Why this flu season could be a bad one

Flu hit the Southern Hemisphere particularly hard over the past few months, which could mean a miserable fall and winter for the U.S.

From: http://www.cbsnews.com/news/flu-season-could-be-bad/

Nurses Believe (Trailer) - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=G8uOazJAAiE

Nurses Believe - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=Z6YqHBQsAXE

Julia Louis-Dreyfus Reveals Breast Cancer

The multiple-Emmy winner revealed her diagnosis on Instagram.

From: http://www.webmd.com/breast-cancer/news/20170928/julia-louis-dreyfus-reveals-breast-cancer?src=RSS_PUBLIC

How Zika Virus Went From Mild to Devastating

Mouse study suggests one genetic mutation in 2013 unleashed its ability to attack developing fetal brains

From: http://www.webmd.com/a-to-z-guides/news/20170928/how-zika-virus-went-from-mild-to-devastating?src=RSS_PUBLIC

FDA OKs Device With No Finger-Prick For Diabetes

Device eliminates need to prick finger to measure blood sugar levels

From: http://www.webmd.com/diabetes/news/20170928/fda-oks-device-with-no-finger-prick-for-diabetes?src=RSS_PUBLIC

Nearly Half of the World's Abortions Are Unsafe

Worst conditions found in Africa, Asia and Latin America, WHO researchers say

From: http://www.webmd.com/infertility-and-reproduction/news/20170928/nearly-half-of-the-worlds-abortions-are-unsafe?src=RSS_PUBLIC

WHO Statement on Philip Morris funded Foundation for a Smoke-Free World

WHO Statement on Philip Morris funded Foundation for a Smoke-Free World

From: http://www.who.int/entity/mediacentre/news/statements/2017/philip-morris-foundation/en/index.html

FDA expands opioids efforts to include guidance on managing acute pain

The Food and Drug Administration announced Sept. 28 that immediate release opioids medications will now be subject to a "more stringent set of requirements" as part of the agency's efforts to address the nation's opioids crisis.

From: By Jennifer Garvin http://www.ada.org/en/publications/ada-news/2017-archive/september/fda-expands-opioids-efforts-to-include-guidance-on-managing-acute-pain

Last chance to register for webinar that addresses third-party payer contracts

Third-Party Payer Contract: The Most Important Decision is a free webinar from the ADA that will stream Oct. 5 from noon-1 p.m. Central Daylight Time.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/last-chance-to-register-for-webinar-that-addresses-third-party-payer-contracts

Mayo Clinic Minute: Sleep and Alzheimer's disease connection

From: Mayo Clinic https://www.youtube.com/watch?v=-gfEepYk92I

Delays in Diagnosis Hurt Women With Heart Disease

Study found they were less likely to receive surgeries involving multiple artery grafts

From: http://www.webmd.com/heart-disease/news/20170928/delays-in-diagnosis-hurt-women-with-heart-disease?src=RSS_PUBLIC

Brain Scan May Explain Parkinson's Hallucinations

Scans showed areas with decreased connectivity

From: http://www.webmd.com/parkinsons-disease/news/20170928/brain-scan-may-explain-parkinsons-hallucinations?src=RSS_PUBLIC

Coffee Doesn't Help Parkinson's Motor Disorders

Caffeine has no impact, says long-term trial that reverses earlier findings

From: http://www.webmd.com/parkinsons-disease/news/20170928/coffee-doesnt-help-parkinsons-motor-disorders?src=RSS_PUBLIC

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.

Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.

Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).

They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counseling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.

The other group (64 people) also received a pretty intensive lifestyle intervention:

• five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training
• an individualized nutrition plan with dietary counseling, including calorie restriction for the first four months
• a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.

*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.

The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counseling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counseling sessions dropped off over the year.

Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.

So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.

And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.

I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

Resources

Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International Journal of Clinical Practice, October 2014.

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association. Circulation, August 2012.

Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ, December 2015.

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA, August 2017.

Effects of Lifestyle Modification Programs on Cardiac Risk Factors. PLoS One, December 2014.

The post Diabetes: Adding lifestyle changes to medication can deliver a knockout punch appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Diabetes: Changing the Conversation, Reaping the Rewards

We’re proud to launch our new initiative, In It Together, in conjunction with John Hancock Life Insurance, to celebrate people living with type 2 diabetes and the actions they take to lead healthy and fulfilling lives.

In It Together features a new podcast series, giving a voice to the stories of people living with type 2 diabetes—their challenges and complications, their breakthroughs and triumphs—to inspire and encourage others and bring a sense of urgency to the prevalence of this disease.

New episodes of the podcast will be posted here on the last Thursday of the month.

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In It Together: From Denial to Awareness and Life-Changing Action

Our first podcast features Ina Mendoza-Wilson, a woman who’s committed to managing diabetes and living healthier—for herself and her family.

Ina offers a first-hand account of the important decisions she makes due to her diabetes and how diabetes self-management is the key to helping her take steps toward living a healthy lifestyle.

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People living with type 2 diabetes encounter daily challenges—from managing medications, deciding what to eat and facing common misconceptions about the disease—and they don’t often talk about it. Through In It Together, we strive to change the conversation about people living with diabetes. Please join us!

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John Hancock life insurance shares our goal of supporting people by changing the conversation about diabetes. To learn more about “In It Together” and John Hancock and its wellness-based life insurance program, John Hancock Vitality, visit http://www.diabetes.org/inittogether.

From: American Diabetes Association http://diabetesstopshere.org/2017/09/28/diabetes-changing-the-conversation-reaping-the-rewards/

Health insurer Anthem is leaving Maine's health insurance exchange in 2018

Anthem this year rolled back its presence in Nevada, California, Ohio, Wisconsin, Georgia and its home state of Indiana

From: http://www.cbsnews.com/news/health-insurer-anthem-is-leaving-maines-health-insurance-exchange-in-2018/

Puerto Rico facing "unparalleled" health crisis, doctor says

Hurricane Maria left Puerto Rico's hospitals in critical condition. Fifty-nine of the island's 69 hospitals are open in some capacity. But some are worried they won't have enough fuel or supplies to keep going. Dr. Jon LaPook reports from San Juan where he spoke with patients and doctors.

From: http://www.cbsnews.com/videos/puerto-rico-facing-unparalleled-health-crisis-doctor-says/

Hunt for illegal opioids in the U.S. starts inside JFK airport

At a time when your mailman may be an unwitting drug dealer, the John F. Kennedy International Airport is also the front lines in the opioid crisis

From: http://www.cbsnews.com/news/opioid-crisis-illegal-shipments-from-china-jfk-airport-mail-room/

The hunt for illegal opioids at JFK airport

John F. Kennedy International Airport processes more than a million inbound packages every day. As fentanyl and other potent synthetic opioids pour into the U.S., it has also become the front lines in the opioid crisis. Tony Dokoupil reports.

From: http://www.cbsnews.com/videos/the-hunt-for-illegal-opioids-at-jfk-airport/

Worldwide, an estimated 25 million unsafe abortions occur each year

Worldwide, an estimated 25 million unsafe abortions occur each year

From: http://www.who.int/entity/mediacentre/news/releases/2017/unsafe-abortions-worldwide/en/index.html

Can Babies Help Heart Patients?

Umbilical cord stem cells could be a treatment for heart failure, small study suggests

From: http://www.webmd.com/heart-disease/heart-failure/news/20170927/can-babies-help-heart-patients?src=RSS_PUBLIC