Fibromyalgia and diabetes: Lab tests essential in diagnosing the difference

Main symptoms of diabetes

Fibromyalgia and diabetes have many of the same symptoms. That's why it's important to have a comprehensive examination in determining the differences. Learning from experience can be the hard way, so here are some tips to help prevent a problem of diagnosis and treatment with these conditions.

As a life care planner and counselor I had many opportunities to interact with clients with their doctors in preparing case material or providing guidance. I also had personal experience with health conditions that helped me learn that medical diagnosis is not a perfect science, so the patient needs to be vigilant and informed. That's particularly true because certain conditions can
produce similar symptoms; and if the right one is not treated, serious harm to a patient can result. My personal story reflects these issues.

I experienced chills and sometimes what I thought were hot flashes at night. I felt lethargic intermittently throughout the day. Sometimes I would have to sleep in my chair at work in order to get through the work day. My feet had small red sores around the toes that sometimes burned, and I had fungus under my toenails I had for years. My face would break out in red patches around the nose and across the forehead. I had fungal infections on my feet and terrible itching. I would frequently ache all over. I had sleep problems and often felt depressed for no reason. During my young adulthood, prior to menopause, I suffered from painful menstrual symptoms. I did not have frequent thirst, but as I was to learn later, this may be a primary symptom but is not always present with diabetics, as diagnosis is based upon a cluster of symptoms, blood sugar problems.

After visiting a rheumatologist, I was diagnosed with fibromyalgia. This was before the present set of medications specifically for the condition. I took medication for sleep, to bring down inflammation, and to help mood. A podiatrist prescribed a special cream for my feet, and a general physician recommended special shampoos and face creams. But the lethargy, aching, and major symptoms remained, although somewhat minimized as I went from doctor to doctor for treatment. But none tested my blood sugar.

After suffering debilitating headaches, on top of other symptoms making it difficult to function, I went to a doctor for assessment and tests. This doctor asked for medical records but said because diagnoses can sometimes be incorrect, she would do complete screening for certain conditions that mirrored fibromyalgia. One of these conditions was diabetes.

When the results came back from testing, I learned I am diabetic. After being placed on diabetic medication and following a regimen of low carbohydrate foods, I found my symptoms all but disappeared. But some of the side effects from long-term diabetes had already caused nerve damage. Had doctors done more thorough lab tests and regular evaluation of symptoms, perhaps there might be a difference in the present outcome of my condition.

My story is one among many people who have treatable conditions not properly diagnosed or where doctors made medical conclusions based upon a particular orientation, specialty or interest of the time. In my case, I had visited specialists in rheumatology, orthopedics, and gynecology whose focus was outside the area of diabetes when an internist trained in working with diabetics may have been sufficient.

These are the symptoms in the conditions of fibromyalgia according to Web MD:
 Anxiety
 Concentration and memory problems
 Depression
 Digestive disorders
 Discoloration of hands and feet (Raynaud's phenomenon)
 Dryness in mouth, nose, and eyes
 Fatigue
 Headaches
 Irritable bowel syndrome
 Morning stiffness
 Pain
 Painful menstrual cramps
 Sleep problems
 Swelling, numbness, and tingling in hands, arms, feet, and legs
 Urinary symptoms
Physicians also maintain people with fibromyalgia have more yeast infections and depression than those without the condition.
Symptoms of diabetes from this same resource
 Excessive thirst and appetite
 Increased urination (sometimes as often as every hour)
 Unusual weight loss or gain
 Fatigue
 Nausea, perhaps vomiting
 Blurred vision
 In women, frequent vaginal infections
 In men and women, yeast infections
 Dry mouth
 Slow-healing sores or cuts
 Itching skin, especially in the groin or vaginal area

It has been found people with diabetes are twice as likely to suffer from depression as non-diabetics. As has been noted earlier, fibromyalgia patients are often seen with depression. Research has also established sleep problems to be frequent among diabetics. Skin complications are one of the concerns, and low blood sugar can cause headaches. Digestive problems can be part of the condition of diabetes as a result of nerve damage. This is also one of the hallmarks of fibromyalgia as well.

The value of having a complete diagnosis, to include lab tests, is critical in preventing wrong diagnoses where the patients end up having complications, which is often the case with diabetes. Given the symptom parallels in diabetes and fibromyalgia, that patients and even their doctors may not properly assess, the information about both conditions can be of consequence in addition to undergoing comprehensive evaluation to include testing blood sugar. This can often be the definitive explanation for certain symptoms that can put the patient on the right track for getting help and prevent serious side effects from developing, as is the case with diabetes.

