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Wednesday, April 28, 2010

Doctors and Patients Doing Better at Managing Diabetes

Doctors and patients doing better at managing diabetes? This I've got to see. I must confess when I first saw this last year, I was intrigued and wanted to know more. That is why I am re-visiting the topic to see if there is something new on the issue.

For one thing that news article made me happy. Why? Because the last report of the health quality group that examined the care of diabetics in the Cleveland area indicated both the doctors and the patients are a little better at managing the condition. If this keeps improving, complications can all be eradicated. I hope they will also evaluate the diabetes care in all areas of the US.

You see in Cleveland area, the health quality group started studying the care the diabetic patients received. Their latest report was that the doctors and patients were doing slightly better at managing the condition. The keyword here is slightly and I am not too happy with that.

The Better Health Greater Cleveland also found that half of approximately 25,000 diabetic patients received a pneumonia vaccine. They also received recommended tests for blood glucose and kidney and eye problems. Although half is not good enough, still Cleveland is doing well for its effort to even track this issue. I doubt if other cities are doing this.

Back to the study findings, around 40% met the standards for blood glucose, cholesterol control, blood pressure and other measures. By the following year, there was a slight improvement. There Is that word again that I do not like. But you know what? There is something else that makes me really, really feel bad.

The slight improvement was not found among the patients who were uninsured. The same is true for those who are on Medicaid. This is the health plan the government has for the poor. This group's success at meeting the standards for blood glucose control and blood glucose is much lower. Doesn't this make you sad? For although I have excellent health care insurance, I am not comfortable when others do not have it.

At least with the new Obama Health Plan, things may get better. Better Health Greater Cleveland should be commended though for checking the clinical care of patients in order to improve the quality. With this in mind, the complications from diabetes will of course be reduced. And this is only possible with better help between doctors and patients.

Thursday, April 22, 2010

Diabetes and Pedicures: Do They Go Together?

Diabetes and pedicures, what's wrong with this combo? Ladies, be careful with pedicures if you have diabetes, in fact you have to be careful even if you do not have diabetes for I have heard some horror stories about it. If you must have a pedicure, make sure you choose the establishment wisely.

I know of a lady who decided to have a pedicure because she felt she needed one. She had calloused feet and so wanted to have better looking feet. The manicurist cut the skin on the side of her big toe and to her horror even drew blood. And you know what happened? It became infected.

She knew she was being vain for wanting nicely red painted toenails. She wanted her feet to look nice when she wears her sandals. She looked at the other women with pretty toenails parading down the street in their sandals and she so wanted them for herself.

The trouble is she has diabetes. She remembers clearly what her diabetes educator said in one of the classes she attended. She advised the class never to have pedicure. And she now thinks she was foolish not to follow that advice because it took a long time for the infection to heal.

You see diabetes and pedicure do not go together because the injury to the feet can become such a big problem. While getting a pedicure, you run the risk of getting injured. This is like inviting infection to the feet which could cause high blood glucose.

You know what happens when the blood glucose is high. The healing process does not come easily and worse, you may not feel the damage which will exacerbate the injury. This can become an ulcer and then when it becomes worse, amputation could become a reality.

That is why we have to take good care of the feet and avoid all kinds of injury. But if you still insist on getting a pedicure, there are certain recommendations you must keep in mind and act on. This way, you have less chance of getting your feet injured. Here are the recommendations:

  • Pick the right salon. Check out some for cleanliness and tools. See if they sanitize the tools before using them. Better still bring your own tools to use.
  • Have the pedicure two days after shaving the legs so there is less chance for the bacteria to get in through the cuts and nicks.
  • Tell the pedicurist some instruction and inform her that you have diabetes.
  • Is the foot tub clean? Do they get this cleaned before every client?
  • If you must use their tools, insist on stainless ones as they are more sanitary than the wooden ones.

There you have the recommendations you need to do before getting a pedicure. Your feet are a very important part of your body. They take you places for a lifetime and so we have to take good care of them. This advise takes on a more important precaution especially when you are thinking of both diabetes and pedicure.

