pain medicine

Archive for Children and Teens

boyBy Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

Whether they travel 1,500 miles or drive fifteen minutes away, going off to college for an individual living with Type 1 diabetes (T1D) is a challenge. Therefore, it is important that students with T1D learn to self-manage the disease on their own.

As a college bound student, they may have limited opportunities to ask, “Hey Mom or Dad have you ordered my diabetes supplies and insulin?” However, the need to replenish these critical items are detrimental to managing the disease. In light of this, colleges around the country have made accessing resources easier for students living with chronic illnesses like diabetes through the school’s Office of Disability Services (ODS).

ODS’s policies call for reasonable accommodations to be made for students with documented disabilities on an individualized and flexible basis. It is the responsibility of the student to seek available assistance and to make their needs known.

To access these resources, the ODS may require a few things: a letter from the student’s physician with the Type 1 diagnosis, a letter stating that the parents or family are still allowed to participate in and have knowledge of the student’s current healthcare status, and a list of things the student will need to make self-care possible. Students living with diabetes should always be prepared to request support and assistance with managing campus activities. Here’s a quick list of items T1D students may need to make their college experience safer and better:

HOUSING

  • Students should request a room that has a refrigerator for snacks and insulin. Also, ask for housing close to the cafeteria and work with cafeteria staff to obtain nutritional information on the meals they serve.
  • Be sure to inform roommates, friends, and residential assistants that the student has Type 1 diabetes.  Educate them about the disease and garner their support as the student’s “survival team” to help them during highs and lows.

SPECIAL CLASSROOM ACCOMMODATIONS

  • Inform instructors and professors about the condition.They will need to know if the student must leave the classroom or if they are showing signs of blood glucose swings.
  • Consider asking for early registration for classes or breaks for self-care.
  • Inquire about attendance policy waivers to accommodate for high and low blood glucose episodes or diabetes-related illnesses. This includes being prepared to ask to reschedule exams because of hypo or hyper glycemic episodes.

MANAGING THE COLLEGE SCENE WITH T1D

  • Know and understand the symptoms for low blood glucose. These can include slurred speech, confusion, tiredness, shakiness, cold pale skin, cold sweats, blurred vision, headaches, nausea, nightmares, and many more symptoms.
  • Know how to treat these symptoms: be sure to carry at least 15 grams of a rapid acting glucose source.  Students will need to carry with them supplies to treat “lows” and keep a “low box” filled with goodies in a frequented place. Items in the box can include skittles, glucose tabs, glucose gel or icing, jellybeans, raw sugar, regular soda, juice, or even gummi bears. The box should also contain emergency glucagon.

LONG NIGHTS OF STUDYING OR PARTYING

  • Students should always know their numbers and carry all supplies with them to late-night study groups or parties.
  • If relying on external insulin delivery systems, always have a back-up insulin pen or vial.  When using a continuous glucose monitor (CGM) always be prepared to check numbers with test strips and monitor if the value does not seem appropriate.
  • When partying, remember, drinking alcohol has effects on blood glucose values and alcohol is processed differently in everyone’s body.  In one evening, a T1D student could go high, go low, or stay low and pass out, not from drunkenness but due to hypoglycemia.
  • Always eat something before drinking and be sure to let friends and roommates know about the disease and ensure they understand that hypoglycemia may have the symptoms of drunkenness. Be aware that hypoglycemia could happen several hours after ingestion of alcohol.

Although self-managing on their own may sound daunting, everyday across the country students with T1D are on college campuses living and loving their post-high school years. To learn more about your college’s Office of Disability Services, please inquire about ways to contact them via the school’s website or admission’s office.

Comments (0)
Sep
08

Obesity in Children

Posted by: | Comments (0)

By Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

obesity graphic

Childhood obesity affects all groups of children in today’s America and in 2019 the United States is experiencing an epidemic of this condition.

The Centers for Disease Control and Prevention (CDC) reports in data from 2015 -2016 that the rate of childhood obesity has more than tripled since the 1970’s with as many as one in five (1 in 5) children aged six through nineteen (6-19) who suffer from this condition. CDC statistics have children from two through five years old experiencing a 10.4 % (percent) rate of obesity. Children between the ages of six to eleven (6 -11) fare worse with an obesity rate of 15.3% (percent). These rates are based on growth charts that measure height and weight by age and gender.