Playing diabetes roulette

Insulin pen

You tire easily, get warm to hot feelings not long after you eat, and knowing you have diabetes, you shrug and say, "It's just too hard.  Besides you only live once, and I'm not going to live my life having to watch everything I do like that.  I don't need to keep track either because I think I know when I'm getting a problem."

Lack of compliance for diabetics can be fatal or it can run its course until there are a set of health conditions that underline the seriousness of the disease.  Many people wait until that point to begin the regimen that might have made a difference earlier, but that "it's too hard" gets in the way.  It's a game of diabetic roulette, hoping your number ends up in a healthy territory, even when the disease itself is of the nature to require its victims to be forever vigilant.

It's easy not to be compliant.  After all, candy and sweet goodies are all around.  So the diabetic makes the promise that candy bar will be the last for the day or the week, when it may only be hours before more sugar is eaten in a cookie or ice cream or a sweet soda somewhere.

Compliant doesn't mean, however, simply not eating too much sugar.  It also means regularly checking the skin, eyes, and feet regularly.  It means testing blood sugar and making sure one's numbers for high blood pressure and cholesterol are also monitored.  That's because these conditions all accompany the potential for heart disease or stroke that is part of the package known as diabetes.

Playing diabetes roulette is a dangerous game, as the disease develops slowly and steadily in sometimes small and sometimes larger intervals before it devastates some area of the body.  By the time that happens, more medications and more conditions occur that require monitoring and medications.  Some of these medications and conditions overlap with others, making the disease even harder to treat.

While the diabetic complains about the problems of compliance, family members are often frustrated as they can see the possibilities of the illness becoming more and more grave, with the need for additional care that involves more than just the patient but others as well.  Eating that extra piece of pie may mean extra work for another person at some time, getting medications or performing other tasks that a diabetic may not be able to do because of the health consequences of the disease.

Whole families sometimes play the game together. After all, diabetes runs in families.  Father is in denial about his disease, so his sons believe they too can play the macho game of denial.  Or Mother can fuss over her female offspring yet not be careful about a diet that denies sweets, while a daughter sees the behavior and follows it, as opposed to maintaining a healthy lifestyle so the diabetes does not wreck havoc on the body, as it can do when there is a lack of compliance.

The game of diabetes roulette has no winners.  It only has people who end up more sick or even dead at an early age, from lack of following guidelines that can make a difference.  It's the game of life that deserves winning, after all; and what it takes is patience, perseverance and the knowledge that a game of chance that takes away most positive chances isn't a game that should be played at all.

Diagnostic errors in medicine more widespread than thought

Doctor's office where diagnoses occur

Leanne Jenkins--Mistakes happen; we all say that.  But when they are medical mistakes in diagnosis, some people die while others live in misery with illnesses that are treated incorrectly.  So what are the issues with regard to diagnostic problems, and what is being done about them.

Kaiser is one of the large medical groups that has recently observed the importance of getting correct diagnoses and acknowledges that nationwide many deaths and long-term disabilities are caused by physician error.

This year the New York Daily News reported about a woman in New York City who died as a result of multiple medical errors and a delayed cancer diagnosis that spanned a two-year period.  She reported in February 2010 chest pain and went to an emergency hospital room where she was told she had an asthma condition, after an x-ray had been done.

During the next two years the woman was treated by doctors who never looked at the x-ray.  She was back eventually at the same hospital, and it was at that time the x-ray was finally examined.  She did not have asthma but lung cancer in its final stages.  The woman died, and her life could have been saved had the x-ray been examined two years earlier.

In another case a woman was treated for fibromyalgia and what some doctors maintained was an systemic inflammation.  No one suggested a diagnostic workup for diabetes, despite the fact the woman had indicated that with the condition she often suffered fatigue in the mid afternoons.  Fibromyalgia pain is similar to peripheral neuropathy, and fatigue can occur when blood sugar drops, often about two hours after a meal, which would be the mid afternoon.  By the time she was diagnosed with diabetes, she already had glaucoma and other conditions related to diabetes.  Had she been diagnosed earlier, some of these problems could have been alleviated earlier than they were.

These stories are similar to many people, according to Kaiser reports.  The medical group tells us that wrong diagnoses occurs far more often than people think.

In 1991 surveys revealed that 14 percent of all adverse medical events happened as a result of wrongful diagnoses.  Many of these occurred as a result of doctors failing to look at the results of tests that had been ordered.

