Have you been out in the sun lately? Have you gotten your first sunburn? If you are a person with diabetes, did the sunburn make you blood glucose levels go up? Most people with diabetes have this problem of managing their blood glucose levels when they get sunburned. I did not say tanned. Tanning it totally another way of living, but becoming sunburned should not happen if you wish to manage diabetes effectively.
This brings us to the question of how best to prevent sunburns. Each year the sunscreen and sunblock creams and lotions are improving. The sun protection factor (SPF) is better and more effective. A couple of years ago, a SPF rating of 15 was considered a good product. Today the better sunscreens require a SPF rating of 30 and some are as high as SPF 100.
I do not follow the rules recommended by most dermatologists. They recommend staying out of the sun as much as possible. They worry about skin cancer and other skin problems that can happen with exposure to the sun. They want you to cover up as much as possible by wearing long-sleeved shirts, wide-brimmed hats, sunglasses, and stay in the shade if possible.
There are several common sense rules that need to be used to prevent sunburn. Use a good sunscreen – with a SPF of 15 and preferably higher. Apply sunscreen 30 minutes before going out in the sun. Apply the sunscreen liberally as most sunscreens now recommend. Reapply sunscreen frequently – at least every hour if you remain exposed to the sun. Reapply more frequently if you are swimming or perspiring a lot. If you have a skin type that burns easily, then consider using the recommendations of the dermatologists.
The SPF rating does not consider the damage caused the UVA (ultraviolet A) rays which is responsible for aging. It is therefore advised to look for and purchase a sunscreen that has a broad spectrum protection for UVA and UVB (ultraviolet B) rays.
UVB rays are the ones that cause the burning that many people suffer from.
Skin types normally are listed as six types. They range from type 1 to type 6. This means that a person with type 1 skin always burns easily, never tans, and is extremely sun-sensitive. Type 6 means a person that never burns, deeply pigmented, and has sun-insensitive skin. Read about the six different types here.
If you are planning on being outdoors and not in the shade for long periods of time, be sure to liberally apply sunscreen. Do not forget your lips. Find a good lip gloss with a SPF of at least 15 or higher and apply regularly.
One point to remember is that the sunscreens do not require FDA approval and thus may not be the best for us. Europe has the best sunscreens available. In the US manufacturers can make any health claims they desire and do not have to provide proof to any regulatory agency. CORRECTION: As of June 14, 2011, the FDA has issued rules for sunscreens, and please read about it on my blog here.
Here are some additional sources to read. Article 1, Article 2, and my blog from May 2010.
May 27, 2011
May 25, 2011
SMBG Can Reduce A1c's For Type 2 Diabetes Patients
Self-monitoring of blood glucose (SMBG) is a term quite well understood by many patients, but it is surprising to see researchers use it in the way this study did. And the report of the study by one of Big Pharma's own. This is a surprise and a pleasant one. Alan at loraldiabetes has been writing about the lack of respect and understanding SMBG has been receiving since at least 2006 and he has not missed much in the lack of understanding by researchers and the medical community.
So it is with respect that I need to report this study which I think for the first time does partially what Alan has been challenging researchers and patients to do. I think this study could have been taken many steps farther, but it is a start in the right direction, and for once it gives patients some insight into what may be accomplished as well as their physicians.
As it is reported by Roche, “an innovative diabetes management concept including structured self-monitoring of blood glucose (SMBG), data visualization, pattern analysis and derived therapy adjustments can significantly reduce HbA1c values, improve glycemic control and enhance patients' quality of life. These are the key findings of the 12-month data from the Structured Testing Protocol (STeP) Study, newly published in Diabetes Care and presented at an exclusive event on effective and structured diabetes management held in London in March”.
“SMBG is a well-established element of therapy management for people with type 1 or type 2 diabetes on insulin therapy. However, there have been controversial views on the question of whether regular SMBG is similarly beneficial for non-insulin treated people with type 2 diabetes. To gain new insights on this subject, the STeP Study was performed: A prospective, cluster-randomised, multi-centre clinical trial, which examined the impact of structured SMBG upon glycemic control in 483 non-insulin treated people with type 2 diabetes who evidenced poor glycemic control (HbA1c ≥ 7.5%) at baseline. The results provide new and significant evidence on its effectiveness”.
The study was designed to analyze the differences between the usual diabetes care and structured diabetes management. Those in the active control group (ACG) and the structured testing group (STG) were in the study for 12 months and all received a baseline evaluation. Then they had scheduled visits at 1, 3, 6, 9, and 12 months. The difference between the two groups was the STG received the SMBG-focused structured diabetes management concept. Free BG monitors and test strips were given to both groups.
The STG used the 7 BG testing profiles (fasting, preprandial, and 2-hour postprandial at each meal, and bedtime) for the three days prior to scheduled healthcare visits. They were to document blood glucose values, meal sizes, plus energy levels, and comment on their SMBG experiences. The STG patients all used the the Roche 360 3-day profile tool and discussed the obtained profiles with their caregivers. The good part was both the patients and caregivers received standardized training in SMBG and pattern analysis. In addition the doctors were equipped with an algorithm suggesting appropriate medication strategies.
The study concluded with finding significant improvement in glycemic control and reduced HbA1c values in the non-insulin treated Type 2 diabetes patients in the STG using the SMBG diabetes management.
Read the article about the study here. You may read Alan's blogs Dec 2, 2006, July 1, 2007, Feb 16, 2010, and Mar 14, 2010. The full study can be read here.
So it is with respect that I need to report this study which I think for the first time does partially what Alan has been challenging researchers and patients to do. I think this study could have been taken many steps farther, but it is a start in the right direction, and for once it gives patients some insight into what may be accomplished as well as their physicians.
