Pharmacists War on Diabetes Month

By Terry Orr

(Type 2 Diabetic)

A War with Diabetes!!!

Why the War?

An estimated 23.6 million Americans have diabetes.  Unfortunately, 5.7 million Americans don't know they have the deadly disease.  Pharmacists are one of the most available health care professionals and have the greatest potential to impact the threat of diabetes. 

Complications of Diabetes:

Heart Disease & Stroke: Diabetics are 2 to 4 times more likely to die from heart disease and stroke than non-diabetics.  Sixty-five percent of diabetics will die of heart disease or stroke.

Blindness: Diabetes is the leading cause of blindness in adults age 20-74.

Kidney Disease: Diabetes is the leading cause of kidney failure.

Nervous System Disease: 60 to 70% of diabetics have a mild to severe form of nervous system damage.  The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems.

Amputations: Diabetes is the leading cause of non-traumatic lower limb amputation.  

Complications of Pregnancy: Poorly controlled diabetes can increase the risk of miscarriage or cause major birth defects.

Sexual Dysfunction: Diabetes significantly increases the risk for sexual dysfunction in both men and women. 

Here are some of the new drugs in the War on Diabetes:

Invokana will be sold by Johnson & Johnson and treats patients with type 2 diabetes in a new way, by causing blood sugar to be excreted in the urine. Many existing drugs work by affecting the supply or use of insulin. FDA approved this drug in late March of this year.

Dapagliflozin by AstraZeneca/Bristol-Myers Squibb, The drugs offer a different way than insulin therapy to lower blood sugar, preventing excess sugar in the kidneys from reentering circulation and allowing glucose to exit the body via urine.

LY2605541 - by Eli Lilly/Boehringer Ingelheim, a potential long-acting insulin option.

MK-3102 by Merck & Co., a once-weekly DPP-4 inhibitor.

Taking Control

Mayo Clinic Type 2 Diabetes Prevention: 5 tips for taking control (Changing your lifestyle could be a big step toward diabetes prevention — and it's never too late to start) consider these tips:

Tip 1: Get more physical activity

There are many benefits to regular physical activity. Exercise can help you:

Lose weight

Lower your blood sugar

Boosts your sensitivity to insulin — which helps keep your blood sugar within a normal range

Research shows that both aerobic exercise and resistance training can help control diabetes, but the greatest benefit comes from a fitness program that includes both.

Tip 3: Go for whole grains

Although it's not clear why, whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and many cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.

Tip 4: Lose extra weight

If you're overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health. And you may be surprised by how much. In one study, overweight adults reduced their diabetes risk by 16 percent for every kilogram (2.2 pounds) of weight lost. Also, those who lost a modest amount of weight — at least 5 to 10 percent of initial body weight — and exercised regularly reduced the risk of developing diabetes by almost 60 percent over three years.

Tip 5: Skip fad diets and make healthier choices

Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first, but their effectiveness at preventing diabetes isn't known nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan.

Be sure to see your primary healthcare provider and discus the plan best for you.

References and Links:

http://www.miracledkc.com

http://www.curediabetesblog.com/2013/diabetes-pick-me-ups/tips-for-the-newly-diagnosed-diabetic-some-ideas-but-by-no-means-the-only-way/

http://www.nytimes.com/2013/03/30/business/invokana-wins-fda-approval-for-diabetes-treatment.html?_r=0

http://henhouseforms.mywebgrocer.com/PharmacyNewsletters/2009/04/page2.html

(All images from Google) 

American Diabetes Month

A Day in the Life of Diabetes

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By Terry Orr

I am a type 2 diabetic and try to follow my doctors’ advice by eating, exercising and taking my medications – key word of course it trying – although doing a better job these days.  For any of you who are, know family and friends or are a good candidate for having diabetes – help them anyway you can and talk with your doctor to get yourself on the right track.  This is the first of six diabetes-related articles we will be posting this month.

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A typical day for a diabetic begins with:

• Checking your weight;
• Check your blood sugar;
• Check your blood pressure;
• Taking your medications;
• Morning exercises (always seems to brighten my day);
• Eating a healthy, diabetic-friendly breakfast;
• Walking and climbing stairs when possible;
• Have a small healthy snack mid-morning;
• Get up from your desk, stretch and walk a little (I used my normal restroom breaks to accomplish this many days);
• Eat a well-balanced and nutritionist lunch (Frequently, I would leave my desk and walk down several flights of stair to eat in the café and return the same way afterwards);
• Walk (when the weather was nice, a couple of my friends and I took a nice walk outdoors before returning to the office – a wonderful break in routine);
• Try and have a stress-free commute home (If you can use mass transit – it is very helpful);
• Exercise (frequently after getting home and checking on everyone – do some stretching and light exercise before dinner);
• Spend time with the family;
• Enjoy a light and healthy dinner;
• Walk around the block once or twice (often with the family and chat along the way – nice way to spend some family time); and
• Go to bed early enough to allow you to get eight restful hours of sleep.

Sounds simple – but totally unrealistic for most of us – but you would be surprised with a little effort how you can blend these activities into your daily routine.

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Here are just a few of the recent statistics on diabetes from the American Diabetes Association (ADA):

• Nearly 26 million children and adults in the United States have diabetes.
• Another 79 million Americans have pre-diabetes and are at risk for developing type 2 diabetes.
• The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $174 billion.

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The Toll on Health (Fact Sheet)

• Two out of three people with diabetes die from heart disease or stroke.
• Diabetes is the leading cause of kidney failure.
• Diabetes is the leading cause of new cases of blindness among adults.
• The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.
• About 60-70 percent of people with diabetes have mild to severe forms of nerve damage that could result in pain in the feet or hands, slowed digestion, sexual dysfunction and other nerve problems.