When errors occur, often doctors don't find out, and the blame for the resulting problems can be shifted to others.  Many of these errors also go unreported.

These are the facts as outlined by The National Center for Policy Analysis:
- 40,500 diagnostic errors that are fatal occur in intensive care units within American hospitals every year.
- Diagnosis errors are more common than errors involving medication and surgery mistakes, affecting 10-20 percent of all medical cases.
- A 2009 study involving 538 diagnostic errors showed that 28 percent of those errors were fatal, caused permanent disability or threatened the life of the patient.
- Many patients fail to take legal action, making it difficult to estimate how many people are victims.
The problems continue because of the culture of blame and the reluctance to report errors.  In order to reduce legal costs in the United States, as well as medical costs, experts remind us how important it is to reduce the errors.  This can be done by both patient and doctor becoming vigilant and the medical professionals willing to take responsibility for the mistakes instead of covering them up or blaming something or someone else.

Here's resolving the fear about Obamacare and offering facts instead

[caption id="attachment_20483" align="alignleft" width="300"] Lutheran Medical Center where costs can be high w/o insurance like other hospitals[/caption]

 Carol Forsloff---“The Cost per day for hospitalization averaged $3,949 in the U.S. In 2012, followed by Chile at $1,552. The average hospital cost for a U.S. patient’s total stay was $15,734; Germany was next at $5,004. “

A one-day stay at a first-class, brand new Kaiser Hospital  in Portland, Oregon was $275. Why so inexpensive? Insurance and integrated medicine. And the quality of that stay? The very definition of compassionate care that virtually anyone around the world would agree was exemplified on that day.

The quality of hospital care in the average hospital? Medical errors have risen, together with prices; and so the emphasis on care has been swamped by costs instead.

Interestingly enough the statistics for a person's chances of being hospitalized are unavailable, but the numbers hospitalized for certain conditions reflect the problems exist. Diabetics, in growing numbers, are a group that requires frequent hospitalization for various conditions, some of which, like heart disease, can lead to death.

For many people the lack of insurance means serious financial burdens that can drive people out of business, cause people to lose homes and allow many people to die prematurely, as they bargain with themselves not to get help when they need it because of the costs.

Yet fear drives much of the discussion instead of the reality check that declares that those without insurance, and under the past rules set by insurance companies alone, meant that folks paid a high price both in personal health and wealth.

An entrepreneur who goes into business who lacks health insurance risks that business the moment the door says open. So rather than causing a business to flounder because of being required to have insurance, it is more likely than not that business will have a better chance of success if the folks who manage the business and those who work for it have health insurance and don't have to worry about that average hospital stay of 5 days with the cost at more than $15,000. That absorbs much of the start-up costs that people need to initiate a business, and that stake can be lost with health risks.

A high percentage of Americans maintain they aren't happy with their jobs. According to Forbes magazine only 12% of employees are happy with their jobs.  How many might go into a business or work at something they really like, as opposed to working for an employer just to have health insurance. For without group coverage, most insurance companies have rejected individuals with certain preexisting health conditions.

So the business person given an option for insurance regardless of health conditions can go into his/her own business without fear of losing everything just because of an illness or accident and the resulting medical costs.

Tonight as people go to bed, the US Congress squabbles over health insurance, with demands that the newest offering be abandoned for at least a year, and according to some, forever. And many of the poor who need it have been afraid of the plan. And why? Because those who were part of the ever-growing schemes that multiplied costs and passed them along to consumers, while not taking persons with health risks so they might have to pay health care bills too high, have stood in the way for years.   And without everyone's participation, insurance costs will continue to increase, as greater participation spreads those costs over more participants.

The father who can't get health insurance because of a heart condition, the woman who is sole support of her and her ailing mother gets pneumonia, stays home, and enters the hospital emergency without insurance and too late for that hoped-for resolution to health, number in the millions each year that health insurance is unobtainable or available only at prices so exorbitant that only the well off can pay.

It's time for that reminder, as the evening closes the day that workers' health is the true basis of a nation's future, for without it everything else will fail.

Pneumonia cases on the rise worldwide

In January 2013, entertainment writers reported Jennifer Lawrence had walking pneumonia when she attended the SAG awards that month. She is one of many this season who suffered, or are still suffering, from pneumonia, as doctors have seen a rise in cases this year, even in areas like Hawaii that don't have the cold, wet weather experienced in the rest of the United States.

