06 November 2010

Inhaled Steroids and Diabetes Risk

Now I realize that steroids have had their place in medicine. When are people going to wake up to the risks inherent in using steroids. This study should be read by anyone using inhaled steroids, especially those with COPD ( chronic obstructive pulmonary disorder).

People with COPD are taking inhaled corticosteroids. By doing this over a longer period of time, they are putting themselves at a much higher of getting diabetes. Even though the medical authorities say that for asthma the benefits outweigh the risk they are questioning this for those with COPD. I would say they should question it for both and tell Big Pharma to work harder for other medications for COPD, asthma, and diabetes.

If people cannot learn from the Canadian study of about 400,000 patients with either COPD or asthma that for every year of corticosteroid use, the rate of diabetes increased from 14 people per 1000 to 19 per 1000. This 34 percent increase should wake people up as this increase is significant.

If you have COPD or asthma you should consider talking with your doctor if you are on corticosteroids. Consider alternatives that will maintain the control needed and are not steroid based. Read about the study here.

If you already have diabetes, then you will need to weigh the problems of elevated blood glucose levels caused by steroids. People that have had hip, knee, or other replacements know the problems caused by steroids. Make sure that before taking any steroid based medication that you are aware of the risks and benefits and that the benefits outweigh the risks.

05 November 2010

Do You Check Your Prescriptions?

This article in Diabetes in Control points out how we as patients can miss important things about our prescriptions. Some can be harmless, but the majority can potentially create life-threatening situations. Even pharmacists and doctors must be careful and the pharmacist writing the article sounds a timely warning for everyone.

What to do when talking to the doctor and he is telling you about the prescription or hands you the prescription:
  • Tune him in and pay close attention, 
  • Ask what the dosage is and how often to take, 
  • Ask when the best time to take the medication, 
  • Ask if this will this be a generic or a brand name only, 
  • Ask what the side effects could be, 
  • Ask if there will be medication conflicts if you take other medications.
When you get to the pharmacy, shut the cell phone off and put your thinking cap on. Ask the pharmacist to explain the medication to you if it is the first time. Ask the same questions of the pharmacist that you asked the doctor. Check the dosage and that it agrees with what the doctor said. If this is a refill ask to see the bottle or vial to make sure that the pill size, shape, and color is the same as before. Most good pharmacists will point this out normally by telling you that they have changed suppliers or that the company has changed the color or pill shape.

Learn what the state law is for prescriptions in your state. My state requires by law that pharmacists explain prescriptions to you. As such I do check all medications for changes. Since I receive some of mine via mail from a centralized Veterans Administration Pharmacy, I check them immediately upon opening the package. There is always an information sheet for each medication. I must be more careful with medications received by mail as you must also.

The next is a warning to everyone.  DO NOT WAIT UNTIL THE LAST DAY PILL IS GONE TO REFILL A PRESCRIPTION.  Normally, Medicare, Medicaid, and insurance companies will allow refilling a prescription up to seven days before medication runs out. Find out from the pharmacist if they know how your insurance treats this, or be prepared to call your insurance company. I also urge that you not use the drive through windows for filling prescriptions. This leaves too much room for further mistakes. I realize the drive-thru windows are popular in many areas, but refrain from using them. Your health is more important!

Please take time to read the article as it also provides some excellent suggestions.

04 November 2010

Is There a Diabetes Diet?

If this wasn't true, I would have to laugh at the idiocracy of this. This, to me at least, smacks of what is being fed us in hopes that if we are given this enough times, we will believe it and learn to accept it. I don't think so, but if you want to believe the author of this article on WEBMD, then they are trying to instill that there is a diabetes diet by the obtuse method in which they write about it.

The author even states that there is “no diabetes diet, per se” and then has the audacity to say this is good news. If this is good, then why does the author title his/her articlethe basics of a healthy diabetes diet”? The more you read in this article, the more the author seemingly tries to lead you down the path that only he/she is capable of defining “THE Diabetes Diet”.

To begin, if there is “no diabetes diet”, why does the author belabor us with the term at every turn as if the author has patented a diet called “Diabetes Diet”. Also, and this now has my ire in full action, why do they have to constantly recycle the same article over and over and over. In my blog of October 23, 2010, fourth paragraph down, I had linked to this article and if I can locate the one previous to that I will post the link also. The article was last reviewed on February 25, 2010 and this is at least the third time the article has been recycled after the original time. Thank goodness for dated emails that show when they used to article.

This also shows how the same article can get your attention each time you read it. At least I had told you to read it with a jaundiced eye then. And while some of the advice is good, I will say diabetes is such an individualized disease and what works for one person, may not work for the next person.

This is why I am starting to not respect WebMD because they re-title the leads and reuse the same article. It is difficult to understand because in an article from 10/23/10 now shows the date of November 3, 2010 and they expect me to believe that. This is very disconcerting when linking to articles when they have a floating date. Now back to the article or should I say the “diabetes diet”.

At least the author does think exercise deserves mention in the second paragraph, but the paragraph is still about healthy food choices. Before I go completely off the deep end, I am going ask that you read the article and draw your own conclusions whether you agree or don't agree.

