Part 2

Part 3

Soon….

Unfortunately, this is just one of the MANY challenges diabetics face every single day. A type 1 diabetic was arrested inside a NYC subway, because he give himself an insulin shot. Even more sad, this happened almost a year ago, and the news just started to give this real recognition. I just can’t comprehend why is America so slow on understanding diabetes? The first group of people that need to understand diabetics ARE the cops. I hope some time in the future, attitudes and awareness about diabetes gets better. However, it will not get better if diabetics stay quiet. Diabetes is a 24/7 job, we don’t get to choose when we could think about our diabetes. Let’s help each other by not staying quiet and tell our stories..

I’m sorry to say but I’ve also encountered Vegans who posses an air of “I’m better than you because I don’t eat meat” kinda attitude. Which is a real turn off by the way. The next thing you know, you are bombarded with hints and innuendos, to try and get you to abandon your horrible meat eating lifestyle, because it’s “bad for everybody”. The truth of the matter is, I’ve seen some pretty unhealthy Vegans too!! However, I digress…

Inside the world of vegan-ism, you’ll read and hear a lot of propaganda concerning the “healing powers of raw foods”. Many vegan venues work very hard to sell everyone the idea that eating raw food will heal ANY sickness you can think of. Those of you who follow my blog know my position on these apostolic like teachings of “miracle cures”.  Don’t get me wrong, I’m not saying in anyway that eating healthy is a waste of time; however, I am saying that it is a whole new bowl of wax, once an organization or entity starts to profess claims of healing that does not work for everyone. Too many of these claims of “you can heal yourself”, comes from doctors and organizations that are simply trying to corner a market and make money.

I’ve seen a few documentaries about “raw food retreats”, that are usually located out in a suburban country somewhere. Many people including diabetics can benefit from something like this, however, once you come back home to the stress of the city; the reality is, what is the likelihood you’ll have access to the same foods? What is the likely hood that 5-10 years later you won’t be tempted to revert back to old way of eating?? I am all about being realistic. In this case, it’s not about eating more leaves and branches, it’s about making better food choices, which can include raw foods.

The same way (for whatever reason) some meds don’t work in some people, the same is true for plant based consumption. It’s important to understand that we all are individuals with bodies that are not replicas of each other. This is by no means meant to discourage anyone from a raw foods lifestyle, I just want to make people aware that, it is very possible to be on a plant based diet, and still be unhealthy, which can be due to a plethora of reasons. Becoming a Vegan does not = (equal) no doctor needed.

Vegetarians are basically individuals who also do not eat meat, and primarily eat a plant based diet. However they DO consume some dairy products such as milk, cheese, and yogurt. Some Vegetarians will even eat eggs. They are generally not fanatical in their lifestyles, in the same way that many Vegans are. I guess it is also safe to say that, most Vegans are born into a lifestyle of Plant eating, were as most people Vegetarians later on in their lives. Vegetarians are not only a little more liberal in their diets, but usually are people that just want to live a little more healthier overall.

In short, ultimately, whether you choose to be Vegan, or Vegetarian, or not at all, is a personal choice. However, It is also my opinion that, one should not become a Vegan/Veg solely because you think it will remove all your preexisting diseases; do it because it’s an overall healthier way of life.

© 2010 DiabeticRadio.com

Ben Vereen is most remembered for his character role as “Chicken George Moore” in the movie “Roots”. You may also remember him in the 80′s hit show “Webster”. He talks with National Public Radio along side Dr. Michael Bush about diabetes awareness. Mr. Vereen has a long acting career that spans over 40+ years; which includes theatre and producing. Listen as Ben shares a piece of his life living with diabetes..

Vitamin A is great for healthy skin; vitamin E is good for healthy eyes; Co q10 is good to promote healthy heart; and Chromium Picolinate is wonderful in helping your cells to become more insulin sensitive. However, have you ever purchased a particular product (herbal or mineral/vitamin based) to help with a specific condition? Have you also noticed that a lot of those products don’t seem to work well, or not at all? There are three main reasons for this.

Unfortunately vitamins, herbs, mineral, and homeopathic based products are not being regulated by the FDA, or any other governing body (at least that I’m aware of). What does this mean? There are no clear set of standards or quality controls forced upon any company or manufacture who produces “healthy supplements”. In other words, you can purchase a bottle of vitamin C, and not know whether or not it truly came from natural sources, or created in a laboratory; neither will you know how potent your new bottle of vitamin C is. There is also the issue of whether or not the particular product has been diluted with extraneous ingredients, or even ingredients that could actually further inhibit the said vitamin’s effectiveness.

As far as I can see, knowing which supplement brands to buy can be nerve racking; you’ll need a college degree just to figure it out!! Some companies I’ve personally used are Solar, and Nature’s Way. These two companies products seem to give me good results when I’ve use them. Sadly, the only real way of knowing a good vitamin product appears to be through word of mouth. This may be due to the fact that they are not regulated.

The Second main reason that should be considered is that, your body knows what it needs better than you do. What do I mean by that??  Remember when I said in the beginning that Vitamin A is good for healthy skin? Well, the same vitamin is also good for several other things, including helping to strengthen skeletal bones. In other words, what I’m trying to say is your body will never use a particular vitamin solely for one thing! If your body is aware of the fact that your bones are brittle, it will use what ever resource at it’s disposal to help repair your brittle bones. Get it??  So in essence, its not that the vitamin is not working, it’s just that the vitamin maybe being used for something more urgent in the body.

Third and last main reasons are vitamins/herbs that are contained in skin cremes. It is my opinion that if you by a skin product to help with “dry skin” for instance, your better off saving your money and just eat more fruits and vegetables. The process for creating such a product is kinda like when you boil raw vegetables (most of the nutrients a boiled away), now your left with putting 80% of perfume on your body, instead of vitamins that are said to help with XY&Z.

© 2010 DiabeticRadio.com

I’ve came to know of Lizmari on a popular diabetes website called TuDiabetes. I was so inspired by not only her amazing transformation, but her outlook on life and her diabetes. Lizmari was diagnosed as Type 2 diabetic November 17th 2009, born in Bayamón, Puerto Rico. At the time of diagnosis, her A1C percentage was 10.5%. With much hard work and positive energy, as of June 2010 her Hemoglobin A1C now runs on average 5%!! In short, Liz Mari has successfully taken her blood sugar down to non-diabetic levels. As a result of tight glucose control, she has lost an amazing amount of weight. She now spends much of her time inspiring others, and lending other diabetics like her some positive energy! These accomplishments are nothing to sneeze at, and is worthy of being honored.

How has she done it? Purely by diet, exercise, and staying focused. On Tudiabetes site, she has written many blog entries on various subjects; ranging from processed foods, building awareness, personal frustrations, and being candid with her life, in addition to sharing with others who are willing to listen.

As many of us know, diabetes can be a very lonely disease for many of us. Rarely have I witnessed someone like Mari, who’s dedicated so much of her time to uplift others via the internet. She has also gone out of her way (many times) to do what ever it takes, in explaining complex subjects, be it concerning her life or diabetes.

© 2010 DiabeticRadio.com

Fiber is extremely important because it helps to create bulk in the lower intestines. Together with a generous daily intake of water, fiber can assist with healthy bowl movements, in order to safely get waste out of your body. In terms of fiber, water is key, because not only does water keep your body hydrated, it can also prevent constipation.  Fiber exist in just about all fruits and vegetables. You can also purchase fiber in the form of capsule or powder/liquid brands such as Benefiber.

How does fiber effect diabetics?? Well, I guess this is one of those things that’s a matter of opinion and personal experience. Speaking for myself, fiber should only be used for the expressed purpose of promoting healthy digestion. However, many dietitians and CDE’s recommend high fiber diets to diabetics because it often prevents sudden spikes in blood sugar. Although this is true, on the other hand, it can be a nightmare for some of us who take insulin.

Though nutrients extracted from fiber are digested more slowly, keep in mind your blood sugars are still rising throughout the day regardless. This means if you are a type 2 diabetic, and control your sugars by way of diet and exercise, you need to test your blood sugar more than once a day. It is the only way you will learn how certain foods effect YOUR particular body. The American Diabetes Association recommends that, your blood sugar should be in the range of 160 180 mg/dl two hours after food consumption. Blood sugar levels that are consistently higher for longer than a two hour period, can not only effect your A1C levels, but risk the start of long term diabetic complications.

In the long run, foods with high fiber, proteins, & fats, can make tight glucose control difficult for anyone that is insulin dependent UNLESS you are on a insulin pump. Newer insulin pumps have the capability of spreading out a bolus insulin dose, to compensate for the still rising blood sugar as a result of high fiber, proteins, and fats consumed. If your on Multiple Daily Injections (MDI) talk to your doctor about adding a few additional dosage of basal insulin; it may help prevent from giving yourself extra bolus shots.

Ultimately, this is clearly an individual decision, and I believe it’s important for all diabetics to have flexibility. Foods effect everyone differently, and understanding how fiber can change your blood sugar levels, is a huge advantage to controlling our diabetes.

© 2010 DiabeticRadio.com

I can’t stress enough, the patient/doctor communication factor. Your ability to effectively express how you feel, give the doctor a clue as to what may be wrong with you. Do not leave any details out, no matter how small you think it is. It is important to remember that in this day and age, doctors can see upwards of 400+ patients in a day, not including paperwork; there is very little time to hold any patient’s hand. Playing an integral role in your own diabetes care is key to a long complication free life.

The best way to manage the small amount of time you have with your doctor, is to purchase a small note pad, and write down any questions that you have for your doctor, along with your blood sugar history. Discuss these questions and concerns with your doctor, and write down his answers if it helps you to remember.

Many of us have more than one doctor or specialist. Do everything in your power to let each and every one of your doctors know all your current medications (even vitamins). Informing your doctors of any herbal substances, vitamins, medications, and sometimes even the kinds of fruits and vegetables you consume, may help avoid drug interactions (even some herbal teas has medicinal effects).

Ask your doctor for any resources he/she may posses, such as dietitians, support groups, Certified Diabetes Educators, and or even mental health. It is a documented fact that a measurable percentage of diabetics are more likely to experience depression. Seeing a therapist does NOT mean there’s something wrong with you mentally, its just another extension of the healing process. Depression and diabetes is a horrible mix, especially for those of us who are emotional eaters. Because of high food intake, stress hormones, and depression meds, can make it nearly impossible for any emotional eater to control their blood sugars. It is my belief that you absolutely cannot truly take care of your diabetes, without addressing emotional and psychological challenges. Otherwise, your life will be like a ping-pong ball.

Explore areas that alter your state of mind. Some examples of these are music, dance, board games, good friends, walking, sight seeing, aromatherapy, yoga, drawing, etc., etc. All of the above mentioned, are great tools that help to facilitate the manifestation of positive energy. Diabetes is a chronic and life long disease. Yet our condition does not inhibit us from doing anything we’d like to do. Let us live life as normal as we possibly can, and learn as much as we possibly can about diabetes. No information is too much information.

© 2010 DiabeticRadio.com

There is much debate amongst the various diabetic online communities, as to whether or not it’s ok to reuse your syringes and lancets. I truly sympathize with diabetics that are seriously struggling financially, and can’t afford their supplies, however, it is not medically safe to reuse syringes. Our blood naturally has pathogens (disease causing bacteria); once a needle has been inserted in to the skin (for longer than a second or two) the needle is now considered a bio-hazard, and or contaminant.  When ever possible, its important to use a brand new needle at all times. Reusing a needle is like using the bathroom without washing your hands.

Once the used needle is out of the skin & exposed to air, the contaminants grows and gets stronger. There are no white blood cells present to fight off those pathogens, therefore, if you reuse your needles, your potentially reinfecting yourself with stronger pathogens/bacteria, and the body has to work harder to fight them off.

Both syringes and pen needles have special anti-bacterial lubricants, that allows for a smoother and less painful entry. Reusing needles will eventually loose this special coding. Both needles will also eventually become dull and jagged at the tips. Once the tips are bent because of over use, you will potentially cause bruising, in addition to the infection that may be caused by the now overly contaminated needle.

In NYC, unfortunately, there are no official known procedures, as to how to dispose of your used diabetic supplies. If your @ work, it is my opinion (as a courtesy to others) that you store all your used test strips, lancets, and syringes in a coffee can, or one of these 99 cent hard plastic containers. Once container is full, tape up top securely and dispose by regular means, or you can give to your doctor and have him/her dispose of your medical waste. If your hanging out with some friends, another alternative, is to rap your used supplies in a napkin securely, and dispose of waste. Be respectful and mindful of non-diabetics; make sure all needles are covered bare minimum!!  No one wants to worry about being stuck with with somebody Else’s needle.