A rise in pneumonia is being seen in countries other than the United States, as doctors from Australia report a rise in influenza cases, not just among young children, but the elderly and other age groups as well.

Ordinary citizens are noticing more people reporting pneumonia and many with prolonged illness from this season's flu. Marie Hatfield, owner of Hatfield Realty in Hawaii tells us, "We are seeing a lot of people sick here. One of my realtors has been sick several weeks, and her son has Type A flu, which is very infectious. So we have had the realtor stay home from work."

Diabetics and those with respiratory ailments such as asthma are particularly at risk. Whether the condition is viral or bacterial in origin the symptoms include fever, shortness of breath, tiredness, coughing and a sharp knife-like pain in the chest.

Treatment ordinarily includes antibiotics and medications to open up the breathing passages. Pneumonia remains a leading cause of death in all age groups. Dr. Hemley, an Australian physician, tells us:

"It doesn't necessarily need hospital admission but you need to get on to it and you need to treat it with high-dose antibiotics for a minimum of 10 days as a rule."

Experts in natural medicine tell us pneumonia can last for a few days, weeks, months, or even on and off for the rest of one's life, especially if one has bacterial pneumonia. Treatment is varied, and when a patient will recover depends upon other factors as well as the pneumonia itself. Those with re-existing conditions that depress the immune system are more at risk. So some experts stress the importance of strengthening the immune system.

Most people will find they have symptoms for several weeks, especially the fatigue that is associated with the disease, so if you are one of those with the condition, the reminder remains from health professionals to be cautious, rest, drink plenty of liquids and expect to be sick for some time, as the disease can be fatal for some people if not managed effectively.

 

Monsanto and the GMOs: Is this the new Soylent Green?

India protest against Monsanto

Carol Forsloff — Years ago Charlton Heston starred in a movie that opened the door to concerns about environment and genetically engineered food products. As a conservative,  Heston might not have supported climate change ideas and environmental issues, but the film itself tells us that fooling around with Mother Nature might mean a health devastation for ourselves and future generations. A recent documentary spells this out in more detail.

The film "Genetic Roulette: The Gamble for Our Lives" takes on Monsanto, the giant producer of GMO's, genetically modified products. What the film does is provide an overview of the consequences of some of this genetic engineering, from the diseases and disabilities as the human concerns and the ongoing problems related to the future of the world and its children.

What are those problems? The film tells us that autism, diabetes and cancer are among a great number of ailments that have been increasing at a rapid rate. Many of these health concerns, the film maintains, result from populations consuming products that are harmful to human health. Some of these products come not directly but indirectly from animals who eat the grains and become sick themselves. These avenues become direct and indirect ways of the toxicity reaching a wider and wider population of people, including infants and very young children.

What evidence is used to support the opposition against Monsanto? Medical experts point out how animals have been sickened after being fed GMO-laden foods. They relate the experience of farmers throughout the world. And the film also speaks of the intimidation and political underpinnings of what is reported to be insidious and vengeful attacks on these medical experts who take responsibility for warning the public about the risks from GMOs.

Years of longitudinal research and case histories of individuals and groups point to the risks of herbicides and an increase in illnesses and diseases that not only impact today's populations but future generations as well, as the lingering byproducts remain in the system and then are transferred to infants through breastfeeding and other means. In addition, infant formulas and food have been found to contain GMO products as well. The theory is that these products have led to an increase in attention deficit disorder, autism and a host of other problems, including allergies. Research has documented many of these problems.

Many countries in the world now require proper labeling of foods and restriction of those that are genetically modified, as people have demonstrated far and wide about the impact on their health and their concern for their own health and that of their children. The United States continues not to take action because of the lobby groups representing Monsanto support politicians and according to some scientists have found ways to intimidate scientists, farmers and protestors.

So what does the film suggest people do? One recommendation is to become informed and to inform others of the risks of the Monsanto GMO reach and to pass along the information about the risks of product use to friends and family. Secondly, the film recommends a Non-GMO Shopping List that provides a documentation of those companies and producers that are GMO free.

For those interested in learning more from the film itself,  it is recommended that readers review the entire film, provided at this website: http://geneticroulettemovie.com/.

Life With Type 2 Diabetes: Part 1

[caption id="attachment_9853" align="alignleft" width="270" caption="Main symptoms of diabetes"][/caption]

Bob Ewing - Chocolate was once a driving force in my life.  Today, I can walk right by it and not even notice that it is there. Well, that is not completely true, I do notice but there is no draw, no urge to grab a piece, then another.   How did this come about?