Obesity in children is defined as a case in which BMI (Body Mass Index) exceeds the recommended level for age and height. Obesity has previously been defined as a state of malnutrition. Over nutrition with excess caloric intake but lack of necessary nutrients is still a form of poor nutrition.

Developing obesity in childhood can be influenced by factors of lack of economic resources, lack of physical activity, social conditions (lack of access to food, unsafe neighborhoods) mental health status and genetics.

Research suggests that childhood obesity can be a precursor to chronic adult health conditions, such as hypertension, dyslipidemia (i.e. high cholesterol, high LDL and high triglycerides) cardiovascular disease and Type 2 diabetes.

Families may create an aggregate of risk factors that predispose the children to obesity by the choice of high fat, high caloric foods and the lack of physical activity or exercise. For children in most stages of growth it may be more important to encourage more physical activity than caloric restriction.

The keys to less childhood obesity may be found in an increase in physical activity, the limitation of less healthy high fat, high sugar, high sodium foods and the choice of higher nutrient density and lower in calorie and fat foods.

Apr
10

A Boy and His Dog

Posted by: | Comments Comments Off

casey

For the past ten months, eight-year-old Casey has had a new four-legged playmate and cuddle buddy named Beamer. Beamer isn’t a small dog by any means, but Casey’s mom, Courtney, doesn’t have any complaints. After all, Beamer is more than just her son’s best friend, he is a diabetes alert dog with the mission to help Casey stay healthy.

Casey has Type 1 diabetes, a chronic illness caused by the body’s inability to produce insulin. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. People living with the disease must maintain stable blood sugar levels to avoid low (hypoglycemia) or high (hyperglycemia) blood sugar events before they become dangerous. People living with diabetes depend on insulin therapy and other treatments to manage their condition.

Raising a child with diabetes can be challenging, to say the least. However, Casey’s family sought new ways to help manage the condition. His mom reached out to a company that trains and supplies service dogs to patients in need. Despite the costly $25,000 price tag, the family set out on a mission to purchase a service dog for Casey. They began a recycling drive by collecting cans and bottles from their community. For an entire summer, Casey hand delivered the recyclables collected and cashed them in himself. As word got out about their story, supporters started making donations. In the end, as a result of the family’s hard work and the community’s backing, they were able to make the full payment.

Beamer, their Labrador Retriever, joined the family the following May, and that’s when the fun really started. The company that provided Casey with Beamer, organized a trip to Disney for patients and their service animals. This trip helped with the adjustment phase of transitioning Beamer in to the family, which can sometimes be tough, but nothing bonds a pair like sharing a seat on the tea-cup ride at one of the most beloved theme parks in the world. Beamer joined Casey and their new friends on “the best Disney trip ever.”

Companionship is only one benefit of having a diabetes alert dog. Courtney shares that Beamer’s presence can indeed be comforting during late nights when she checks Casey’s blood sugar. Beamer’s real skill lies in noticing Casey’s lows and highs, especially during times when they are not expecting his levels to be imbalanced. Such a fail-safe can be a huge blessing to the minds and hearts of parents raising children with diabetes.

As for her advice to parents considering alert dogs for their own children, Courtney says that service dogs are a wonderful addition to the family, but they can also mean a lot of extra work. It’s important to make sure the child is on board with the extra tasks that come along with their new companion and helper.

Is a diabetes alert dog the right fit for your family? Talk to your physician and your child and spend the necessary time processing the decision. Service animals aren’t for everyone, but those willing to put in the time and work required will find themselves with an amazing new member of the family.

Comments Comments Off
Oct
06

Alert: Nasal sprays, FluMist out this year

Posted by: | Comments Comments Off

Nasal sprays used in the past to prevent the spread of influenza should not be an option for the 2016-17 flu season.  The U.S. Centers for Disease Control and Prevention is only recommending the use of injectable influenza vaccines this year.

The category of injectable vaccines includes inactivated influenza vaccines and recombinant influenza vaccines. The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017.

The nasal spray version of the flu vaccine was very popular with parents and pediatricians because many children are afraid of needles. This year, however, the nation’s leading pediatrics group is leaning to the side of caution.