Lancets are a little different. To my understanding, lancets are generally ok to reuse, because today’s lancet devices are so fast, that the needle has no contact with blood. However, keep in mind that like syringes, lancets do become dull, and can cause bruising. Try to change your lancets at least once a week. Also make sure that you are rotating ALL sites..

© 2010 DiabeticRadio.com

Various things that can effect your blood sugars.

A couple of days ago, I happen to see the front page of my local newspaper, a picture of our NYC’s (legally blind) Governor David Paterson signing vetoes. I couldn’t help but share this picture with my visitors, because it gave me powerful flashbacks (just before my surgery). A reminder as to where I was, (visually speaking), and where I am now.  Like him, or hate him; indirectly, he is my role model in terms of not allowing his disability stop him from accomplishing his goals.  Granted, although both our situations are different, I’ve got a tiny glimpse of what my life may have been like, if I were permanently blind. It’s scary to think that there exist several other more serious and irreversible diabetic eye complications I could have had. Yet those cataracts has caused absolute chaos in my life. I could only stop and think, as to what Governor Paterson may have become, if he’d allowed his disability to be a hindrance, or the kind of health care he would have received if he were not Governor, or even the kinds of discrimination that disabled people often face.Were would I have been, if I did not grab the bull by the balls and get my job?? You’ll never know what you can accomplish, unless your pushed against a brick wall!!

I don’t think the average person understands, the level of emotional strength that is required, once you discover your going blind. Just trying to accomplish basic daily tasks was at times unbearable. I was barely mobile, and the insurance in/out of network crap did not make things any easier for me. I knew that if I did not act fast (before I’ve gone totally blind), my chances of finding someone to be my second eyes were slim.

At the end of the day, and all is said and done; experience has taught me that, you must keep yourself as healthy as you possibly can. So many hospitals are absolutely horrendous, often disorganized, unequipped, understaffed, and uncaring. Unfortunately, as health care cost rise, I predict this will get exponentially worse. This is were building a strong family & friends support group is important.

The time is now to take care of your diabetes!! If you  have a known family history of diabetes, get tested right away. Demand that your doctor give you an Hemoglobin A1C test. Take charge of your diabetes.

© DiabeticRadio.com

How to prepare for those unexpected moments, when diabetic looses his or her job. The importance of staying focused..

This nutrition label is based on two large oranges, taken from Calorie King's website. As you can see, these oranges has more sugar than one pack of plain old fashioned Twinkies (which is about 24-30 carbs) We need to focus on quality carbohydrates. calorieking.com

Although not the sole cause, but a huge contributor of type 2 diabetes, are what I call “empty sugars”. Empty sugars to me are basically foods that contain sugars with no nutritional value. Two average sized oranges can actually contain more sugar than a 1 pack of 2 traditional Twinkies cakes, yet, oranges are enriched with immune boosting vitamin C. Sugars aren’t the “bad” stuff. Sugars are really what the body uses to sustain life!! But if you consistently consume empty carbs, such as things that have processed sugars (ie, cakes, microwavables, canned foods), your not giving your body the nutrition it needs to rebuild itself. Glucose is the energy your body needs to live, but overall good nutrition are the building blocks of life. Without decent nutrition, your body cannot regenerate cells to heal wounds, fight bacteria, metabolize sugar properly, or keep vital organs functional.

Your liver shares the responsibility of regulating blood sugar, and in essence, produces the glucose your body needs to survive. During the digestion process, the liver also stores about 8-12 hours worth of glucose to be used as reserves. Before Glucose is stored in the liver, it is converted into glycogen. Throughout the day, your liver breaks down that reserved glycogen back in to glucose, and delivers small amounts of now sugar in to the blood stream. This keeps your body functional.

Sensing the presence of  glucose, the pancreas’s beta cells release insulin to help glucose enter your body’s millions of cells for energy. As a result of these processes, both the liver and the pancreas together help regulate your blood sugars and keep them at safe levels.

The pancreas and liver are extremely important, because it protects your body from accumulating high sugar levels in the body. If high glucose levels occur, the body will try to use expel this excess sugar by way of urination (which is the reason for the heavy thirst). Over time if not corrected, will start to damage vital organs, such as kidneys and heart, as well as a host of other complications.

Every single body movement, heartbeat, exercise, and even mental thoughts, require glucose to function normally. The brain uses a large portion of daily glucose, because it is the central processing unit. This is one of the reasons why, if your glucose levels are too low, confusion often sets in. Your brain absolutely cannot perform with low glucose. Your brain would be literally in competition with the rest of your body for glucose.

References: EHow,

© 2010 DiabeticRadio.com

Saturday August 28, 2010 @ St. Mary’s Park South; Food Demonstrations by: Chef Denisse Oller. Affiliated with the American Diabetes Association. Free medical Screenings, Live Music & Dancing, Children Activities, Guest Speakers, Health Info and More..

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August 28, 2010 11AM – 6PM

Ernie Isley, Chris Jasper and Marvin Isley. Photograph: AP

Bass player Marvin Isley of the Isley brothers has passed away on Sunday June 6, 2010; inside a Chicago hospital as a result of diabetic complications. Before his death, he retired early from playing in the group some time in the 1990′s. Later on, the disease progressed to a stage were both his legs were eventually removed.

Marvin was a great bass payer who helped the Isley brothers develop their distinct sound. At one point there were five Isley brothers in the group, including Marvin. Today, only Ronald Isley is touring full time after a three-year stint in federal prison for tax evasion.

The group’s hits included “Twist and Shout,” later recorded by The Beatles, “Love The One You’re With,” and the Grammy-winning 1969 smash, “It’s Your Thing.”

Diabetes is real folks!! It’s not a game. Become aware, and learn all you can about diabetes; by reading books, talking to your DOCTOR, and asking your DOCTOR questions..

© 2010 DiabeticRadio

A pilot medical study by the University of California, Los Angeles, or UCLA, uses mobile phones to help diabetes patients in South Africa. Our correspondent spoke with the physician behind the study, Neal Kaufman, about the expanding role of technology in personalized health care.

The UCLA project uses texting on mobile phones to encourage patients with type 2 diabetes to adopt more healthful lifestyles.

Dr. Kaufman, a professor of pediatrics and public health at UCLA, says this form of the disease, called adult-onset diabetes, is becoming common, even among children. He says the problem is in our genes.

“Our genetics have programmed us to want to eat sugar, salt and fat, and to be as inactive as possible,” he said. “And that’s what allowed us to survive when there was famine and when there was not enough food, when we didn’t want to burn any calories.”

Today, he says fat, salt and calories are too readily available and that health care practitioners must find ways to urge patients to avoid them. Text-messages provide one way to do that.

The South African study pairs low-income women with type 2 diabetes and links them by cell phone. Each day, a computer program sends an automated message to prompt a conversation between the women. The message might ask whether they ate a healthy breakfast or simply how they are feeling.

“The text message will ask them a question. That question, they answer to their peer as a way to begin a conversation or to encourage a conversation between peers,” said Dr. Kaufman. “And what we find is that a lot of these women who would otherwise be isolated and not have someone they could talk with are texting back and forth to each other, which they’ve never done before, in a way that’s really quite supportive.”

The text messages are supplemented by group meetings to help educate patients and provide face-to-face support.

Dr. Kaufman developed the program through a company he co-founded called DPS Health – one of many initiatives that uses technology in health care.

The South African project fosters peer-to-peer support and Dr. Kaufman says it has the advantage of being inexpensive. If the program proves successful, it can be expanded to a larger population at low cost. Most important, Dr. Kaufman says, it does not require a computer or Internet connection.

Other technologies connect patients to physicians or offer online chat rooms moderated by a trained medical practitioner. Internet sites provide prenatal advice for mothers or allow patients with specific medical conditions to share advice and comments. Some sites are moderated by trained professionals.

Dr. Kaufman says this type of technology will be an increasingly important link between patients and medical providers.

“We basically believe that most outcomes from chronic conditions can be improved if you help patients to help themselves,” said Dr. Kaufman. “Some people call that self-management support – managing their daily lives, helping them take their medicines, helping them to be more active, helping them to adopt health behaviors.”

Dr. Kaufman says the South Africa study will yield important information on how a population of middle-aged diabetes patients responds to text prompts from mobile phones. He says results so far show that patients are interacting and encouraging each other.

The UCLA researcher says the project is part of a trend to connect patients.

“We know that social support is the wonder drug of the 21st century, that connecting people to other people – whether it’s in person, whether it’s online, whether it’s through a cell phone – is really a very, very powerful medicine,” he said.

The World Health Organization says six people die every minute from complications from diabetes and that the prevalence of the disease is rising rapidly. It says the largest number of diabetes patients is in India, followed by China.

Dr. Kaufman says that if the UCLA project is successful, it can be applied to low-income diabetes patients around the world, including in the United States, where the disease is also a major problem.

© 2010

What is Diabetes?

Regardless of what type of diabetes you have, it boils down to the inability to process glucose properly. Either you don’t produce any insulin to assist glucose into your body’s cells; or you are insulin resistant, which basically means your body has become stubborn and will not accept any instruction from insulin. What is insulin? Insulin is one of the many vital hormones, that the pancreas produces to help keep glucose levels safe, and assist in feeding your cells glucose, such as muscle tissue and the brain.

A percentage of fats and proteins are converted in to glucose. However, carbohydrates is what effects our glucose levels the most. Our bodies take longer to break down fats and proteins in to glucose, but carbohydrates are processed rather quickly. I should also explain that their are two different types of carbohydrates, called simple and complex. Simple carbs are normally found in natural foods like fruit (processes quickly). Complex carbs, are normally found in processed foods like rice, pasta, and some vegetables such as potatoes (takes longer to break down).

With the exception of “FREE” foods, such as leafy foods like lettuce, greens, etc., virtually EVERY food has carbohydrates in them. Glucose powers our bodies and give it life, as well as give cells the energy it needs to build, heal, reproduce, fight infection, and all other overall functions. So you see, carbohydrates are not a bad thing, however, consuming it in excess is!!

The Key is quality foods. Since virtually everything has carbohydrates in them, it is important to make better food choices. It’s not enough to only eat low carbs. If what your eating has no nutritional benefits, then eating low carb (in my opinion) is in vain.

Fifty+ years ago, there was only one type of diabetes. Today, as we learn more about the disease, scientist realize that categories needed to be made to understand more about diabetes.

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TYPE 1:

This type of diabetes is an autoimmune disorder. This means that for whatever reason (not yet known), the bodies defense mechanisms, in essence attacks the beta cells of the pancreas, that produces insulin. The beta cells cells continues to be attacked until all beta cells are destroyed. Without these vital beta cells, insulin cannot be produced, therefore, glucose cannot be control, and in essence in a matter of a week can be life threatening.

It’s important to understand that in the case of people with type 1 diabetes, there is no cure, no amount of fruits, vegetables, herbs, vitamins, or minerals will “cure” type 1 diabetes.  Type 1, is NOT caused by poor diet, however, eating healthier and exercise clearly is the key for a longer life as a type 1 person. All type one’s will eventually become insulin dependent, and must inject a minimum of 3x a day, or before every meal to survive.

It was thought at one time that, only extremely young Caucasian children get type 1 diabetes. We now know that type 1 can occur in ANY age, and ANY race. There are many tests one can use to find out if you have type 1, however, the unfortunate reality is, most type 1 people find out when they are in the emergency room, with life threatening DKA. Doctors must do a better job in screening for type 1.

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TYPE 1.5:

Also known as LADA (Latent Autoimmune Diabetes in Adults), basically in my opinion, it’s the same thing as type 1, the only difference is that it is diagnosed much later in life. Also many LADA patients posses both characteristics of both type 1 ( no insulin production), and type 2 (insulin resistance). Because LADA happens much later in life, doctors often mistaken this as type 2.

Personally, on an emotional level, this effected me a lot because, I first thought it was because I was a bad diabetic, but in reality, it wasn’t my fault. I needed insulin. Sometimes it just takes work trying to understand, and finding a good doctor to overcome many of the challenges of diabetes.

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TYPE 2:

This is the most common type around the world. Statistics show that more people of color (this includes Latino, Asians, Indian, African, etc.,) are effected with type 2 that any other group.  Type 2 are what is called insulin resistant. Insulin resistance is really one of the body’s many “defense mechanisms”. When the body becomes insulin resistant, it is protecting itself from drowning in glucose, or glucose overload. Therefore the receptors no longer respond to insulin.