It did not happen over night. I have Type 2 diabetes,  as did my father and his father before him. My doctors had warned me that unless I maintained a firm control over my diet and got enough exercise, my borderline case could explode.

I kept up the exercise. I walk every day. I gave up driving over 30 years ago and have been a walker ever since. This is good for me, my pocket book and the environment, a triple win scenario.

Permaculture education teaches you how to design systems and activities that provide three or more services. This is sound advice and often happens even when you are not planning it but it does require you to pay attention, which brings another permaculture principle into play, paying attention.

Being aware of where you are, what you are doing and what is taking place around you provides a grounding force and much useful information.

I did not watch my diet close enough, my love of chocolate, cake, pie and anything sweet and a tendency to overeat ruled my behaviour. This did not change until one day about four years ago.

We had just moved here when one morning I woke up and when I opened my eyes it was as though I was seeing the world through a thin grey gauze. After a trip to my doctor and an appointment with the eye doctor, I was told that I had floaters.

The Canadian National Institute for the Bind defines floaters as:

Floaters are dark specks in the form of dots, circles, lines, or cobwebs that seem to move across your field of vision. They are most noticeable when you are looking at a light-coloured background, such as a clear sky or a white wall. Floaters come in many sizes and numbers, and they seem to move when you look in different directions.

Floaters can diminish and today I only notice them now and then, usually when I am tired.

Now, as I have Type 2 diabetes, the doctor thought it best that a specialist, an ophthalmologist take a closer look. An ophthalmologist is a doctor who specializes in the branch of medicine concerned with the study of the physiology, anatomy, and pathology of the eye and the diagnosis and treatment of disorders of the eye.

Diabetic retinopathy is a leading cause of adult blindness. It is a complication of diabetes that results from damage to small blood vessels in the eye. This damage to blood vessels affects the nourishment of the retina which leads to visual loss. This condition can occur in both types 1 and type 2 diabetes.

Now by this time I had had three doctors appointments that combined lasted about three hours. This did not cost me anything. The treatment for this early stage was laser surgery. In all I have had four laser surgeries performed one ach eye and my vision is excellent.

Today, I do not eat chocolate, not even the sugar free; ignore most deserts even though a little sugar now and then cannot hurt me. Fortunately, peanut butter, another food love affair, is recommended in proper moderation.

The worst disaster for America will likely occur in the next decade

[caption id="attachment_9889" align="alignleft" width="300" caption="Insulin pen"][/caption]

Carol Forsloff - It’s worse than you thought. In fact, most people simply shrug and name a friend or relative headed for disaster, as it is so commonplace; but the numbers are staggering and the consequences of the disease are far beyond what most folks might even imagine, so here are the new numbers and the future that might bring.

The Centers for Disease Control underlines how serious things have become for diabetes. At least half of all American adults will have diabetes by the year 2020, if there isn’t a change in lifestyle for the millions of vulnerable people. 135 million in 2020 – and cost society $3.35 billion by decade’s end. In addition, diabetes is becoming one of the most widespread and devastating diseases of the century.

The American Diabetes Association recommends people consider eating and living like a diabetic if they are diagnosed with pre-diabetes. In fact, many doctors, like Ana Pere of Natchitoches, believe there is no such thing as pre-diabetes, as the characteristics eventually become worse if an individual continues with the same patterns of behavior. So cutting down on carbohydrates and being mindful of sugar imbalance is important for those testing at that pre-diabetes period. 79 million Americans are said to be pre-diabetic. Three years ago doctors made a specific point of telling people that pre-diabetes must be treated in order to prevent the huge numbers of diabetics that are predicted to occur by the end of the present decade.

So how can someone find out if he or she is pre-diabetic? There are three different tests that can be administered to determine whether a person has prediabetes. These are:

• The A1C test


• The fasting plasma glucose test (FPG)


• or the oral glucose tolerance test (OGTT).

The blood glucose levels measured following these tests determine whether you have a normal metabolism, or whether you have prediabetes or diabetes.

Problems associated with diabetes can impede not just physical but mental and emotional functioning as well. Because it is a progressive disease, it means the symptoms continue to worsen with age and severity of the disease. It can cause depression, neuropathic pain, amputation, blindness, liver and kidney damage as well as heart attack and stroke. Some of the more subtle signs such as skin irritations, fatigue, irritability, depression can gradually increase in frequency and severity over many years before the actual diagnosis of diabetes.

