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Better Management Of Diabetes With Diabetesdek

By: Adam s casper

If you have a child or teen that faces problems managing and coping with diabetes the latest edition of the easy to read and informative Pediatric DiabetesDek is now available. It contains useful and up-to-date information about better managing life with diabetes.

The Pediatric DiabetesDek contains reliable and practical how to information about coping with the challenges of living a life affected by type 1 diabetes. The Pediatric DiabetesDek helps families that have a child or teen with type 1 diabetes better understand their special needs. It facilitates standing up to the stress and challenges of such situations.

The Pediatric DiabetesDek contains valuable information that helps family members control the diabetes of their loved one. It is not uncommon for diabetics to suffer from conditions such as ketoacidosis or hypoglycemia. The information available helps you better deal with such potential emergencies.

The Pediatric DiabetesDek provides in-depth information about the various types of diabetes such as type 1, type 2, monogenic, and gestational diabetes. It also tells you how they are connected and why it is important to have all the data possible about such conditions.

You can share correct information with a friend or a family member about the importance of maintaining the right levels of blood glucose and how exercising regularly and eating the right type of food can help them mitigate the risks associated with pediatric diabetes.

 
The Pediatric DiabetesDek explains in great detail and in lucid language, the various crucial aspects of diabetes management. It describes in detail the role of insulin in diabetes management and other important aspects of using insulin such as an insulin regime, the dosage that needs to be administered for effective treatment as well as the different types of insulin available for treatment of various types of diabetes.

 
The Pediatric DiabetesDek will also point out some proper foods to eat and the appropriate serving sizes. This useful information will help you help your loved ones manage their weight.

Diabetes is a health condition that requires intense care and proper health management on all fronts. The information provided in the Pediatric DiabetesDek describes how you can provide children and teens with much of the care they need. It helps address crucial issues such as managing depression, and long term health concerns such as stroke and heart related diseases.

Article Source: http://www.articlesnatch.com

About the Author:
Welcome to InfoDek, A Professional pediatric diabetes guide for your family to manage and control diabetes in children and teens. DiabetesDek publications are pocket sized booklets that contains useful advice and information regarding diabetes.

Diabetes, Heart Disease, and Stroke

Education Programs

• National Diabetes Education Program
• National Kidney Disease Education Program

On this page:

• • What is diabetes?
  • What is pre-diabetes?
  • What is the connection between diabetes, heart disease, and stroke?
  • What are the risk factors for heart disease and stroke in people with diabetes?
  • What is metabolic syndrome and how is it linked to heart disease?
  • What can I do to prevent or delay heart disease and stroke?
  • How will I know whether my diabetes treatment is working?
  • What types of heart and blood vessel disease occur in people with diabetes?
  • How will I know whether I have heart disease?
  • What are the treatment options for heart disease?
  • How will I know whether I have had a stroke?
  • What are the treatment options for stroke?
  • Points to Remember
  • Hope through Research
  • For More Information

Having diabetes or pre-diabetes puts you at increased risk for heart disease and stroke. You can lower your risk by keeping your blood glucose (also called blood sugar), blood pressure, and blood cholesterol close to the recommended target numbers-the levels suggested by diabetes experts for good health. (For more information about target numbers for people with diabetes, see “How will I know whether I have heart disease?”.) Reaching your targets also can help prevent narrowing or blockage of the blood vessels in your legs, a condition called peripheral arterial disease. You can reach your targets by:

• choosing foods wisely
• being physically active
• taking medications if needed

If you have already had a heart attack or a stroke, taking care of yourself can help prevent future health problems. 

What is diabetes?

Diabetes is a disorder of metabolism-the way our bodies use digested food for energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the body’s main source of fuel.

After digestion, glucose enters the bloodstream. Then glucose goes to cells throughout the body where it is used for energy. However, a hormone called insulin must be present to allow glucose to enter the cells. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

In people who do not have diabetes, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. However, diabetes develops when the pancreas does not make enough insulin, or the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy.

Over time, high blood glucose levels damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes. Uncontrolled diabetes can eventually lead to other health problems as well, such as vision loss, kidney failure, and amputations.

Diabetes can lead to heart and blood vessel disease. 

What is pre-diabetes?

Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is also called impaired fasting glucose or impaired glucose tolerance. Many people with pre-diabetes develop type 2 diabetes within 10 years. In addition, they are at risk for heart disease and stroke. With modest weight loss and moderate physical activity, people with pre-diabetes can delay or prevent type 2 diabetes and lower their risk of heart disease and stroke. 

What is the connection between diabetes, heart disease, and stroke?

If you have diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. If you are middle-aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.

People with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition, heart attacks in people with diabetes are more serious and more likely to result in death. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).

What are the risk factors for heart disease and stroke in people with diabetes? 

Diabetes itself is a risk factor for heart disease and stroke. Also, many people with diabetes have other conditions that increase their chance of developing heart disease and stroke. These conditions are called risk factors. One risk factor for heart disease and stroke is having a family history of heart disease. If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.

You can’t change whether heart disease runs in your family, but you can take steps to control the other risk factors for heart disease listed here:

• Having central obesity.
• Central obesity means carrying extra weight around the waist, as opposed to the hips. A waist measurement of more than 40 inches for men and more than 35 inches for women means you have central obesity. Your risk of heart disease is higher because abdominal fat can increase the production of LDL (bad) cholesterol, the type of blood fat that can be deposited on the inside of blood vessel walls.
• Having abnormal blood fat (cholesterol) levels.
•  
  - LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteries-the blood vessels that carry blood from the heart to the rest of the body. Arteries can then become blocked. Therefore, high levels of LDL cholesterol raise your risk of getting heart disease.
  - Triglycerides are another type of blood fat that can raise your risk of heart disease when the levels are high.
  - HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal. Low levels of HDL cholesterol increase your risk for heart disease.
• Having high blood pressure.
• If you have high blood pressure, also called hypertension, your heart must work harder to pump blood. High blood pressure can strain the heart, damage blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.
• Smoking.
• Smoking doubles your risk of getting heart disease. Stopping smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels. Smoking also increases the risk of other long-term complications, such as eye problems. In addition, smoking can damage the blood vessels in your legs and increase the risk of amputation.

What is metabolic syndrome and how is it linked to heart disease?

Metabolic syndrome is a grouping of traits and medical conditions that puts people at risk for both heart disease and type 2 diabetes. It is defined by the National Cholesterol Education Program as having any three of the following five traits and medical conditions:

Traits and Medical Conditions
Definition

Elevated waist circumference
Waist measurement of

• 40 inches or more in men
• 35 inches or more in women

Elevated levels of triglycerides

• 150 mg/dL or higher
  or
• Taking medication for elevated triglyceride levels

Low levels of HDL (good) cholesterol

• Below 40 mg/dL in men
• Below 50 mg/dL in women
  or
  Taking medication for low HDL cholesterol levels

Elevated blood pressure levels

• 130 mm Hg or higher for systolic blood pressure or
• 85 mm Hg or higher for diastolic blood pressure
  or
  Taking medication for elevated blood pressure levels

Elevated fasting blood glucose levels

• 100 mg/dL or higher
  or
• Taking medication for elevated blood glucose levels

What can I do to prevent or delay heart disease and stroke?

