20 November 2010

Hospital Care Deadly for Some

A new government study makes my blood boil and should raise concern for everyone. I may sound a little harsh, but having seen the results of some of the carelessness recently, I was not surprised. This study and another version by the Department of Health and Human Services need attention and broad public attention.

I am not trying to single out one medical profession as it appears that all medical professions are at fault if they work in and around hospitals. I would like to know how other patients fare, but I can believe that non-Medicare patients could be better off. According to the study, hospital care-related problems account for about 15,000 deaths per month.

One in seven Medicare patients receives injuries or other harm from hospital care. This includes infections, bed sores, and excessive bleeding from blood-thinning drugs. This works out to be 13.4 percent of one million Medicare patients. Another 13.4 percent suffer temporary harm which is detected in time and corrected and the patients receive no lasting harm from these events.

With over a quarter of our Medicare patients receiving poor care in our hospitals, is it any wonder that our elderly do not want to be admitted into the hospitals. Patient safety is not getting the attention it deserves and this makes me wonder what happens to those on Medicaid and those younger patients with insurance. The studies make no accusations, but I have to raise the question about euthanasia being practiced by some in our medical system.

The CMS (the Centers for Medicare and Medicaid Services) has been called on to hold hospitals accountable for adoption of evidence-based practice guidelines. This is to be enforced through the survey and certification procedures that hospitals must go through to be eligible for Medicare Reimbursement.

The Office of the Inspector General also recommended a greater effort by CMS and the Agency for Healthcare Research and Quality to pinpoint the incidence of adverse events, at the individual hospitals and across the healthcare system. This would include doctor's offices, clinics, and nursing homes.

19 November 2010

Now That World Diabetes Day is Over

Now that the day is over, what was accomplished? I have thought about this the last few days and wonder how many people were better off for it? Have the goals been met? Yes, I know that this is Diabetes Month and that there are days left in the month, but that still leaves me less than enthusiastic about one day. I would like to think more of what could be accomplished if the energy of one day could be channeled into 365 days.

I started to think about the money spent in advertising world diabetes day and diabetes month, the money spent for lighting buildings, monuments, and all the promotions that were done. How many people were truly educated by this. The one great idea was originated by a few people and with Roche donating money for those in developing countries to get insulin to those that otherwise would not have it. That is a positive and money wisely contributed!

The biggest goal I thought was to educate people about diabetes. If all the money spent on advertising and lighting buildings, was used for articles on diabetes and advertising with a personal story in newspapers, magazines, and in other media, a lot more people would probably have better, if not greater, knowledge of diabetes.

Another thought would be wearing the blue circle every day. This would always give you something to talk about and educate others about diabetes. Some of us will need an extra dose of patience to deal with some people, but it could be worth the extra patience. This would help put all types of diabetes in front of the public on a year-round basis and should reach more people than a one day event.

While the ADA has finally recognized World Diabetes Day, they still are hung up on the color red and have not recognized the blue circle that the JDRF and IDF have adopted for diabetes. We also need to encourage ADA to adopt a more realistic approach to the different types of diabetes. They could publish small pamphlets for the medical profession and pharmacies to hand out explaining the different types of diabetes. And I mean all types – polygenic and monogenic.

I am a little tired of having to explain that Type 2 does not progress into Type 1, or that diabetes is a disease. Just because we appear normal to people around us, does not mean that daily, we do not have to carefully manage our diabetes to prevent the complications from developing. This is what our neighbors and acquaintances do not see, the testing, taking medications, and the worry of getting it right.

There was really nothing locally to celebrate World Diabetes Day, so I just had to do my thing and be happy.

18 November 2010

Your Legal Rights to Medical Records in the USA

Your medical records are important to you. A federal law called the HIPAA Privacy Rule gives you the right to see, get a copy of, and amend (correct) your medical record by adding information to it. This link should get you most of the information necessary under the federal law and the laws of your state. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996.

Why is this so important? Because everyone should be able to track what is entered in their medical records for accuracy and completeness. Everyone is human and mistakes can be made. Test results are important and getting copies of these allow you to track the test results over time and discern for yourself what is happening to your health. The test will show you trends, whether they are good or bad and can alert you to something the doctor may have missed. You normally should be able to get copies of test results almost immediately.

When compared to the standards for that test, what do the results mean? Before this can be explained, you need to know what the standards are for the lab doing the tests. These should be with the results. Standards for testing labs in the United States can vary between labs and labs in different states even if owned by the same firm. If you made the statement that this is not good, you are right.

An observation – even though the American Diabetes Association had declared that the lab standard variances for the HbA1c test has been corrected and standardized, this is not necessarily the case. Some labs have a long way to go to improve and meet a national standard. The need is great for federal set of standards which each lab would be mandated to follow or face being put out of business or at minimum face punitive fines.

