A lot of the reading about diabetes lately has been about education. Too often the improvements made during the study disappear when the study is completed and support ends. This study states that even three months after, the improvements remained. While the study was indeed small and too short, this means that there could be hope.
It can be hoped that John Hopkins researchers will make the program available for others to use and on a wider basis. Will this happen – highly doubtful. Most researchers are very protective of the programs they use and wide dissemination seldom sees the light of day.
Yes, the findings were published online in the Journal of General Internal Medicine and the article says this will offer clinicians a proven tool to help those with unmanaged diabetes. But what I dispute is that this may be available for those in the know, but it is not being widely publicized so that wide distribution can take place. Often clinicians are so overworked that they do not have time to evaluate new tools like this to even consider putting something like this into practice.
Until the medical community starts sharing this with advocacy groups and giving it wider publicity, it will be another tool that languishes in a file of disuse. This is a shame for the researchers and for the broader medical community. For example, I found this back in April when it was published and because I was not ready to write about it, it sat in my files until today. In that time, I have seen no more publicity or even mention about this study, so it is already three months with no further action to take advantage of this important proven tool.
Even this could use widespread news coverage, but apparently it isn't sexy enough to make it newsworthy. Also many of the doctors (clinicians) will not make use of this as they frown on patients who are knowledgeable and proactive in their care. So you know this group in the medical community will ignore this. It is also a known fact that most medical insurance companies will hesitate to reimburse for this. They need to be convinced that it will save dollars in the long-term.
The researchers have found a way to give patients the skills needed to solve problems in their lives so that they can take diabetes out of the closet and start caring for their own health. The success of this small study comes because the group that received an intensive nine-session, problem solving course that not only covered standard diabetes self management and care, but were taught problem-solving as a skill to help manage the financial, social, resource, and interpersonal issues that can often stand in the way of managing their diabetes.
Read about the study and its results here. Please pass this on to others that might benefit in reading about this. Lets not let this die in the files of John Hopkins medicine.
July 21, 2011
July 20, 2011
Personalizing Medicine for Diabetes Patients
It is going to be interesting to see how well this works for HealthPartners clinics in the Minneapolis, St Paul, and St Cloud area in Minnesota. I hope that there will be followup articles and maybe some blogs by those in this area about how this is working.
The article states that patients with diabetes and their physicians will have access to a new decision support tool that will support a highly customized and state-of-the-art treatment plan. The electronic medical record can present personalized patient information in a single screen to the physician and patient. This “Diabetes Wizard” is believed to be the first application that uses electronic medical records to customize individual care.
Why could this be so important? As we all know, diabetes is not a one size fits all disease, even though many doctors would like it to be that way. The Diabetes Wizard helps physicians engage patients in a discussion of the best medications (oral and insulin) plus lifestyle improvements that can give them tools for excellent management of diabetes and lower their chances of diabetes complications.
The HealthPartners Diabetes Wizard will use the results of helping patients achieve management of their diabetes and tailor a treatment plan for each patient based on best medical evidence. This will include medications for better blood pressure, blood glucose, and cholesterol management.
What was pleasantly surprising is that it will take the current blood glucose, blood pressure, and cholesterol test results that are not at goal and provide a list of medications and treatments for the physician and patient to evaluate. The Wizard will provide positives and risks of the medications, recommended doses, and clinic visit intervals. It will also suggest seeing an educator, dietitian, or pharmacist the might provide help with medication counseling, nutrition, and self management.
The Wizard can identify gaps in care. This alone could be a life saver if it alerts physicians to screen for kidney disease. It will use all data available, such as patient age, current medications, smoking status, kidney function, plus history of heart disease. This will help the physician and patient through complex treatments and can become the best approach to caring for diabetes and related issues that is customized and personalized.
I sincerely hope that we can hear from patients that this is happening to and get their input on its value. Maybe there will be a followup report on this. Read the press release here.