Thursday, April 15, 2010

Blood Glucose Levels Affect Cognitive Functioning

Blood glucose levels
that are higher in type 2 diabetics are associated with lower cognitive functioning, that is worse functioning on three cognitive tasks. These will be any responsibilities that need speed, memory and the ability to do multitasking.

There are two ongoing studies on the relationship between high blood glucose levels and lower cognitive performance. One is called MIND (Memory in Diabetes) while the other is named ACCORD (Action to Control Cardiovascular Risk in Diabetes). What did these two researches find?

They both found that higher A1C levels are closely related to poorer functioning cognitively. As we know A1C is the measure that tells the average of the blood glucose level over a period covering 2-3 months. The higher reading on this also shows a link with lower result on a global cognitive function test.

Before these ongoing studies, it has been found out that the diabetics have a 1.5 times more risk to decline cognitively and experience dementia than people who do not have diabetes. The results of MIND show that diabetes may also be related to cognitive impairment although mild.

Although the cognitive function is only mildly impaired, still it is a concern to those with type 2 diabetes. So said Dr. Tali Cukierman-Yaff who is the leader of the research team. He works at the School of Medicine of Israel's Tel-Aviv University.

It is not known whether the higher blood glucose leads to the cognitive impairment or whether it is the other way around. Does the impairment lower the ability to control the blood sugar level? Here is where the sub study Accord comes in.

That is why we really have to monitor the blood glucose levels closely. The more we follow what we are supposed to do to look after ourselves, the better we will be in. There will be none of this cognitive functioning decline stuff. And no dementia please. Just look at the latest addition to the Supreme Court. If she can do it, we can all do it.

Sorry to digress, but in the research, there will be follow-up on the patients and they will be tested three times. This will let the researchers know whether the lower sugar levels will result in better cognitive functioning. And it looks like there is improvement in cognitive functioning with the lower or near normal blood glucose levels.

Thursday, April 8, 2010

Diabetes Toll Continues to Grow

Diabetes toll news are discouraging. For one thing, it is growing thanks to unhealthy lifestyle and obesity. Some studies have reported around 7% of the population in the United States are affected by it. The figure is around 20.8 million children and adults have it.

By 2050, the estimate is grim. About 48 million Americans will develop type 2 diabetes. The complications that come with it makes the diabetes toll discouraging indeed. These complications could come in the form of loss of hearing, blindness, kidney damage, disorders of the nervous system and amputations.

Now studies are saying that the generations born in 2000 will probably have shorter life than their parents. That's because of diabetes, obesity and heart disease. Now the sad part is that they are saying the most promising drug Avandia seems to increase the risk of heart attack. That is why I am glad when I hear of briefing like below.

Diabetes experts, American Diabetes Association, and the Congressional Caucus held a briefing to talk about the yearly cost estimate for diabetes. They discussed the Lewin Group study that compiled these statistics for the American Diabetes Association.

There are both direct and indirect costs of this condition. The speakers at this briefing revealed the overwhelming figures. They made the disturbing expense incurred by the Americans public. The economic impact of this disease is truly staggering.

The leaders of the Congressional Caucus who spoke at the briefing are Representatives Mike Castle, Diana DeGette, Mark Kirk, and Xavier Becerra. ADA was represented by its Chairman of the Board, Stewart Perry.

The president of ADA's Health Care and Education, Ann L. Albright, PhD, RD also delivered a speech. The same is true with the director of the National Institutes of Diabetes and Digestive Kidney Diseases, Griffin Rodgers, MD, MACP and the chief of the Centers for Disease Control and Prevention's Epidemiology and Statistics Branch, Ed Gregg, PhD.

In the United States, diabetes is now recognized as the fifth cause of death by disease. The death rate caused by diabetes has risen by 45% since 1987. Compare this statistics for the death rate caused by stroke, cancer and heart disease which has gone down and you will see what a difference a few years made.

I was hoping they would discuss not only the economic impact of the disease but also the emotional struggle the diabetics along with their families have to go through but I didn't see this in the agenda. But we can help along because by changing to healthier lifestyle we could lower the diabetes toll.