Diabetes Care at Diabetes Camps
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INTRODUCTION
Since Leonard F.C. Wendt, MD, opened the doors of the first diabetes camp in Michigan in 1925, the concept of specialized residential and day camps for children with diabetes has become widespread throughout the U.S. and many other parts of the world. It is estimated that worldwide camps serve 15,000–20,000 campers with diabetes each summer.
The mission of camps specialized for children and youth with diabetes is to facilitate a traditional camping experience in a medically safe environment. An equally important goal is to enable children with diabetes to meet and share their experiences with one another while they learn to be more responsible for their condition. For this to occur, a skilled medical and camping staff must be available to ensure optimal safety and an integrated camping/educational experience.
DIABETES MANAGEMENT AT CAMP
The recommendations for diabetes management of children at a diabetes camp are not significantly different from what has been outlined by the American Diabetes Association (ADA) as the standards of care for people with type 1 diabetes or for children with diabetes in the school or day care setting.
Diagnosis and Classification of Diabetes Mellitus
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DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the ß-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia.
Obesity in Adolescents
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Obesity and overweight are the second most major reasons of preventable deaths in America. Stagnant lifestyle and junk food is to be blamed for more than three hundred thousand deaths per annum. The sad thing is that this problem is on the rise. Obesity is a chronic disease which poses serious health risk to the health of an individual. Also, obesity is the easiest recognizable medical problem, but is very difficult to deal with.
People usually confuse obesity with overweight. Overweight is gaining of a few extra pounds. A person is considered obese when the total body weight is minimum ten percent more than the recommended weight for his/her body structure and height. According to an estimate every year hundred billion dollars are spent on the obesity problem. It is very important to treat the problem as early as possible. Obese children between the age of ten and thirteen have eighty percent chances of growing into obese adults, unless they change their ways and adopt a healthier lifestyle. The obesity problem starts from the age of five and continue till adolescence.
Obesity can be caused due to complex reasons including biological, genetic, cultural and behavioral factors. Usually a person gets obese when he/she consumes more calories than the body burns.
Herbs, supplements often sold deceptively: US report
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Sellers of ginseng, echinacea and other herbal and dietary supplements often cross the line in marketing their products, going as far as telling consumers the pills can cure cancer or replace prescription medications, a U.S. government probe found.
In an undercover probe, investigators at the Government Accountability Office also found that labels for some supplements claim to prevent or cure ailments like diabetes or heart disease - a clear violation of U.S. law.
GAO staff targeted supplements most popular with older consumers and posed as elderly buyers in stores or over the telephone.
FDA says acid reflux drugs carry fracture risk
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U.S. health regulators have cautioned doctors and patients of an increased risk of fractures of the hip, wrist, and spine from high doses or long-term use of a widely used class of drugs to control the amount of acid in the stomach.
The class of heartburn drugs, called proton pump inhibitors, include prescription brands such as AstraZeneca Plc’s top-selling Nexium and the company’s Prilosec, an older generic treatment that is also available over the counter at a lower dosage strength.
The U.S. Food and Drug Administration said on Tuesday that studies suggest a possible increased risk of bone fractures with the use of proton pump inhibitors for one year or longer, or at high doses.
Mayo Clinic Proceedings: Review of pain management practices for cirrhosis patients
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In the May issue of Mayo Clinic Proceedings, physician experts review current practices for pain management in cirrhotic patients. The physician experts reviewed all current literature available on PubMed and MEDLINE with no limits in the search to recommend a uniform and practical guide to approaching analgesia in the cirrhotic patients.
Cirrhosis is a substantial public health problem, accounting for approximately 770,000 deaths annually and, according to autopsy studies, affecting 4.5 percent to 9.5 percent of the global population. “Pain management in patients with cirrhosis is a difficult clinical challenge for health care professionals, and few prospective studies have offered an evidence-based approach,” says Kymberly Watt, M.D., Department of Gastroenterology and Hepatology at Mayo Clinic.