The article states that patients with diabetes and their physicians will have access to a new decision support tool that will support a highly customized and state-of-the-art treatment plan. The electronic medical record can present personalized patient information in a single screen to the physician and patient. This “Diabetes Wizard” is believed to be the first application that uses electronic medical records to customize individual care.
Why could this be so important? As we all know, diabetes is not a one size fits all disease, even though many doctors would like it to be that way. The Diabetes Wizard helps physicians engage patients in a discussion of the best medications (oral and insulin) plus lifestyle improvements that can give them tools for excellent management of diabetes and lower their chances of diabetes complications.
The HealthPartners Diabetes Wizard will use the results of helping patients achieve management of their diabetes and tailor a treatment plan for each patient based on best medical evidence. This will include medications for better blood pressure, blood glucose, and cholesterol management.
What was pleasantly surprising is that it will take the current blood glucose, blood pressure, and cholesterol test results that are not at goal and provide a list of medications and treatments for the physician and patient to evaluate. The Wizard will provide positives and risks of the medications, recommended doses, and clinic visit intervals. It will also suggest seeing an educator, dietitian, or pharmacist the might provide help with medication counseling, nutrition, and self management.
The Wizard can identify gaps in care. This alone could be a life saver if it alerts physicians to screen for kidney disease. It will use all data available, such as patient age, current medications, smoking status, kidney function, plus history of heart disease. This will help the physician and patient through complex treatments and can become the best approach to caring for diabetes and related issues that is customized and personalized.
I sincerely hope that we can hear from patients that this is happening to and get their input on its value. Maybe there will be a followup report on this. Read the press release here.
July 19, 2011
Help From Diabetes Support for Type 2 Diabetes
When I first read this, I have some serious doubts about what WebMd was advising, but after rereading the article, there are some excellent points and some I may ignore.
When you live with a chronic illness like Type 2 diabetes, it can often be overwhelming at times. There are times when we feel that no one understands the stress that we feel from living 24/7 with diabetes. If this is prolonged, these feelings of anxiety, stress, and isolation can become a barricade to your goal of wellness.
While the last statement can be true for many people, there are alternatives not mentioned in the article that I feel need to be said. These may not work for all people with Type 2 diabetes, but if you make it a priority and part of your daily life, a positive attitude, positive thinking, and positive acting can get you past many of the feelings of anxiety, stress, and isolation. Just realizing that I must have that positive attitude about daily living has helped me get past these feelings many times. Even when I felt like I was going down the path to a depression, thinking positive and acting positive stopped it cold and I felt like moving on with life.
Another tip not mentioned is what I am doing now – writing this blog. This is therapeutic in and of itself. Then I also read other bloggers which can make me laugh, nod my head in agreement with, release my frustrations with them, and cry once in a while. Commenting on another persons blog can be helpful at times. More often you will be offering them support or encouragement, but this can feed back to you many times over.
Now back to the WebMD article. They state that whether your main support comes from your spouse, a close friend, your physician, or a diabetes support group, there are people who care and can help.
They do make some very accurate statements in the article about the need for doctors that give an accurate diagnosis and understands diabetes. This is important because Type 2 diabetes requires regular medical checkups and for this you need a doctor that will help educate you about diabetes, diabetes medications and will help you devise an effective treatment plan. Yes, there can also be ophthalmologists, pharmacists,, dietitians, and educators that can also be helpful, but unless you live in an area that has all of these available, you may need to depend on a doctors and pharmacist only.
Wisely, the article does suggest when possible to see an endocrinologist that specializes in diabetes, even for Type 2 diabetes. Another important statement is about seeing a therapist. This should be a therapist that is knowledgeable about diabetes and the types of problems people with diabetes encounter.
Yes, I know the resistance people have to therapists – they don't like this because they are all wrapped up in the myth that people that say this imply that the disease is “all in your head.” The fact that people with diabetes get depression and often suffer from stress, makes this even more important. Both can make diabetes more difficult to manage and by talking to a therapist can often help reduce stress and make depression more recognizable and easier to get past mild to moderate episodes of depression.