Test results over time for an individual done by the same lab should point out changes in a person's health and which direction the changes are occurring. Now getting to your medical records may be more difficult. There are delaying tactics used by many physicians and by most hospitals that are quite effective. This is to allow them time to sanitize the records and remove personal comments entered by medical personnel that they don't want you to see. If they think there is a possibility of legal repercussions, the delaying tactics can be very convincing. Unfortunately, they generally have 30 days that they can legally delay access to an individual and most will use as much of this time as they need.

Do not think that you can just go in and ask to see your medical records. Won't happen! They do not keep enough people on staff for this and they want to review them before you see them. All will still tell you that you must request specifically what you want and they will make copies for you. They will not allow you to handle the records (for good reasons). Also be prepared to pay a handsome fee for this service. The thicker your records are the greater the fee, if you ask for everything.

17 November 2010

Study Urges - Beware of Facebook for Diabetes Info

Social media is good for distribution information. This study indicates that this can be dangerous as well. It raises valid concerns about the accuracy on these sites. It is this type of information that causes concerns for doctors and helps them doubt all information from the internet.

I personally stay away from Facebook because I know that there is bad information especially from advertisers promoting their “cures” which are false and more dangerous than helpful. This study just confirms that about 25 percent of the information is not what many people need.

The researchers examined 15 of the largest Facebook communities about diabetes and discovered that one in four comments on these sites were promotional in nature. This means that people are advertising products that are not approved by FDA. This says that a quarter of the people on these sites are most likely non-diabetic and are there to make sales.

Another area of concern are the number of surveys, marketing, and efforts to get people for clinical trials where the identity of the poster was unknown or even remotely discernable. These people prey on the people desperate for information and line their pockets with their schemes.

Now I understand why doctors may not like you getting your information from the internet. They are aware that often people are not as discriminating as they should be in what they select to read. This is why I have a list of sites I visit regularly to give the doctor. This does not always please him, but he finally did ask that I send him the list in an email. Now we are able to talk about things and he is not as likely to tune me out. I also send a list of questions and which site generated them.

I agree with the results of the study concluding that there is often much good on some of the sites, but little control in the advertising and promotional position of the site. This is why I also warn you to fact check the information and be prepared to discard the misinformation.

This is also why I recommend sites that are monitored to prevent promotional advertising and that monitor the site for misinformation, correcting it or giving warnings to information that misses the mark. Some diabetes forums are excellent and provide a safe place to ask questions and guard their members from unsafe practices. From the information in the study and from talking to friends about their experiences on Facebook I do feel safe in urging people to check out the diabetes forums and sites I have listed here.

16 November 2010

Sufficient Sleep is Part of Lifestyle Change

Yes, I am back to encourage you to get more sleep. This time, I am concerned for several reasons. Another study now tells us that lack of sleep makes it more difficult to successfully lose weight. The message is now “eight hours plus of sleep, exercise, and nutrition”.

People that can regularly get 8.5 hours of restful sleep burn more fat than people getting 5.5 hours of sleep. They have concluded that sleep loss while dieting increases the ghrelin (a hormone that stimulates appetite) associated changes in hunger, glucose and fat utilization, and energy metabolism which slows or halts weight loss.

The researchers reported that sleep-deprived participants reported feeling hungrier during the study. They agreed that sleep may be an important factor in successful weight loss and that adequate sleep may be a significant part of the lifestyle change that has normally concentrated on diet and exercise.

The message to physicians is that they need to explain to overweight patients with diabetes that people who slept 8.5 hours reduced their weight than those who slept for less time. Doctors also should remind patients that the lack of sleep causes more hunger and they expend less energy to compensate for the reduction in sleep.

So if you have been losing weight, but now or have hit a weight loss plateau, you may want to add sleep to the other remedies to break through the plateau and get on with losing weight. This is just another part of the lifestyle change so important for people of diabetes. Good luck!

15 November 2010

Diabetes and Alzheimers now linked?

I have to thank fellow blogger, Diabetic Guy, for getting me thinking and finding more information on diabetes and alzheimers. Now I have found a study that points out that there is a link between diabetes and alzheimers. The information is more technical than I am comfortable with, so if I confuse you, I am providing the links for you to read.

The study was conducted at the Mount Sinai School of Medicine and was co-authored by geneticist Alan Attie, PhD, Professor of Biochemistry, University of Wisconsin. They have analyzed the relationship between alzheimers and diabetes and identified a single gene to the causes of both Alzheimer's and Type 2 diabetes.

This fact is very bothersome for me. Yes, I am concerned about developing Alzheimer's since I have Type 2 diabetes. A gene for a protein called SorCS1 which may cause Type 2 diabetes, also impacts the the accumulation of amyloid-beta (Abeta) which plays a prominent role in the development of Alzheimer's.

This will generate more studies and possibly new drugs for the treatment of both diseases. This is going to take time and patience. Alzheimer's professionals have for several years maintained that there is a link, and now part of this has come true. Now it is learned that those with Type 2 diabetes are at risk of developing Alzheimer's about 50 percent of the time.