While much of medicine is devoted to diabetics physical symptoms and the medical costs, the emotional costs can be devastating as well, bringing trauma into relationships and misunderstanding when it is often the disease doing the “talking” as well as the “walking” and the painful consequences that can occur when diabetes takes charge of a life.

Serious rise in kidney disease, costs of diabetes, Medicare

[caption id="attachment_6299" align="alignleft" width="300" caption="Kidney disease"][/caption]

Carol Forsloff - According to a study reported in the June edition of the Journal of the American Medical Association diabetic kidney disease is on the rise in the United States, even though diabetes care has improved,  which is reflective of concerns about the cost of this disease in the future.

Kidney disease from diabetes is at its highest point in 50 years, according to the report.  Medications to lower blood pressure, sugar and cholesterol have advanced, however the number of diabetics in the population has grown and so has the rate of kidney disease.

The medical advances have not slowed down the rate of kidney disease, in spite of improvements in medications.  It accounts for nearly half of the cases of end-stage kidney failure in America at a cost of $26.8 billion in Medicare funds.

The University of Washington narrative tells us that within five years more than half of all persons with end-stage kidney disease will die.  Even a mild case of the disease can significantly impact a person’s health and raise health care costs.  In fact, the researchers maintain the rate of growth, and absolute number of cases found, are likely underestimated.

The study was supported in part by the UW Institute for Translational Health Sciences, part of the University’s ongoing research programs.

2011 national statistics on diabetes shows that during the period 2005-2008 more than a third of the adult population of the United States has pre-diabetes and half of those over age 65.

“Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States,” sums up the future for health care in America, as diabetes is outlined as a disease on the rise with its impact on the finances of the country and the health of its citizens at great cost to the nation’s future.

Projecting the date at which the Medicare funds will be exhausted is based upon income revenues.  It is, according to the report issued in 2010, estimated to be exhausted in 2024, which is five years earlier than it had been projected.  Even so, the current administration’s report further states that the fund itself is not adequately funded over the next 10 years, as H1 taxable earnings in the year 2010 were lower than previously determined.  The rate of growth of these earnings, however, is expected to rise.

But will the rate of growth of H1 earnings, those earnings that fund Medicare, be able to overcome the rising costs of health care and the growing rate of serious diseases like diabetes?  These unknown factors continue to be examined, as Medicare funds are imperiled by a number of serious concerns.

New artificial pancreas,diabetic breakthrough, underway at Mayo Clinic

[caption id="attachment_6224" align="alignleft" width="300" caption="Pancreas"][/caption]

Staff - The Mayo Clinic has announced it is working on a breakthrough development, an artificial pancreas to support insulin delivery.

This breakthrough is called the “closed loop system” and includes a blood sugar monitor, automatic insulin pump, and monitors to establish the level of activity, as well as a unit for processing information.

Additional research has established exercise to reduce blood sugar levels, which decrease faster in the morning than later in the day.



Type 2 diabetics do not produce sufficient insulin to support good health.  The goal of treating diaetes is to lower blood sugar that builds up in the blood because the diabetic does not produce enough insulin to reduce sugars to a normal level.

This new breakthrough for diabetics can help millions of people not affected by diabetes, the fastest growing disease in the United States, with 1 in 3 now afflicted with it.  This is particularly important as diabetes is responsible for the rise in kidney disease.

Hawaiians found at special risk for diabetes and stroke

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Carol Forsloff - Most mainlanders might not know this but Hawaiians are the disadvantaged group in their own lands with poor health levels compared to other ethnicities.  Diabetes and stroke impact them most according to the American Academy of Neurology.

The Academy will be meeting in Honolulu April 9 to April 16.  The news they bring for Hawaiians sent out in a press release today, however, from a study done through Queens Medical Center in Honolulu reveals the problems of health faced by Hawaiians.“Racial differences in stroke risk factors have been well-studied in Hispanic and African-American populations, but this is the first study to address people of Native Hawaiian ethnicity,” said study author Kazuma Nakagawa, MD,  A cross-section of people of different ethnicies on the islands was used in this study for a total of 573 people  described as other.

On average, Native Hawaiians who experienced a hemorrhagic stroke were around the age of 55, more than 10 years younger than those from other racial groups which had a combined average age of 67 when a stroke occurred. More Native Hawaiians also had diabetes; 35 percent compared to other racial groups at 21 percent. There were no differences in gender or other cardiovascular risk factors between the groups.

“Knowing risk factors for certain populations is an important step toward recognizing, treating and preventing stroke. More research needs to be done to determine which factors are contributing to stroke at such a young age in Native Hawaiians,” said Nakagawa.

