Category Archives: Chronic disease

It’s Diabetes Alert Day: Take the test

It’s the fourth Tuesday in March, which means it’s time for Diabetes Alert Day.

Held by the American Diabetes Association, Alert Day is a one-day “wake-up call,” asking Americans to take the Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes.

Diabetes affects nearly 26 million children and adults in the United States. About one-quarter of them—7 million—do not even know they have it.

An additional 79 million, or one in three American adults, have prediabetes, which puts them at high risk for developing type 2 diabetes.

What is prediabetes?

Pre-diabetes, says  Dr. Floyd Shewmake, M.D., J.D., senior medical director for Blue Cross Blue Shield of Arizona (BCBSA), refers to a blood sugar level which is higher than normal but not yet high enough to result in the diagnosis of diabetes.  Almost all type 2 diabetics go through a period of time when they meet the criteria for pre-diabetes.

The only way to determine if you are pre-diabetic is to have a fasting blood sugar test done, he adds.  Pre-diabetes has no symptoms but there is evidence that even at this early stage damage to critical organs such as the heart and kidneys can begin.

So, who’s at risk?

Adults and children who have one or both parents diagnosed with type 2 diabetes are at a higher risk for developing type 2 diabetes, says Shewmake.

Women who developed elevated blood sugars during pregnancy are also at a higher risk of type 2 diabetes as they get older, and should be monitored more closely for diabetes.

Shewmake says that the risk for developing diabetes can be delayed, or even avoided. Healthy dietary habits, maintaining a normal weight, and an active lifestyle with regular exercise can help.

Type 2 diabetes occurs more often in adults with high blood pressure, so Shewmake encourages regular checkups to make sure that blood pressure stays in the normal range.

What’s normal blood pressure?

Recent research shows a link between type 2 diabetes and the development of colon cancer.  This association has been identified in several studies though it is not yet understood exactly why this link exists.

Colon cancer screening is important for all adults, says Shewman, and especially important for individuals with type 2 diabetes because of this link.

“We have known for years that the better the sugar is controlled, says Shewman, “the less likely secondary complications such as heart, vascular and kidney diseases will occur.” New drug therapies developed over the last ten years are helping type 2 diabetics better control their blood sugars.

Blue Cross Blue Shield of Arizona encourages families to follow the “5-2-1-0” plan for staying healthy and active. Aim for:

FIVE fruits or vegetables per day

TWO hours or less of screen time

ONE hour of physical activity

 ZERO sweetened drinks.

More on BCBSA’s school-based health education program Walk On!

Helping college kids cope with diabetes

Creating a safe learning environment for kids with diabetes

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A road map for kids’ cardio risk

Cardiovascular disease may be rare in kids, but risk factors present in childhood can increase the chances that a child will develop heart disease as an adult.

Because of these risks, new guidelines released online on Monday, November 14in the journal Pediatrics will give health care providers a “road map” to address all the major cardiovascular risk factors as part of regular well-child visits.

So what has changed?

Previous recommendations, issued in 1992, called for screening only children with a family history of heart disease or high cholesterol.

These new recommendations call for all children to be screened for high cholesterol at least once between the ages of 9 and 11 years, and again between ages 17 and 21 years.

Physicians now will be able to use a non-HDL cholesterol test that does not require children to fast; children with abnormal results should be followed up with a fasting lipid profile..

The new guidelines suggest ways to prevent the development of cardiovascular risk factors and optimize cardiovascular health starting from the beginning by encouraging breast feeding.

The guidelines recommend a diet low in saturated fat starting at a child’s first birthday. Protection from tobacco smoke as well as regular physical activity will also be advised by pediatricians and other care providers.

“The more we learn about heart disease and stroke in adults, the more we know that the process begins in childhood and progresses over time,” said Stephen R. Daniels, MD, PhD, FAAP, chair of the expert panel that reviewed the guidelines. “By working with families, we can keep kids at a lower lifetime risk and prevent more serious problems in adulthood.”

It is anticipated that a universal screening will more accurately identify children who are at high risk of cardiovascular disease and allow pediatricians to follow up, Dr. Daniels said.

Most children with high cholesterol would be referred to lifestyle modifications including diet and physical activity; for children with high blood pressure, the DASH diet is recommended.

The guidelines also identify age-specific strategies to reduce risk factors and manage cardiovascular disease in children and adolescents.

Packing a lunch from home and limiting screen time are ways to help prevent children from putting on too much weight. Cutting down on salt  and increasing fiber in the diet are others.

Find out more about pediatric obesity and the link to diabetes from an Arizona endocrinologist.