In a policy statement recently released by the American Academy of Pediatrics, the group recommended children over six months old receive the flu shot rather than the FluMist vaccine, which federal health officials have recently discovered was not effective in preventing the flu during the past three seasons. About a third of children who are vaccinated against the flu each year receive FluMist.

Everyone 6 months and older should get a yearly flu vaccine by the end of October, if possible, but getting vaccinated later is OK. Vaccination should continue throughout the flu season, even in January or later. Some children who have received flu vaccine previously and children who have only received one dose in their lifetime, may need two doses of flu vaccine. A health care provider can advise on how many doses a child should get.

The diabetes educators at Diabetes Management & Supplies can help educate and prepare individuals for the challenges of diabetes. For more information on the DMS diabetes education services, call our Education Department at 1-888-738-7929 or email education@diabetesms.com.

Comments Comments Off
Apr
06

Glucose control key in avoiding kidney damage

Posted by: | Comments Comments Off

Good blood sugar control today will reduce the risk of damage to kidneys and other organs tomorrow.

kidney_chartThe kidneys filter waste products from your blood and keep fluids in your body balanced. Having diabetes puts you at a greater risk for developing kidney disease also called diabetic nephropathy. This complication is also called diabetic kidney disease. It is a progressive kidney disease caused by damage to the tiny blood vessels in the kidneys that are used to filter waste from the blood.

High blood glucose, sometimes paired with high blood pressure, slowly damages the kidneys. High blood sugar makes the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine.

People living with type 1 and type 2 diabetes can experience kidney complications. Chronic hyperglycemia, excess blood sugar, is the primary cause of the disease. In type 1 diabetes, hyperglycemia starts in the first decades of life and is usually the only recognized cause of nephropathy. With type 2 diabetes, to the contrary, hyperglycemia starts near middle-age, usually when the kidneys have already suffered the long‐term consequences of aging and of other recognized promoters of chronic renal injury such as arterial hypertension, obesity, high cholesterol, and smoking.

Early detection of kidney damage is important, but there might not be noticeable symptoms in the early stages. It’s important to have regular urine tests to find kidney damage early because early kidney damage might be reversed.

Later in the progression, swelling in your body is a primary symptom. The feet and legs are key areas where swelling will be seen as kidneys become damaged.

Keeping blood sugar as close to normal as possible is the first step to preventing kidney disease. Control your blood pressure by checking it on a regular basis and following your doctor’s recommendations for acceptable levels. Finally, don’t use tobacco because it narrows your blood vessels including the already tiny ones working deep inside your kidneys.

Educating individuals on best ways to avoid this and other diabetes complications is a goal of self-management courses. If you need help developing a strategy to avoid complications or face other challenges, Diabetes Management & Supplies can assist with diabetes self-management and education services. For more information, call our Education Department at 1-888-738-7929 or email education@diabetesms.com.

Mar
10

Later flu season shines light on sick-day prep

Posted by: | Comments Comments Off

sickday_supplies

flu-seasonAlthough the calendar says the influenza season should be over, cases of the flu are increasing into March 2016 instead of winding down to a close. Avoiding illness is a prime goal, but people living with diabetes should be aware of the special needs presented by sick days caused by the flu and other conditions.

The blood sugar targets for a sick day are the same as other days. A blood sugar reading over 180 mg/Dl is still a high blood sugar. The purpose of a sick day management plan and more vigilant testing has to do with limiting hyperglycemia and dehydration. The goals are to prevent DKA in the Type 1, avoid dehydration of the Type 2 individual and avoid potential hospitalizations for either individual.

A sick day plan should include these elements of good blood sugar control.  Monitoring, meals and medications are key while exercise or physical activity is usually halted during the illness.

The sick individual needs to follow a schedule for monitoring that gives the diabetes care team information to direct the modifications for the patient’s needs. Meals and eating will play an important role as medication will need to be adjusted to match rising or falling blood sugar levels. Medications are to be taken on the usual schedule or may be modified to meet the patient’s needs by the doctor or a member of the healthcare team.

Recording temperature, blood sugar, medication amount and time, fluid and food intake and the presence of ketones are highly important on sick days. This log or report will give insight to the diabetes care team of current health status and allow them to help adjust medication or intake to prevent dehydration or ketoacidosis.