Without exercise and good diet, this condition becomes worse, ultimately resulting in dangerously high levels of glucose and eventually ketones. Type 2 people who are not injecting insulin must work much harder to control their blood sugars. Exercise is the key! When you walk, run, play, etc., this forces your muscles to become more insulin sensitive, or become more hungry for glucose. This will not only help the body control glucose levels, but prevent cells in your body from becoming starved for glucose.

This type of diabetes can be controlled without daily injections (for most people). However, their are times when diet and exercise is not enough, and you must take meds. This does NOT in anyway mean that you’ve failed, it just mean that you must take a different path, when current regimens are not working.

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TYPE GESTATIONAL:

Gestational diabetes occurs in women during or just after pregnancy. For some women gestational diabetes is only temporary, and goes away after giving birth. This would be understandable, as all kinds of hormones are ranging in a pregnant woman’s body. However, for some other women, it comes back later on in their lives as type 2.

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TYPE 3:

In essence, these are people who care for friends and loved one’s with diabetes. In my opinion, in many cases I called the the diabetes police!! I’m not sure if this needed a category, however, I guess it is necessary to acknowledge the emotional and psychological stress, that many of these people go through in caring and watching  loved ones with diabetes.

Copyright © 2010 DiabeticRadio

Researchers studied the prevalence of heart disease and stroke in four ethnic groups: whites, Chinese, South Asians and blacks all living in Ontario province, Canada.

Cardiovascular disease kills some 17 million people each year, and about 80 percent of these deaths occur in the developing world. Not every country is affected equally. But when scientists study populations in different countries, their results are influenced by a mix of culture, environment, and genetics.

A new study tries to sort out some of those factors.

A closer look at four ethnic groups

Researcher Maria Chiu and her colleagues studied the prevalence of heart disease and stroke in four ethnic groups: whites, Chinese, South Asians and blacks all living in Ontario province, Canada. They used data collected in national and community health surveys from 1996 to 2007.

Although all were living in the same place and had access to universal healthcare, Chiu found striking differences. Her analysis showed that more than one in 20 South Asians suffered from heart diseases, compared to around only one in 30 among the Chinese and black populations.

Chiu notes that those three ethnic and racial groups comprise 60 percent of the world population. “So it is important that we understand how these groups are, in terms of their heart health. And this study in Canada allows us to do that in a more controlled environment where everyone is living within the same physical environment as well as having access to universal healthcare.”

Chiu also looked at the prevalence of eight risk factors for heart disease and stroke, including smoking, obesity, high blood pressure and diabetes. These also differed significantly from group to group. For instance, whites were three times more likely to smoke than Chinese and South Asians. And South Asians and blacks were twice as likely to suffer from diabetes as members of the other two groups.

“Our study did not look at the causes for these risk factors being high and low,” Chiu explains. “It was important that we reported that they were high and low, and the next step would be to understanding why.”

Implications for policy makers

Chiu says her research raises important questions. And the answers will likely draw from a combination of factors, including genetic predisposition, cultural factors and socioeconomic status.

Chiu also said her research has important planning implications for policy makers. “For example, if we know from the study that diabetes is twice as prevalent among the blacks and the South Asian populations, and we know that the South Asian and the black populations are going to double or triple within the next 20 years, then our projections for our health care needs in the future, which currently are predominantly based on the white population, will be grossly underestimating our needs.”

Maria Chiu’s research is published in the Canadian Medical Association Journal.

© 2010 VOA

A new study released by the Registrar General of India indicates that obesity-related diseases have joined malnutrition as leading causes of death.

As India’s economy grows, so does the temptation for many people to eat more and do less. Tired and home late? Fatty food is just a phone call away.

Overweight, but eager to get married? Now there’s overweightshadi.com, an Indian dating site exclusively for obese people.

In a country where the Global Hunger Index shows that nearly half of all children are malnourished, many of India’s well-off citizens are now seeking treatment for obesity.

New Delhi-based business professional Aradhna Tripathi admits she loves to eat. “Eating is the most important thing in any Indian household and how you show your love and gratitude for a person is through the kind of food you serve him,” she said. “Indian people are used to eating the kinds of foods cooked at home that are filled with masala and oil. With the kind of sedentary lifestyle we lead, these are the reasons we have obesity increasing. “

India’s current National Family Health Survey indicates that more than 20 percent of urban Indians are overweight or obese. And in the northwestern state of Punjab, nearly 40 percent of all women are overweight or obese.

Tripathi says she was inspired to lose weight after contracting gestational diabetes during her recent pregnancy. Her mother and grandmother are both diabetic.

More and more Indians are signing up for weight loss programs out of fear of disease, says Vandana Luthra, managing director of VLCC, a global slimming agency based in India. “Earlier it was more of a luxury going to a spa or wellness center, but today it has become a necessity,” she said.

New data released by the International Diabetes Federation shows every sixth diabetic in the world is an Indian – earning India the title “the world’s diabetes capital.” Research over the past decade shows that genetically, Indians store more body fat per kilogram than Europeans. Leading health professionals agree, obesity puts Indians at an even greater risk of getting diabetes.

This risk is now crossing socioeconomic lines, says Dr. Anoop Misra director of diabetes and metabolic disease at New Delhi’s Fortis Hospital.

He says five years ago obesity and diabetes were limited to India’s most affluent. But, now poor Indians also are getting fatter. “We thought we’d find all malnutrition, but what we found was the paradox. Many people were thin and undernourished. The other side was many were fat and some of these belonged to the poorest section of this slum. This was a clear contrast, a paradox occurring in the same community. Half people overnourished, half undernourished,” he said. He blames the rise in obesity on inexpensive and oily snacks popular in Indian slums, and a lack of preventative education.

China is not too far behind India. The World Health Organization says China’s obesity rates hover at 5 percent, and almost 20 percent in select cities. But Dr. Misra says China is better equipped to contain the epidemic because it can employ uniform prevention efforts in schools. India has a more heterogeneous mix of government and private schools.

Despite that, Dr. Misra says he is optimistic that India’s obesity epidemic can be curbed. “It is the schools that we have to concentrate upon, it is the children that we have to concentrate upon. And if it a uniform physical activity and discipline dietary instructions are given right to the children I’m sure that it can be curbed,” he stated.

© 2010 VOA

Diabetes Forecast

The Diabetes Forecast magazine, has written a wonderful article about understanding the new “Latent Autoimmune Diabetes in Adults” (LADA), also known as Type 1.5 (personally I rather refer to this is LADA, type 1.5 makes me feel like I have a computer software in my body, and 1.5 is the upgrade version). Some people feel that it should be simply called type 1.

Do you get the feeling that we are starting to see too many labels for diabetes? Does these new categories help us, or drive more debate amongst the medical profession, and the general community at large? At present, there is so much lack of awareness about diabetes, from complications to actually learning how to take care of yourself as a diabetic.

I am really concerned that these labels will indirectly cause many more diabetics to hide their condition. As I try to educate myself more and more about diabetes and its complexity, the more I realize how so many of us are still in the dark. The average person has never even heard of LADA before.

This for me brings up an interesting subject. In doing my own personal research about LADA, I’ve found that most people who have LADA were misdiagnosed as type 2.  This is because most often LADA has both characteristics of  type 1 & 2.

Now, it has become general knowledge that type 1 are supposed to make up 10% of  all diabetics. However, with all the combined misdiagnosis of many patients supposed to be type 2, I think in actuality the percentage of type 1′s are significantly higher.

This strikes a personal cord with me. Because, the reality is………. You hear about all the diabetics that have died from complications, however, how many of those actually died from misdiagnosis? How many of those patients that died, should have been on insulin from the beginning? How many diabetics assumed that they were failures because they could not get their sugar down, when they should have been on insulin from the get go? What are doctors using to test for diabetes? Or are they base their diagnosis on the way a patient looks?

Visit the American Diabetes Association website and read their article on LADA, it is extremely interesting.

© 2010 DiabeticRadio

Mary Beth Eilders walks at Pecatonica River Forest Preserve. Photo by: AMY J. CORRENTI | RRSTAR

Mary Beth Eilders knew lifestyle changes were in order. The German Valley, Ill., resident didn’t exercise with any consistency, smoked up to a pack of cigarettes a day for 20 years and, at one point, weighed 240 pounds.

Dr. Murray Feingold, MetroWest Daily News health columnist

By Dr. Murray Feingold

Recently, I stopped at a drug store to buy a newspaper and strolled by the pharmacy counter. There was a long line of people waiting to pick up their prescriptions. And they weren’t all oldsters.

Looking at all of these people brought to mind a concern I have regarding the huge number of people who are taking medications.

What will they do if there is some type of disaster and there is no way for them to get their meds? To my knowledge there are no solid back-up plans to address this potentially serious issue.

How many of these people really need all of the medications they are taking?

Studies have shown that we are an overmedicated society.

Approximately 75 percent of all adults take at least one prescription drug. During the past 10 years the number of people taking a medication for diabetes or high blood pressure has increased by 75 percent. The number of prescriptions for antidepressants has increased by 50 percent.

The cost for all these medications is staggering. One estimate is that it costs close to $15 billion a year.

Medical progress is responsible for a great deal of the problem. Because of medical advances, people are living much longer and about a third or more of all medications are prescribed for this group.

The drug industry continues to produce newer, more effective medications that are usually quite expensive.

Today, more drugs are frequently used to treat an illness. For example, some people with hypertension are now taking three or four medications instead of one or two.

Years ago there were no statin drugs such as Lipitor or Zocor. Now, probably the majority of senior citizens are taking some type of statin medication.

During the recent debate on health care, because of the financial burden the cost of medications has placed on our economy, there were rumblings of limiting medications for our senior citizens.

It is obvious that we cannot continue on the present path regarding medications. Changes need to be made.

One thing is certain, there will be more intervention by the federal government – the automobile industry comes to mind.

Also, there will be increased limitations on the medications patients will be able to take.

Doctors will also encounter more paperwork if they want to prescribe drugs that are not on federal or third party-approved lists.

Consider today the glory days as far as getting your medications because tomorrow will be a much different story.

Massachusetts-based Dr. Murray Feingold is the physician in chief of the National Birth Defects Center, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.

Copyright 2010 Allston/Brighton TAB. Some rights reserved

© 2010 VOA

Photo: Image courtesy of El-Khatib et al., Science Translational Medicine, 14 April 2010 Depiction of the bi-hormonal closed-loop control system used in the clinical trial. The controller responded to venous blood glucose measured every five minutes using the FDA-approved GlucoScout (International Biomedical) and commanded insulin-glucagon control doses. The doses were administered using FDA-approved Deltec CoZmoinfusion pumps (Smiths Medical).

Jessica Berman | Washington

Scientists have developed a computerized system for diabetics that takes the guesswork out of controlling their disease. The prototype artificial pancreas monitors and regulates the amount of glucose, or sugar, in the blood of people with type 1 diabetes.

People with type 1, or juvenile, diabetes must keep a watchful eye on their blood glucose levels because their pancreases are not working normally.

The pancreas is an organ that in healthy people secretes insulin to convert glucose into energy. But in people with juvenile diabetes, the pancreas does not produce insulin and blood sugar levels can get dangerously high. Failure to maintain tight control of glucose levels – by measuring blood sugar with a meter and compensating with doses of insulin – can result in serious health complications, including blindness, kidney failure and heart disease.

Edward Damiano, a biomedical engineer at Boston University in Massachusetts, knows firsthand the challenge of managing juvenile diabetes.

“This is a condition that does not take holidays at all,” he said. “It’s a 24/7 kind of commitment, which is why it’s nice for me at this stage of my life to be able to take care of my son at night. But in seven years, he’s off to college. This has given me tremendous impetus to try and develop this technology and get it out there and make it available to people with type 1 diabetes before my son goes to college.”

Dr. Damiano has partnered with scientists at Massachusetts General Hospital to develop a computer program designed to run a system they call an artificial endocrine pancreas.

The system utilizes existing diabetic technology. The computer program continuously takes in data from a glucose monitor inserted into a patient’s vein and calculates the dose of artificial insulin that needs to be infused through an insulin pump.

The pump developed by researchers is a double pump – in addition to insulin, it automatically secretes glucagon, a hormone that taps glucose reserves in the liver, raising blood sugar levels when they get too low, a condition called hypoglycemia.

Dr. Damiano says the system restores, as nearly as possible, the body’s delicate metabolic balance.