Helping college kids cope with diabetes

One in every 400 children and adolescents have Type 1 diabetes — and that includes college students, too.

Previously known as juvenile diabetes, Type 1 diabetes is usually diagnosed in children and young adults. According to the American Diabetes Association,  in Type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar (glucose), starches and other food into energy needed for daily life.

Managing diabetes in college can be tough. It can be a young person’s first crack at complete independence from mom and dad.

Catherine Griffiths and her son, Harlyn

For some, that means learning to manage the challenges of classes, extracurricular activities, making new friends — and controlling blood sugar levels and diet in an away-from-home setting — on their own.

Read RAK sales staffer Catherine Griffiths’ story about her own teen son’s experience with Type 1 diabetes.

Kim Hohol, a registered dietician with Cigna Medical Group who practices at the CJ Harris location in Tempe,  offers some tips for college students with diabetes who are trying to cope with new challenges:

• Meet with a diabetes counselor in your health center

• Inform your roommate, professor and close friends of your diabetes

• Keep snacks handy

• Remember that walking to class can affect your blood sugar levels

• Buy your supplies in bulk

• Consider wearing a Medic Alert Bracelet

Anyone can join the American Diabetes Association  annual “Step Out to Stop Diabetes” walk sponsored by Cigna Medical Group.

The event takes place on Saturday, Oct. 1 this year. One walk will be held in the morning, and one in the evening. The two locations and additional details:

Chandler

Location: Rawhide at Wild Horse Pass, 5700 N. Loop Road, Chandler
Registration: 6:30-7:30 a.m.
Start: 8am.
Distance: 1 or 3 mile walk

Glendale

Location: Midwestern University, 19555 N. 59th Ave., Glendale
Registration: 4:30-5:30pm.
Start: 6pm.

A safe learning environment for kids with diabetes

Unless you have a child with diabetes, you probably don’t think about this disease very often.

But for parents raising children who deal with monitoring glucose levels, life can be unpredictable.

School-age children with diabetes face unique challenges and sometimes dangerous situations because of fluctuations in these levels.

To help teachers, principals and others ensure the safety of youngsters with diabetes during the school day, the U.S. Department of Health and Human Services’ National Diabetes Education Program has recently updated their guide, Helping the Student with Diabetes Succeed: A Guide for School Personnel.

The NDEP committee notes that everyone, from bus drivers to teachers to administrators, has a role in helping students with diabetes succeed, and that they  hope this guide helps to explain the critical role that school staff members at every level can play.

Diabetes management remains an evolving science. The guide’s latest edition, the first update since 2003, describes the most current recommendations of leading health care experts for developing a diabetes management plan to handle diabetes-related emergencies.

Training is recommended for all school staff members who have responsibility for students with diabetes. The training should provide a basic understanding of the disease, the needs of a child with diabetes and the symptoms signaling a diabetic emergency.

Also, a few staff members at every school should be trained in student-specific routine and emergency diabetes care tasks so that at least one staff member is always available for younger, less experienced students and for any student with diabetes in case of an emergency.

The guide urges parents to notify school officials that a child has diabetes and to work with the child’s personal diabetes health care team to develop a diabetes medical management plan.

It also recommends that parents permit sharing of relevant medical information by the school and the child’s health care team.

Diabetes facts:

  • Diabetes is a group of diseases in which the body does not produce or respond properly to insulin, a hormone the body needs to convert sugars, starches and other food into energy.
  • Although most prevalent in older adults, it is one of the most common chronic diseases in children and adolescents
  • About 19,000 young people are diagnosed with diabetes annually.
  • The vast majority have type 1 diabetes, an autoimmune disease resulting from defects in the pancreas.
  • A smaller number of children are diagnosed with type 2 diabetes, the type of diabetes that typically shows up in adulthood.
  • As obesity rates have increased among youth, the prevalence of type 2 diabetes among children and adolescents also is rising, especially for children in ethnic and racial minorities.
  • Children with type 1 or type 2 diabetes are at increased risk of serious complications, including heart disease and stroke, blindness, kidney disease and amputations.

NDEP is jointly sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention.

The NDEP Guide, along with many other materials, is available on the NDEP website or by calling toll-free 1-888-693-NDEP (1-888-693-6337).

 

Tis the season – for flu shots

It’s a sure sign that summer is over when the “Flu Clinic” signs start popping up in front of pharmacies all over town.

The American Academy of Pediatrics (AAP) has issued updated recommendations for the prevention and treatment of influenza in children. The policy statement will be published in the October 2010 print issue of Pediatrics.

The AAP recommends annual trivalent seasonal influenza immunization for all children and adolescents 6 months of age and older.