The diet of Hawaiians is one that lends itself to obesity, a risk factor for diabetes and stroke.  In Hawaii there are movements, such as on the Leeward Coast at the Waianae Coast Comprehensive Center, to upgrade the health of Hawaiians by special diet plans.  This Shintani diet has worked for many people, but the fact remains the healthy eating style has not yet been fully adopted by this native Island group.  The sad thing is the health so compromised removes that flavor or Polynesian beauty as more and more of these beautiful people die early.

Health Crisis: 26 Million Americans Now with Diabetes

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GHN News - CDC - According to the Centers for Disease Control more than 1/3 of all American adults are said to have pre-diabetes.  This startling percentage is critical with respect to health care costs looming in the future.

Nearly 26 million Americans have diabetes, according to new
estimates from the Centers for Disease Control and Prevention (CDC). In
addition, an estimated 79 million U.S. adults have prediabetes, a
condition in which blood sugar levels are higher than normal, but not
high enough to be diagnosed as diabetes. Prediabetes raises a person's
risk of type 2 diabetes, heart disease and stroke.

Diabetes affects 8.3 percent of Americans of all ages, and 11.3
percent of adults aged 20 and older, according to the National Diabetes
Fact Sheet for 2011. About 27 percent of those with diabetes—7 million
Americans—do not know they have the disease. Prediabetes affects 35
percent of adults aged 20 and older.

"These distressing numbers show how important it is to prevent
type 2 diabetes and to help those who have diabetes manage the disease
to prevent serious complications such as kidney failure and blindness,"
said Ann Albright, Ph.D, R.D., director of CDC's Division of Diabetes Translation.
"We know that a structured lifestyle program that includes losing
weight and increasing physical activity can prevent or delay type 2
diabetes."

CDC is working on the National Diabetes Prevention Program, as
stated in the Affordable Care Act. This program, based on the NIH-led
Diabetes Prevention Program research study, is aimed at helping people
reduce their risk for developing type 2 diabetes.

In 2008, CDC estimated that 23.6 million Americans, or 7.8
percent of the population, had diabetes and another 57 million adults
had prediabetes. The 2011 estimates have increased for several reasons:

• More people are developing diabetes.


• Many people are living longer with diabetes, which raises the
  total number of those with the disease. Better management of the disease
  is improving cardiovascular disease risk factors and reducing
  complications such as kidney failure and amputations.


• Hemoglobin A1c is now used as a diagnostic test, and was
  therefore incorporated into calculations of national prevalence for the
  first time. The test, also called glycated hemoglobin, measures levels
  of blood glucose (sugar) over a period of two to three months. Because
  of this change, estimates of populations with diabetes and prediabetes
  in the 2011 fact sheet are not directly comparable to estimates in
  previous fact sheets.

In a study published last year, CDC projected that as many as 1
in 3 U.S. adults could have diabetes by 2050 if current trends continue.
Type 2 diabetes, in which the body gradually loses its ability to use
and produce insulin, accounts for 90 percent to 95 percent of diabetes
cases. Risk factors for type 2 diabetes include older age, obesity,
family history, having diabetes while pregnant (gestational diabetes), a
sedentary lifestyle, and race/ethnicity. Groups at higher risk for the
disease are African-Americans, Hispanics, American Indians/Alaska
Natives, and some Asian-Americans and Pacific Islanders.

Other data from the fact sheet:

• About 215,000 Americans younger than age 20 have diabetes.
  Most cases of diabetes among children and adolescents are type 1, which
  develops when the body can no longer make insulin, a hormone that
  controls the amount of blood glucose.


• An estimated 1.9 million Americans were diagnosed with diabetes in 2010.


• Racial and ethnic minorities continue to have higher rates of
  diabetes after adjusting for population age differences. For adults,
  diabetes rates were 16.1 percent for American Indians/Alaska Natives,
  12.6 percent for blacks, 11.8 percent for Hispanics, 8.4 percent for
  Asian-Americans, and 7.1 percent for non-Hispanic whites.


• Half of Americans aged 65 and older have prediabetes, and nearly 27 percent have diabetes.

The fact sheet estimates are drawn from a variety of sources,
including CDC surveys, the Indian Health Service National Patient
Information Reporting System, the U.S. Renal Data System of the National
Institutes of Health, the U.S. Census Bureau, and published studies.
The fact sheet was prepared in collaboration with a number of agencies
within the U.S. Department of Health and Human Services, other federal
agencies, and the , the American Diabetes Association, and the Juvenile Diabetes Research Foundation International.