Even if you are at high risk for heart disease and stroke, you can help keep your heart and blood vessels healthy. You can do so by taking the following steps:

• Make sure that your diet is “heart-healthy.”Meet with a registered dietitian to plan a diet that meets these goals:
  • Include at least 14 grams of fiber daily for every 1,000 calories consumed. Foods high in fiber may help lower blood cholesterol. Oat bran, oatmeal, whole-grain breads and cereals, dried beans and peas (such as kidney beans, pinto beans, and black-eyed peas), fruits, and vegetables are all good sources of fiber. Increase the amount of fiber in your diet gradually to avoid digestive problems.
  • Cut down on saturated fat. It raises your blood cholesterol level. Saturated fat is found in meats, poultry skin, butter, dairy products with fat, shortening, lard, and tropical oils such as palm and coconut oil. Your dietitian can figure out how many grams of saturated fat should be your daily maximum amount.
  • Keep the cholesterol in your diet to less than 300 milligrams a day. Cholesterol is found in meat, dairy products, and eggs.
  • Keep the amount of trans fat in your diet to a minimum. It’s a type of fat in foods that raises blood cholesterol. Limit your intake of crackers, cookies, snack foods, commercially prepared baked goods, cake mixes, microwave popcorn, fried foods, salad dressings, and other foods made with partially hydrogenated oil. In addition, some kinds of vegetable shortening and margarines have trans fat. Check for trans fat in the Nutrition Facts section on the food package.
• Make physical activity part of your routine. Aim for at least 30 minutes of exercise most days of the week. Think of ways to increase physical activity, such as taking the stairs instead of the elevator. If you haven’t been physically active recently, see your doctor for a checkup before you start an exercise program.
• Reach and maintain a healthy body weight. If you are overweight, try to be physically active for at least 30 minutes a day, most days of the week. Consult a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight. Aim for a loss of no more than 1 to 2 pounds a week.
• If you smoke, quit. Your doctor can help you find ways to quit smoking.
• Ask your doctor whether you should take aspirin. Studies have shown that taking a low dose of aspirin every day can help reduce the risk of heart disease and stroke. However, aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.
• Get prompt treatment for transient ischemic attacks (TIAs). Early treatment for TIAs, sometimes called mini-strokes, may help prevent or delay a future stroke. Signs of a TIA are sudden weakness, loss of balance, numbness, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache.

How will I know whether my diabetes treatment is working?

You can keep track of the ABCs of diabetes to make sure your treatment is working. Talk with your health care provider about the best targets for you.

A stands for A1C (a test that measures blood glucose control). Have an A1C test at least twice a year. It shows your average blood glucose level over the past 3 months. Talk with your doctor about whether you should check your blood glucose at home and how to do it.

A1C target

Below 7 percent

Blood glucose targets

Before meals
90 to 130 mg/dL

1 to 2 hours after the start of a meal
Less than 180 mg/dL

B is for blood pressure. Have it checked at every office visit.

Blood pressure target

Below 130/80 mm Hg

C is for cholesterol. Have it checked at least once a year.

Blood fat (cholesterol) targets

LDL (bad) cholesterol
Under 100 mg/dL

Triglycerides
Under 150 mg/dL

HDL (good) cholesterol
For men: above 40 mg/dL
For women: above 50 mg/dL

Control of the ABCs of diabetes can reduce your risk for heart disease and stroke. If your blood glucose, blood pressure, and cholesterol levels aren’t on target, ask your doctor what changes in diet, activity, and medications can help you reach these goals.

What types of heart and blood vessel disease occur in people with diabetes?

Two major types of heart and blood vessel disease, also called cardiovascular disease, are common in people with diabetes: coronary artery disease (CAD) and cerebral vascular disease. People with diabetes are also at risk for heart failure. Narrowing or blockage of the blood vessels in the legs, a condition called peripheral arterial disease, can also occur in people with diabetes.

Coronary Artery Disease

Coronary artery disease, also called ischemic heart disease, is caused by a hardening or thickening of the walls of the blood vessels that go to your heart. Your blood supplies oxygen and other materials your heart needs for normal functioning. If the blood vessels to your heart become narrowed or blocked by fatty deposits, the blood supply is reduced or cut off, resulting in a heart attack.

Cerebral Vascular Disease

Cerebral vascular disease affects blood flow to the brain, leading to strokes and TIAs. It is caused by narrowing, blocking, or hardening of the blood vessels that go to the brain or by high blood pressure.

Stroke

A stroke results when the blood supply to the brain is suddenly cut off, which can occur when a blood vessel in the brain or neck is blocked or bursts. Brain cells are then deprived of oxygen and die. A stroke can result in problems with speech or vision or can cause weakness or paralysis. Most strokes are caused by fatty deposits or blood clots-jelly-like clumps of blood cells-that narrow or block one of the blood vessels in the brain or neck. A blood clot may stay where it formed or can travel within the body. People with diabetes are at increased risk for strokes caused by blood clots.

A stroke may also be caused by a bleeding blood vessel in the brain. Called an aneurysm, a break in a blood vessel can occur as a result of high blood pressure or a weak spot in a blood vessel wall.

TIAs

TIAs are caused by a temporary blockage of a blood vessel to the brain. This blockage leads to a brief, sudden change in brain function, such as temporary numbness or weakness on one side of the body. Sudden changes in brain function also can lead to loss of balance, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache. However, most symptoms disappear quickly and permanent damage is unlikely. If symptoms do not resolve in a few minutes, rather than a TIA, the event could be a stroke. The occurrence of a TIA means that a person is at risk for a stroke sometime in the future. See page 3 for more information on risk factors for stroke.

Heart Failure

Heart failure is a chronic condition in which the heart cannot pump blood properly-it does not mean that the heart suddenly stops working. Heart failure develops over a period of years, and symptoms can get worse over time. People with diabetes have at least twice the risk of heart failure as other people. One type of heart failure is congestive heart failure, in which fluid builds up inside body tissues. If the buildup is in the lungs, breathing becomes difficult.

Blockage of the blood vessels and high blood glucose levels also can damage heart muscle and cause irregular heart beats. People with damage to heart muscle, a condition called cardiomyopathy, may have no symptoms in the early stages, but later they may experience weakness, shortness of breath, a severe cough, fatigue, and swelling of the legs and feet. Diabetes can also interfere with pain signals normally carried by the nerves, explaining why a person with diabetes may not experience the typical warning signs of a heart attack.

Peripheral Arterial Disease

Another condition related to heart disease and common in people with diabetes is peripheral arterial disease (PAD). With this condition, the blood vessels in the legs are narrowed or blocked by fatty deposits, decreasing blood flow to the legs and feet. PAD increases the chances of a heart attack or stroke occurring. Poor circulation in the legs and feet also raises the risk of amputation. Sometimes people with PAD develop pain in the calf or other parts of the leg when walking, which is relieved by resting for a few minutes.

How will I know whether I have heart disease?

