13 November 2010

Smart Phone Apps Put Doctors in Charge

This is meant to bring Doctors into the twenty-first century, but there may be some serious doubts. I think the right people (John Hopkins) are involved. This also should make it more convenient for the medical community to stay more current with the latest developments in diabetes.

This is now available on all smart phone devices and something more bulky which should help. I have to wonder if this will be available for the computers systems found in many doctors offices to be more effective. This will be potentially a great asset for nurses and other healthcare providers since this is portable.

I not have seen this application; however, according to the reviews, it provides real-time advice for diabetes management to medication side-effects. Since this is written by physicians, it should be an excellent source of information and offer the latest expert opinions in diabetes care. At least we can hope that it is the correct information.

Named the POC-IT, the application should raise the standard of care and improve patient safety. This is the third POC_IT application. The other two were successful guides on antibiotics and HIV.

I hope this guide starts eliminating problems that many patients have with uninformed nurses and diabetes educators that do not have their information correct.

12 November 2010

Why is Diet Always Listed First?

I had intended on another post today; however, my thoughts and heart just weren't in it. It is almost complete, but my final thoughts just went away when I read another study advocating diet and lifestyle changes to manage diabetes. Others have already written about this, but now it is my turn.

I must state that I have some doctor's and medical limitations, but I do believe in what I am advocating. Understanding why almost every article and study about lifestyles and the need to change lifestyles starts with diet and lifestyle changes is something that does not set well with me. Many of these articles do mention exercise someplace, but the emphasis definitely excludes exercise. If the article is about nutrition, often exercise is not even mentioned.

So with this in mind, I need to look at why this happens. The quickest thought is that there is no money in covering exercise. While the next thought applies to exercise and diet, they are something that people choose to do themselves and habits can be hard to change. Most people do use the term diet to mean what we eat and nutrition. What many writers forget is that many people have tried diets (way of losing weight) and have discovered that diets fail. This generally leads to people not reading some articles when diet is the lead.

Lifestyle is harder to define. Does lifestyle not include exercise, diet, and healthcare habits. Or are we supposed to think this is couch-potato habits and other unhealthy habits? Maybe I am reaching to think that researchers are not totally defining lifestyle, and possibly using this to avoid talking about issues that they know people will not accept.

I have and will probably continue to use the word lifestyle, I would define it as including exercise, nutrition, and other habits such as smoking, drinking, and not leading a sedentary life. When a person has diabetes, they must, if health allows, exercise, normally change the types of foods consumed or restrict the quantity, and stop the unhealthy habits as quickly as possible.

I will more than likely continue to wish that exercise is given a more prominent position in studies, and articles about many chronic diseases and especially diabetes. Some writers seem to consciously seem to separate exercise and diet (nutrition) and discuss each separately and then cover lifestyle. This I understand and accept. I would hope that writers about diabetes would re-prioritize their writing so that exercise is number one, nutrition is number 2, and lifestyle is number 3.

11 November 2010

Pharmacies Becoming Sources for Medical Care?

Is this what we want or what we need? I have to wonder if this will be a good thing for people with chronic diseases. I am not sure I want my medical care retailized or taken care out of a storefront. But this is the latest desire from Walgreens – to become your one-stop health care facility.

Walgreens and other large retail pharmacies are lobbying to make this a fact of life. I do not want to have nurse practitioners in charge of my medical health care. I am thankful that in some of the more remote areas or largely rural areas in the United States, nurse practitioners have been needed to get medical care to people and have done excellent work. This has been a necessity because of the lack of doctors in these areas. But for a retail store like Walgreens in non-rural area, this runs against my better nature.

Walgreens is wanting to do this because of the “national shortage of primary care doctors”. They are proposing to “assist patients in managing chronic conditions of diabetes, hypertension, and high cholesterol”.

We have to wonder if we are going to be prescribed extra drugs or medications as a result. Is the American Medical Association going to allow this to happen? Are the states going to allow this to happen? It is happening in some states that have nurse practitioners, but I hope that this does not come to pass in our more populated states.

