Higher BMI Associated With Reduced Costs, Better Health For Diabetics

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diabeteswordIt’s a paradox: Diabetics with above-normal weight use health care less and report overall better physical health than their diabetic counterparts with normal weight, according to two new studies from UC Davis Health System. The authors suggest that the extra weight isn’t protecting diabetics as commonly assumed, but that normal-weight people with diabetes are afflicted with a more severe form of the disease.

Prior studies found that diabetics with normal BMIs have a higher mortality risk than those who are overweight or obese.

“The mortality paradox led to the ‘protection explanation’ that seems unlikely to be true because we didn’t see any beneficial effects of excess weight in people who did not have diabetes,” said Anthony Jerant, professor of family and community medicine at UC Davis and lead author of the studies. “The possibility that there is more than one form of type 2 diabetes is supported by basic science studies showing physiological differences in leaner people with diabetes.”

For their research, Jerant and his colleagues evaluated data on about 120,000 patients in the 2000-2011 Medical Expenditures Panel Surveys (MEPS), an annual assessment from the U.S. Department of Health and Human Services on health status, medical services and health care costs among a representative sample of U.S. civilians.

Characterized by unstable blood sugar levels, diabetes is currently diagnosed as type 1, an unpreventable form typically diagnosed in children or young adults, or type 2, which mostly affects adults and is linked with unhealthy lifestyles. Because the vast majority — about 90 percent — of the nearly 30 million diabetics in the U.S. have type 2, the study results are most applicable to type 2 diabetes.

In a study published online March 20 in the journal Medical Care, the UC Davis team compared health care expenditures, hospitalizations and emergency department visits for those with and without diabetes and in relation to their BMIs (normal, overweight or obese), a standard measure of weight adjusted for height. For all three study criteria, health care utilization was significantly higher in normal weight than in heavier diabetic persons, differences that were not observed in those who did not have diabetes.

In another study published online April 27 in the journal Nutrition & Diabetes, the researchers evaluated results of self-reported physical and mental health status for patients with and without diabetes. Overall, those with diabetes had worse physical and mental health status than non-diabetic persons. Among just those with diabetes, physical health status was better for those who were either overweight or obese as compared to those who had normal weight, and most optimal for those who were overweight.

Jerant believes the new findings provide evidence that it’s time to quit thinking that leaner type 2 diabetics are at lower risk for bad outcomes from the disease than their heavier counterparts.

“Researchers should be looking at genetic and metabolic factors that define type 2 diabetes for those with different weights,” said Jerant. “Teasing out those factors could eventually enable us to develop and test diabetes management plans that address those differences.”

Jerant’s co-authors were Peter Franks and Klea Bertakis, professors of family and community medicine at UC Davis. They received no external funding for their research.

“Body Mass Index and Health Care Utilization in Diabetic and Nondiabetic Individuals” is available at http://journals.lww.com/lww-medicalcare/Abstract/publishahead/Body_Mass_Index_and_Health_Care_Utilization_in.99062.aspx.

“Body Mass Index and Health Status in Diabetic and Nondiabetic Individuals” is available at http://www.nature.com/nutd/journal/v5/n4/full/nutd20152a.html

For more information about UC Davis Health System and its Department of Family and Community Medicine, visit http://healthsystem.ucdavis.edu.

Keeping Your Children And Family Health High And Costs Low

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By James Helliwell

familytvFast food restaurants, burgers, and video games are taking precedence over home cooked meals, vegetables, and outdoor play time for kids of all ages. Instead of playing cricket and chasing after runaway footballs, kids are glued to video games and munching on junk food. With a rise in obesity comes a rise in children’s diabetes as well as other health issues. This also has a financial impact with freedom and free charge activities of playing out, playing sport in the park and building rope swings being replaced by the expensive screens and great value healthy lunches being replaced with the local expensive fast food joint. Our little children are experiencing an epidemic that never should have occurred. So, in what ways can we encourage our children to keep active and eat the leafy greens and engage in the activities that they need to grow strong and healthy?