03 November 2010

Diabetes in Future Years

Everyone is making their prognostications about the future of diabetes. Because diabetes is expanding its influence on people's lives, this seems to be where all the evidence and predictions are being waged. People have learned that predicting when a cure will happen is futile.

Is it Big Pharma that is blocking a cure? Maybe. It does merit some concern as it would definitely eat into their profits. I agree with Gretchen Becker that the cure will come from the academic community; however, I will continue to watch with interest the alliance of Big Pharma with the academic community as news comes out about different products.

The ADA has laid out some statistics that should be considered. Yes, the American Diabetes Association now has a blog with posts by Gayle Kern from the communications division. These facts are as follows and not prognostications.

Today, more than 4300 people will be diagnosed with diabetes.
More than 200 people will die today from diabetes.
1 in 3 Americans (and 1 in 2 minorities) born today will develop diabetes if current trends continue.
Diabetes kills more Americans each year than breast cancer and AIDS combined.

Type 2 diabetes is on the increase and will continue to increase according to the Centers for Disease Control and Prevention (CDC) and Emory University. They predict Type 2 diabetes increase by 2050 to about one in every three adults in the US.

Even if there are about one in every ten adult Americans has diabetes there are several justifications why this will increase. First, the percentage of minority groups in the US with a higher risk for diabetes will continue to grow. Second, more people are putting on the pounds and weight/obesity are key risk factors in type 2 diabetes. And third, people with diabetes in America continue to live longer with more effective therapies and medications coming on the market.

It is not a total surprise that expectations are for an increase and for this the media has been cooperative within their limited knowledge of diabetes. Education by the various diabetes and medical groups will only help. Then we will need the cooperation of these groups to aggressive in diagnosis and treatment for this to be successful. The picture is not pretty, but needs the attention of everyone.

The actions of one group discussed here may be the help needed to get this started.

02 November 2010

Who is the AADE Kidding?

I had some very mixed feelings when Lee at LifeAfterDx – CGM Chronicles made his post of August 15, 2010. He did an excellent analysis of the AADE (American Association of Diabetes Educators) and their white paper (AADE discussion is about two thirds down the page). Be sure to read his entire blog as he has the experience to speak to this.

I had read the white paper put forth by the AADE. While I was wondering what was being fed to us and whether to believe the white paper, Lee made his post. Talk about removing the haze. While their paper sounds good, further analysis reveals how little they think of Community Health Workers (CHW's). The white paper on the surface appears to have a place for CHW's, but when read carefully, it is not hard to see how they want to actually demote these people to almost no responsibility and almost servitude to promote their own importance and create more prestige for their titles so they can charge more for their services. I do not want to be a part of this charade.

They want CHW's to serve as liaison personnel between the CDE's and the patients and the community in general. Nothing is said about what CHW's will do for assisting or educating the people diagnosed with diabetes. It seems, by the white papers, that this is reserved for the CDE's. Yes, they want to force education on the CHW's, but won't say what type of education, the requirements and amount of education, or even if this will be something the CHW's can use.

I am happy in one respect that the Academic community is working with volunteers in a peer to peer groups and making a success of this. This shows that there is an honest need to help outside the AADE. This also suggests that the AADE is short of people and may be falling short in their responsibilities.

As such I will continue to question the sincerity of the AADE and forget about any hopes I may have had. A group that is so wrapped up in their own importance will get no respect from me.

01 November 2010

Sleep, Sleep, Sleep

I love bloggers that can pull ideas together. David Spero has an excellent blog on diabetes and sleep at diabetes self management. He list many points that most writers and myself often forget when writing about sleep and its importance.

David did mention sleep apnea and left a group of other sleep disorders unmentioned. Not an error on his part as I am sure by mentioning one he was meaning all collectively. I will encourage you read his blog here. I will mention parts of it because it is important to all of us and what many people don't think of or do to get the sleep they need.

A list of his points - first the sleep robbers: diabetes, sleep apnea, stress, pain, noise, and using bedroom for other activities besides sex and sleep.

Aids that help include the following, bedroom a sleep palace, comfortable bed, dark room, pleasing or comfortable noise level, right temperature for individuals, bed reserved for sleep and sex, exercise during daylight – not before bed, avoid caffeine after dinner, get some sunshine during the day, take time to wind down and relax, and put the world on hold.

Now some of the points that I have found to expand on David's. The sleep robbers are insomnia, restless leg syndrome, snoring (you or your partner), night sweats, sleepwalking, bruxism (teeth grinding), and other sleep disorders.

Factors that are more unpredictable include a couple of of disorders that cause people to be sleepy to the extreme. They are narcolepsy and hypersomnia. This can cause problems of people getting the restful sleep they need during normal sleep time.

Hypoglycemia is a problem for for many people on insulin and quite a few of the oral medications. Hypoglycemia while sleeping may cause you to awaken. This happens to me and for that I am thankful. It does interrupt my sleep, especially when I am below a blood glucose reading of 65, I like to test, have something to eat that will rapidly raise my BG reading and test again in 15 minutes and then in 30 minutes to see what is happening to the BG. This means about an hour of lost sleep. Fortunately, this does not happen that often, still three times in the last nine months is disturbing. The lowest reading was 59 and the other two were below 65.