One sign of heart disease is angina, the pain that occurs when a blood vessel to the heart is narrowed and the blood supply is reduced. You may feel pain or discomfort in your chest, shoulders, arms, jaw, or back, especially when you exercise. The pain may go away when you rest or take angina medicine. Angina does not cause permanent damage to the heart muscle, but if you have angina, your chance of having a heart attack increases.

A heart attack occurs when a blood vessel to the heart becomes blocked. With blockage, not enough blood can reach that part of the heart muscle and permanent damage results. During a heart attack, you may have

• chest pain or discomfort
• pain or discomfort in your arms, back, jaw, neck, or stomach
• shortness of breath
• sweating
• nausea
• light-headedness

Symptoms may come and go. However, in some people, particularly those with diabetes, symptoms may be mild or absent due to a condition in which the heart rate stays at the same level during exercise, inactivity, stress, or sleep. Also, nerve damage caused by diabetes may result in lack of pain during a heart attack.

Women may not have chest pain but may be more likely to have shortness of breath, nausea, or back and jaw pain. If you have symptoms of a heart attack, call 911 right away. Treatment is most effective if given within an hour of a heart attack. Early treatment can prevent permanent damage to the heart.

Your doctor should check your risk for heart disease and stroke at least once a year by checking your cholesterol and blood pressure levels and asking whether you smoke or have a family history of premature heart disease. The doctor can also check your urine for protein, another risk factor for heart disease. If you are at high risk or have symptoms of heart disease, you may need to undergo further testing.

What are the treatment options for heart disease?

Treatment for heart disease includes meal planning to ensure a heart-healthy diet and physical activity. In addition, you may need medications to treat heart damage or to lower your blood glucose, blood pressure, and cholesterol. If you are not already taking a low dose of aspirin every day, your doctor may suggest it. You also may need surgery or some other medical procedure.

For additional information about heart and blood vessel disease, high blood pressure, and high cholesterol, call the National Heart, Lung, and Blood Institute Health Information Center at 301-592-8573 or see www.nhlbi.nih.gov on the Internet.

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How will I know whether I have had a stroke?

The following signs may mean that you have had a stroke:

• sudden weakness or numbness of your face, arm, or leg on one side of your body
• sudden confusion, trouble talking, or trouble understanding
• sudden dizziness, loss of balance, or trouble walking
• sudden trouble seeing out of one or both eyes or sudden double vision
• sudden severe headache

If you have any of these symptoms, call 911 right away. You can help prevent permanent damage by getting to a hospital within an hour of a stroke. If your doctor thinks you have had a stroke, you may have tests such as a neurological examination to check your nervous system, special scans, blood tests, ultrasound examinations, or x rays. You also may be given medication that dissolves blood clots.

What are the treatment options for stroke?

At the first sign of a stroke, you should get medical care right away. If blood vessels to your brain are blocked by blood clots, the doctor can give you a “clot-busting” drug. The drug must be given soon after a stroke to be effective. Subsequent treatment for stroke includes medications and physical therapy, as well as surgery to repair the damage. Meal planning and physical activity may be part of your ongoing care. In addition, you may need medications to lower your blood glucose, blood pressure, and cholesterol and to prevent blood clots.

For additional information about strokes, call the National Institute of Neurological Disorders and Stroke at 1-800-352-9424 or see www.ninds.nih.gov on the Internet.

Points to Remember

• If you have diabetes, you are at least twice as likely as other people to have heart disease or a stroke.
• Controlling the ABCs of diabetes-A1C (blood glucose), blood pressure, and cholesterol-can cut your risk of heart disease and stroke.
• Choosing foods wisely, being physically active, losing weight, quitting smoking, and taking medications (if needed) can all help lower your risk of heart disease and stroke.
• If you have any warning signs of a heart attack or a stroke, get medical care immediately-don’t delay. Early treatment of heart attack and stroke in a hospital emergency room can reduce damage to the heart and the brain.

For More Information

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892-3600
Phone: 1-800-438-5383
Fax: 703-738-4929
Internet: www.ndep.nih.gov

National Heart, Lung, and Blood Institute Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: 301-592-8573
Fax: 301-592-8563
Email: nhlbiinfo@nhlbi.nih.gov
Internet: www.nhlbi.nih.gov

National Institute of Neurological Disorders and Stroke
Brain Resources and Information Network (BRAIN)
P.O. Box 5801
Bethesda, MD 20824-5801
Phone: 1-800-352-9424
Fax: 301-402-2186
Internet: www.ninds.nih.gov

Weight-control Information Network
1 WIN Way
Bethesda, MD 20892-3665
Phone: 1-877-946-4627
Fax: 202-828-1028
Email: win@info.niddk.nih.gov
Internet: www.win.niddk.nih.gov

American Diabetes Association
National Call Center
1701 North Beauregard Street
Alexandria, VA 22311-1742
Phone: 1-800-DIABETES (1-800-342-2383)
Fax: 703-549-6995
Email: askADA@diabetes.org
Internet: www.diabetes.org

American Association of Diabetes Educators
100 West Monroe, Suite 400
Chicago, IL 60603-1922
Phone: 1-800-338-3633
Diabetes Educator Access Line: 1-800-TEAMUP4 (1-800-832-6874)
Fax: 312-424-2427
Email: aade@aadenet.org
Internet: www.diabeteseducator.org

Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005-4001
Phone: 1-800-533-2873
Fax: 212-785-9595
Email: info@jdrf.org
Internet: www.jdrf.org

American Heart Association
7272 Greenville Avenue
Dallas, TX 75231-4596
Phone: 1-800-AHA-USA1 (242-8721)
Fax: 214-369-3685
Internet: www.americanheart.org

Source:

The National Diabetes Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: 1-800-860-8747
TTY: 1-866-569-1162
Fax: 1-703-738-4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

Type 2 Diabetes: Yesterday, Today & Tomorrow

• Diabetes, Type 2

YESTERDAY

• No proven strategies existed to prevent the disease or its complications.
• The only ways to treat diabetes were the now-obsolete forms of insulin from cows and pigs, and drugs that stimulate insulin release from the beta cells of the pancreas (sulfonylureas). Both of these therapies cause dangerous low blood sugar reactions and weight gain. Patients monitored their glucose levels with urine tests, which recognized high but not dangerously low glucose levels and reflected past, not current, glucose levels. More reliable methods for testing glucose levels in the blood had not been developed yet.
• While scientists knew that genes played a role (i.e., the disease often runs in families), they had not identified any specific culprit genes.
• National efforts were not being made to combat obesity—a serious risk factor for the disease. Fewer people developed type 2 diabetes compared to today because overweight, obesity, and physical inactivity were not pervasive.
• Patients were almost exclusively adults—the reason that the disease was formerly called “adult onset diabetes.” It was rare in children or young adults.