Special efforts should be made to immunize all family members, household contacts and out-of-home care providers of children who are younger than 5 years; children with high-risk conditions (e.g., asthma, diabetes, or neurologic disorders); health care personnel and pregnant women. These groups are most vulnerable to influenza-related complications.

The AAP policy includes a flow chart to simplify decision-making about the number of influenza vaccine doses a child needs, which depends on the child’s age at the time of the first dose and vaccine history:

• Children younger than 6 months are too young to receive influenza vaccine.

• Children 9 years of age and older need only 1 dose.

• Children younger than 9 years need a minimum of 2 doses of 2009 pandemic H1N1 vaccine. If they did not receive the H1N1 vaccine during last year’s flu season, they will need two doses of seasonal influenza vaccine this year.

• Children younger than 9 years who have never received the seasonal flu vaccine before will need 2 doses.

• Children younger than 9 years who received seasonal flu vaccine before the 2009-2010 flu season need only one dose this year if they received at least one dose of the H1N1 vaccine last year. They need two doses this year if they did not receive at least one dose of the H1N1 vaccine last year.

• Children younger than 9 years who received seasonal flu vaccine last year for the first time, but only received 1 dose, should receive 2 doses this year.

• Children younger than 9 years who received a flu vaccine last year, but for whom it is unclear whether it was a seasonal flu vaccine or the H1N1 flu vaccine, should receive 2 doses this year.

• All children who need 2 doses should receive the second dose at least 4 weeks after the first dose.

As always, it’s best to check with your primary care physician or pediatrician if you have any questions about immunizations for your children.

Obesity rates still climbing for some girls

The prevalence of obesity continues to climb for black and Native American girls, according to a study that examined the health records of more than 8 million fifth-, seventh-, and ninth-grade students in California from 2001 through 2008.

The study appears in the September issue of Pediatrics, the journal of the American Academy of Pediatrics.

Obesity rates for most boys and non-Hispanic white girls peaked in 2005 and then declined. Because that is not the case for black and Native American girls, the authors recommend that this knowledge be used to guide interventions and policies specific to these groups, in order to reduce their risk. Learn about the AAP’s recommendations for the prevention and treatment of childhood obesity.

Most recent statistics from the Centers for Disease Control rank 24.8 percent of Californians as “obese.” Arizonans fare worse; 25.5 percent of our state’s population is obese. So you have to wonder what the results of this recent study would be if it had been conducted here.

Several local organizations are working hard to combat the epidemic of childhood obesity, which affects self-esteem and well-being in the short term but wreaks devastating effects on physical and emotional health in the long term. The most recent program we have learned about is the YMCA’s Food and Fun Curriculum.

The curriculum, developed by the Prevention Research Center at the Harvard School of Public Health and other YMCAs, is a nutrition and physical activity curriculum designed to encourage children and their families to develop healthy eating habits and the desire to lead active lives. This 10-week, easy-to-understand curriculum provides a wealth of activities, recipes, menus, targeted messages, parent communication tools and many other resources to reinforce healthy habits.

“The childhood obesity epidemic in America is a national health crisis,” says Jen Hewitt, Childcare Resource Director for the Valley of the Sun YMCA. “One in every three children (31.7 percent) ages 2 to 19 is overweight or obese. The life-threatening consequences of this epidemic create a compelling and critical call for action that cannot be ignored. The YMCA has an obligation to the community to be at the forefront of tackling the problem.”

Maintaining a healthy lifestyle is critical to combatting chronic diseases including heart disease, cancer and diabetes — the leading causes of death in the United States. While such diseases are prevalent and costly, they are also often preventable through eating healthy and physical activity.

For more information about the YMCA program, call 602-212-5121 or email jhewitt@vosymca.org.

Keeping kids fit | Childhood obesity and diabetes. | Tackling obesity through nutrition education. | When to talk about weight.

Introducing solid foods: the scoop on allergies

In the January 2010 issue of Pediatrics, the American Academy of Pediatrics will announce that late introduction of solid foods may increase the risk of allergic sensitization to foods and allergens that are inhaled.

Introducing rice cereal at five months

Researchers examined the diets and allergic sensitivities of 994 children with susceptibility to type 1 diabetes.  The results indicated that late introduction of solid foods was associated with increased allergies to some foods as well as allergy to inhalants, such as pollen.

Eggs, wheat and oats were most commonly related to food sensitization, while potatoes and fish were strongly associated with inhalant sensitization.

The American Academy of Pediatrics recommends the introduction of solid foods between the ages of 4 and 6 months.

Extended, exclusive breastfeeding, nor delaying the introduction of solid foods, are likely to prevent allergic diseases in children, according to the study.