This can be a key for better diabetes management. The emotional toll that diabetes exerts on your everyday life with diabetes can be eased by talks with a therapist specializing in diabetes. Your better health is important.
Please take time to read the entire article here and take advantage of what it offers.
When you live with a chronic illness like Type 2 diabetes, it can often be overwhelming at times. There are times when we feel that no one understands the stress that we feel from living 24/7 with diabetes. If this is prolonged, these feelings of anxiety, stress, and isolation can become a barricade to your goal of wellness.
While the last statement can be true for many people, there are alternatives not mentioned in the article that I feel need to be said. These may not work for all people with Type 2 diabetes, but if you make it a priority and part of your daily life, a positive attitude, positive thinking, and positive acting can get you past many of the feelings of anxiety, stress, and isolation. Just realizing that I must have that positive attitude about daily living has helped me get past these feelings many times. Even when I felt like I was going down the path to a depression, thinking positive and acting positive stopped it cold and I felt like moving on with life.
Another tip not mentioned is what I am doing now – writing this blog. This is therapeutic in and of itself. Then I also read other bloggers which can make me laugh, nod my head in agreement with, release my frustrations with them, and cry once in a while. Commenting on another persons blog can be helpful at times. More often you will be offering them support or encouragement, but this can feed back to you many times over.
Now back to the WebMD article. They state that whether your main support comes from your spouse, a close friend, your physician, or a diabetes support group, there are people who care and can help.
They do make some very accurate statements in the article about the need for doctors that give an accurate diagnosis and understands diabetes. This is important because Type 2 diabetes requires regular medical checkups and for this you need a doctor that will help educate you about diabetes, diabetes medications and will help you devise an effective treatment plan. Yes, there can also be ophthalmologists, pharmacists,, dietitians, and educators that can also be helpful, but unless you live in an area that has all of these available, you may need to depend on a doctors and pharmacist only.
Wisely, the article does suggest when possible to see an endocrinologist that specializes in diabetes, even for Type 2 diabetes. Another important statement is about seeing a therapist. This should be a therapist that is knowledgeable about diabetes and the types of problems people with diabetes encounter.
Yes, I know the resistance people have to therapists – they don't like this because they are all wrapped up in the myth that people that say this imply that the disease is “all in your head.” The fact that people with diabetes get depression and often suffer from stress, makes this even more important. Both can make diabetes more difficult to manage and by talking to a therapist can often help reduce stress and make depression more recognizable and easier to get past mild to moderate episodes of depression.
This can be a key for better diabetes management. The emotional toll that diabetes exerts on your everyday life with diabetes can be eased by talks with a therapist specializing in diabetes. Your better health is important.
Please take time to read the entire article here and take advantage of what it offers.
July 18, 2011
Have You Experienced Hypoglycemia Unawareness?
An article by Elizabeth Woolley at About dot com appeared on my computer on July 7 and sort of shocked me. I guess I should not be surprised any more with all the new information coming out every day on diabetes. But this one gave me a funny feeling and made me wonder why I had missed this before. Hypoglycemic unawareness is known to affect people with Type 1 diabetes, but there is significant evidence that Type 2 people also have this problem.
The evidence presently that hypoglycemia unawareness affects those Type 2 people on insulin, or on oral medications that can cause low blood glucose. Hypoglycemia is defined as a blood sugar reading of below 70 mg/dl. If a person does not experience the symptoms of hypoglycemia, they need to take action. The more common symptoms include trembling or weakness, lack of coordination, drowsiness or confusion, headache, dizziness, double vision, excessive sweating, and convulsions or unconsciousness.
If you get to the last symptom, you are in already in trouble and a glucagon kit should also be kept available, in case the person is unable to take in sugar orally. Early in the symptoms, a juice box, candy (but not chocolate because of the fat), or glucose tablets will normally bring blood glucose levels back to normal fast.
