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 Prevent Retinopathy With A Night-Light?One complication of diabetes is diabetic retinopathy where high blood sugar leads to changes in blood flow and overgrowth of abnormal blood vessels in the retina or back of the eye. This condition can lead to blindness if it progresses too far. A new study suggests that leaving a light on during sleep may be one way to lower the risk of retinopathy. The study was conducted by researchers at Cardiff University in Wales. Their study group included seven adults with Type 2 diabetes who did not have retinopathy, and eight adults without diabetes. The researchers found that total darkness caused decreased activity in tissues near the surface of the retina in those with diabetes, but that this change was not observed in those without diabetes. Exposure to oxygen or a night-light appeared to reverse the abnormal changes. According to the researchers, if their findings are correct, a night-time light may help in preventing the onset of retinopathy. Their findings have been published in The Lancet (volume 359; pages 2251-2253; June 29, 2002). However, they warn that this research is very preliminary and will need more research before people with Type 2 diabetes decide to start sleeping with their lights on to prevent retinopathy. Light may have other unwanted effects, such as decreased REM sleep. Already-known ways to prevent retinopathy include carefully managing diabetes for better control of blood sugar levels.
Healthcare Lacking For Latino KidsAlthough Latino children now represent 16% of the population under the age of 18, researchers have found that these children are not receiving adequate health care. The task force that is looking into Latino children's health issues includes thirteen experts from The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research (CCHR). They have found that Latino children are more likely to have depression and anxiety, more likely to be hospitalized or die from injuries, 13 times more likely than whites to be infected with tuberculosis, and more likely to have dental problems. Latino children are also more overweight than children of other groups, and therefore have a higher risk of developing Type 2 diabetes. The panel is calling for more research into Latino children's health, as well as more involvement of Latino health personnel. They believe that doctors need to have awareness of the Latino culture in order to more effectively serve this population's health needs, so that patients will follow through with treatment recommendations. The panel's findings and recommendations can be found in the most recent issue of the Journal of the American Medical Association (volume 288; number 1; pages 82-90; July 3, 2002).
Poor Treatment Of Obese ChildrenChildren who are obese are at risk for a variety of health problems, including Type 2 diabetes and heart problems. However, research again confirms that few of these children are getting the medical treatment they need in order to prevent these chronic health problems. According to a survey of pediatricians across the nation that was administered by the Maternal and Child Health Bureau in 1999, many doctors aren't properly treating children who are obese. Although most of the survey respondents agreed that obesity in children is a serious medical issue, over a third of pediatricians and nurses and about half of dietitians said they didn't initiate preventative treatment in overweight children who did not have obesity-related medical problems. Also, most respondents said they would not initiate treatment in obese children who did not want to control their weight. The researchers, who have published the results of the survey in a supplement to the journal Pediatrics (volume 110, 1 Pt 2, pages 236-8, July 2002), say that these findings point to a need for behavior management education and training so that doctors can help kids lose weight. Other issues that need to be addressed are those of patient motivation and how to handle insurance and parental involvement.
Government Encourages Active KidsTo counteract the increasingly sedentary lifestyle of today's children, the Centers for Disease Control and Prevention has begun a new ad campaign to encourage children to participate in outdoor activities. Their target is to increase outdoor activity for children to the Federal recommendations of 60 minutes of a day (30 minutes a day for adults). Congress has provided $125 million to fund the first year of the ad campaign, and $68.5 million for the second year. Television commercials began airing in June, with the message, "VERB. It's what you do." The campaign is aimed at nine- to thirteen-year-olds, and commercials will air on networks like Nickelodeon and MTV. The campaign will also include school physical education and community events, as well as Nickelodeon's summer show tours. All of these efforts tie into the Bush administration's focus on increasing physical activity nationwide. It is hoped that the campaign will be more effective than previous efforts, such as the "Just say no" campaign. How the effectiveness of the campaign will be measured was unclear, but the rapidly diminishing budget does not appear to give the campaign any legs.
Type 2 TipsA new study shows that people with Type 2 diabetes are not generally following standard guidelines for diet and exercise that are necessary for good health. Doctors from the Puget Sound Health Care System in Seattle, Washington recently analyzed health information from 1,480 adults with Type 2 diabetes who participated in the Third National Health and Nutrition Examination Survey. About one third of the participants did not exercise regularly, especially people who were lower-income, older, or without a high school diploma. Over 60% of the participants ate fewer than five servings of fruits and vegetables per day, while 70% said that daily calories coming from fat was above the recommended 30% of total calories. The doctors believe these results show that people with diabetes need to consult their doctors about what is required, as well as undertake positive changes in their diets and exercise routines. They hope that by so doing, people with Type 2 will improve their overall health. The researchers presented these findings at June's annual meeting of the American Diabetes Association (Diabetes, June 2002, vol 51, suppl 2, abstract 149-OR).
Diabetes Treatment Plan In UKIn the United Kingdom, the National Service Framework (NSF) is a treatment plan that is intended to manage blood sugar, cholesterol, and blood pressure levels in people with diabetes. However, some doctors fear that the guidelines are too strict to be practical. Doctors at Queen Elizabeth II Hospital in Hertfordshire, England have recently published information in the British Medical Journal (volume 324; pages 1577-1580; June 29, 2002) that question the feasibility of the NSF. They say that the targets for lowering blood sugar, cholesterol, and blood pressure have only been met in only 50-70% of those who participate in research studies. They believe that people who are not involved in a research study would have an even harder time meeting the NSF goals. The doctors fear that people will be over-medicated in order to reach the goals of the plan, taking many different drugs to address all the different problem areas associated with diabetes. Authors of the NSF state that the plan is designed to empower people with diabetes to make their own choices about their treatment and to encourage them to become more informed about their healthcare. While these British reseachers may have reason to be frustrated, it seems to us that providing less healthy targets for people with diabetes will only have the obvious result: a less healthy diabetes population. We suggest rather than loosening health targets, that consistent and clear goals continue to be provided to physicians and the population at large. If there are health or economic problems that result from excess use of medications, this should be clearly stated. Changing the lifestyles that contribute to chronic disease and health costs will not occur overnight. Setting lower health goals would not appear to aid this process.
Breast-Feeding Campaign To BeginThe U.S. Department of Health and Human Services Office of Women's Health has contracted the advertising company McKinney + Silver to manage a three-year campaign to create breast-feeding awareness. Currently, only 29% of American mothers choose to breastfeed their babies. The goal of the Office of Women's Health is to increase this percentage to 75% by the year 2010, as breast feeding has been connected with lower rates of diabetes and cancer for mothers and multiple health benefits, including increased brain development, in their babies.
New Chief Of CDCThe Centers for Disease Control and Prevention (CDC) has a new director, Julie Gerberding. She is the first woman to head the CDC. Gerberding is a specialist in infectious disease, and was instrumental in investigating the anthrax attacks of last fall. Aside from bioterrorism, the CDC conducts research and develops policies on many public health issues, including AIDS, diabetes, and smoking.
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