| Type 2 diabetes treatments: Why oral meds first? Feb 13th 2013, 21:22  - With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N. read biography
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Living with diabetes blog -
Feb. 13, 2013 Type 2 diabetes treatments: Why oral meds first? By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Controlling Your Diabetes Subscribe to our Controlling Your Diabetes e-newsletter to stay up to date on diabetes topics. Sign up now  One of our readers asked "Why is insulin only considered after oral medications have been found ineffective?" I think this is an excellent question. However, I'm not sure that I have a good answer. An October 2008 study in Diabetes Care concluded that a six-month course of insulin therapy, compared with oral anti-diabetes drugs (OADs), could more effectively result in adequate glycemic control and improvement of pancreatic insulin producing cells in those who had new-onset type 2 diabetes with severe high blood sugar levels. Type 2 diabetes is progressive, and the insulin producing cells in the pancreas deteriorate over time. There are an increasing number of children, teens, and young adults who are diagnosed with type 2 diabetes. They'll live longer with diabetes than others before them, and so will be more likely to develop severe insulin-deficiency that requires insulin replacement earlier in life. Reasons why insulin might not be prescribed sooner if you have type 2 diabetes may include: - Doctors are concerned about you getting low blood sugar.
- You might not be willing to start insulin or might not have the ability to give yourself injections.
- Primary care providers may perceive that insulin therapy is too complex to manage in their busy practice.
- Prescribing information may be vague, and the provider may be unsure about initial dosing, titration and what kind of insulin to start you on, which may delay making the necessary transition from oral medications to insulin.
According to an April 2005 article in Clinical Diabetes, an A1C level of 9 percent or more signifies the need to take action to lower blood glucose. Numerous studies have shown that early intervention with insulin is more important than was previously believed. So, I don't have a good answer to this reader's question. However, if your oral medication(s) are no longer helping you control your blood sugar, discuss the option of insulin as a next step with your provider. Taking insulin doesn't mean that you've failed to manage your blood sugar. Type 2 diabetes is a progressive disease, and if you have it long enough, chances are you may eventually need insulin. Have a good week, Peggy blog index  |  | Lettuce gets a bad rap, but cooks need to clean up their act Feb 13th 2013, 06:00  - With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D. read biography
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Nutrition-wise blog -
Feb. 13, 2013 Lettuce gets a bad rap, but cooks need to clean up their act By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Recipes for Healthy Living Subscribe to our Recipes for Healthy Living e-newsletter for healthy and tasty recipes. Sign up now Eat your greens! Just be sure to wash them first. Food safety is often overlooked. Most of us shop at grocery stores with beautiful presentations of bounties of food. We forget that the food was grown or raised elsewhere, was handled by many hands and traveled through varying temperatures to arrive in our kitchens. Conditions are right for bacteria already present on food to multiple, as well as for new bacteria to join the crew. The Centers for Disease Control and Prevention recently released a report on illnesses and deaths from foodborne illnesses. The statistics are startling and a sobering reminder of the importance of food safety. Over 9 million people are sickened by foodborne illnesses each year, according to the report. Over 50 percent of the illnesses were from plant foods, with leafy greens being a primary host. A close second is poultry. Sadly for thousands of people each year, this is more than stomachache or flu-like symptoms. Foodborne bacteria and toxins are serious and can lead to hospitalizations and death for the very young and the very old, as well as people with weakened immune systems. What can you do to protect yourself? Don't forgo leafy vegetables or lean poultry! Instead, remember these words: Clean. Separate. Cook. Chill. - Clean. Before and after handling food, wash your hands, your kitchen surfaces, including your sink, refrigerator, and preparation areas. All produce should be rinsed produce running water (no need for detergents or special washes).
- Separate. Don't let meat juices leak onto other foods. Keep produce and meat and fish separate in the cart and in the refrigerator. Use separate cutting boards and/or clean prep area and knives for produce and meat.
- Cook. Use a food thermometer. Heat and reheat food to proper internal temperatures.
- Chill. Don't leave food at room temperature for longer than 1-2 hours. Use shallow containers to quickly allow foods to reach 40 degrees or less in the refrigerator or freezer.
What are your thoughts about food safety? Will you change your food shopping, preparation or storage habits to keep yourself and your family safe from foodborne illnesses? To your health, Katherine blog index References - Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998-2008. Centers for Disease Control and Prevention. http://wwwnc.cdc.gov/eid/article/19/3/11-1866_article.htm. Accessed Feb. 11, 2013.
- Check your steps. FoodSafety.gov. http://www.foodsafety.gov/keep/basics/index.html. Accessed Feb. 11, 2013.
- Tips for fresh produce safety. FoodSafety.gov. http://www.foodsafety.gov/keep/types/fruits/tipsfreshprodsafety.html. Accessed Feb. 11, 2013.
| | Dad-to-be? Take center stage! Feb 12th 2013, 06:00  - With Mayo Clinic certified nurse-midwife
Mary M. Murry, R.N., C.N.M. read biography
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Pregnancy and you blog -
Feb. 12, 2013 Dad-to-be? Take center stage! By Mary M. Murry, R.N., C.N.M.
I was talking to my husband about my blog. He wanted to know if I'd ever written anything for expectant fathers — and I had to admit that I hadn't written much. It got me thinking about how little support there is for a dad-to-be. Moms are given center stage in the drama of pregnancy and birth. Dads are co-stars and sometimes even bit players. Still, sometimes a dad-to-be needs to be given center stage. A dad is becoming a parent, too, and men don't have nearly the amount of support and education that women do. A dad-to-be might worry about not getting enough time with the baby or with mom, or about being pushed aside by the women in his life. He might be concerned about what kind of father he'll be, especially if he doesn't have a strong role model. If you're a dad-to-be, look for mentors — men who've had babies, who know what it's like, who can help you through it. If you're concerned about a dad-to-be, recognize his support and contributions. Show your appreciation for his efforts. Ask about his hopes, fears and concerns for the birth and all that comes after. Dads, please share some helpful hints with us all. blog index | |
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