Many pharmacies are now giving blood screening, flu shots, and other medical advice mainly under the supervision of pharmacists. This is not always the best for many patients as they do not check any medical records to verify allergies and other medical conditions which might preclude some treatments.

What many are banking on is the new health care act providing insurance to people and they want to cash in on the potential increase of cash. And Walgreens is not bashful about saying this.

Before I would want to utilize pharmacies (or what name they will change to), I would want to know who is responsible for writing the prescriptions and whether they have met the education requirements necessary to be able to write prescriptions. Are the pharmacies going to require filling the prescriptions in their store or can these prescriptions be filled at any pharmacy?

These are just some of the questions that need to be answered before I would accept pharmacies taking over primary medical care. Will pharmacies be required to have doctors available to consult or oversee and supervise prescriptions with appropriate approvals available for states to audit? Will this action create or necessitate more state agencies to oversee questionable medical decisions and audit procedures? Will this just increase medical fraud, Medicare, Medicaid, and other fraudulent practices.

And with the shortage of nurses that exists today, where will all of the nurse practitioners come from? Or will they come from our hospitals and doctors offices thus creating a more critical shortage there?

Before this becomes practice, I would hope that our federal and state legislators will examine this very carefully. The last question I would want answered or information made available to the public is the political contributions made in the last election and to whom were they made.

10 November 2010

Writing about the same topic

Over the last year I have had several email discussions with fellow Type 2 bloggers on writing about the same topics. Most have felt like the first person I discussed this with. He said that we could always write about the same topic and we would seldom repeat what the other person had written about. He stated further that our life's experiences are all different and as such we will emphasize different aspects and relate differently to the same topic.

Another blogger has told me that if one blogger writes about a topic, he feels that blogger has “dibs” on the topic, and as such he will attempt to avoid the topic as he does not want what the other person wrote to influence his presentation. This was the way I had felt in the beginning, but now I have found that I enjoy writing about whatever topic peaks my interest. Often I find topics like my last post that are from personal experiences, good and bad.

I like it when another blogger has written about the same topic as I don't mind and actually prefer giving them credit for their work and I like the challenge of bringing my thoughts out about similar ideas and giving readers the opportunity to read both. What the other blogger covered may be what the reader was looking for which he may not have found without my link. Other readers may find mine is what they are looking for and at the some time, he has the opportunity to compare insights between two bloggers.

I sometimes will start a blog, find that my thoughts are not coming together and set it aside. Then another blogger writes about it from another perspective and it brings my thoughts together. Even though I try to write mainly for type 2 topics, there are often ideas and other interests that get my attention.

What brings these to the forefront? Often it is is one of the newsletters I subscribe to. At other times it can be a combination of newsletters and a friend, acquaintance, or family member that has something that really drives the topic home. Even a comment from a casual acquaintance can spark interest in a topic. There are times when another blogger writes about something that begs for further thoughts, whether, to disagree, add a point or points that may have not been covered, agree with their thoughts, or just take off on a different tangent.

What got me started on this today? I am reading many blogs written about the same topic because that is what someone had suggested a few years back. This will be a day late, but because I wanted to read what others had written for D-blog day. There are many interesting points that we would like people to know about diabetes. Scott Strange did an excellent two blogs and you should read Nov 8 and then Nov 9. I am one that appreciates his idea of two sides to the suggestion of what we want people to know.

Then the other blog that caught my attention is by Kerri at six until me, dated Nov 9, 2010. Yes, there are many others, but I don't have time to read all of them, so please read your favorites. Kerri's sixth point resonated with me. It is this that I would like to expand on. Her thoughts and last sentence “We deserve a cure” really says it all. Her other points are well stated, but the last sentence drove it home for me.

With the millions of people with various types of diabetes, we need to get many of them writing, emailing, or otherwise notifying our representatives, senators, and even our governors asking them to support a cure, maybe, just maybe, we could bring a cure to the front faster.

A few hundred bloggers from the diabetes online community will get minimal attention, but if family members and friends can do this as well, plus ask other people to do the same, it will get their attention. This is what is needed to energize our elected officials to take action. Here are a few of the sites I chose in searching for congressional email addresses and some also have suggestions for making your email get noticed.