The individual with diabetes or the parent/ care giver of the child with diabetes should be proactive in assessing conditions during an illness. Certain foods, testing equipment and testing supplies need to be handy before a sickness occurs.  The phone number of the doctor or diabetes care team should be readily available.

A log to monitor the sickness over time, glucose meter, lancets, lancing device, test strips, control solution, and a bottle of Ketostix should be included in a sick day management tool kit. The food pantry should contain: broth, both sugar-free and regular Jello, both diet and non-diet soft drinks, both sugar-free and regular popsicles, both thin and creamy soups, regular and sugar free pudding, yogurt, juice and milk.

The U.S. Centers for Disease Control (CDC) reports that across the country, this flu season was significantly less severe than in the last few years, though number of cases have been increasing since early January.

Did you know the CDC tracks the flu like a hurricane? Visit CDC Flu Central for current reports, maps and alerts.

Comments Comments Off
Nov
02

Diabetes: A proactive, informed approach

Posted by: | Comments Comments Off

Diabetes Wordcloud Glowing
This month (November) is Diabetes Awareness Month, a time set aside to education and inspire those living with a form of diabetes and those who can take steps to reduce their risk of the preventable conditions associated with diabetes.

Diabetes is not a single disease. It is group of similar conditions that fall into the same category because the symptoms and effects on the body may be similar. The most common types of diabetes in our presence society are Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes. Understanding what they have in common, how they differ and the associated risk factors is crucial to raising awareness and encouraging prevention, when possible.

insulin-pump-for-childrenType 1 Diabetes accounts for only 5 – 10 percent of all cases, and used to be called juvenile diabetes. Three-quarters of people who develop type 1 are under the age of 18, and most others are under 40 years old, but older adults develop it as well.

The cause of Type 1 Diabetes is unknown. Most experts believe it is an autoimmune disorder, which is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. With Type 1 Diabetes, an infection or some other trigger causes the body to destroy the cells in the pancreas that make insulin.

This condition can be passed down through families. In fact, in most cases of Type 1 Diabetes, people inherit risk factors from both parents. Such factors appear to be more common in whites, who have the highest rate of type 1 diabetes.

The pathway to developing Type 1 Diabetes can take years. In studies that followed relatives of people with Type 1 Diabetes, researchers found that relatives who later developed diabetes had certain auto-antibodies in their blood for years.

bigstock-Progress-In-Glucose-Level-Bloo-2485554Type 2 Diabetes is the most common form of diabetes, accounting for 90 – 95 percent of all cases. It used to be called adult-onset diabetes, but, unfortunately, both children and adults develop this kind of diabetes. Many people think of it as the kind of diabetes that does not require insulin. However, about half of people with type 2 diabetes will eventually need insulin. This is because the pancreas produces less and less insulin over time, so it must be injected to meet the body’s needs.

The causes of Type 2 Diabetes are not completely understood, but it almost always starts with insulin resistance. So what contributes to this insulin resistance? Here are some of the most common risk factors:

  • Family history of diabetes
  • Growing older – your risk increases as you age
  • History of gestational diabetes
  • Lack of exercise
  • Member of a high-risk ethnic group, such as:
    • African American
    • Asian American or Pacific Islander
    • Hispanic American
    • Native American
    • Overweight or obese

Gestational Diabetes is diabetes that develops while you are pregnant. Gestational diabetes is still diabetes, which means your blood sugar levels are abnormally high. That excess sugar crosses the placenta and can make your baby grow too large and lead to problems with your pregnancy and delivery.

The causes of Gestational Diabetes have not been determined, but the many hormonal changes during pregnancy contribute to what is called insulin resistance – which is your body not using the insulin that your pancreas produces.

For more on these forms of diabetes, visit the Diabetes Management & Supplies Learning Center.

Aug
27

Planning key when school, diabetes mix

Posted by: | Comments Comments Off

medicalchecklist_lr

Attending school or getting a child with diabetes ready for school presents an added challenge. School supplies and pencils and pens are joined by diabetes testing supplies, needles or insulin pens. Proper planning and measures, however, can counter the anxiety and stress.