The risk of hypoglycemia unawareness increase the longer the person has had diabetes. In a study done with people with type 2 diabetes on insulin, those who had severe hypoglycemia in the prior year were at a 17-fold higher risk of having severe hypoglycemia the next year.
Hypoglycemia can make management and treatment more difficult, but the following ways may help reduce the risk. The first suggestion is difficult with the insurance restrictions on test strips they will pay for, but you still should consider frequent testing and let your doctor know if you find your blood glucose levels are low and you do not feel any of the symptoms.
Next, if possible get self management education which most insurance will cover with a doctors order. Then work with your doctor for individualized blood glucose level goals. Also ask about flexible treatment regimens. All of these can greatly assist in your management to prevent hypoglycemia.
If you develop a history of hypoglycemia unawareness, ask your doctor about hypoglycemia avoidance for a period of 2 to 3 weeks to possibly increase sensitivity. This means allowing your blood glucose levels to be higher for this period in an effort to increase your sensitivity to the symptoms of hypoglycemia.
Read the blog here by Elizabeth Woolley, and the ADA article here. The abstract for reading is here. This last link may not work if you browser does not accept cookies.
The evidence presently that hypoglycemia unawareness affects those Type 2 people on insulin, or on oral medications that can cause low blood glucose. Hypoglycemia is defined as a blood sugar reading of below 70 mg/dl. If a person does not experience the symptoms of hypoglycemia, they need to take action. The more common symptoms include trembling or weakness, lack of coordination, drowsiness or confusion, headache, dizziness, double vision, excessive sweating, and convulsions or unconsciousness.
If you get to the last symptom, you are in already in trouble and a glucagon kit should also be kept available, in case the person is unable to take in sugar orally. Early in the symptoms, a juice box, candy (but not chocolate because of the fat), or glucose tablets will normally bring blood glucose levels back to normal fast.
The risk of hypoglycemia unawareness increase the longer the person has had diabetes. In a study done with people with type 2 diabetes on insulin, those who had severe hypoglycemia in the prior year were at a 17-fold higher risk of having severe hypoglycemia the next year.
Hypoglycemia can make management and treatment more difficult, but the following ways may help reduce the risk. The first suggestion is difficult with the insurance restrictions on test strips they will pay for, but you still should consider frequent testing and let your doctor know if you find your blood glucose levels are low and you do not feel any of the symptoms.
Next, if possible get self management education which most insurance will cover with a doctors order. Then work with your doctor for individualized blood glucose level goals. Also ask about flexible treatment regimens. All of these can greatly assist in your management to prevent hypoglycemia.
If you develop a history of hypoglycemia unawareness, ask your doctor about hypoglycemia avoidance for a period of 2 to 3 weeks to possibly increase sensitivity. This means allowing your blood glucose levels to be higher for this period in an effort to increase your sensitivity to the symptoms of hypoglycemia.
Read the blog here by Elizabeth Woolley, and the ADA article here. The abstract for reading is here. This last link may not work if you browser does not accept cookies.
July 16, 2011
It Is All About The Money for Hospitals
Hit them in the pocket book seems to be the only way the get the attention of Hospitals. This is exactly what the Centers for Medicare and Medicaid Services (CMS) has done and it is having widespread impact. While this needs to be expanded and incentives put in place, it is proving to have an effect and may lead to more actions.
Although I take my shots at the CMS for its euthanasia policies, for once I have to praise them to being on the right path. Those in the medical professions working in hospitals have ignored medically caused infections as just the cost of doing business, when if fact, this is caused by sloppy procedures and carelessness on the part of the people themselves.
Now we need to be concerned about hospital coding procedures and the fraudulent practices of some hospitals. While they say that they are working for coding accuracy, I think this is hospital talk for coding to hide the actual happenings. The survey has one gigantic fault – it did not look at whether the CMS policy actually caused a reduction in infections. The CMS no-payment policy appears to have had a positive impact on hospital infection prevention and control efforts though.
