Thank you for the query Mr. Kiser.
From the information provided, you are 64yrs old, diabetic (since the age of 14yrs) with End Stage
Renal Disease (ESRD) awaiting a transplant, and having Cardiac problems (for 15 yrs).
There can be two reasons for your passing out - Diabetes (with ESRD) and Cardiac problem.
Firstly, Diabetic subjects with ESRD are proaned to get hypoglycemic attacks (
low blood sugar levels), which can cause them to pass out. Warning symptoms (like sweating, palpitations etc) may not always be present, specially in long term diabetics (as in your case), since the autonomic nervous system may be blunted. In such case keeping glucose biscuits/glucose water with you may help out. Also, you may need to adjust your anti-diabetic medications, if the reason for your passing out is
hypoglycemia.
Secondly, Cardiac causes can also lead to dizziness/
unconsciousness. Some basic investigations like ECG and
Echocardiography can help out. If you are having Coronary artery disease, you will need a management plan for the same. Cardiac arrythmias can also cause this and a 24 hrs
Holter monitor may help. A carotid artery doppler may help to rule out
carotid artery disease, which can cause one to pass out.
The cause I have provided are generalised, as per you history. However, the exact cause can be elicited only after examining you, which can be best done by your treating physician. As per the cause, the treatment can be started.
Hope this helps you out.
Regards,
Dr. Ayusmati Thakur