on ..........

Well, I am one of the newbie members of the forum and certainly not as knowledgeable as so many of the others.

However I can tell you that I have Type II Diabetes and that in discussing my warfarin dosing with both the cardiologist and my PCP, who is initially managing my INR testing and warfarin dosing, nothing at all was said about my diabetes or diabetes meds, and I was under the distinct impression the two treatments did not have any effect on each other.

Diabetic patient at cardiac rehab is in for a rough ride INR wise. The same old, same old management myths. She's losing weight, becoming fit and her tolerance for increased activity is improving.