But first, lets use some of the terms for clarity. Infection preventionists is for a medical professional specializing in preventing infections in the hospital settings. This is a recent addition for many hospitals. The next is hospital-acquired conditions (HAC) and this includes much of what is targeted by CMS policy. Healthcare-associated infections (HAI) at present is not targeted by CMS. Catheter-associated urinary tract infections (CAUTIs) is a large concern and catheter-associated bloodstream infections (CLABSIs) bothers me as well.
The Association for Professionals in Infection Control and Epidemiology (APIC) is the professional organization which was conceived in 1972 in recognition of the need for an organized, systematic approach to the "control" of infections acquired as a result of hospitalization. Originally called The Association for Practitioners in Infection Control, the name was changed to the Association for Professionals in Infection Control and Epidemiology, Inc. in 1994 to recognize the organization's maturation and evolution into the broader context of health care delivery in this country. This includes the study of non-infectious adverse outcomes and the movement of care outside the traditional health care system, specifically the hospital. They have even expanded to include activities in prevention of or at least minimizing the effects of Bioterrorism.
In the first paragraph, I mentioned putting incentives in place. This could mean that the hospitals that actually (and not by coding) reduce HACs could receive a bonus for a reduction. I'll leave this to the experts to determine a formula, but this could also help. Would I assess a penalty for an increase in HACs – by all means, even up to losing all CMS monies. Patient safety needs to be a number one priority.
The press release is here for your reading.
Although I take my shots at the CMS for its euthanasia policies, for once I have to praise them to being on the right path. Those in the medical professions working in hospitals have ignored medically caused infections as just the cost of doing business, when if fact, this is caused by sloppy procedures and carelessness on the part of the people themselves.
Now we need to be concerned about hospital coding procedures and the fraudulent practices of some hospitals. While they say that they are working for coding accuracy, I think this is hospital talk for coding to hide the actual happenings. The survey has one gigantic fault – it did not look at whether the CMS policy actually caused a reduction in infections. The CMS no-payment policy appears to have had a positive impact on hospital infection prevention and control efforts though.
But first, lets use some of the terms for clarity. Infection preventionists is for a medical professional specializing in preventing infections in the hospital settings. This is a recent addition for many hospitals. The next is hospital-acquired conditions (HAC) and this includes much of what is targeted by CMS policy. Healthcare-associated infections (HAI) at present is not targeted by CMS. Catheter-associated urinary tract infections (CAUTIs) is a large concern and catheter-associated bloodstream infections (CLABSIs) bothers me as well.
The Association for Professionals in Infection Control and Epidemiology (APIC) is the professional organization which was conceived in 1972 in recognition of the need for an organized, systematic approach to the "control" of infections acquired as a result of hospitalization. Originally called The Association for Practitioners in Infection Control, the name was changed to the Association for Professionals in Infection Control and Epidemiology, Inc. in 1994 to recognize the organization's maturation and evolution into the broader context of health care delivery in this country. This includes the study of non-infectious adverse outcomes and the movement of care outside the traditional health care system, specifically the hospital. They have even expanded to include activities in prevention of or at least minimizing the effects of Bioterrorism.
In the first paragraph, I mentioned putting incentives in place. This could mean that the hospitals that actually (and not by coding) reduce HACs could receive a bonus for a reduction. I'll leave this to the experts to determine a formula, but this could also help. Would I assess a penalty for an increase in HACs – by all means, even up to losing all CMS monies. Patient safety needs to be a number one priority.
The press release is here for your reading.
July 15, 2011
Some Drugs Sold Without Safety Information
Do you know what to look for when you receive your prescriptions? In the State of Iowa, it is mandatory by law that the pharmacist tell you about your medications especially if they are new to you medications. Plus you have the right to ask about any medication and have them explain the printout if you have questions. Only once have I needed to do this.