As it is reported by Roche, “an innovative diabetes management concept including structured self-monitoring of blood glucose (SMBG), data visualization, pattern analysis and derived therapy adjustments can significantly reduce HbA1c values, improve glycemic control and enhance patients' quality of life. These are the key findings of the 12-month data from the Structured Testing Protocol (STeP) Study, newly published in Diabetes Care and presented at an exclusive event on effective and structured diabetes management held in London in March”.
“SMBG is a well-established element of therapy management for people with type 1 or type 2 diabetes on insulin therapy. However, there have been controversial views on the question of whether regular SMBG is similarly beneficial for non-insulin treated people with type 2 diabetes. To gain new insights on this subject, the STeP Study was performed: A prospective, cluster-randomised, multi-centre clinical trial, which examined the impact of structured SMBG upon glycemic control in 483 non-insulin treated people with type 2 diabetes who evidenced poor glycemic control (HbA1c ≥ 7.5%) at baseline. The results provide new and significant evidence on its effectiveness”.
The study was designed to analyze the differences between the usual diabetes care and structured diabetes management. Those in the active control group (ACG) and the structured testing group (STG) were in the study for 12 months and all received a baseline evaluation. Then they had scheduled visits at 1, 3, 6, 9, and 12 months. The difference between the two groups was the STG received the SMBG-focused structured diabetes management concept. Free BG monitors and test strips were given to both groups.
The STG used the 7 BG testing profiles (fasting, preprandial, and 2-hour postprandial at each meal, and bedtime) for the three days prior to scheduled healthcare visits. They were to document blood glucose values, meal sizes, plus energy levels, and comment on their SMBG experiences. The STG patients all used the the Roche 360 3-day profile tool and discussed the obtained profiles with their caregivers. The good part was both the patients and caregivers received standardized training in SMBG and pattern analysis. In addition the doctors were equipped with an algorithm suggesting appropriate medication strategies.
The study concluded with finding significant improvement in glycemic control and reduced HbA1c values in the non-insulin treated Type 2 diabetes patients in the STG using the SMBG diabetes management.
Read the article about the study here. You may read Alan's blogs Dec 2, 2006, July 1, 2007, Feb 16, 2010, and Mar 14, 2010. The full study can be read here.
May 23, 2011
Communication About Alternative Medications Lacking
This subject just won't go away. And I can understand why. Too many people feel that the doctors and other medical occupations, including pharmacists have no reason to know about what natural remedies they use. Complementary and alternative medicine (CAM) is prevalent in most countries and under reported by patients.
This is dangerous because some can have deadly effects when taken with prescribed medications. While this was a survey, it still indicates the people over the age of 50 often do not inform their healthcare providers of the CAM supplements they are taking. One question apparently not asked is whether they are doing this on their own or from recommendation of homeopaths. Either way, many are putting themselves at risk of fatal combinations of medications.
CAM is a diverse group of medical and healthcare interventions, practices, products, plus disciplines that are not generally part of conventional medicine. While older Americans wish to lead healthy and active lives, the CAM, which includes herbal supplements, manual therapies, and mind/body practices such as chiropractic care, massage, acupuncture, and meditation are sometimes counter productive with medical interventions.
Mainly it is the herbal supplements, but any of them can cause problems depending on the medical treatment a patient is receiving. I do use chiropractic care, but there have been times the chiropractic doctor has wisely refused treatments as they would have interfered with the medical treatment I was receiving. So communication is important with all concerned, not only to prevent problems, but for your own medical safety.
CAM can be an important factor in staying healthy, but care needs to be taken as some CAM products will make certain conventional medications less effective and lead to potentially deadly interactions. Patients need to communicate with their doctors and vice versa.
The AARP/NCCAM survey also found that it was the patients that brought up the topic of CAM most frequently. The two main reasons respondents gave for not discussing it was that the doctor never asked (42 percent) and the patients did not know they should bring it up (30 percent).
AARP is the American Association of Retired Persons which I do not belong to for personal reasons, and NCCAM is the National Center for Complementary and Alternative Medicine.
The article about the study can be read here.
This is dangerous because some can have deadly effects when taken with prescribed medications. While this was a survey, it still indicates the people over the age of 50 often do not inform their healthcare providers of the CAM supplements they are taking. One question apparently not asked is whether they are doing this on their own or from recommendation of homeopaths. Either way, many are putting themselves at risk of fatal combinations of medications.
CAM is a diverse group of medical and healthcare interventions, practices, products, plus disciplines that are not generally part of conventional medicine. While older Americans wish to lead healthy and active lives, the CAM, which includes herbal supplements, manual therapies, and mind/body practices such as chiropractic care, massage, acupuncture, and meditation are sometimes counter productive with medical interventions.
Mainly it is the herbal supplements, but any of them can cause problems depending on the medical treatment a patient is receiving. I do use chiropractic care, but there have been times the chiropractic doctor has wisely refused treatments as they would have interfered with the medical treatment I was receiving. So communication is important with all concerned, not only to prevent problems, but for your own medical safety.
CAM can be an important factor in staying healthy, but care needs to be taken as some CAM products will make certain conventional medications less effective and lead to potentially deadly interactions. Patients need to communicate with their doctors and vice versa.
The AARP/NCCAM survey also found that it was the patients that brought up the topic of CAM most frequently. The two main reasons respondents gave for not discussing it was that the doctor never asked (42 percent) and the patients did not know they should bring it up (30 percent).
AARP is the American Association of Retired Persons which I do not belong to for personal reasons, and NCCAM is the National Center for Complementary and Alternative Medicine.
The article about the study can be read here.
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