A prime example if having a diabetes organization send a list of names supporting their position as well as a personal email. I know that the elections have taken place and many representatives and senators will not have email addresses until probably after the new session starts. This still should not stop us from getting our message across.

I personally have written mine, since none of my congressional members were defeated, but I will need to wait for the new governor to take office. This is my one and only thing I want people to know and to do for the coming days and year.

09 November 2010

Diabetes, Is Our Education Failing?

Before you get upset, please read carefully. A Type 1 acquaintance has really gotten me more than a little upset. He maintains that diabetes, is diabetes, is diabetes. He says basically that there is only one type and that if you are on insulin, you are a Type 1. Even though I told him that I have type 2 diabetes and am on insulin, he said I must have been misdiagnosed as I was Type 1. Nothing I could say was going to change his mind.

Then a few days later he contacted me and asked if I would go with him and see how his doctor determines that people are Type 1. I politely declined as I trust my endocrinologist and other doctors and know nothing about this doctor other than what this person says about seeing only type 1 diabetes patients. When I ask him when he was diagnosed, he said he was 48 years of age. Oh really? And he is sure he is Type 1?

Then I asked him to explain Type 2. He said these were people that might have Type 1, but basically do not have Type 2 or even diabetes because when they loose the weight and use exercise and nutrition (diet) they do not have any symptoms of diabetes. This can be correct, but if they truly have diabetes, they will definitely find out if they do not take care of themselves with exercise and nutrition.

All of this has me wondering who is educated about diabetes. This simplistic definition by a person with supposedly Type 1 has me wondering (but not about diabetes, Type 2). Then today Scott Strumello has an excellent post about the diabetes diseases (yes, plural) that fits very well into this topic. Please take time to read it.

I just know that Scott has the correct read on diabetes. I don't know enough to state positively that Type 1 has many variants, but there logically seems that there are some variations in Type 1. Type 2 definitely has many variants. Find any point on a bell curve and you can state with some certainty that there will likely be several thousand(s) Type 2 fitting the conditions.

This helps explain why what works for you, may not work for me. This does not explain why there are so many variables, just that there are many variables. Now it seems that there are several causes of insulin resistance including over weight, a hormone secreted by the liver and possibly individual body chemistry. This also adds to the knowledge of variations in Type 2.

08 November 2010

Direct to Consumer Advertising

Now that the political ads have stopped, it is interesting to see what Big Pharma is back to doing. Especially in the late evening hours. On the 11/4/10, my wife and I logged a baker's dozen drug ads in four hours. Then on 11/6/10, I have heard over 16 drug ads from 4:00 PM to 2:00 AM. Three of the ads were for asthma medications, two repeat ads for gout medication, four ads for cholesterol medications, and several other medications.

What got me started on this? A blog by R. Centor named medrants from October 31, 2010. He wrote from a doctors perspective, but I want to write from a patient point of view, specifically a diabetes perspective. Also my blog here had started my investigating and watching some blogs more closely.

In the US prior to 1985 this advertising was not legal. Prior to 1997, many restrictions kept direct to consumer advertising almost non-existent. Then in 1997 the Food and Drug Administration basically lifted the rule requiring the listing of the side effects, opening the flood gates for companies to use the advertising. The only other country allowing legal direct-to-consumer advertising is New Zealand.

I personally am not happy watching advertising for many of the drugs, Several have been pulled from the market because of harmful side-effects. And I know that the drugs they are advertising are the ones that are high-priced and need a lot of sales to recoup research and development quickly and then have a high profit margin.

These tactics need to be outlawed again to lower the cost of drugs. This will probably not happen with the amount of money being pumped into campaign coffers. It is a shame that this is allowed to go on as this only insures that consumer protection will become weaker and more dangerous. This is one of the reasons I chose to end the oral medications early and go on insulin.

The doctors know that if a medication has been advertised on TV that I probably will not be willing to use it. Actually, this tactic allows me to check out the side-effects and that means that I will probably not take it. I will never suggest to my doctors a medication that has been on TV. For some reason, I take a very unfavorable view of advertised medications.

These are the links where you can read more about direct to consumer advertising.
Site 1 and Site 2.