For Consumer Reports to find discrepancies in information that lack crucial safety warnings means that some states need to revisit their prescription laws and rules that pharmacists must adhere to and up the penalties for safety violations committed by pharmacists.
The recommendation by Consumer Reports for a nationwide standard, similar to the Nutrition Facts labels on food packages or the Drug Facts labels on over-the-counter medication may be justified. Now, each state pharmacy board sets the rules, the report says. Especially since these findings are so poor when the requirements from the FDA that medication guides are always be included and even this is not happening.
I wish we know which states were included in the investigation, but that is for another day apparently or another report. The chain pharmacies all failed dramatically and you have to wonder when they say that one-third of preventable medication errors occur outside the hospital. I would have thought that this could have been larger, but when you consider that about 1.5 million preventable medication errors occur each year, this is still a staggering number.
According to Lisa Gill, prescription drug editor for Consumer Reports Health, the inconsistencies are difficult for every patient, especially when the font size used for printed material is so small it is often difficult to read. Another problem is all the medical jargon used tends to confuse patients.
The findings are concerning, says Allen J. Vaida, PharmD, executive vice-president of the Institute for Safe Medication Practices, an advocacy group who reviewed the findings for WebMD. He also stated the importance of talking to your pharmacist if the drug is new to you. Another trend by some pharmacies of promising a prescription will be ready in minutes is not a good trend.
Allen J. Vaida, emphasized asking the pharmacist the exact and best times to take a medication. If the directions say twice a day, does that mean at 9 and 3, or is it better to be taken at 9 and 9.
Read the report here. This may help you understand the necessity of getting clear instructions and checking your medications before leaving the pharmacy.
For Consumer Reports to find discrepancies in information that lack crucial safety warnings means that some states need to revisit their prescription laws and rules that pharmacists must adhere to and up the penalties for safety violations committed by pharmacists.
The recommendation by Consumer Reports for a nationwide standard, similar to the Nutrition Facts labels on food packages or the Drug Facts labels on over-the-counter medication may be justified. Now, each state pharmacy board sets the rules, the report says. Especially since these findings are so poor when the requirements from the FDA that medication guides are always be included and even this is not happening.
I wish we know which states were included in the investigation, but that is for another day apparently or another report. The chain pharmacies all failed dramatically and you have to wonder when they say that one-third of preventable medication errors occur outside the hospital. I would have thought that this could have been larger, but when you consider that about 1.5 million preventable medication errors occur each year, this is still a staggering number.
According to Lisa Gill, prescription drug editor for Consumer Reports Health, the inconsistencies are difficult for every patient, especially when the font size used for printed material is so small it is often difficult to read. Another problem is all the medical jargon used tends to confuse patients.
The findings are concerning, says Allen J. Vaida, PharmD, executive vice-president of the Institute for Safe Medication Practices, an advocacy group who reviewed the findings for WebMD. He also stated the importance of talking to your pharmacist if the drug is new to you. Another trend by some pharmacies of promising a prescription will be ready in minutes is not a good trend.
Allen J. Vaida, emphasized asking the pharmacist the exact and best times to take a medication. If the directions say twice a day, does that mean at 9 and 3, or is it better to be taken at 9 and 9.
Read the report here. This may help you understand the necessity of getting clear instructions and checking your medications before leaving the pharmacy.
July 14, 2011
Avoid Heat-Related Illnesses This Summer
I hope that you are enjoying your summer, but if you have diabetes, are you taking the precautions necessary to continue enjoying your summer? Some of us have already had some record breaking heat problems and more are expected yet as summer progresses towards fall.
United Health Group's Diabetes Prevention and control Alliance (DPCA) is alerting people and offering some tips to help people with diabetes prevent serious, heat related illnesses. As a person with diabetes, and having had heat stroke as a teenager, I know most of the tips and problems that can happen. Do I need to review these – yes – as each year since developing diabetes, I take time to make sure that I am prepared. You should too!
This reminder from United Health Group is one of the better reminders and as such I urge you to read it. They offer the following seven tips or safety precautions.