TODAY

• Type 2 diabetes can be prevented or delayed. The NIH-funded Diabetes Prevention Program (DPP) clinical trial (http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/) found a lifestyle intervention (modest weight loss of 5 to 7 percent of body weight and 30 minutes of exercise 5 times weekly) reduced the risk of getting type 2 diabetes by 58 percent in a diverse population of over 3000 adults at high risk for diabetes. In another arm of the study, the drug metformin reduced development of diabetes by 31 percent.
• Based on the DPP findings, the National Diabetes Education Program developed the education campaign, “Small Steps. Big Rewards. Prevent Type 2 Diabetes.” to help people at high risk take the necessary steps to prevent the disease (www.ndep.nih.gov).
• Ongoing NIH translational research efforts are testing cost effective ways to deliver the DPP-proven lifestyle change in real-world settings. This vigorous effort is needed to address the escalating prevalence of type 2 diabetes which now affects 7.8 percent of Americans, disproportionate affects minorities, and is conservatively estimated to be the seventh leading cause of death in the U.S.
• Type 2 diabetes is increasing in children, in tandem with rising obesity rates. This trend is alarming because, as younger people develop the disease, the complications, morbidity, and mortality associated with diabetes are all likely to occur earlier. Also, offspring of women with type 2 diabetes are more likely to develop the disease. Thus, the burgeoning of diabetes in younger populations could lead to a vicious cycle of ever-growing rates of diabetes.
• The SEARCH for Diabetes in Youth Study (www.searchfordiabetes.org) has provided the first national data on incidence and prevalence of diabetes in youth. About 3700 youth under 20 years old are diagnosed with type 2 diabetes each year, and the disease is particularly prevalent in minority youth.
• Research has vastly expanded understanding of the molecular underpinnings of diabetes and its complications. Recent work has boosted to nearly 40 the number of gene regions associated with increased risk of type 2 diabetes, laying the foundation for new approaches to prevention and therapy.
• NIH-supported clinical trials validated a marker called hemoglobin A1C (A1C). This marker reflects average blood sugar control over a 3 month period. This technology, along with tests that allow patients to monitor their own blood glucose throughout the day, helps make better blood glucose control achievable for many people with type 2 diabetes.
• Because lower A1C levels have been shown to be predictive of longer life and fewer complications, the test has helped speed development and approval of better forms of insulin and new diabetes medicines that work though a variety of mechanisms. New drugs are available that lower glucose without weight gain or even with modest weight loss. Several agents targeting the specific metabolic abnormalities of type 2 diabetes are now available and can be combined, thus delaying the need for insulin.
• Tight blood sugar control has become a standard of treatment for most diabetes patients based on results from NIH clinical trials demonstrating that keeping A1C below 7 can prevent or delay devastating disease complications.
• A large clinical trial showed that older patients with longstanding type 2 diabetes at high risk of heart disease do not benefit from more intensive blood glucose control than is currently recommended. These findings spare patients from unneeded therapy and provide important data to help individualize therapy, with less stringent A1C targets suggested for some people such as those with advanced diabetes complications.
• Clinical trials have shown that blood pressure and lipid control reduce diabetes complications by up to 50 percent. Physicians are now much better equipped to prevent and control heart disease, which often accompanies diabetes, and is the leading cause of death in people with diabetes.
• Nationwide improvements in risk factor control show research-proven strategies are being translated into practice. Improvements in control of cholesterol, blood glucose, and blood pressure have added an estimated one year to the expected lifespan of a person with type 2 diabetes since 1992, and improved quality of life by reducing the incidence of burdensome complications like blindness, lower limb amputations, kidney failure, and coronary heart disease.
• As a result of research proving their benefits, Medicare now covers blood glucose self monitoring materials and diabetes education services, helping people to better control their diabetes.
• Kidney disease can be detected earlier via urine tests. Therefore, patients can be treated earlier to slow the rate of kidney damage. Improved control of glucose and blood pressure prevents or delays progression of kidney disease to kidney failure. With good care, less than 10 percent of patients develop kidney failure.
• With timely laser surgery and appropriate follow-up care, people with advanced diabetic retinopathy can reduce their risk of blindness by 90 percent. A recent study showed a drug which limits blood vessel growth can be an important supplement to laser therapy for diabetic macular edema.
• The NIH spent over $1.1 billion on diabetes research in fiscal year 2009. In 2007, total costs attributable to diabetes for Americans was estimated at $174 billion—an increase of 32 percent since 2002.

TOMORROW

• Research will find better ways to bring proven diabetes prevention strategies to more people at lower cost.
• Earlier and more aggressive treatment approaches may help better prevent diabetes complications.
• New understanding of the biology of obesity and insulin resistance is informing the development of new therapeutics to prevent and treat type 2 diabetes.
• Identification of susceptibility genes for diabetes and its complications will enable earlier implementation of prevention measures targeted to those at highest risk.
• Research on the effect of maternal diabetes on offspring may help to break the vicious diabetes cycle.
• Continued research on the mechanisms underlying the development and progression of disease complications will result in the ability to predict who is likely to develop them. Personalized treatments could then be developed to preempt complications. This strategy would dramatically improve the health and well-being of patients.
• NIH clinical trials will identify new approaches to prevent and treat the emerging problem of type 2 diabetes in children.

For more information, contact The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): NIDDKinquiries@nih.gov
The National Institute of Diabetes and Digestive and Kidney Diseases www.niddk.nih.gov

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Diabetics get Blood Vessels Made From Donor Cells

By MARILYNN MARCHIONE, AP Medical Writer

2:28 p.m., June 27, 2011

Three dialysis patients have received the world’s first blood vessels grown in a lab from donated skin cells. It’s a key step toward creating a supply of ready-to-use arteries and veins that could be used to treat diabetics, soldiers with damaged limbs, people having heart bypass surgery and others.

The goal is to one day have a refrigerated inventory of these in various sizes and shapes that surgeons could order up as needed like bandages and other medical supplies.

The work so far is still early-stage. Three patients in Poland have received the new vessels, which are working well two to eight months later. But doctors are excited because this builds on earlier success in about a dozen patients given blood vessels grown in the lab from their own skin – a process too long and expensive to be practical.

“This version, built from a master donor, is available off the shelf and at a dramatically reduced cost,” estimated at $6,000 to $10,000, said Todd McAllister, chief of Cytograft Tissue Engineering Inc., the San Francisco-area company leading the work.

The American Heart Association considers it so promising that the group featured it on Monday in the first of a new series of webcasts about cutting-edge science.

“This is tremendously exciting,” because the failure of blood vessels used in dialysis is “a huge public health problem,” said Duke University‘s Dr. Robert Harrington, a heart expert who had no role in the work.

If a larger study getting under way now in Europe and South America shows success, “this is big news,” Harrington said.

Kidney failure, which is common in diabetics, requires dialysis to filter wastes from the blood through a connection between an artery and a vein called a shunt. It gets punctured several times a week to hook patients up to the dialysis machine, and complications include blood clots, clogging and infection.

What’s more, patients often run out of suitable sites for these shunts as problems develop. Plastic versions have high rates of failure and complications, too. Doctors have long wished for a natural substitute.

The lab-grown vessels are free of artificial materials. They don’t involve stem cells, so they’re not controversial.

Researchers start with a snip of skin from the back of a hand, remove cells and grow them into sheets of tissue that are rolled up like straws to form blood vessels.