“We’re bringing back to people with Type 1 diabetes not only the proper amount of insulin dosed correctly into the right amount, but also this ability to provide a little bit of glucagon after meals, if the insulin dosing turned out to be a little excessive. And that typically is enough to prevent people from becoming hypoglycemic. So it really prevents you from going low, and that’s its main function.”

Researchers ran trials of the software for the artificial pancreas with 11 diabetics. The system effectively controlled participants’ blood sugar for 27 hours, during which time they ate three high-carbohydrate meals and slept through the night at a hospital.

The artificial pancreas kept glucose levels within the target range for six participants. But the remaining five other patients did not respond as quickly to the insulin infusion and developed low blood sugar because the computer continued to administer medication.

Researchers adjusted their computer algorithm to the slower insulin absorption rate and on a repeat experiment blood glucose was tightly controlled in all of the subjects.

Steven Russell, director of Massachusetts General Hospital’s Diabetes Unit and co-author of the study, the next step is for researchers to develop a portable system about the size of a cellular telephone.

“The insulin pumps exist, the continuous glucose monitors exist. What’s really been missing is the right algorithm to connect the two components. Although we run it on a laptop [computer] so that we can monitor its operation, the algorithm itself doesn’t require a lot of computer power and could easily be run from a chip that has the capabilities of one that’s already in insulin pumps or in cell phones.”

With normal regulatory hurdles, Boston University’s Edward Damiano estimates that it could be between five and seven years before an artificial endocrine pancreas is commercially available.

Dr. Damiano says the system is not a cure, but it is the next best thing.

“It’s just something that hopefully will tide us over until hopefully a cure can be found,” he said. “But if it can’t be in the near term, it’s a far better solution than what people are doing right now. With all that decision-making on their own, this is basically coming in lieu of that.”

Researchers describe their artificial pancreas in this week’s issue of the journal Science Translational Medicine.

© 2010 VOA

Barb Marks and five of her seven siblings are diabetic. Marks watches what she eats and shops for sugar-free food, but she has recently become concerned about the potential health risks of aspartame, which is an artificial sweetener used in many sugar-free products.

By Pam Adams

Life’s just not fair. Biologically speaking, women carry more body fat than men. They require fewer calories than men. For most men and women, fitting in an hour of moderately intense exercise in an already hectic day is difficult, if not impossible. But for many women, most hours are already filled with a full-time job and raising a family. At the end of the day, at least in the U.S., there is little incentive to prepare a real dinner when fast food is so available – and so much more fattening. But some women working out at a Boston gym say they would be willing to wedge that hourly workout into their day. “I would be willing to do it if it was going to maintain my weight and keep my health,” Jane Davern said. “All right, I would do it,” Jean Holmes states. “I would exercise to maintain my body weight, yes.”

The U.S. Centers for Disease Control says the percentage of overweight Americans increased 60 percent between 1991 and 2000. The World Health Organization says more than one billion adults in other nations are in the same shape. While there is advice aplenty on how to lose pounds or kilograms, a new study focuses on middle aged and older women who maintain normal body weight, or BMI (Body Mass Index) and do not diet. “We found that physical activity was effective in controlling weight only among women who started off with a normal BMI,” I-Min Lee states. She and colleagues at Brigham and Women’s Hospital in Boston studied data from 34,000 women, whose average age was 54.

During a 13-year period, the women were separated into three groups. The first group exercised daily for 60 minutes. The second exercised 30 minutes a day, and the third group worked out less than half an hour daily. “These two lesser activity groups of women were significantly more likely to gain weight,” she said. “Compared to the most active group of women.” During the study, the average weight of the participants went up by six pounds, or 2.7 kilograms.

So, what can overweight women do? Surprisingly, I-Min Lee and her colleagues found more exercise did not help. “Once a woman became overweight or obese, there was no relation between physical activity and weight change among these women,” Lee said. But I-Min Lee says heavier women should keep on exercising. “While our study shows that this might not be sufficient to maintain normal weight, it clearly is sufficient to reduce the risk of developing many chronic diseases, including heart disease, certain types of cancer, type two diabetes,” Lee explained. The researchers say while exercise helps prevent disease, the only way that heavier women can lose weight is to simply cut calories. The study was published in the Journal of the American Medical Association.

© 2010 VOA

The fine line between faith, and getting medical attention!!

By TIM EHRENS

At age 19, Ryan Shafer knew there was something wrong with his body. The teenager from Horseheads, N.Y., felt lackadaisical, had vision problems and all of a sudden lost 25 pounds. When he was finally checked out by a doctor, the news confirmed one of his worst suspicions: He had Type 1 diabetes. Instantly, Shafer was forced to change to deal with the disease. He was enrolled in a junior college at the time and planned on attending prestigious Cornell University. But the kid had a passion for bowling and decided to see his dreams through.

His struggles with the disease inspired him to become what he is today, the 19th-ranked bowler on the Professional Bowlers Association tour coming into the Go RVing Match Play Championship beginning today at the Norwich Bowling and Entertainment Center. Shafer, the No. 16 seed, will face 49th-seeded Jason Sterner in the first round. “I had bowled in college and had a lot of success, and, eventually, I was going to go on tour,” Shafer said. “I started going on tour with diabetes, I don’t know any different. The entire time I’ve been on tour I’ve been diabetic.”

Shafer joined the tour after his graduation from junior college at age 20. His success was immediate — he won the PBA Rookie of the Year Award in 1987. With Type 1 diabetes, which typically becomes apparent earlier in life as in Shafer’s case, the person is insulin-dependent.

Big adjustment

At first, this was a hindrance to Shafer in terms of dealing with the constant travel inherent in a tour schedule. From a young age, Shafer was traveling from city to city, often switching time zones, all while trying to keep up with his insulin injections and making sure he didn’t have a sudden attack on the lanes.

Longtime friend and fellow tour member Eugene McCune, who met Shafer when he joined the tour in 1986, has seen the kind of physical demands Shafer has had to deal with firsthand.

“His body breaks down on him every once in a while. He gets cold shoulder, his joints hurt,” McCune said. “But it’s just going through it, some days it’s not anything he does but just all of a sudden he gets cold shoulder and he can barely move his shoulder. He just gets up and doesn’t quit and he just keeps on bowling.” A scheduling change about 18 years into Shafer’s professional career made it easier for him to deal with his disease and play his best on a consistent basis.

A big change

In 2004, the PBA switched to a more condensed schedule in which most of the competition takes place on Thursdays and Fridays instead of Tuesday through Friday. Shafer could abandon his old ways of taking three to four shots a day and sticking to a regimented eating schedule to deal with his condition.

In response, he switched to an insulin pump — made by a company called Animas — that he wears while he bowls. It supplies him with insulin and makes it easier for him to compete.

“What’s good about the Animas pump is, when I exercise, I can put it on a temporary rate that gives me less insulin so I don’t get lulls while I bowl,” Shafer said. “I can eat whatever time of day I want to and I don’t have to be on a stricter routine. It’s easier to manage my blood sugar levels.”

It seems to be working. Shafer is coming off of one his most successful years as a professional with seven top-10 finishes in 2008-09 and earning a payday in all 21 events in which he competed.

He also has four PBA tour wins over his career with two in 2000 and one each in 2002 and 2003, and he won the Stave Nagy Sportsmanship Award in 2009.

Opening up

Now, without worrying when or where he’s going to have to take his next injection, the 43-year-old Shafer has become a lot more open about his disease and, through his relationship with Animas, can educate people, especially youngsters, about diabetes and encourage them to lead an active lifestyle.

“I used to be a very private person when it came to that. I didn’t care whether I was diabetic or not,” Shafer said. “When I realized that there are kids out there who think that just because they’re diagnosed with diabetes that they can’t do anything and they kind of lead a sedentary life … that’s exactly the wrong thing to do. So, I thought it was kind of good for me to get my message out there and to tell people that you can do whatever you want as long as you correctly manage your diabetes.”

Shafer said as far as he knows, no other bowler on the tour is a diabetic. Since the pump is so visible, looking like Shafer “is bowling with a cell phone on his waist,” according to McCune, Shafer’s ailment is more apparent to other bowlers and has given him the chance to help others on the tour who might have a family member diagnosed with the disease.

Offering help

When Chris Barnes, one of the PBA’s biggest earners, realized his son Troy had Type 1 diabetes at age 6, Shafer instantly sought his fellow competitor out and offered advice on how to  move forward.

“He was one of the first to come to us and (offer) his help, his guidance. He was there to lend his support any way he could,” Chris Barnes said. “He’s been great about it from the get-go. He was very helpful, especially in those first couple of months (after the diagnosis).”

Shafer is approached by amateur bowlers and their families and is frequently asked how he deals with the disease. It’s just another example of how the 24-year professional can tell people his story.

“Once in a while, I’ll bowl regional events and another bowler will come up to me and tell me he’s a diabetic,” Shafer said. “Where it mostly comes into play is Pro-Ams. At Pro-Ams, I’ll have adults and even adults with their children come up to me and say their children’s diabetic and ask ‘How do you manage your diabetes?’ with such a schedule of traveling and stuff like that. It kind of makes me feel good that I can help them.”

For most, a diabetes diagnosis puts their dreams on hold. Not Shafer. The disease is the main reason he’s on the tour.

“I’m a professional athlete and I’m doing what I want to do in my life, and (anyone with diabetes) can do the same thing,” Shafer said.

n the US more people are developing kidney failure, and are becoming candidates for a transplant

Most of the studies on kidney donation focus on the recipients and how well they adjust to their new kidneys. A new study documents how well donors fare after the surgery. Kidneys are the most sought after donor organs around the world, according to the World Health Organization. To address the shortage, some hospitals have created programs that pair prospective donors with recipients. In 2006, the Johns Hopkins University Hospital held a news conference to announce a successful operation involving 10 people: five donors and five recipients.

Dr. Dorry Segev was one of the surgeons. He outlined the problem in an interview with VOA. “Every year we list more and more people for a kidney transplant and that’s because more and more people are developing kidney failure, more people are becoming candidates for a transplant,” he stated. People often become donors because a loved one needs a kidney. Some do it for altruistic reasons. That was Judy Payne’s motive. “It didn’t seem to be that hard of a decision. I like to give to others. I like to share what I can of my blessings,” she said.

Dr. Segev studied more than 80,000 live kidney donors from the time of surgery until three months afterwards. “What we found is that live donation is very safe, the risk of dying from donating a kidney is 3 in 10,000 which is much lower than the risk of almost any other operation that you can undergo.” Dr. Segev says the research snows that men and African-Americans have a slightly higher risk of dying after donation than other groups, but the risk is still small and that it has nothing to do with having only one kidney. “If you match live donors to other healthy people in the population there is no increased risk of dying down the road attributable to having only one kidney instead of two,” he said.

Research shows that the number of donors over the age of 50 has doubled. That’s one reason doctors want to know the risk of all groups of people before heading into surgery. The study appears in the Journal of the American Medical Association.

© 2010 VOA

HD quality.. First videocast for diabeticradio! In this episode I talk about my experience having cataracts, and growing up without any diabetic diagnosis.

Clinical trials showed a connection between Avandia and heart problems

A county in the U.S. state of California is suing GlaxoSmithKline, the maker of Avandia, a controversial diabetes drug. The lawsuit was spurred by a report on the drug released by the U.S. Senate last week (March 22). That report accused the drug company of withholding information about side effects of serious heart problems, including death. At issue now is whether Avandia should be taken off the market. A U.S. Senate report on the diabetes drug Avandia says both the manufacturer, GlaxoSmithKline, and the U.S. Food and Drug Administration should have warned patients about the dangers of the drug years before they did. The report recommends taking Avandia off the market. In 2007, Dr. Steven Nissen published a study showing that those taking Avandia had a 43 percent higher risk of having a heart attack and a 64 percent greater chance of dying from a heart attack than those not taking the drug. “We’ve been warning about this for two and a half years,” he said. “There really isn’t a good reason for physicians to continue to prescribe the drug. It’s time to get it off the market.” But doctors still prescribe Avandia to hundreds of thousands of patients worldwide.

Dr. Yasser Ousman at Washington Hospital Center prescribes it for some pre-diabetic patients or those in the early stages of diabetes. “There are a number of drugs that have been tested in these individuals and Avandia is one of them, and actually, it is quite effective in improving the blood sugar, in normalizing the blood sugar or delaying the occurrence of diabetes in these individuals,” Dr. Ousman said. “What bothers me the most is that every month that goes by, more people are harmed by a drug that people simply don’t need,” Dr. Nissen said. Dr. Nissen’s report was based on 42 clinical trials that showed a connection between Avandia and heart problems.