1. Be prepared to check your blood glucose levels more often as you change your activity level and know that the heat can affect your body's insulin needs.
2. Please avoid sunburn. Use the sunscreens liberally as sunburn can cause blood glucose level to increase.
3. Drink plenty of water to prevent dehydration. Dehydration adds to the stress and affects your blood glucose levels.
4. Do your best to remain cool and if possible take more breaks – preferably in air conditioned surroundings and if possible exercise in air conditioned areas.
5. Avoid caffeine and alcohol in high temperatures. In addition to raising your blood glucose levels, they can increase the risk of dehydration for people with diabetes.
6. This is IMPORTANT! Keep medication and diabetes supplies as cool as possible, away from direct sunlight, and preferably in a type of cooler. High temperatures and direct sunlight can cause medications and supplies to break down and be less effective.
7. Know the signs of heat exhaustion. If you or someone you know has diabetes and experiences any of the symptoms, seek medical attention immediately. In these circumstances, always place safety first.
The Centers for Disease Control and Prevention lists many of the signs for heat exhaustion - heavy sweating; paleness; muscle cramps; tiredness; weakness; dizziness; headache; nausea or vomiting; and/or fainting.
I have written blogs previously and it would not hurt to review some of them as well.
The first one is here and the second blog refers to many of my prior blogs. Enjoy your
summer safely!
United Health Group's Diabetes Prevention and control Alliance (DPCA) is alerting people and offering some tips to help people with diabetes prevent serious, heat related illnesses. As a person with diabetes, and having had heat stroke as a teenager, I know most of the tips and problems that can happen. Do I need to review these – yes – as each year since developing diabetes, I take time to make sure that I am prepared. You should too!
This reminder from United Health Group is one of the better reminders and as such I urge you to read it. They offer the following seven tips or safety precautions.
1. Be prepared to check your blood glucose levels more often as you change your activity level and know that the heat can affect your body's insulin needs.
2. Please avoid sunburn. Use the sunscreens liberally as sunburn can cause blood glucose level to increase.
3. Drink plenty of water to prevent dehydration. Dehydration adds to the stress and affects your blood glucose levels.
4. Do your best to remain cool and if possible take more breaks – preferably in air conditioned surroundings and if possible exercise in air conditioned areas.
5. Avoid caffeine and alcohol in high temperatures. In addition to raising your blood glucose levels, they can increase the risk of dehydration for people with diabetes.
6. This is IMPORTANT! Keep medication and diabetes supplies as cool as possible, away from direct sunlight, and preferably in a type of cooler. High temperatures and direct sunlight can cause medications and supplies to break down and be less effective.
7. Know the signs of heat exhaustion. If you or someone you know has diabetes and experiences any of the symptoms, seek medical attention immediately. In these circumstances, always place safety first.
The Centers for Disease Control and Prevention lists many of the signs for heat exhaustion - heavy sweating; paleness; muscle cramps; tiredness; weakness; dizziness; headache; nausea or vomiting; and/or fainting.
I have written blogs previously and it would not hurt to review some of them as well.
The first one is here and the second blog refers to many of my prior blogs. Enjoy your
summer safely!
July 13, 2011
ADA Is Now Fear Mongering
When I opened my browser today, like normal my email list shows first. American Diabetes showed in bold letters. I had to wonder as I don't normally receive emails from the American Diabetes Association. If it is for contributions my spam filter redirects it and I don't even see it. So I thought why not and clicked on it.
In a way, I am glad I did and in another it got my blood pressure one bang of a jolt. Now that I have had time to relax and think about it, it makes sense that since this affects the pocket books of its medical professionals, they would turn to fear mongering. This is a common tactic among politicians to get reelected, but I had not thought a professional medical organization would stoop to such a low-life tactic. Actually, I should have realized that this is just an expansion of the fear tactics they use on their patients all the time.