So far, these lab-grown vessels have been tolerated by the recipients’ immune systems; no anti-rejection medicine or tissue matching is needed. That’s not surprising because lab-grown skin is already used to treat many burn victims.

“There are literally hundreds of thousands of patients that could use this technology,” McAllister said.

Each year, nearly 400,000 Americans undergo dialysis and half of them use plastic shunts. More than 160,000 people lose limbs because of poor circulation that might be improved with lab-grown vessels.

About 300,000 people have heart bypass operations using blood vessels taken from other parts of the body to create detours around clogged heart arteries. Some heart patients say the leg wound from removing the long vein to create heart bypasses hurts more than the chest wound for the open-heart surgery.

In 2005, Cytograft reported success with its first attempt at dialysis shunts using patients’ own skin. Some of the early work was sponsored by the National Heart, Lung and Blood Institute.

The new work, using donor cells, makes this advance more practical for wide use, said Dr. Timothy Gardner, a heart surgeon at Christiana Care Health Services in Newark, Del., and former American Heart Association president.

“It provides the option or the opportunity for off-the-shelf graft availability as opposed to something that has to be built from the individual’s own cells,” he said.

Cytograft plans a study in Europe and South America comparing 40 patients getting the lab-grown vessels to 20 getting plastic shunts. Studies also are planned on a mesh version for people with poor leg circulation. 

Online:

Company and video: http://www.cytograft.com

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Source:  The Associated Press/San Diego Union-Tribune

Diabetic Foot Care – Podiatrist in Jacksonville, FL

Source: Uploaded by webpowervideo on Dec 3, 2009 to YouTube

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here’s some basic advice for taking care of your feet:

Always keep your feet warm.Don’t get your feet wet in snow or rain.
Don’t put your feet on radiators or in front of the fireplace.
Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
Don’t soak your feet.
Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.

Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.

Wash your feet every day with mild soap and warm water.
Wear loose socks to bed.
Wear warm socks and shoes in winter.
When drying your feet, pat each foot with a towel and be careful between your toes.
Buy shoes that are comfortable without a “breaking in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don’t wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don’t lace your shoes too tightly or loosely.

Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.
When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

Visit our website: http://www.firstcoastfootclinic.com

Financial Help for Diabetes Care

Financial Help for Diabetes Care

On this page:
•Medicare
•Medicaid
•State Children’s Health Insurance Program (SCHIP)
•Health Insurance for Those Not Eligible for Medicare or Medicaid
•Health Insurance after Leaving a Job
•Health Care Services
•Hospital Care
•Kidney Disease: Resources for Dialysis and Transplantation
•Prescription Drugs and Medical Supplies
•Prosthetic Care
•Classroom Services
•Technological Assistance
•Food and Nutrition Assistance for Women with Diabetes or Gestational Diabetes
•Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) Benefits
•Local Resources
•Acknowledgments
•National Diabetes Education Program

Diabetes treatment is expensive. According to the American Diabetes Association, people with diabetes spend an average of $11,744 a year on health care expenses—more than twice the amount spent by people without diabetes.

Many people who have diabetes need help paying for their care. For those who qualify, a variety of governmental and nongovernmental programs can help cover health care expenses. This publication is meant to help people with diabetes and their family members find and access such resources.

Medicare

Medicare is federal health insurance for the following groups:

• people 65 or older
• people younger than 65 with certain disabilities or amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease
• people of any age with end-stage renal disease—permanent kidney failure requiring dialysis or a kidney transplant

Medicare Health Plans

People with Medicare can choose how to get their health and prescription drug coverage. The following options are available:

• Original Medicare
• Medicare Advantage Plans—such as health maintenance organizations (HMOs) or preferred provider organizations (PPOs)
• other Medicare health plans

Original Medicare. Original Medicare, managed by the Federal Government, has two parts: Medicare Part A is hospital insurance and Medicare Part B is medical insurance. People in this plan usually pay a fee for each health care service or supply they receive.

People who are in Original Medicare can add prescription drug coverage—Medicare Part D—by joining a Medicare Prescription Drug Plan. These plans are run by insurance companies and other private companies approved by Medicare.

People can also choose to buy insurance to help fill the gaps in Part A and Part B coverage. This insurance is known as Medigap or Medicare Supplement Insurance.

Medicare Advantage Plans. Medicare Advantage Plans are health plan options, like an HMO or PPO, approved by Medicare and offered by private companies. These plans are part of Medicare and are sometimes called Part C or MA Plans. Medicare Advantage Plans provide Medicare Part A and Part B coverage and usually Medicare Part D coverage. The companies that run these plans must follow rules set by Medicare. Not all Medicare Advantage Plans work the same way. People considering one of these plans should find out the plan’s rules before joining.

Other Medicare Health Plans. Other Medicare health plans include Medicare Cost Plans, Demonstrations/Pilot Programs, and Programs of All-Inclusive Care for the Elderly (PACE). These plans provide hospital and medical insurance coverage, and some also provide prescription drug coverage.

To get more information about Medicare coverage, see “More Information about Medicare.”

Medicare Covers Diabetes Services and Supplies

Original Medicare helps pay for the diabetes services, supplies, and equipment listed below. Coinsurance or deductibles may apply. In addition, Medicare covers some preventive services for people who are at risk for diabetes. A person must have Medicare Part B or Medicare Part D to receive these covered services and supplies.

Medicare Part B helps pay for

• diabetes screening tests for people at risk of developing diabetes
• diabetes self-management training
• diabetes supplies such as glucose monitors, test strips, and lancets
• insulin pumps and insulin if used with an insulin pump
• flu and pneumonia shots
• foot exams and treatment for people with diabetes
• eye exams to check for glaucoma and diabetic retinopathy
• medical nutrition therapy services for people with diabetes or kidney disease, when referred by a doctor
• therapeutic shoes or inserts, in some cases

Medicare Part D helps pay for

• diabetes medicines
• insulin, but not insulin used with an insulin pump
• diabetes supplies like needles and syringes for injecting insulin

People who are in a Medicare Advantage Plan or other Medicare health plan should check their plan’s membership materials and call for details about how the plan provides the diabetes services, supplies, and medicines covered by Medicare.

More details are available by calling 1–800–MEDICARE (1–800–633–4227) and requesting the free booklet Medicare Coverage of Diabetes Supplies & Services. This booklet is also available at www.medicare.gov/publications/pubs/pdf/11022.pdf (PDF, 4.7 MB) *.

More Information about Medicare

More information about Medicare is available at www.medicare.gov, the official U.S. Government website for people with Medicare. The website has a full range of information about Medicare including free publications like Medicare & You, the official Government handbook about Medicare, and Medicare Basics—A Guide for Families and Friends of People with Medicare. Through the Medicare website, people can also

• find out if they are eligible for Medicare and when they can enroll
• learn about their Medicare health plan options
• find out what Medicare covers
• find a Medicare Prescription Drug Plan
• compare Medicare health plan options in their area
• find a doctor who participates in Medicare
• get information about the quality of care provided by nursing homes, hospitals, home health agencies, and dialysis facilities

Calling 1–800–MEDICARE (1–800–633–4227) is another way to get help with Medicare questions, order free publications, and more. Help is available 24 hours a day, every day, and is available in English, Spanish, and other languages. TTY users should call 1–877–486–2048.