“I think when you look at the information and the statistics from the initial study, the initial paper by Dr. Nissen in 2007, the increase in the risks of heart attacks is actually small,” Dr. Ousman points out. He says that many over the counter drugs – aspirin, ibuprofen, acetaminophen or paracetamol – can be toxic if used improperly. “If you look at the large studies, that were published over the last several years, including a large number of patients comparing Avandia to a placebo or other drugs, there was actually no increase in that risk. That risk was based on smaller studies,” Dr. Ousman said.

A study on Avandia funded by GlaxoSmithKline published last year, found no increase in heart attacks. But it found a significant increase in the risk of heart failure where the heart cannot pump enough blood to the organs or muscles. A number of cases resulted in hospitalization or death. The Food and Drug Administration says it will review Avandia for heart risks and has scheduled a meeting of its advisory panel in July. The agency warns those taking Avandia not to discontinue use without consulting with a doctor.

Copyright© 2010 VOA

Joel Selanikio

Epidemiologist Joel Selanikio has used the explosion in mobile phone technology and the World Wide Web to deliver more effective public health services throughout the developing world.  Dr. Selanikio and his organization DataDyne.org are making a difference by improving the medical information available to public health programs in under-served areas of the world.  VOA’s Natalia Ardanza has a profile for this week’s “Making a Difference” series.

In Africa there is  another use for mobile phones.  Public Health workers in Kenya are now using mobile phones to gather health information from patients in remote areas and upload it to the internet for instant analysis at distant centers. And it is all happening thanks to Dr. Joel Selanikio. “You can really make a difference using just common modern information technologies,” he said. Dr. Selanikio first noticed the need to better use information technology for health care while working as a disease outbrake investigator for the U.S. Centers for Disease Control and Prevention.

“I began to take the first steps toward using things like pocket computers or PDAs [i.e., personal digital assistants] for doing field work,” Selanikio said. Dr. Selanikio left his position five years ago to co-found DataDyne.org with partner Rosa Donna — as a non-profit organization dedicated to providing sustainable information technologies in poor areas.  And with financial support from the United Nations Foundation and the Vodaphone Foundation, Selanikio developed EpiSurveyor — a free, mobile, Web-based and open-source data collection tool that is transforming the way public health is practiced in under-served areas of the world.

EpiSurveyor replaces cumbersome and costly paper-based data collection that can take months, and sometimes years to produce results. “Instead of collecting data today to plan for a campaign next year, changing from that to collecting data today to plan for what we do tomorrow,” Selanikio explained. “That is a pretty radical change.” Public health relies on the rapid collection of accurate data to track disease outbreaks, monitor vaccine supplies and other similar functions.

“The issue of flexibility, we need that,” Data Manager Yusuf Ajack Ibrahim said. Ajack is with Kenya’s Health and Sanitation Ministry and saw EpiSurveyor at work when a polio outbreak in 2006 was quickly contained, saving the lives of perhaps hundreds of children. “If you are to respond to an outbreak, I cannot wait for somebody to come all the way from the United States,” he said.

This year, Joel Selanikio received the prestigious Lemelson-MIT Award for Sustainability in recognition of these innovations.  EpiSurveyor is being used by more than 500 organizations in more than 100 countries, and it is being adopted for use in areas such as agriculture and public opinion polling.

© 2009 VOA

Genetic prediction of type 2 diabetes in the Botnia study

Type 2 diabetes has been loosely defined as “adult onset” diabetes, but as diabetes becomes more common, cases are being diagnosed in younger people and children. In determining the risk of developing diabetes, environmental factors, such as food intake and exercise, are known to have an important role; most people with type 2 diabetes are either overweight or obese. Inherited factors are also important, but the genes involved remain poorly defined. In rare forms of diabetes, mutations of one gene can result in disease, whereas in type 2 diabetes, many genes are thought to be involved. One difficulty in understanding the genetic role is that genes associated with diabetes might show only a subtle variation in their sequence, and these variations may be extremely common. Hence, it can be very hard to link such common gene variations, known as single nucleotide polymorphisms (SNPs), with increased risk of developing diabetes.

One method of finding these diabetes genes is by whole-genome linkage studies in which associations between parts of the genome and risk of developing diabetes are looked for. Studies so far have identified several candidate genes associated with type 2 diabetes, although many results have been difficult to replicate. The list of genes for which there is good evidence from meta-analyses includes genes encoding for PPARG, calpain 10, Kir 6.2, and insulin receptor substrate-1 (IRS1).

These genes have a variety of effects; PPARG P12A polymorphism is associated with enhanced insulin sensitivity and protects against type 2 diabetes. Two SNPs in the gene encoding for cystein protease calpain 10 (CAPN10) confer increased susceptibility to insulin resistance and type 2 diabetes. Kir 6.2 is involved in glucose-stimulated insulin secretion in pancreatic cells. And carriers of a polymorphism in the IRS1 gene have been shown to have reduced islet insulin content in pancreatic islets.

In this issue of PLoS Medicine, Valeriya Lyssenko and colleagues from Lund University sought to consolidate previous work by studying the predictive value of these variants for type 2 diabetes side by side in the largest study of its kind to date. They investigated the effect of these gene variants in 2,293 nondiabetic people aged 18–70 years old in western Finland—the Botnia study—over a median of six, range 2–12, years. In addition, they also studied the uncoupling protein 2 gene (UCP2)—a polymorphism in the promoter of this gene (UCP2 −866G>A) (rs659366) has been associated in some, but not all, studies with increased risk of type 2 diabetes and impaired insulin secretion.

The study took place from 1990 to 2002, and enrolled patients from five health centers in western Finland who were asked to have health checks every two to three years. Six percent (132) of people developed type 2 diabetes. The key finding was that variants in the PPARG and CAPN10 genes increased future risk for type 2 diabetes, particularly in individuals with other risk factors. In individuals with a high risk of developing diabetes—with a fasting plasma glucose (FPG) of 5.6 millimoles per liter and body mass index (BMI) of 30 kilograms per square meter—the hazard ratio increased to 21.2 for the combination of the PPARG PP and CAPN10 SNP43/44 GG/TT genotypes compared with those with low-risk genotypes with normal FPG and BMI less than 30 kilograms per square meter.

The researchers found that replacing the family history with the PPARG and CAPN10 variants in a predictive model (particularly in combination) gave almost the same strong prediction of subsequent type 2 diabetes. These genotypes also influenced the relationship between BMI and FPG, that is, in carriers of risk genotypes, there was a steeper increase in FPG for any given BMI.

The authors argue that the comparison of all the key gene variants side by side in one large study adds substantially to previous papers that have examined the effect of single gene variants on the risk of conversion to type 2 diabetes in interventional trials.

However, it is important to understand the effect of these variants on the risk of disease in a large, prospective observational study before studying additive or synergistic effects with interactions such as lifestyle changes, they said. One of the problems of other studies has been that results have been different between different subgroups.

Although this study has limited power, as the largest of its kind it suggests that genetic variants in candidate genes can predict future type 2 diabetes, particularly in association with conventional risk factors such as obesity and abnormal glucose tolerance. With accumulating data from prospective studies, it should be possible to define whether there will be a future role for genetic prediction of type 2 diabetes or whether these variants will influence response to prevention or treatment.

Photo: White House US President Barack Obama delivers the weekly address

As U.S. lawmakers work toward a final agreement on overhauling health care, President Barack Obama says some of the reforms will take effect this year. The president admits, however, that other changes will not be in place for several years. President Obama is working with Democrats in both houses of Congress to merge their two versions of health reform. In the meantime, the president is using his weekly radio and Internet address to assure Americans that once he signs a health overhaul bill, they will see immediate benefits. “We are on the verge of passing health insurance reform that will finally offer Americans the security of knowing they will have quality, affordable health care whether they lose their jobs, change their jobs, move or get sick. The worst practices of the insurance industry will be forever banned,” he said.

Mr. Obama hopes to sign the bill into law by early February. Some consumers and advocates are disappointed that parts of the plan will not take effect until as late as 2014. The president acknowledges that some of the changes will take time to implement, but he says others will start working sooner. “Now, it will take a few years to fully implement these reforms in a responsible way. But what every American should know is that once I sign health insurance reform legislation into law, there are dozens of protections and benefits that will take effect this year,” he said.

Mr. Obama says before year’s end, insurance companies will be prohibited from dropping coverage when a person becomes ill, people with medical conditions will be allowed to buy affordable health insurance, and some small businesses will get government help in covering their employees. “All told, these changes represent the most sweeping reforms and toughest restrictions on insurance companies that this country has ever known,” he said.

The president began his address by talking about the economy. The U.S. unemployment rate remained at 10 percent in December, and 85,000 more Americans lost their jobs last month. Mr. Obama said the road to recovery will be long and sometimes bumpy.

© 2009 VOA

SPRINGFIELD, Ill. —

Veteran central Illinois broadcaster Bob Murray lost 170 pounds on a liquid diet and got down to 210 – his “perfect weight” – in 2002.

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He maintained that weight for several months before beginning a slide into his old habits as a “volume eater” and food addict. He switched jobs and worked a new schedule that didn’t allow him to continue attending a weight-loss support group. After noticing he was gaining weight, he became self-conscious, and his daily workouts at the YMCA in his hometown of Decatur became less frequent. Then, after Murray found that his new wardrobe didn’t fit anymore, the floodgates to big portions and drive-through fast food swung wide open. And his motivation to exercise plunged. “You think that you’re doing OK, and suddenly the pants don’t fit like they used to,” he said. “Once you get the next-size pants, it’s goodbye.” Murray, 62, is far from alone in his journey. Gaining and losing weight are common in the United States, where two-thirds of adults are either overweight or obese, and it’s common knowledge that excess weight increases a person’s risk of heart disease, Type 2 diabetes, high blood pressure and several forms of cancer.

Some people maintain weight loss

Maintaining a weight loss is not as uncommon as once thought. Studies from the early 1990s indicated that almost everyone who lost weight gained it back within a few years. But those studies may have been skewed because they focused on people who were the heaviest and sickest, according to a 1999 study in the International Journal of Obesity. Authors of the study wrote that their nationwide survey of the general population found almost half of overweight adults who had intentionally lost 10 percent or more of their weight maintained the weight loss for at least a year. As many as 27 percent of them had kept the weight off for five years or more. That still means a majority of people regained weight, but the study’s authors wrote that they “reject the notion that weight loss maintenance is impossible.” Murray, who said he has gained back all the weight he lost – plus 30 pounds – said he would “love to lose weight, but like a lot of people who are overweight, I want to do it the easiest way possible.” David Steward doesn’t have to be told how hard it is to maintain a weight loss. The Springfield resident, a physician specializing in general internal medicine at Southern Illinois University School of Medicine, lost 60 pounds 4 1/2 years ago through healthier eating and regular exercise. Steward, 59, credited exercise – primarily bicycling – for helping him keep the weight off. But he won’t guarantee that he will continue to be successful, and he doesn’t look down on people who end up regaining weight. “I’m glad that it’s lasted this long,” he said “I’m always surprised that this is so hard.”

What has worked

The Rhode Island-based National Weight Control Registry has studied the habits of successful weight losers since 1994. More than 6,000 Americans who have sustained a weight loss of 30 pounds or more have volunteered to be in the registry. They lost weight with a variety of diets, and almost all increased their physical activity – mostly through walking. The ways they kept from regaining weight were strikingly similar, according to Graham Thomas, a clinical psychologist and co-investigator at the not-for-profit registry.

Most of them tend to eat a low-fat, low-calorie diet, and most said they consume fewer than 2,000 calories a day, although they really may be eating more than that and underestimating their consumption, he said. “They don’t tend to splurge on weekends or holidays, either,” he said. There’s not a lot of variety in their diets, which may help them keep track of calories through a limited number of “safe foods,” Thomas said. Most weigh themselves daily or, at minimum, once a week, and they exercise – a lot. The average was 60 minutes of moderate physical activity every day, which is what the Institute of Medicine recommends.

How do they find the time for all that huffing and puffing? They watch far less television – averaging 10 hours or less each week – compared with 28 hours for the average American adult, Thomas said. “The average American is sedentary,” said Anne Daly, a registered dietitian and director of a weight-management program operated through the office of Springfield endocrinologist Dr. Norman Soler. And most jobs don’t require heavy lifting, she said. The average farmer in 1900 burned 5,000 calories a day, she said. “Today, farmers sit on a machine and push buttons,” she said. To be successful at maintaining weight loss, Daly said most people need to both eat less and exercise more.

