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The Future of Diabetes Testing
June 25, 2009
When we think about testing for blood glucose we often think about pricking a
fingertip and testing a drop of blood. This is very painful and inconvenient for
most people. An international committee of experts have recommended a test
called the A1C assay, at the American Diabetes Association's 69th Scientific
Sessions over the weekend. The findings from this meeting could instigate a
change in the way diabetes is diagnosed, the American Diabetes Association said.
The A1C assay has been used for nearly 30 years to determine how well a
patient controls diabetes, and is a more stable, reliable test and tool for
diagnosing patients. The A1C test consists of a simple blood test, is easier on
the patient and more convenient than the two tests commonly used for diabetes --
the fasting plasma glucose and the oral glucose tolerance test. The fasting test
means the patient has to fast for 12-14 hours which is very hard to do and the
Glucose Tolerance Test forces you to drink a horrible sickly sweet solution in a
very short amount of time, and then you have to wait at the lab to have your
blood drawn an hour later. Trust me, that test makes even the strongest person
want to vomit and it often gives false positives, especially in pregnant women.
Pregnant women are naturally glucose intolerant and will test higher, causing
them to be falsely diagnosed with gestational diabetes. This causes unnecessary
daily blood tests and restriction of carbohydrates to keep the baby from
becoming too large. The actual reason is that you are on a strict diet and the
baby is smaller because it is not getting the variety of foods it would normally
get. There are very few cases of actual gestational diabetes in which insulin is
necessary in order for blood glucose control. In fact the guidelines used in the
United States to classify a pregnant woman as having gestational diabetes would
be well within the normal range in several other major industrialized nations.
The advantage of the A1C is that it tracks blood glucose levels over a
120-day period, providing a long-term view that takes blood glucose spikes and
dips into account without making them the primary focus. The lowest and highest
results are thrown out and a percentage is obtained in which 6.5% is the cut off
point for diagnosing diabetes. Those who have results of 6.5% or higher are
considered diabetic. Individuals with A1C levels running more than 6%, but not
quite as high as 6.5%, are considered at high risk of developing type 2
diabetes.
"The American Diabetes Association supports the concept, supports the use of
the A1C to diagnose diabetes, and just has to look at the implications of it,
and the implementation of it," said Richard Kahn, Chief Scientific and Medical
Officer for the American Diabetes Association, who was part of the committee."
"Using A1C in diagnosis would be particularly useful for determining whether
patients have type 2 diabetes, which is more difficult to diagnose than type 1",
said Dr. William Bornstein, assistant professor of endocrinology at Emory
University, who was not part of the committee. However they go on to say that
the current means of diabetes testing and diagnosis is more than adequate, and
that using A1C is more costly and takes longer (3 months), and therefore there
is no rush to switch treating methods even though it would indeed help prevent
some cases of type 2, by making people aware that they are at risk.
Switching to this A1C assay still only requires simple blood tests, is far
more accurate but is not currently being considered as becoming the next
standard of diagnosing diabetes as there are still far too many "incentives"
from blood glucose companies such as free meters, discounted strips and even
discounts on other expensive non-diabetes medical supplies from large
pharmaceutical companies to stick with the current standard. This is wonderful
for all of their bottom lines, but not for the patients or the future of their
diagnosis and care.
Urgent Health Message
Unacceptable Contamination Risk
for Some Colonoscopy/ ENT Patients
March 25, 2009
Miami Veterans Affairs Healthcare System officials announced Monday that
thousands of veterans who had colonoscopies in facilities in Miami, Florida,
Murfreesboro, Tennessee, and Augusta, Georgia were at risk of contracting
hepatitis and HIV. This disturbing information came to light when hospital
officials said a review of safety procedures found that the tubing used in
endoscope procedures was rinsed but not disinfected.
While the Miami Health Department has said that, "the risk of infection is
minimal", there is still a real possibility that people may have been infected
at the worst, and at the least these people are very concerned about their
health. The Veteran's Administration has notified more than 6,000 people who
underwent colonoscopies between May 2004 and March 12, 2009 at the clinic were
notified and offered free testing for infections. Since these patients were
notified via a letter sent by U.S. mail, anyone that had this procedure at any
of these clinics should call for more information and to set up testing.
At the VA clinic in Murfreesboro alone, over 6,000 patients were notified
that they were at risk. In Miami, on Monday, the VA sent letters to 3,260 people
who may have been infected, and the Charlie Norwood VA Medical Center in
Augusta, Georgia also said it had "recently notified 1,200 veterans they may
have been exposed to infection when undergoing ear, nose and throat (ENT)
procedures between January and November of 2008." This breach of standards
for maintaining health and safety is so egregious that Representatives Kendrick
B. Meek, D-Florida, and Sen. Bill Nelson, D-Florida are requesting an official
inquiry by the inspector general of the VA.
For more information on this contact the Veterans Administration.
Study shows caffeine
may help prevent skin cancer
March 2, 2009
Caffeine (yes the chemical in your coffee) has been shown to stimulate cells
that have been damaged by ultraviolet (UV) rays to self destruct. Too much
exposure to ultraviolet light is one of the major causes of skin cancer.
Caffeine specifically targets these cells that have been damaged and could
become cancerous; it leaves normal cells alone. The study was published in
the Journal of Investigative Dermatology. According to the lead
researcher, Dr. Paul Nghiem, an associate professor of dermatology at the
University of Washington in Seattle, caffeine could one day be used in
sunscreens. For those thinking about drinking more coffee or tea, Dr. Nghiem
points out that an increase in intake will not have a significant impact in skin
cancer prevention. The study doesn't say how much caffeine a person would need
to take or rub on to be beneficial.
Another benefit of Vitamin D
discovered
February 24, 2009
A research study published in the February 23 issue of the Archives of
Internal Medicine, states that Vitamin D (known for developing strong bones)
actually plays a big role in helping the body's immune system against the common
cold and flu. The author of the study, Dr. Adit Ginde states that "...our study
provides support that lower levels of vitamin D are associated with an increased
risk for respiratory infections, such as the common cold and the flu. And people
who have pre-existing respiratory disease -- like asthma and emphysema -- appear
to be at an increased risk for this association." Good sources of
Vitamin D are salmon with bones, milk and sunshine. However, don't over do
it with the sunshine and get yourself burned, as that can raise the risk of skin
cancer. 10 to 15 minutes daily should be enough.
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