Medicare information can also be obtained from the following agencies or programs:

• Each state has a State Health Insurance Assistance Program (SHIP) that provides free health insurance counseling. A state’s SHIP may have a unique name. SHIP counselors can help people choose a Medicare health plan or a Medicare Prescription Drug Plan. The phone number for the SHIP in each state is available by by calling Medicare or visiting www.medicare.gov and selecting “Find Helpful Phone Numbers and Websites” under “Search Tools.”
• The Social Security Administration can provide information about eligibility for Medicare. People can contact the agency at 1–800–772–1213, visit its web-site at www.socialsecurity.gov, or check with their local Social Security office to learn if they are eligible for Medicare.
• State Medical Assistance (Medicaid) offices in each state can provide information about help for people with Medicare who have limited income and resources. The phone number for each state’s Medicaid office can be obtained by visiting www.medicare.gov or calling Medicare.

People who enroll in Medicare can register for MyMedicare.gov, a secure online service, and use the site to access their personal Medicare information at any time. People can view their claims, order forms and publications, and see a description of covered preventive services.

Help for People with Medicare Who Have Limited Income and Resources

People who have Medicare and have limited income and resources may qualify for help paying for some health care and prescription drug costs from one of the following programs:

• Extra help paying for Medicare prescription drug coverage. Those who meet certain income requirements may qualify for extra help from Medicare to pay prescription drug costs. People can apply for this help by calling Social Security; visiting www.socialsecurity.gov to apply online; visiting their local Social Security office; or by contacting their State Medical Assistance (Medicaid) office. Each state’s SHIP can provide information and answer questions about this program.
• State pharmacy assistance programs (SPAPs). Several states have SPAPs that help certain people pay for prescription drugs. Each SPAP makes its own rules about how to provide drug coverage to its members. Information about each state’s SPAP can be obtained by calling Medicare or the state’s SHIP.
• Medicaid programs for people with Medicare. State Medicaid programs help pay medical costs for some people with Medicare who have limited income and resources. People who qualify for both Medicare and Medicaid may get coverage for services that aren’t fully covered by Medicare, such as nursing home and home health care. States also have programs called Medicare Savings Programs that pay Medicare premiums and, in some cases, may also pay Medicare Part A and Part B deductibles and coinsurance. More information is available at www.medicare.gov. The phone number for the State Medical Assistance (Medicaid) office for each state can be obtained by calling Medicare. Each state’s SHIP can also provide more information.

Medicaid

Medicaid, also called Medical Assistance, is a joint federal and state government program that helps pay medical costs for some people with limited income and resources. Medicaid programs and income limits for Medicaid vary from state to state. The State Medical Assistance (Medicaid) office can help people find out whether they qualify for Medicaid or provide more information about Medicaid programs. To contact a state Medicaid office, people can

• search for Medicaid information for a state at www.GovBenefits.gov
• visit www.medicare.gov and select “Find Helpful Phone Numbers and Websites” under “Search Tools,” or call 1–800–MEDICARE (1–800–633–4227) and say “Medicaid”
• check the government pages of the phone book for the local department of human services or department of social services, which can provide the needed information

State Children’s Health Insurance Program (SCHIP)

SCHIP is a federal and state government partnership to expand health coverage to uninsured children from families with income that is too low to afford private or employer-sponsored health insurance but too high to qualify for Medicaid. The free or low-cost coverage is available to eligible children younger than 19.

SCHIP provides an extensive package of benefits including doctor visits, hospital care, and more. Information about the program is available at www.insurekidsnow.gov or by calling 1–877–KIDS–NOW (1–877–543–7669). Callers to the toll-free, confidential hotline are automatically connected to their state’s program.

Health Insurance for Those Not Eligible for Medicare or Medicaid

People who are not eligible for Medicare or Medicaid may be able to purchase private health insurance. Many insurers consider diabetes that has already been diagnosed a pre-existing condition, so finding coverage may be difficult for people with diabetes. Insurance companies often have a specific waiting period during which they do not cover diabetes-related expenses for new enrollees, although they will cover other medical expenses that arise during this time.

Certain state and federal laws may help. Many states now require insurance companies to cover diabetes supplies and education. The Health Insurance Portability and Accountability Act (HIPAA), passed by Congress in 1996, limits insurance companies from denying coverage because of a pre-existing condition. Information about HIPAA is available at www.dol.gov/dol/topic/health-plans/portability.htm.

More information about these laws is available from each state’s insurance regulatory office. Some state offices may be called the state insurance department or commission. This office can also help identify an insurance company that offers individual coverage. The National Association of Insurance Commissioners’ website, www.naic.org/state_web_map.htm, provides a membership list with contact information and a link to the website for each state’s insurance regulatory office.

The Georgetown University Health Policy Institute offers consumer guides on health insurance topics, including guides for each state about getting and keeping health insurance. The guides are available at www.healthinsuranceinfo.net.

Health Insurance after Leaving a Job

When leaving a job, a person may be able to continue the group health insurance provided by the employer for up to 18 months under a federal law called the Consolidated Omnibus Budget Reconciliation Act, or COBRA. People pay more for group health insurance through COBRA than they did as employees, but group coverage is cheaper than individual coverage. People who have a disability before becoming eligible for COBRA or who are determined by the Social Security Administration to be disabled within the first 60 days of COBRA coverage may be able to extend COBRA coverage an additional 11 months, for up to 29 months of coverage. COBRA may also cover young people who were insured under a parent’s policy but have reached the age limit and are trying to obtain their own insurance.

More information is available by calling the U.S. Department of Labor at 1–866–4–USA–DOL (1–866–487–2365) or visiting www.dol.gov/dol/topic/health-plans/cobra.htm.

If a person doesn’t qualify for coverage or if COBRA coverage has expired, other options may be available:

• Some states require employers to offer conversion policies, in which people stay with their insurance company but buy individual coverage.
• Some professional and alumni organizations offer group coverage for members.
• Most states have a high-risk health insurance pool or other means for covering people otherwise unable to get health insurance. Information about high-risk pools is available at www.nahu.org/consumer/hrpguide.cfm.
• Some insurance companies also offer stopgap policies designed for people who are between jobs.

Each state insurance regulatory office can provide more information about these and other options. The National Association of Insurance Commissioners’ website, www.naic.org/state_web_map.htm, provides a membership list with contact information and a link to the website for each state’s insurance regulatory office. Information about consumer health plans is also available at the U.S. Department of Labor’s website at www.dol.gov/dol/topic/health-plans/consumerinfhealth.htm.

Health Care Services

The Bureau of Primary Health Care, a service of the Health Resources and Services Administration, offers primary and preventive health care to medically underserved populations through community health centers. For people with no insurance, fees for care are based on family size and income. Information about local health centers is available by calling 1–888–ASK–HRSA (1–888–275–4772) and asking for a directory, or by visiting the Bureau’s website at www.bphc.hrsa.gov.