Bob Murray’s struggles

Murray, the voice behind the “Morning Newswatch” at Springfield radio station WTAX (1240 AM/107.5 FM), said he was successful at both sides of the weight-loss equation four times in his life, losing between 90 and 100 pounds in the 1980s before his biggest loss seven years ago. That was when a 4,000-calories-a-week liquid diet, supervised through Soler’s Health Management Resources weight-loss program, calmed his appetite and provided support and coaching, Murray said. Though never very athletic, Murray felt more energetic as he lost weight – an average of two pounds a week – and walked a treadmill for 45 minutes most days. Murray, who stands 6-foot-2, bought a whole new wardrobe and fielded questions from people who asked whether his shrinking body was the result of cancer.

But after he returned to solid food, he said he fell into a familiar pattern of feeling “cured” and relaxing his eating and exercise regimen. His switch from a daytime work schedule at WMAY-AM to a shift at WTAX that started at 1:30 a.m. coincided with his backsliding. But he didn’t put the blame on his new job. “It’s not the shift; it’s me,” he said. “In my case, I have to concentrate on losing weight. I have to change my complete lifestyle.” Since gaining back the weight, Murray said he and his wife, Sandy, who has never had a weight problem, don’t go to restaurants much anymore because he doesn’t want to draw attention to himself. For the same reason, he said he doesn’t eat when he makes personal appearances for his job.

“It gets you down,” he said.

Murray doesn’t go to the Y anymore and has a hard time mustering the motivation to exercise. “I have a great Schwinn Airdyne stationary bike at home that is a great clothes rack now,” he said. Daly said successful weight control usually is connected with accountability. For Steward, it’s his scale at home. “I weigh myself every day,” he said.

Dr. Steward’s success

Steward grew up in a small town in Iowa and was “always a little overweight,” he said. He played basketball and baseball for his high school teams and ran the 440-yard dash “slowly” for the small school’s track team, he said. His weight rose from 190 in high school to about 220 in college and fluctuated a bit during medical school at the University of Iowa, said Steward, who stands 5-foot-9. His maximum weight, in the mid-1980s, was between 240 and 250, he said. His big weight loss began after he fell on slick pavement while riding his bicycle in Washington Park. His knees, which had been giving him trouble for years, were badly twisted. The pain he felt while recovering from the fall made him realize that the excess weight he was carrying might make his knees wear out to the point that he would need orthopedic surgery within a few years.

Steward began exercising every day, something that his wife, Dr. Gina Kovach, had been doing already as part of her own strategy to stay fit. Steward, who is chairman of SIU’s internal medicine department, stopped snacking on candies, cookies and other junk food at work. And when the weather is bad, he works out hard – 40 minutes to an hour most mornings, getting his heart rate to about 140 beats a minute – on a stationary recumbent bicycle in his basement. He has set up a television in front of the cycle to help pass the time. “I keep telling myself I have to do this,” he said. “There’s no variety in it, but it’s easy on my knees.” Steward said he is fortunate to have the income to afford exercise equipment, and the time and a stable schedule that allows for regular workouts. He is quick to say that he doesn’t always eat healthy foods, but when he snacks, he tries to make low-fat selections. “I feel better in a lot of ways,” he said. “And my joints feel better.”

Dean Olsen can be reached at (217) 788-1543 or dean.olsen@sj-r.com.

Maintaining weight loss

People in the National Weight Control Registry who are successful in maintaining weight loss do these things:

_Most say they maintain a low-calorie, low-fat diet.

_78 percent eat breakfast every day.

_75 percent weigh themselves at least once a week.

_62 percent watch fewer than 10 hours of TV a week.

_90 percent exercise, on average, about one hour a day.

–Source: National Weight Control Registry, part of Brown University Medical School

While scientists have known for decades that vitamin D deficiency leads to bone diseases like rickets, more recently they have found connections between low vitamin D levels and a wide range of other illnesses, including cancer, autoimmune disorders and caradiovascular disorders.  The human body creates vitamin D through exposure to sunlight, and yet some of the sunniest parts of the world have the highest rates of vitamin D deficiency. Several factors have contributed to dangerously low vitamin D blood levels among people in the Middle East, Africa and Asia.

Vitamin D necessary for bone strength

Healthy bones depend on vitamin D, says Ambrish Mithal of the Indian Society for Bone and Mineral Research.  “Vitamin D is what absorbs calcium into our body and helps it reach the bone. Vitamin D deficiency, therefore, results in weak bones and bones that are soft, that will bend and break.”  Getting enough vitamin D should be relatively simple. “The major source of vitamin D is sunshine,” Mithal says. “We make vitamin D under the influence of UV rays that we get in the sunlight. We make it in our skin.”

Vitamin D deficiency common, even in sunny places

But some of the world’s sunniest regions have the highest rates of vitamin D deficiency. That’s the finding of a recent report from the International Osteoporosis Foundation, which reviewed research done over the past three decades. Mithal is a coauthor of that report. “Vitamin D deficiency is a global phenomenon. But certain parts of the world, they’re prone to severe vitamin D deficiency – for example, South Asia, like India, or Middle East, like Lebanon. There have been studies from these areas which have shown that almost 80 percent, or maybe even more, of the urban population is significantly vitamin D deficient.”

He points to several factors to explain why people who live in sunny areas still may not get sufficient vitamin D. “Those who live closer to the equator are actually less prone to vitamin D deficiency, but at times this, can be overshadowed by other factors like skin pigmentation, less outdoor activity and more skin cover with clothes,” Mithal says.

Vitamin D expert Michael Holick, of the Boston University Medical Center, explains why people with darker skin generally have lower levels of the nutrient than lighter-skinned people, even in the same country. “The major reason is that their melanin, which protects their skin from excessive exposure to sunlight, also prevents them from making vitamin D,” he says. “We showed that African-Americans need to be exposed three to five times longer to sunlight to be able to make the same amount as a white person.”

Another coauthor of the vitamin D review, Ghada El-Hajj Fuleihan, describes how people in the Middle East can spend time outdoors without absorbing enough vitamin D. “In these, the Middle Eastern countries, people tend to follow a very much more conservative clothing style, in a large proportion of subjects. And the other thing is that with modernization, women who do not follow the conservative clothing style use sunblock. Sunblock with sun protection factor as low as six and eight can completely block the ability of the skin to make vitamin D.” El-Hajj Fuleihan, of the American University of Beirut Medical Center, says this may explain why women in general have lower vitamin D levels.

Deficiency could be dangerous

There is new concern about vitamin D deficiency because, as Michael Holick explains, recent medical discoveries show it may be much more dangerous than previously thought. “What we haven’t appreciated until about the past decade is that vitamin D seems to be important for reducing risk of many chronic illnesses that span anywhere from autoimmune diseases like type 1 diabetes, multiple sclerosis, rheumatoid arthritis, to infectious diseases like tuberculosis and influenza, reduces risk of heart attack, stroke and most importantly, reduces risk of deadly cancers.”

Ways to get more vitamin D

People can get more of the nutrient in their diet. In the United States and other countries, some foods are fortified with vitamin D. But Holick says that’s generally not enough. “Children probably need a thousand units of vitamin D a day. Teenagers and adults need two thousand units of vitamin D a day to satisfy their requirement… You cannot get an adequate amount of vitamin D to satisfy your body’s requirement from your diet.”

So, he and other experts like Ghada El-Hajj Fuleihan, now recommend spending a little more time in the sun. “We are fully aware of the risk of skin cancer with sun exposure but suggest that there may be a happy compromise and that maybe the first 10 minutes or so three times a week… let the skin get some ability to make vitamin D, and then put the sunblock on.” In addition, she says, those who spend their days indoors should take a vitamin D supplement.

Although the World Health Organization has said that most people get enough vitamin D through sun exposure and diet, in light of the new research, it has commissioned its own report and may issue new recommendations.

© 2009 VOA

By monitoring the carbohydrates in all of the food and drink she consumes, Sarah knows how much insulin to give herself, but recently the teenager was fitted with an artificial pancreas that did the work for her. Sarah explains, “Not having the every day, every minute, every hour hassle of worrying about my blood sugars, if this comes into play, I can live a life like I did before, which is awesome [wonderful].” Sarah was one of 17 teenagers with type one diabetes who were fitted with the artificial pancreas at Yale-New Haven Children’s Hospital.

The device uses a sensor to monitor the glucose and a pump which distributes the correct amount of insulin needed. Dr. Stuart Weinzimer of Yale-New Haven Children’s Hospital says the artificial pancreas has wide potential for other diabetics. Dr. Weinzimer explains, “It would potentially benefit anyone with diabetes, type one or type two, anybody who requires insulin.” Researchers say as a precaution the insulin was dispensed only with a doctor’s approval.

But the artificial pancreas was found to maintain appropriate blood glucose levels for up to 16 hours. It kept on pumping throughout exercise, meal time, even long after it was time to turn off the light. Scientists plan less controlled studies on patients outside the hospital setting.

© 2009 VOA

By Melissa Westphal
Norwich Bulletin

ROCKFORD, Ill. — Shopping for health insurance plans has become increasingly stressful for small-business leaders and their employees.

Choosing the right insurer — for the right price — is a time-stealer, tearing them from their focus on customers and profits.

“It takes a lot of time to dig through the different plans and meet with people. It’s a part-time job” in itself, says Lucas Derry, executive vice president of Header Die & Tool Inc. in Rockford. “That’s time I (can’t) dedicate to strategic planning, to growth, to face-time with customers.”

For workers, it’s an ever-increasing financial burden.

Family premiums for Illinois workers rose 5.6 times faster than their paychecks from 2000 to 2007. On average, premiums rose by 73.1 percent, although median earnings rose by 13.1 percent, according to the nonpartisan Families USA, a research and advocacy group based in Washington.

Increasingly expensive medical technology and rising prescription-drug costs are the culprits behind the steadily rising costs, says Kim Bailey, a senior health policy analyst for Families USA. Those increased costs force employers into the agonizing annual process of finding affordable health insurance plans, even if it means reducing coverage or increasing premiums for employees. For some of them, dropping health insurance is the only option — which creates different problems as trained and trusted workers find work with employers who offer it. The number of Americans covered by employment-based insurance fell more than 5 percent between 2000 and 2007, Families USA reported this year. Many Rock River Valley employers provide coverage, but more are asking employees to help foot the bill.

Mike McKinnon, president of Rogers Brothers Galvanizing, says the company covered 100 percent of the premiums for its 75 employees about five years ago. But it fell to about 85 percent in 2007 because of increased costs. Rogers Brothers absorbed the increases for 2008 but asked employees to cover a larger part of their deductibles. “There is a considerable amount of administrative time involved in the insurance process,” McKinnon says. “It’s more of a retention tool because it’s something you want to offer to keep people.” Gary Dietz, a Rogers Brothers employee of 15 years, wasn’t surprised to learn that his health insurance costs through work would increase. But the company did a good job of explaining why, Dietz says. “They had a meeting before they ever raised the premiums. They explained where their money goes as a company and how much insurance costs have shot up.” Dietz, his wife and their four sons — ages 14 to 22 — are covered by his employer insurance plan, and he most notices the increase when it comes to filling prescriptions.

Still, he’s grateful the company offers it: “They shopped around and got their money’s worth.” Gloria Stuhr Pernacciaro, CEO of metal stamping company Reliable Machine, says the company shopped 11 other insurance carriers this year but stayed with Blue Cross/Blue Shield. That meant better coverage but increased costs. The company had not increased employee contributions since 2005, but Reliable couldn’t weather a 24 percent cost increase this year without passing it on. “We will have to find ways to save money in other areas to make up for the increase in health-care costs,” she says.

For instance, Reliable changed its production schedule in February 2006 so crews work four 10-hour days each week, saving the company money and giving employees three-day weekends. Pernacciaro also says employees were involved in investigating alternatives for insurance coverage so they better understood the costs.

Health insurance is the third-largest cost for Header Die & Tool, behind labor and raw materials, Derry says. Derry doesn’t see a point when the company would have to drop health insurance for employees, but deductibles and employees’ out-of-pocket expenses will increase. “We’re doing everything we can internally with employees to work on wellness initiatives and sharing what the costs are and how that affects the company. This does affect the overall bottom line of the company. When you absorb more costs, there is less left at the end of the day.”

About 50.7 million American families will spend more than 10 percent of their pre-tax income on health-care costs in 2008, and more than one-fourth of insured Americans report problems with medical bills or are paying off medical debt. Ella Hushagen, a health policy analyst and state policy coordinator for Families USA, says Illinois lacks protection in the individual insurance market to protect consumers, and some of the same issues can be applied to the small-group market.