No evidence-based guidelines exist on the use of analgesics in patients with liver disease and cirrhosis, says Dr. Watt. From her findings in the current literature, her recommendation for long-term acetaminophen use in cirrhotic patients (not actively drinking alcohol) is for reduced dosing at 2 to 3 grams per day. For short-term use or one-time dosing, patient should not exceed 4 grams total per day but the proposed new FDA guidelines (yet to be finalized) may recommend a maximum daily dosage of 2.6 grams per day for anyone.
Protein Regulates Enzyme Linked to Alzheimer’s Disease
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Researchers at Tufts University School of Medicine have zeroed in on a protein that may play a role in the progression of Alzheimer’s disease. The team found that increasing levels of the protein (called GGA3) prevented the accumulation of an enzyme linked to Alzheimer’s. The strategy may lead to new treatments for the neurodegenerative disease. The findings were published online May 18 in The Journal of Biological Chemistry.
People with Alzheimer’s disease typically have higher levels of an enzyme called BACE1 in their brains. BACE1 produces a toxin that researchers have pinpointed as a cause of Alzheimer’s, and now, researchers have found a way to prevent BACE1 from accumulating in the brain.
“We have identified the protein that takes this enzyme to the cell’s garbage disposal for removal. Increasing levels of the protein allows more of the enzyme to be eliminated, possibly preventing the high levels seen in people with Alzheimer’s disease,” said senior author Giuseppina Tesco, MD, PhD, assistant professor in the department of neuroscience at Tufts University School of Medicine (TUSM).
MRI research highlights high-risk atherosclerotic plaque hidden in the vessel wall
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Researchers from Boston University School of Medicine (BUSM) have shown that use of magnetic resonance imaging (MRI) in an animal model can non-invasively identify dangerous plaques. The findings, which appear in the May issue of Circulation Cardiovascular Imaging, offer possible applications in the diagnosis and treatment of patients with atherosclerosis.
Rupture of vulnerable atherosclerotic plaque, which often occurs without prior symptoms, is responsible for a substantial number of deaths and disabilities worldwide. The untimely death of television journalist Tim Russert was caused by the sudden rupture of a vulnerable plaque in a critical location in a coronary artery. Identification of atherosclerotic plaques with a high risk for disruption and thrombosis would allow preventive therapy to be initiated before thrombi begin to clog arteries and cause stroke or heart attack.
The BUSM researchers examined diagnostic protocols in an animal (rabbit) model of human disease with procedures that never could have been applied to humans. Plaque disruption was stimulated at a precise time to allow MRI imaging before and after the rupture.
Coffee Break Physicals
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“Who has time?” is a frequent question in response to the suggestion of a medical check-up. Job demands aren’t becoming easier to meet in this challenging economy. And there is always a “to-do” list waiting at home. Naturally employees feel these pressures.
Still, personal health has to be a top priority for individuals and businesses facing global competition and rising medical costs. Health risks that are not addressed early can become big medical problems hampering job productivity and increasing health-related spending.
“Wellness is valuable. In the opposite case, when an employee is too sick to come in or not able to perform at a high level because of illness, their enterprise sees less of their contributions. As a result the employee has less job security and probably less income,” said Dr. Mary Capelli-Schellpfeffer, medical director Loyola University Health System Occupational Health Services.
Banning all gay men from donating blood is unscientific and wrong, say AIDS research pioneers
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Since 1983, blood agencies in Canada, the United States and many other industrialized nations have disallowed all blood donations from men who have sex with men (MSM.) While a total ban was justified scientifically and ethically in 1983, in 2010 it no longer makes sense, say pioneering AIDS researchers Dr. Mark Wainberg and Dr. Norbert Gilmore in an article to be published May 25 in the Canadian Medical Association Journal (CMAJ.)