The Department of Veterans Affairs (VA) runs hospitals and clinics that serve veterans who have service-related health problems or who simply need financial aid. Veterans who would like to find out more about VA health care can call 1–800–827–1000 or visit www1.va.gov/health.

Many local governments have public health departments that can help people who need medical care. The local county or city government’s health and human services office can provide further information.

Hospital Care

People who are uninsured and need hospital care may be able to get help from a program known as the Hill-Burton Act. Although the program originally provided hospitals with federal grants for modernization, today it provides free or reduced-fee medical services to people with low incomes. The Department of Health and Human Services administers the program. More information is available by calling 1–800–638–0742 (1–800–492–0359 in Maryland) or visiting www.hrsa.gov/hillburton.

Kidney Disease: Resources for Dialysis and Transplantation

Kidney failure, also called end-stage renal disease, is a complication of diabetes. People of any age with kidney failure can get Medicare Part A—hospital insurance—if they meet certain criteria. To qualify for Medicare on the basis of kidney failure, a person must

• need regular dialysis

or

• have had a kidney transplant

and must

• have worked long enough—or be the dependent child or spouse of someone who has worked long enough—under Social Security, the Railroad Retirement Board, or as a government employee

or

• be receiving—or be the spouse or dependent child of a person who is receiving—Social Security, Railroad Retirement, or Office of Personnel Management benefits

People with Medicare Part A can also get Medicare Part B. Enrolling in Part B is optional. However, a person needs to have both Part A and Part B for Medicare to cover certain dialysis and kidney transplant services.

Those who don’t qualify for Medicare may be able to get help from their state to pay for their dialysis treatments. More information about dialysis and transplantation is available by

• calling Social Security at 1–800–772–1213 or visiting www.socialsecurity.gov for information about the required amount of time needed under Social Security, the Railroad Retirement Board, or as a government employee to be eligible for Medicare based on kidney failure
• visiting www.medicare.gov to read or download the booklet Medicare Coverage of Kidney Dialysis and Kidney Transplant Services or calling 1–800–MEDICARE (1–800–633–4227) to request a free copy; TTY users should call 1–877–486–2048
• reading the National Kidney and Urologic Diseases Information Clearinghouse’s publication Financial Help for Treatment of Kidney Failure, available at www.kidney.niddk.nih.gov or by calling 1–800–891–5390
• visiting Medicare’s “Dialysis Facility Compare” at www.medicare.gov/dialysis for important information about chronic kidney disease and dialysis, including choosing a dialysis facility

Information about financing an organ transplant is available from the following organization:

United Network for Organ Sharing (UNOS)
P.O. Box 2484
Richmond, VA 23218
Phone: 1–888–894–6361 or 804–782–4800
Fax: 804–782–4817
Internet: www.unos.org

Prescription Drugs and Medical Supplies

Health care providers may be able to assist people who need help paying for their medicines and supplies by directing them to local programs or even providing free samples.

A free nylon filament—similar to a bristle on a hairbrush—is available to check feet for nerve damage. The filament, with instructions for use, can be obtained by calling 1–888–ASK–HRSA (1–888–275–4772) or by accessing www.hrsa.gov/leap.

Prescription drug coverage for those eligible for Medicare is available through Medicare’s Prescription Drug Plans and many Medicare Advantage Plans. More information is available at the Medicare website at www.medicare.gov.

Drug companies that sell insulin or diabetes medications usually have patient assistance programs. Such programs are available only through a physician. The Pharmaceutical Research and Manufacturers of America and its member companies sponsor an interactive website with information about drug assistance programs at www.PPARx.org.

Also, because programs for the homeless sometimes provide aid, people can contact a local shelter for more information about how to obtain free medications and medical supplies. The number of the nearest shelter may be listed in the phone book under Human Service Organizations or Social Service Organizations.

Prosthetic Care

People who have had an amputation may be concerned about paying their rehabilitation expenses. The following organizations provide financial assistance or information about locating financial resources for people who need prosthetic care:

Amputee Coalition of America
900 East Hill Avenue, Suite 205
Knoxville, TN 37915–2566
Phone: 1–888–AMP–KNOW (1–888–267–5669)
Fax: 865–525–7917
Internet: www.amputee-coalition.org

Easter Seals
230 West Monroe Street, Suite 1800
Chicago, IL 60606
Phone: 1–800–221–6827
Fax: 312–726–1494
Internet: www.easterseals.com

Classroom Services

Public agencies and other organizations that provide services and assistance, such as providing special equipment, to children with diabetes and other disabilities and to their families are listed on the State Resource Sheets published by the National Dissemination Center for Children with Disabilities (NICHCY). Each state’s resource sheet lists the names and addresses of agencies in the state. The free resource sheets are available at www.nichcy.org/states.htm or by contacting

NICHCY
P.O. Box 1492
Washington, DC 20013
Phone: 1–800–695–0285
Fax: 202–884–8441
Email: nichcy@aed.org
Internet: www.nichcy.org

College-aged students who have diabetes-related disabilities may be faced not only with the costs of tuition, but also with additional expenses generally not incurred by other students. These costs may include special equipment and disability-related medical expenses not covered by insurance. Some special equipment and support services may be available at the educational institution, through community organizations, through the state vocational rehabilitation agency, or through specific disability organizations. The names and addresses of these and other agencies are also listed in the State Resource Sheets available from the NICHCY.

The HEATH Resource Center, an online clearinghouse on postsecondary education for individuals with disabilities, offers information about sources of financial aid and the education of students with a disability. Contact the clearinghouse at

The George Washington University
HEATH Resource Center
2134 G Street NW
Washington, DC 20052–0001
Phone: 202–973–0904
Fax: 202–994–3365
Email: AskHEATH@gwu.edu
Internet: www.heath.gwu.edu

Technological Assistance

Assistive technology, which can help people with disabilities function more effectively at home, at work, and in the community, can include computers, adaptive equipment, wheelchairs, bathroom modifications, and medical or corrective services. The following organizations provide information, awareness, and training in the use of technology to aid people with disabilities:

Alliance for Technology Access (ATA)
1304 Southpoint Boulevard, Suite 240
Petaluma, CA 94954
Phone: 707–778–3011
Fax: 707–765–2080
Email: ATAinfo@ATAccess.org
Internet: www.ATAccess.org

United Cerebral Palsy (UCP)
1660 L Street NW, Suite 700
Washington, DC 20036
Phone: 1–800–872–5827 or 202–776–0406
Fax: 202–776–0414
Email: info@ucp.org
Internet: www.ucp.org/ucp_channelsub.cfm/1/14/86

Food and Nutrition Assistance for Women with Diabetes or Gestational Diabetes

Food, nutrition education, and access to health care services are available through the U.S. Department of Agriculture’s Women, Infants, and Children (WIC) program. The WIC program provides assistance to women during pregnancy or the period following childbirth and to infants and children up to age 5. Applicants must meet residential, financial need, and nutrition risk criteria to be eligible for assistance. Having diabetes or gestational diabetes is considered a medically based nutrition risk and would qualify a woman for assistance through the WIC program if she meets the financial need requirements and has lived in a particular state the required amount of time. The WIC website provides a page of contact information for each state and Indian tribe. Contact the WIC’s national headquarters at

Supplemental Food Programs Division
Food and Nutrition Service—USDA
3101 Park Center Drive
Alexandria, VA 22302
Phone: 703–305–2746
Fax: 703–305–2196
Email: wichq-web@fns.usda.gov
Internet: www.fns.usda.gov/wic

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) Benefits

The Social Security Administration pays disability benefits through the SSDI and SSI programs. These benefits are not the same as Social Security benefits. To receive SSDI benefits, a person must be unable to work and must have earned the required number of work credits. SSI is a monthly amount paid to people with limited income and resources who are disabled, blind, or age 65 or older and meet certain other conditions.