It is not surprising that when something has the potential to put a dent in the income level or retirement plan of a doctor, the professional organizations will rally to the cause. What rubs me wrong about the tactic of using the ADA is that the organization has little concern for patients or people with diabetes in the first place, but they will ask for our support when their pocket book might take a hit.
Where is the ADA when they are needed for other issues? Oh yes, when there is a public relations opportunity – they will be there. If there is an issue where they can scratch the back of their legal friends – they will be there. If they can somehow be made to look like the good-guy, count on it – they will be there.
Do not expect any support from the ADA when those of us with diabetes just happen to need support to prevent euthanasia because we are going to cost too much money to be keep alive. They will be happy to nail the lid on our coffin.
Where is the ADA when we need test strips for Type 2 diabetes? Yes, they helped the medical insurance companies restrict the number of test strips we may use. So ADA, if you are wondering why you get no sympathy from me, start behaving like professionals and do a few things for patients for a change instead of worrying about your pocket book so much before it happens. Posturing will not get my attention, only my wrath. Both political parties are making with the threats to get support and bring people to their side. It is all posturing for the voters.
What will count in the ballot box in 2012, is the actions taken now, not the fear mongering actions of a medical group. If you feel that way about things, run for political office, then when you use fear mongering, we will know what you mean and how we can vote to chase you out of office. Now we have to live with your threats to instill fear in a community that is tired of this tactic from doctors. (IDEA*!) That may be a solution, make it an added requirement that they (doctors) must receive so many votes to retain their license on a four year basis. The use of fear might just disappear - poof!!! Oh well, it was just a thought.
If you advocated more for patients and their well being over your financial condition, you might receive more support. If we are ever to recover from this financial mess, everyone will need to share the burden – and that includes you – the fear mongering doctors of the American Diabetes Association.
In a way, I am glad I did and in another it got my blood pressure one bang of a jolt. Now that I have had time to relax and think about it, it makes sense that since this affects the pocket books of its medical professionals, they would turn to fear mongering. This is a common tactic among politicians to get reelected, but I had not thought a professional medical organization would stoop to such a low-life tactic. Actually, I should have realized that this is just an expansion of the fear tactics they use on their patients all the time.
It is not surprising that when something has the potential to put a dent in the income level or retirement plan of a doctor, the professional organizations will rally to the cause. What rubs me wrong about the tactic of using the ADA is that the organization has little concern for patients or people with diabetes in the first place, but they will ask for our support when their pocket book might take a hit.
Where is the ADA when they are needed for other issues? Oh yes, when there is a public relations opportunity – they will be there. If there is an issue where they can scratch the back of their legal friends – they will be there. If they can somehow be made to look like the good-guy, count on it – they will be there.
Do not expect any support from the ADA when those of us with diabetes just happen to need support to prevent euthanasia because we are going to cost too much money to be keep alive. They will be happy to nail the lid on our coffin.
Where is the ADA when we need test strips for Type 2 diabetes? Yes, they helped the medical insurance companies restrict the number of test strips we may use. So ADA, if you are wondering why you get no sympathy from me, start behaving like professionals and do a few things for patients for a change instead of worrying about your pocket book so much before it happens. Posturing will not get my attention, only my wrath. Both political parties are making with the threats to get support and bring people to their side. It is all posturing for the voters.
What will count in the ballot box in 2012, is the actions taken now, not the fear mongering actions of a medical group. If you feel that way about things, run for political office, then when you use fear mongering, we will know what you mean and how we can vote to chase you out of office. Now we have to live with your threats to instill fear in a community that is tired of this tactic from doctors. (IDEA*!) That may be a solution, make it an added requirement that they (doctors) must receive so many votes to retain their license on a four year basis. The use of fear might just disappear - poof!!! Oh well, it was just a thought.
If you advocated more for patients and their well being over your financial condition, you might receive more support. If we are ever to recover from this financial mess, everyone will need to share the burden – and that includes you – the fear mongering doctors of the American Diabetes Association.
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