Dr. Wainberg heads the HIV research program at the Lady Davis Institute for Medical Research (LDI) at the Jewish General Hospital and was a co-discoverer of 3TC, one of the first drugs known to control HIV. He also heads the McGill University AIDS Centre, based at the LDI. Dr. Norbert Gilmore is a professor at the McGill Faculty of Medicine and the McGill Centre for Medicine, Ethics and Law, and is a clinician at the McGill University Health Centre (MUHC.)
“The 1983 ban has hung on so long, unfortunately, because many people became infected by HIV in the early 80s through blood transfusions, and they have mounted continuing pressure on the blood agencies to maintain the ban,” says Wainberg. “While we can sympathize with them, this no longer makes sense in 2010, and with each passing year it makes less sense.”
Start obesity prevention in the cradle, US study urges
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A team of US doctors has urged that obesity screening start in the cradle after a study they conducted showed that half of US children with weight problems became overweight before age two.
The “critical period for preventing childhood obesity” in the children observed in the study would have been in “the first two years of life and for many by three months of age,” said the study, published in Clinical Pediatrics.
“Unfortunately, the chubby healthy baby myth is alive and well despite the high prevalence of childhood obesity, with only 20 percent to 50 percent of overweight children being diagnosed and even fewer receiving documented or effective treatments,” the authors of the study said.
Milestone in effort to stem health worker exodus
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Health ministers sealed a rare global accord on Friday to avoid recruiting doctors and nurses from poor countries where there is an acute shortage of medical staff.
The voluntary code for World Health Organisation members is only the second such accord in its history and follows six years of negotiations aimed at stemming the exodus of health care workers from around 60 of the world’s poorest countries.
“You reached agreement on some very important items that are a real gift to public health, everywhere. Thanks to some all night efforts, we now have a code of practice on the international recruitment of health personnel,” Margaret Chan, WHO director-general, told the closing session of the annual week-long ministerial meeting of the 193-member body.
Diabetes Raises Risks Of Many Cancers
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People with type 2 diabetes—formerly known as adult-onset diabetes—are more likely to get 24 kinds of cancer than the general population, according to a new study.
Researchers in Sweden and the U.S. reviewed records of more than 125,000 people in Sweden who had been hospitalized for complications of diabetes.
They found that the greatest increase in risk was for pancreatic and liver cancers. People with diabetes were six times more likely to get pancreatic cancer and 4.25 times more likely to get liver cancer.
Bad Boost in Blood Pressure? Log On and Chill Out
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Folks with out-of-control blood pressure take note : all you need to get things back on track may just be a keyboard and a cable modem.
A new study shows a pharmacist-led blood pressure monitoring (HBPM) program supported by the American Heart Association’s “Heart 360” website improved blood pressure control for patients with uncontrolled hypertension.
More than 350 patients with uncontrolled hypertension aged 18 to 85 years with Internet access were randomized into the HBPM group, or the UC (Usual Care) group. They were then led to the website http://www.Heart360.org, which is the American Heart Association’s free online heart health management center. The site allows patients to track and manage their blood pressure, then share that information with their medical provider.
Health leaders discuss polio, alcohol, childhood obesity at WHA
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From the 63rd World Health Assembly (WHA) in Geneva, the Associated Press reports on what some “describe as a new strategy to get rid of” polio that focuses on developing solutions to “problems in each country, provides more WHO monitoring, like more teleconferences, and holds governments more accountable.” The plans also provide “[n]ew [polio] outbreak response plans,” according to the AP.
Some “say there is little new [in this strategy] and that if this effort fails ... serious questions about whether to continue the campaign should be raised,” the news service reports.
“Since WHO, the U.S. Centers for Disease Control and Prevention, UNICEF and Rotary International set out to eradicate polio in 1988, they have come tantalizingly close,” the news service writes. “By 2003, cases had dropped by more than 99 percent. But progress has stalled since and several deadlines have been missed.”