More information is available by calling Social Security at 1–800–772–1213 or contacting the local Social Security office for more information. TTY users should call 1–800–325–0778. A “Benefit Eligibility Screening Tool” is available at www.socialsecurity.gov to check whether a person is eligible for benefits.

Local Resources

Local resources such as the following charitable groups may offer financial help for some of the many expenses related to diabetes:

• Lions Clubs International can help with vision care. Visit www.lionsclubs.org.
• Rotary International clubs provide humanitarian and educational assistance. Visit www.rotary.org.
• Elks clubs provide charitable activities that benefit youth and veterans. Visit www.elks.org.
• Shriners of North America offer free treatment for children at Shriners hospitals throughout the country. Visit www.shrinershq.org.
• Kiwanis International clubs conduct service projects to help children and communities. Visit www.kiwanis.org.

In many areas, nonprofit or special-interest groups such as those listed above can sometimes provide financial assistance or help with fundraising. Religious organizations also may offer assistance. In addition, some local governments may have special trusts set up to help people in need. The local library or local city or county government’s health and human services office may provide more information about such groups.

The National Diabetes Information Clearinghouse (NDIC) gathered information from various agencies and organizations to try to provide the most comprehensive and helpful information possible. Changes may occur in these programs from the time this fact sheet is published. Please contact each organization directly for the most up-to-date information. The NDIC welcomes corrections and updates to the information in this fact sheet. Updates should be sent to ndic@info.niddk.nih.gov.

Source:

National Diabetes Education Program

1 Diabetes Way
Bethesda, MD 20814–9692
Phone: 1–888–693–NDEP (1–888–693–6337)
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndep@mail.nih.gov
Internet: www.ndep.nih.gov

The National Diabetes Education Program is a federally funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention and includes over 200 partners at the federal, state, and local levels, working together to reduce the morbidity and mortality associated with diabetes.

Top 4 Ways to Manage Your Diabetes at Weddings and Graduations

A Type 2 diabetic diet and meal plans is all about controlling the number of calories people with diabetes eat. Because, unused calories become body fat. And, excess fat cells reduce insulin’s ability to remove sugar from the blood.

With the summer just around the corner, it’s time to gear up for weddings, graduations, cookouts, and other celebrations that, often, involve large amount of food and small amounts of sugar-free options. Here are some tips to help you eat healthy & diabetic food plan (without having to take your own food) to this summer’s events.

Snack Beforehand
A healthy snacks for diabetics and diabetic dessert before attending a summertime event may help to satisfy you for longer than if youCarrots was to attend the event on an empty stomach. Have a handful of carrots with peanut butter about thirty minutes before the event. The sugar in the carrots will give you energy while the protein in the peanut butter will help you stay full.

Stay Hydrated
While you certainly don’t want to make it through an event drinking water alone, water can help you to feel full if the healthy food for diabetes options is limited. Water will not only hydrate your body and keep you cool from the summer heat, but water will also keep your stomach from growling until you can get your hands on something healthier.

Skip the Bread and Buns
Bread is a normal part of many summertime meals. Whether you are served a roll at a fancy wedding reception, or a bun with that char-broiled burger, it’s important to remember that Diabetics need to be cautious when it comes to dining on diabetes carbohydrates. Therefore, remove (or avoid) the bread in order to stay in better control of your blood sugar level. And hey – don’t worry about people staring at you for eating a bun-less burger – skipping unnecessary carbs can be trendy, especially in the swimsuit season!

Appreciate the Veggie Tray
Nearly all hosts and hostesses will set out a fruit and veggie tray for their guests, regardless of the kind of event. Veggie Tray Therefore, even if everything else on the table is cooked in grease, fried, or filled with sugar, healthy snacks of diabetes & food-seeking folks can find something to nosh on.
Pile your plate high with a variety of veggies and add a small portion of cheese and wheat crackers for fully well-rounded diabetic diet meals that would delight even the most meticulous nutritionist. Warning: stay away from dips, unless it’s a low-sugar yogurt dip. Veggie dips can quickly tack on an additional 300 or more calories without to what would otherwise be a healthy meal.

Typefreediabetes offers a full line of diabetic supplies, including; male incontinence products, diabetic footwear, diabetic strips, durable diabetes medical equipment, diabetic dessert and many other home health care products and supplies. Typefreediabetes offers quality products at discounted prices on a wide selection of quality name brand equipment and supplies.
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FDA Approves New Treatment for Type 2 Diabetes

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FDA NEWS RELEASE

For Immediate Release: May 2, 2011

FDA approves new treatment for Type 2 diabetes

The U.S. Food and Drug Administration today approved Tradjenta (linagliptin) tablets, used with diet and exercise, to improve blood glucose control in adults with Type 2 diabetes.

People with Type 2 diabetes do not produce or respond normally to insulin, a hormone that regulates the amount of glucose in the blood. Over time, high blood glucose levels can increase the risk for serious complications, including heart disease, blindness, and nerve and kidney damage.

“This approval provides another treatment option for the millions of Americans with Type 2 diabetes,” said Mary Parks, M.D., director of the Division of Metabolism and Endocrinology Products in the FDA’s Center for Drug Evaluation and Research. “It is effective when used alone or when added to existing treatment regimens.”

Type 2 diabetes is the most common form of the disease, affecting between 90 percent and 95 percent of the 24 million people in the United States with diabetes. Tradjenta increases the level of hormones that stimulate the release of insulin after a meal by blocking the enzyme dipeptidyl peptidase-4 or DPP-4, which leads to better blood glucose control.

Tradjenta was demonstrated to be safe and effective in eight double-blind, placebo-controlled clinical studies involving about 3,800 patients with Type 2 diabetes. The studies showed improvement in blood glucose control compared with placebo.

Tradjenta has been studied as a stand-alone therapy and in combination with other Type 2 diabetes therapies including metformin, glimepiride, and pioglitazone. Tradjenta has not been studied in combination with insulin, and should not be used to treat people with Type 1 diabetes or in those who have increased ketones in their blood or urine (diabetic ketoacidosis).

Tradjenta will be dispensed with an FDA-approved Patient Package Insert that explains the drug’s uses and risks. The most common side effects of Tradjenta are upper respiratory infection, stuffy or runny nose, sore throat, muscle pain, and headache.

Tradjenta is marketed by Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Conn., and Indianapolis-based Eli Lilly Co.

For more information:

• Approved Drugs: Questions and Answers

Source: FDA – U.S. Food and Drug Administration

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