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From the good people at CDC they offer the following information on important steps to take to control diabetes:

• Talk to your health care provider about how to manage your blood glucose (A1c), blood pressure, and cholesterol.
• Stop smoking and do not use any other tobacco products.
• Get a flu vaccine. For those with diabetes, type 1 and type 2, it is important to ask for the "shot" version. Talk to your health care provider about a pneumonia (pneumococcal) shot. People with diabetes are more likely to die from pneumonia or influenza than people who do not have diabetes. CDC recommends that everybody aged 6 months and older get a flu vaccine, including family members of people with diabetes.
• Reach or stay at a healthy weight.
• Make sure you're physically active. Plan for 2 hours and 30 minutes each week of moderate physical activity, such as walking quickly or gardening, or 1 hour and 15 minutes each week of vigorous physical activity, such as jogging or jumping rope. Add muscle strengthening activities on 2 or more days each week. Physical activity can help you control your weight, blood glucose, and blood pressure, as well as raise your "good" cholesterol and lower your "bad" cholesterol.

Obesity is a Major Risk Factor.  Being overweight or obese raises your risk of developing type 2 diabetes.

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Other risk factors for type 2 diabetes include the following:

• Age 45 or older
• Developed diabetes while pregnant (gestational diabetes)
• Have a parent, brother or sister with type 2 diabetes
• Are not physically active
• Belong to certain racial or ethnic groups. African Americans, Hispanic/Latino, American Indians, and some Asian Americans and Pacific Islanders are at high risk for type 2 diabetes.

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People with diabetes are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year. Fast Facts from CDC:

• People with diabetes are three times more likely to die from flu complications than people without diabetes.
• Death rates from pneumonia and influenza among African-Americans with diabetes are double the death rates among whites with diabetes.

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References and Links:

• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/
• http://diabetes.webmd.com/
• http://diabetes.webmd.com/glossary
• http://www.stopdiabetes.com/whats-happening/american-diabetes-month.html?cr=redcpcggdiabetesmonthgenhelptheamerican&gclid=CKLV3L7sprMCFYZM4Aod9S4AxA
• http://www.diabetes.org/in-my-community/programs/american-diabetes-month/
• http://www.diabetes.org/in-my-community/programs/american-diabetes-month/american-diabetes-month-2012-fact-sheet.pdf
• http://www.cdc.gov/Features/LivingWithDiabetes/index.html
• http://healthfinder.gov/nho/PDFs/NovemberNHOtoolkit.pdf

Heat Safety Awareness Day

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By Akindman

Heat is the number one weather-related killer in the United States, resulting in hundreds of fatalities each year. In fact, on average, excessive heat claims more lives each year than floods, lightning, tornadoes and hurricanes combined. In the disastrous heat wave of 1980, more than 1,250 people died. In the heat wave of 1995 more than 700 deaths in the Chicago area were attributed to heat. In August 2003, a record heat wave in Europe claimed an estimated 50,000 lives.

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North American summers are hot; most summers see heat waves in one or more parts of the United States. East of the Rockies, they tend to combine both high temperature and high humidity; although some of the worst heat waves have been catastrophically dry.

How does heat affect the workplace? When exposed to extreme heat or when working in hot environments, workers can be at risk of heat stress. Heat stress occurs when the body is unable to cool itself by sweating. Heat rashes, heat cramps, heat exhaustion, and heat stroke can occur as a result. Heat also increases the risk of workplace injuries. Sweaty palms, fogged safety glasses and dizziness can all contribute to injury.

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Who's at risk? Workers with heart disease, high blood pressure, overweight or over 65 years are at greatest risk. Those who work outdoors, including farmers, utility and construction workers, firefighters, miners, factory works, and bakery workers are a few examples.

Here are a few tips and reminders for keeping yourself, loved ones, and pets safe when temperatures rise:

• Those whose work, or whose activity schedule requires that they be, outdoors for prolonged periods should take frequent breaks to get out of the sun.
• Remain well hydrated (drink plenty of water).  Water is the best fluid to drink to re-hydrate and/or to stay hydrated.  Beverages high in sugar or caffeine are not recommended.
• Prolonged exposure to heat and humidity may increase the chances for a variety of ailments such as sunburn, heat exhaustion, heat stroke (hypothermia), and heat cramps.
• Pets and small children should never be left in automobiles, even for short periods of time.  Seeing as though most episodes of extreme heat occur in the spring and summer months, when the sun angle is highest, the interior of an automobile can undergo rapid rises in temperature very quickly.  Did you know that recent studies suggest that on a day when the temperature is 80 degrees, the interior of an automobile with closed windows is capable of reaching 120 degrees after an hour of being left unattended?  Imagine how high those temperatures could get if the air temperature were 85 or even 90 degrees!  Furthermore, closed windows do not allow for the heat to escape as easily (open windows will not provide much heat reduction either, especially if the vehicle is stationary).  Dangerous, or even life threatening, conditions may materialize for pets, children, and even adults in these situations.
• Check on the elderly to ensure that they are remaining safe and healthy.
• Make sure pets have adequate fresh, cold water and food.  Pets should not be left outdoors in the heat for prolonged periods of time.
• Get out of the heat, and into an air conditioned environment, for at least a few hours each day during periods of excessive heat.  If your home is not air conditioned, go to a shopping mall or other air conditioned place.

Links:

http://www.cdc.gov/niosh/topics/heatstress/

http://www.crh.noaa.gov/lbf/?n=heatawarenessday