Diabetes is the seventh leading cause of death in the United
States. People with diabetes are more likely to suffer from
complications such as heart attacks, strokes, high blood pressure,
kidney failure, blindness and amputations of feet and legs. Diabetes
costs $174 billion annually, including $116 billion in direct medical

expenses.

Two new therapies found to slow vision loss in diabetics

 

[caption id="attachment_4400" align="alignleft" width="265" caption="Eye test at Guantanamo"][/caption]

Editor - The National Institute of Health has announced the results of research on two therapies that may slow the progression of diabetic retinopathy, an eye disease that is the leading cause of vision loss in working-age Americans and impacts many diabetics.

Diabetic retinopathy is a disease in which blood vessels in the eye’s light-sensitive retinal tissue are damaged by diabetes. Blood vessels can begin to leak, causing swelling in the retina, and abnormal new blood vessels can develop, both causing vision loss. In the study, disease progression was identified through retinal photographs that indicated blood vessel changes or by the need for laser or eye surgery to treat abnormal blood vessels.

Intensive blood sugar control reduced the progression of diabetic retinopathy compared with standard blood sugar control, and combination lipid therapy with a fibrate and statin also reduced disease progression compared with statin therapy alone. However, intensive blood pressure control provided no additional benefit to patients compared with standard blood pressure control.

Results of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study, supported by the National Institutes of Health, are published online June 29 in the New England Journal of Medicine (NEJM) and will be presented June 29 at the 70th Scientific Sessions of the American Diabetes Association.

"The ACCORD Eye Study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy," said Emily Chew, M.D., chair of the Eye Study and chief of the Clinical Trials Branch of the Division of Epidemiology and Clinical Applications at the National Eye Institute (NEI).

"The main ACCORD findings showed that fibrate treatment added to statin therapy is safe for patients like those involved in the study. However, intensive blood sugar control to near normal glucose levels increased the risk of death and severe low blood sugar, so patients and their doctors must take these potential risks into account when implementing a diabetes treatment plan."

The ACCORD study was a landmark clinical trial that included 10,251 adults with type 2 diabetes who were at especially high risk for heart attack, stroke or cardiovascular death. The study evaluated three intensive strategies compared with standard treatments for lowering cardiovascular risks associated with diabetes.

Intensive treatments included control of blood sugar to near normal levels, control of blood pressure to normal levels, and combination treatment of multiple blood lipids with fenofibrate and simvastatin compared to standard treatment with simvastatin alone. Fenofibrate treatment lowers triglycerides and raises the "good" high density lipoprotein (HDL) cholesterol levels, while simvastatin lowers the "bad" low density lipoprotein (LDL) cholesterol levels. All participants were enrolled in the blood sugar trial and in either the blood pressure or lipid trial.

"Previous clinical trials have shown the beneficial effects of intensive blood sugar control on slowing the progression of diabetic retinopathy in people with type 1 diabetes or newly diagnosed type 2 diabetes," said NEI director Paul A. Sieving, M.D., Ph.D.

Dr. Sieving went on to underline the value of the present study,  "The ACCORD Eye Study expands these findings to a larger population of adults who had type 2 diabetes for an average of 10 years, and demonstrates that the eye benefits from the reduction of glucose below previously established levels."

The ACCORD study began in 2001, and participants were treated and monitored for an average of five years. Results of the blood sugar clinical trial were reported in 2008, when the intensive blood sugar therapy was stopped 18 months early due to an increased risk of death in that treatment group compared with the standard blood sugar control group. Findings from the blood pressure and lipid clinical trials appeared in the April 29, 2010 edition of NEJM.

"A key question in the main ACCORD study was whether intensive glucose control, previously demonstrated to reduce risk of microvascular disease, including eye problems,  in diabetes, would reduce large vessel disease that causes problems like heart attacks.

"Investigators are continuing to evaluate the risks and benefits of the treatment strategies in these high-risk patients with type 2 diabetes," said Susan B. Shurin, M.D., acting director of the National Heart, Lung, and Blood Institute, the primary sponsor of the ACCORD study. "

The value of this research is explained by Dr. Shurin as significant in the treatment of eye conditions, especially for diabetics, "Clinicians should individualize treatment for each patient to prevent complications, also incorporating information about conditions such as cardiovascular or visual problems. Lifestyle interventions, including physical activity, weight loss and healthy diets, can improve diabetes control and reduce onset of diabetes."