The state needs to limit how much insurers can charge people based on their health status, she says, and needs to implement a minimum medical loss ratio to make sure insurers are using premium dollars efficiently. Hushagen also recommends requiring insurers to seek prior approval before increasing premiums. “Those are especially helpful for smaller firms because they see more impact from just one person’s health. In this case, there would be better risk-sharing capacity.”

Melissa Westphal can be reached at (815) 987-1341 or mwestpha@rrstar.com.

The bottom line
A report last month from the Kaiser Family Foundation, a nonpartisan health policy and communications research group, shed some light on why health care is so costly:

Expanding wealth. As nations become wealthier, they spend more money on health care. New treatment options and the development of new technology affect cost, too.

Obesity. People are getting fatter, and the chronic diseases related to obesity, such as hypertension and diabetes, tax the system because more people are seeking medical care and buying prescription drugs. About 45 percent of Americans suffer from one or more chronic illnesses, which account for 70 percent of deaths and 75 percent of all health-care spending.

Comprehensive health benefits. In a predictable irony, when insurance pays a higher percentage of the cost, people use more health care.

Inefficiencies in medical care delivery, such as lack of systems for electronically storing and transmitting health data, is another factor.

Prescription drug spending. It stood at $216.7 billion in 2006, more than five times higher than the $40.3 billion spent in 1990. Three factors driving those increases are increased use, price increases and changes in the types of drugs used.

Reforming the system
The National Federation of Independent Business (fixedforamerica.com) has published its small-business principles for health-care reform.

Included in those efforts is a list of 10 points:

1. Universal. All Americans should have access to quality care and protection against catastrophic costs. A government safety net should enable the neediest to obtain coverage.

2. Private. To the greatest extent possible, Americans should receive their health insurance and health care through the private sector. Care must be taken to minimize the extent to which governmental safety nets crowd out private insurance and care.

3. Affordable. Health-care costs to individuals, providers, governments and businesses must be reasonable, predictable and controllable.

4. Unbiased. Health care and tax laws should not push Americans into employer-provided or government-provided insurance programs and hobble the market for individually purchased policies. Small employers should be treated the same as large employers, who already can pool across state lines. A health-care system built on employer mandates is unacceptable.

5. Competitive. Consumers should have many choices among insurers and providers. Policymakers must alleviate the limitations that state boundaries and treatment mandates place on competitiveness.

6. Portable. Americans should be able to move throughout the United States and change jobs without losing their health insurance.

7. Transparent. Information technology should enable all parties to access accurate, user-friendly information on costs, quality and outcomes. Providers must be able to obtain relatively complete medical histories of patients. At the same time, patients’ privacy must be guarded zealously. The private sector must play a vital role in developing the new technologies.

8. Efficient. Health-care policy should encourage an appropriate level of spending on health care. Laws, regulations and insurance arrangements should direct health-care spending to those goods and services that will maximize health. Adequate risk pools throughout the health-care system are vital to accomplishing these goals.

9. Evidence-based. The health-care system must encourage consumers and providers to accumulate evidence and to use that evidence to improve health. Appropriate treatment choices and better wellness and preventive care should be key outcomes.

10. Realistic. Health-care reform should proceed as rapidly as possible, but not so quickly that firms and individuals cannot adjust prudently. It is important to assure that no one’s quality of care suffers as we move to provide coverage for all Americans.

By Mike DeDoncker

ROCKFORD, Ill. —

Caroline Trapp wants you to give yourself three weeks — OK, four counting a week to prepare to do it right — to become a vegetarian. Trapp, a nurse practitioner and director of diabetes education and care for the Physicians Committee for Responsible Medicine, offered that challenge in a series of talks sponsored by the University of Illinois College of Medicine at Rockford and Vegetarians in Motion last week. Her main message was that a low-fat, plant-based diet can be just as effective as some medicines in fighting type 2 diabetes. But she didn’t discount other possible benefits such as weight control, more energy and better-looking skin. “You can do anything for three weeks,” said Trapp, referring to a kick-start support program the Physicians Committee for Responsible Medicine will offer at www.pcrm.org/kickstart beginning Jan. 1. “The important thing before starting kick-start is the week of preparation.” She said that week is when “all the troublemaker foods” such as meats, dairy products, eggs and high-fat processed foods get cleaned out of the house and are replaced by fruits, vegetables, whole grains and beans.

“I always say to my patients, ‘Don’t walk out the door of this office visit thinking ‘OK, that’s it, I’m going vegan,’ ” said Trapp, who is board certified in adult primary care, diabetes education and advanced diabetes management. “Because when you encounter ‘OK, what am I going to make for dinner,’ and you don’t have the right foods in the house, you throw up your hands and say, ‘Oh, I can’t do this.’ “If you take an academic approach, and you do a little bit of reading, you’re going to get the right foods in the house and you’re going to figure it out. People go on diets and then they get hungry and it all goes out the window. If you’ve got the wrong things around, it’s too tempting, too readily available, too easy to fall back.”

Once the troublemaker foods are out of the house, Trapp said, the idea is to be 100 percent vegan for three weeks and the kick-start program will offer 21 daily menu ideas, videos and other support to help with the motivation. The upside of the program, she said, is that it doesn’t require attention to portion control, calorie restriction or limiting carbohydrates. “Three weeks, that’s not very much time,” Trapp said. “But it’s enough time to find that maybe your blood sugar has come down, or your weight might drop a few pounds, or you might find you have more energy.”

Trapp, who has 25 years experience in nursing, said she has seen several drugs that were touted as having the ability to revolutionize diabetes treatment come and go because of the effects they had on various body organs. “Drugs come with side effects,” she said, “and I’m not saying all drugs are bad and that some can’t control diabetes. But we have an opportunity here with a different way of eating that can help as well as some of those drugs, and I don’t think we’re going to prescribe our way out of this diabetes epidemic.”

Mike DeDoncker can be reached at (815) 987-1382 or mdedoncker@rrstar.com.

On the Web

Diabetes expert Caroline Trapp also recommends these Web sites for information on diabetes and diet:

By DEBORAH STRASZHEIM

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Griswold, Conn. —

Nick Emard, 17, used to bring in the back of the pack on the Griswold High School track team.

He was short, stocky and not very fast. But he liked running, so he kept at it. He met James Strmiska, 16, his sophomore year. In Little League, coaches used to have to stop Strmiska from sprinting past his teammates when running the bases. The two trained together with the cross country team, running nearly every day, until they became Griswold’s top runners.

Emard won the three-mile Windham Invite in September. Strmiska set a personal record in the mile of 4.34 minutes.Both athletes have type 1 diabetes, and are insulin-dependent. “They’re both unbelievable kids,” said Glenn LaBossiere, athletic director at Griswold High School. “They’re good students, the teachers all like them. They represent the school very well. They’re just kids you can count on.” Track and cross country coach Mike Flynn said Emard’s improvement is among the most remarkable he’s ever seen.“He just kept showing up, even in the snow,” he said. “You never know with new runners if they’re going to stick with it … but he just kept coming every day and he kept getting better and better.” He said both students are open to coaching and have excellent work ethics.“James is a kid who came out his freshman year of outdoor track, and the talent was there right off the bat,” Flynn said.

Both teens were diagnosed with diabetes at routine physicals without any symptoms. Type 1 diabetes disease occurs when the body doesn’t make enough insulin to control blood sugar levels. “They borrow each other’s (glucose) meter,” said Antoinette Strmiska, James’ mother. “When Nick was having a lot of trouble with his glucose level, James would say, ‘Here, borrow my meter,’ or, ‘You need to have a snack.’ They’d look out for each other.” Strmiska, of Canterbury, has an older brother who was diagnosed with diabetes at age 5. James Strmiska used to help his older brother, his mother said. James Strmiska played basketball in middle school and said he started track because of the disease.

“It definitely takes my mind off it, and it helps with the blood sugar,” he said. Strmiska also likes to eat — hamburgers, apples and spaghetti — and exercise helps lower the blood sugar. Emard is the second of three boys. He moved to Griswold about seven years ago from Indiana, ran in middle school, and played a year of high school soccer before trying winter track. “I like the team aspect of cross country, that you compete as the team,” he said. “But it’s also individual, because you run for yourself and your own times. I think it’s kind of relaxing, too. Because you just put your problems behind you and run.” The boys ran together all summer, and ran near the front of the pack during the Windham Invite. Strmiska’s mother was cheering in the crowd when Emard finished first.

“We were so excited, we were screaming at the top of our lungs when he came around the corner,” Antoinette Strmiska said. Both said they’d like to keep running in college. Strmiska said he might become an athletic trainer or a doctor someday. Emard’s thought about physical therapy. “I think Nick will run in college wherever he goes, and I think throughout his college running he will just get better,” Flynn said. “James has all the talent in the world. He can be as good as he wants to be.”

Soda Vending Machine

Sugary soft drinks are coming under fire from health experts and government officials, who blame them for making people fat. While millions of people around the globe continue to purchase and enjoy the sweet, carbonated beverages, others have come to see them as a health hazard. In the United States, experts are careful not to put all of the blame for the nation’s expanding waistlines on the consumption of just one food item. But they say about half of the recent increase in Americans’ caloric intake comes from liquids, and primarily sweetened beverages. Soft drinks, at least the non-diet variety, are loaded with calories. Some brands contain as much as 83 g of sugar in one serving. The U.S. National Soft Drink Association acknowledges that people drink huge amounts of their products. The association says the biggest consumers of soda are young males, who drink, on average, nearly two liters each day.

SUGARY CALORIES CAN MAKE YOU FAT

Diets high in sugary drinks are linked to obesity, which in turn is linked to a number of serious diseases such as diabetes, high blood pressure, heart disease and stroke. Some medical experts say nearly two thirds of Americans are already overweight. They predict that more than a quarter of the public could soon be become obese if the trend continues. (Obesity is roughly defined as being 13 kg heavier than one’s expected weight). n the face of such facts, government and school officials, as well as medical associations are becoming more aggressive in their opposition to soft drinks. Already, many schools in the U.S. have banned or restricted the sale of soda. According to researchers hired by The Alliance for a Healthier Generation, the campaign resulted in a 65% reduction in shipments of full-calorie soft drinks to schools from 2007 to 2008.

“In August, the American Heart Association issued a recommendation that Americans significantly reduce their intake of sugar. The new recommended maximum sugar intake is 44g daily. That’s less than the amount of sugar found in one can of Coke or Pepsi.”

GOVERNMENTS TAKE ACTION

Government leaders across the country are beginning to propose new taxes on the popular beverages.

California state senator Alex Padilla, who chairs his state’s Select Committee on Obesity and Diabetes, plans to hold hearings in November on the link between soda consumption and obesity. In San Francisco, Mayor Gavin Newsom says he will propose legislation that would impose a fee on stores that sell sugary beverages. Newsom calls soft drinks “the new tobacco,” saying they have joined cigarettes in the pantheon of dangerous health hazards.

DOCTORS TAKE AIM AT SODA

The medical establishment in the United States seems to be lining up solidly behind the idea that the consumption of sugary soft drinks should be discouraged through taxation. The American Medical Association (AMA) has called for a tax on the sweeteners used in soft drinks with the money going to pay for a public health education campaign. The New England Journal of Medicine, wants a tax on each purchase of any beverage that has added caloric (non-diet) sweetener. The tax would raise the cost of a bottle of soft drink by 15-20 percent, but reduce by 10% the nation’s caloric intake from sweetened beverages.

Although the Obama administration has not officially come out in favor of a such a tax, Dr. Thomas Frieden, Director, U.S. Centers for Disease Control, openly favors it. Sweetened beverages “play a significant role in the obesity epidemic,” Frieden says.

THE NEW TOBACCO?

The New York Times newspaper recently quoted soft drink industry spokesman Kevin W. Keane as denying that soda alone is responsible for the nation’s obesity problem. He calls obesity a complex problem and questions whether taxing the beverages would help.

With all of the bad publicity, the soft drink industry has seen a decline in sales beginning in 2005 and in each following year.

Products popular with the public have come under government fire before. In the last century, scientific studies demonstrated that smoking was harmful to people’s health. The U.S. government restricted the sale of tobacco and put high taxes on cigarettes to discourage people from smoking. Some are wondering if sugary soft drinks are about to get similar treatment.