A parent of a child with diabetes should first contact the school and connect with the school nurse. A health plan specific to the child should be carefully crafted with providers or a diabetes care team. The child must be properly educated to safely attend school and the school must be prepared and educated on the exact needs of any child living with diabetes.

The Joslin Diabetes Center makes some basic points to cover with school and diabetes mix:

  • Know the school’s policies
  • Create a plan specific for each person
  • Provide the school with a container of supplies
  • Investigate the cafeteria and menu plans
  • Select a means for disposal of sharps
  • Have a plan for field trips and special events

Students who qualify for services under the Individuals with Disabilities in Education Act (IDEA), should have an Individualized Education Program (IEP). This is the document that sets out what the school is going to do to meet the child’s individual educational needs. There are a lot of specific rules about developing an IEP, reviewing it, and what it must contain. Because IEPs are so detailed and have specific requirements, school districts often use their own form. Although students with diabetes who qualify for services under IDEA are also covered by Section 504, there is no need to write two separate plans. Diabetes provisions should be included in the IEP.

The term “504 Plan” refers to a plan developed to meet the requirements of a federal law that prohibits discrimination against people with disabilities, Section 504 of the Rehabilitation Act of 1973 (commonly referred to as “Section 504”).

A 504 Plan sets out the actions the school will take to make sure the student with diabetes is medically safe, has the same access to education as other children, and is treated fairly. It is a tool that can be used to make sure that students, parents/guardians, and school staff understand their responsibilities and to minimize misunderstandings.

The American Diabetes Association recommends that every student with diabetes have a Section 504 Plan or other written accommodations plan in place.

Students leaving for college should also take steps to prepare for the new demands of college life and the continued health needs of living with diabetes.

For more, visit: Back to School with Diabetes | The Basics or Written Care Plans for School

Aug
14

Cloud-assisted blood sugar monitoring near

Posted by: | Comments Comments Off

dxcm3_large

cgm_googleThe future of glucose monitoring seemed very promising after a recent announcement that Dexcom, a leader in Continuous Glucose Monitoring (CGM), announced plans to partner with Google to provide the next generation of monitoring technology that will involve smaller sensors and data stored “in the cloud” for instant archiving and record-keeping.

Dexcom will work with the new Google Life Sciences company to make bandage-thin CGM devices. Google Life Sciences, a part of the parent company Alphabet, is one of the companies created in a recent Google corporate reshuffling.

CGM devices give glucose readings continuously through the day. This helps people with diabetes track their blood sugar levels in more effectively. Blood sugar monitors use finger sticks for each reading, but CGM can provide up to 288 glucose readings a day. Most CGM users have type 1 diabetes, but some patients with type 2 diabetes who are insulin-dependent also use CGM.

Diabetes Management & Supplies is a certified distributor of Continuous Glucose Monitoring devices and a provider of diabetes education and insulin pump training. For more information on CGM, insulin delivery or training needs, call our Education Department at 1-888-738-7929.

For more on this CGM advancement, see:

Jun
29

Jockey with diabetes shares winners circle path

Posted by: | Comments Comments Off

chris_camp
chris_cardfrontChris Rosier is well on his mission of bringing hope and becoming a positive role model to children living with type 1 diabetes. Rosier, the Diabetes Management & Supplies spokesman, was invited to be a guest speaker at the annual Arizona American Diabetes Association’s Camp (AZDA) held at Friendly Pines.

Rosier and the campers discussed different types of pumps, testing strips, and more seriously, the struggles and stigma that follow this disease. “I don’t remember my life without diabetes,” said 14-year-old Ginger Netten of Scottsdale.

Rosier, 34, was in his mid-20s before he was diagnosed. “I went blind for a week,” Rosier said. “You want to make a grown man cry. Take away his sight.”

Learn more about Chris by visiting the DMS blog: Jockey set to motivate youth with diabetes.

Full article from the Daily Courier (AZ): Diabetes does not have to hold you back.

Comments Comments Off

Ordering Supplies and Equipment

A diabetes treatment plan is very important. Make sure you know how things should work. Carefully following any medication orders and instructions is vital to your plan's success. Make sure you don't run out of supplies just as you refill prescriptions so you don't run out of medication.

Here are some ways you can let us help you reorder supplies:

At Diabetes Management & Supplies, we value the part we play on your treatment plan team and realize that winning is promoting good health.