© 2009 VOA

All-American Sweetheart Mary Tyler More Tells Story of Battle with Diabetes

This is an adorable clip i’ve found, of a mother talking about her son who is a type 1 diabetic.If a mere child can test and take care of his diabetes, then adults can to! lets all follow this young man’s example..

O'odham people are being encouraged to go back to eating the traditional foods and a cafe on the reservation is making those foods appealing

The second largest Native American tribe, Tohono O’odham, has the highest rate of adult onset diabetes in the world.   Many of the tribe’s 28,000 members live on a reservation in the desert in the U.S. southwest state of Arizona.  Until 1960, no one had diabetes because people ate traditional foods that helped prevent the disease.  But with the introduction of foods high in fat and calories, diabetes became widespread, including in children.  Now the O’odham people are being encouraged to go back to eating the traditional foods and a cafe on the reservation is making those foods appealing.

This is lunch hour at the Desert Rain Cafe on the Tohono O’odham reservation in Arizona.  Each dish contains at least one traditional food from plants that grow on the reservation.   This popular chicken sandwich has a sauce made from Prickly Pear cactus.  Customers are raving about the tasty and healthy food. The cafe also serves calcium rich cholla buds from the Cholla cactus, and fruit smoothies with nutritious chia seeds.  Cafe manager Sam Saunders says another popular meal is meat with high protein tepary beans.   He also says he put seeds from a giant cactus in the region in some dishes. “These are the saguaro seeds that are grown on the Saguaro cactus.  It’s harvested only one time a year,” he explained.

Tristan Reader, Co-Director of the Tohono O’odham Community Action group, started the cafe to encourage people to eat traditional foods. “A mom might be able, if she doesn’t have time to cook, she can come in, get those good, healthy foods, and take them home for dinner,” Reader explained. Tribal health officials say up to 70 percent of the O’odham people have diabetes.  Reader says the traditional foods can prevent diabetes, which affects children as young as six years old. “The same compounds that let the plant survive actually regulate blood sugar levels.  They keep blood sugar levels even and help prevent diabetes and keep diabetics healthier,” he said.

Faith Pablo is with a diabetes prevention program on the reservation and is testing this woman’s blood sugar level. “We want people to eat more traditional foods again, to use more of those foods that weren’t raising sugars, to get people to become more aware of what they’re putting in their bodies,” Pablo said. Traditionally, the Tohono O’dham were farmers who harvested food from native plants and grew crops that could withstand the desert heat.   But today few people farm and the cafe is growing its own crops.

Until 1960, no one had diabetes because people ate traditional foods that helped prevent the disease. But with the introduction of foods high in fat and calories, diabetes became widespread among the Tohono O’odham tribe.

Farm manager Noland Johnson says the tepary bean is one of the world’s most heat resistant. “They’re very drought tolerant.  I’ve seen them go up to 4 or 5 weeks without water,” he explained. The farm also plants corn that sprouts quickly from the dry earth.   The corn is served at the café and is also dried for future use. “It’s pretty much saved for years, that you can keep it and store it, and then eat is when you need it,” Johnson said. The Desert Rain Cafe is introducing traditional foods to young people who may not have eaten them before.  This girl says it would be hard to give up some of the less healthy foods she’s used to eating. Reader says he wants schools on the reservation to serve traditional foods, instead of high calorie and fatty meals. “And if a kid grows up eating traditional foods, one or two meals a day, every day at school, then that’s what they are going to be used to,” he said. He says bringing back traditional foods is also important in preserving the Tohono O’odham culture, because those foods are part of stories and used in ceremonies.

Deborah Block | Tohono O’odham Reservation, Arizona

Keeping diabetes in check between doctor visits (ARA) – Americans are taking a closer look at their own personal health and assessing changes they can make, as the topic of health care remains front and center. More and more, people are paying attention to the cost of prevention and care for chronic illnesses such as diabetes, as they have a high risk for health complications. Diabetes now affects nearly 24 million people in the United States, an increase of more than 3 million in approximately two years, according to 2007 prevalence data estimates released by the Centers for Disease Control and Prevention (CDC). If not controlled, diabetes in particular can lead to serious health complications including heart disease, blindness and kidney failure. That’s why it is extremely important to manage the disease on a daily basis. To stay healthy and avoid potential consequences, people with diabetes can take steps every day to manage the disease. In addition to eating a balanced diet and exercising, this also involves monitoring blood glucose levels each day and seeing their physician regularly to check in and monitor their A1C levels – a test that provides a two to three month indication of average of blood glucose. Fortunately, medical advances have made it easier for people with chronic illnesses, like diabetes, to closely monitor their health and better manage the disease, along with their healthcare providers. For example, years ago, people with diabetes relied on laboratory obtained tests to get a clinical measure of their A1C levels – a process that required a wait time. Now patients can, for the first time, test their A1C at-home and get results within five minutes with Bayer’s A1CNow(R) SELFCHECK in between regularly scheduled doctor visits. This allows them to take a more active role in their diabetes over the long term, like modifying their diet and exercise, and have an informed discussion with their healthcare provider based on the results. By working with their doctors on appropriate disease management, patients may see a reduction of their A1C level and subsequently reduce their risk for complications associated with diabetes. A 1 percent point reduction in A1C can reduce the risk of serious complications by 40 percent. The A1CNow SELFCHECK allows patients to further participate in their diabetes care by monitoring their A1C levels in between physician visits. The American Diabetes Association (ADA) recommends performing an A1C test at least two times a year in patients who are meeting treatment goals and have stable glycemic control. The ADA recommends quarterly testing (four times a year) for patients whose therapy has changed or are not meeting glycemic goals. Clinical research and advancements in technology are helping people with diabetes manage the chronic condition to achieve long-term success until a cure for the disease is found. People with diabetes are encouraged to visit www.SimpleWins.com for more information on the tools and resources that can help them properly manage the disease and invest in their health. Courtesy of ARAcontent.

Rubyna Bhayani , Registered Nurse and Certified Case Manager with extensive clinical experience in the fields of Geriatric Case Management, Long Term Disability Management and Home Health Services.  I am the Proud owner and manager of Senior Care Companion, an in-home Personal Care Assistance Provider.

I’ve read many articles on diabetes, but there is one subject that seems to be seriously overlooked; and that is….. diabetics who are starving themselves, because they think its the only way, to control sugar AND loose weight (without medication). Too many diabetics are also not talking to their doctors about this major problem; a lot of people are too embarrassed to tell their doctor that they are hungry, in addition to some diabetics seeing this as a possible sign of failure, weakness, and or not having will power. Diabetes is more complicated than people realize. It is extremely important that you stay in constant communication with your doctor. I understand that their are many people who prefer to do it naturally. However, for some of us, sometimes for what ever reason our bodies will not cooperate. Some diabetics (type 2 in particular) have no other choice but to be put on medications.

Another element that adds more difficulty, is the assumed or misinformation about carbohydrates. In the fitness world or the world of gym bunnies, there are some diets that promote high consumption of carbohydrates; but to a diabetic can be extremely dangerous in terms of long term. Many assume that carbohydrates are bad for you, then try to cut it out of their diet completely. This is not a good plan of action and can often prove dangerous for some diabetics; since carbs are literally our life force.  Paring up with a good endocrinologist is key. Endocrinologist, are not just people who talk to you about diet, they ARE DOCTORS and  most specialize in this area of diabetes and metabolism. Remember, just like computers, research and the study of diabetes, are always changing.

ALL DIABETICS NEED TO KNOW that carbohydrates is one of the main and vital sources for the body’s energy and fuel. Over 90% of what we consume has some form of carbohydrates, and that includes meats, rice, veggies, even some of the so called “sugar free” products (but that’s another subject by itself). The main thing to focus on is your quality of carbs you consume. You also need to know that, if you deprive yourself of all carbs (which is just about everything, short of leafy vegetables), your not only run the risk of making your body grow hungry; your depriving the body of its prime source of energy, depriving it of being able to defend itself against outside forces, such as bacteria, germs, infection, the ability to regenerate cells, to heal itself, as well as possible organ damage (long-term), these are just a few… The key thing to remember as a diabetic, your sugar cannot be consistently high OR consistently low, for a prolonged period of time. It is the consistency that causes the diabetic complications. This is when your blood glucose meter comes in, so you can monitor your blood and know where your heading, allows you to know how particular foods effect your blood glucose, and the opportunity to change your A1C to healthier numbers.

Carbohydrates are good for us in moderation. There are 2 main things to consider, in terms of carbohydrates (aka sugar) that is, natural sugars and processed sugars. Natural sugars are fruits, honey, etc., (some fruits have more sugars than others), and the process sugars are cakes, chocolates, taffys, pies, breads, etc,. You would want to go after the natural sugars, not just because of more vitamins and minerals, but because your body can break them down much better. You may be treating your tongue to a great tasting ‘devil’s chocolate cake”, but you are definitely not doing good by the rest of your body, when it is consumed in excess. On the other hand, it’s about better food choices, not starving your body either. Do not allow your tongue’s taste buds, override your need for nutrition.

Yogirajj
copyright © 2009 USA/International

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Melissa, 17, has had diabetes since she was 3 years old. When she was young, her mother took care of her diabetes management, and Melissa’s A1C’s were usually under 8 percent.

When Melissa became a teenager, she began to take more responsibility for her diabetes care. She took glargine once a day and lispro before meals. She based her mealtime doses on how much carbohydrate she planned to eat. She also added a correction factor if needed, adding 1 unit for every 50 mg/dl above 100 mg/dl.

At a recent diabetes clinic visit, Melissa said that she was satisfied with her blood glucose control. When her meter memory was downloaded, it showed at least three or four blood glucose checks a day, and almost all were in the 70-180 mg/dl range. But her A1C was 9.4 percent. That meant that Melissa’s average blood glucose level over the past two to three months had been over 250 mg/dl.

Possible Reasons:

There are many reasons an A1C may not agree with home blood glucose checks.

If you check your blood glucose levels only before meals, you catch only the lowest values of the day. By checking two hours after meals, you may catch some high glucose levels that would otherwise be missed.
Glucose meters need to be calibrated with a code from the test strip. If the wrong code is entered, the results may be wrong.
Test strips need to be protected from light. If they aren’t, they may give incorrect results.
Some medical conditions can affect A1C.
But in teens, a surprisingly common reason that an A1C does not agree with the blood glucose log is that the numbers in the log aren’t true. Some teens simply make up numbers without checking blood glucose. Others report numbers that are “better” than what the meter showed.

“Exhausting”
After a lengthy discussion, Melissa admitted that she had used the meter’s control solution for most of the checks. She said she was tired of dealing with her diabetes, and she found it “exhausting” to meet the expectations of her family and diabetes team.

Her mother, who always came with Melissa to her clinic visits, was surprised to find out that Melissa had used the control solution. She said she had little involvement now with Melissa’s diabetes care. Melissa seemed to want to be more independent, didn’t want her mother to “nag” her, and seemed to have things under control.

Caution: Teen Years Ahead
The teen years are rough, for teens and their parents. Diabetes adds another area for conflict.

In many children, blood glucose control worsens when they hit their teens. Part of this is biology: Growth hormone, testosterone, and estrogen make their bodies less sensitive to insulin. Part is social and psychological: Teens want to be to be like their peers. They want to be independent. They test limits.

When out-of-range blood glucose numbers start coming up, parents may get upset or angry, and may nag or punish. Or at least, this is how the teen sees it. So the teen may become secretive.

It’s tempting to think that this is “just a phase” and that diabetes control will get better again after high school. But recent research suggests that poor coping habits now may continue into adulthood. It’s important to break this cycle now.

Your teen is not mature enough to handle all his or her diabetes care alone and still needs your help with this complicated, frustrating, never-ending task.

What You Can Do

Get help from your diabetes care team. Extra sessions with the diabetes educator may be needed. It may help to see a social worker or psychologist, who can teach your teen coping skills.
To keep from “nagging,” try having a set time every evening to review your teen’s blood glucose results.

- Keep in mind that the numbers on the meter are neither “bad” nor “good,” they are information.

- Your job could be to simply record the numbers from the meter’s memory. Or you might help your teen look for patterns: highs or lows at certain times of days, or on certain days. Talk to your diabetes educator about how to adjust the insulin plan when you see these patterns. Your teen may need to take a break from diabetes care, and you could do all the tasks that day.

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Susan C. Conrad, MD, is a pediatric endocrinologist at Children’s Hospital and Research Center at Oakland in Oakland, Calif. Stephen E. Gitelman, MD, is a professor of clinical pediatrics in the Department of Pediatric Endocrinology at the University of California, San Francisco.