Here are a few great ideas for both you and your children to try!

Encourage Outdoor Activities:

The more you’re outside, enjoying the fresh air and drinking in the warm rays of the sun, the better chance both you and your children have at staying healthy. Worldwide we are losing this natural connection to the outdoors and nature Keeping active and staying in motion not only keeps the extra pounds off you and your children’s frames, but it also helps to keep your system running the way it should.

Encourage your children to play at least one to two hours a day outside. If at all possible, go outside with them, throw the ball around, build a fort, or let them help you wash your car. Any outdoor activities done together as a family will not only make it fun, but will keep all of you active.

You could also enroll your children in extracurricular activities, such as sports like hockey, cricket, football, or even golf. There is no shortage in fun and active sports, so finding something your children like and enjoy should be easy.

Healthy Eating is Cost Effective:

Whether or not you realise it, children follow the large footsteps of mum and dad. When you eat healthy, your children eat healthy, so make sure to load their dinner plates, as well as yours, with lots of veggies, good meats like lamb chops or mincemeat, and healthy sides. Make their breakfasts as filling and nutritious as possible, like porridge or granola If you pack your children’s lunches for school, fill their boxes with a healthy sandwich and a piece of fruit. Keeping your children interested on healthy food is a great way to make sure they are getting what they need and help keep your costs lower and healthy home mad food is always much better value.

Visit Your Doctor Regularly:

Make sure your little ones visit their pediatrician regularly to ensure that they’re not only growing properly, but that they receive the help, shots, and nutritional advice they need. An excellent pediatrician will not only help to give you tips and advice on healthy living for your children, but a good doctor and an excellent insurance will help to keep your children as healthy as possible. By covering your children with a high quality health insurance, you can rest easy knowing that your children will and can be seen by the best Doctors around. Finding a quality health insurance will help cover most of your doctor visits and medical expenses. If your child has diabetes, having insurance will help to cover the costs that come with the disease.

Make sure you have the right health insurance:

familywalkIn some countries people have access to medical services that are free (or cheap) at point of access. However, even people going between European Economic Area countries and who hold an EHIC card are only entitled to the service a national of that country gets – so it doesn’t replace insurance. In most countries, such as the US, an adequate level of health insurance in crucial, otherwise you could end up with very large bills or even not be able to be treated. There are even stories of people being turned away from some countries for not being insured.

Travelling abroad to live will usually mean making sure that you have international health insurance to keep you covered for unexpected medical treatment or illness. For an idea of how much costs can vary for the uninsured, this recent infographic shows the often very high costs of operations worldwide. So make sure you are covered as this is a cost you never want to incur it great for your peace of mind to know your family and children are covered.

Eldercare Navigator Advocates That Preventing Home Falls Reduces ER Visits And Healthcare Costs

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By Mardy Chizek, RN, FNP, BSN, MBA, AAS

seniors2Eldercare Navigator Advocates that Preventing Home Falls Reduces ER Visits and Healthcare Costs

The Journal of the American Geriatrics Society found that falls among the elderly are common, with as many as 40% of people age 65 and older falling each year, often resulting in hip fractures or concussions. An estimated 25%-75% of those who are independent before a hip fracture can neither walk independently nor achieve their previous level of independent living within one year following their fracture. Most alarming is that between 18%-33% of older hip fracture patients die within 1 year of their fracture.

The Centers for Disease Control and Prevention estimates that in 2000, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion. The financial toll for older adult falls is expected to increase as the population ages, and may reach $54.9 billion by 2020 (adjusted to 2007 dollars).

“Aging is not an automatic cause for falls in the home. Falls among seniors are usually associated with dizziness and balance problems attributed to lack of exercise, medications, failing eyesight, Vitamin D deficiency and hazards in the home,” says Mardy Chizek, an RN and an Eldercare Navigator with Charism Eldercare Service in Westmont, Illinois..

Following are the five most common steps to take to prevent at-home falls:

1. Using medication incorrectly may lead to dizziness, so be especially aware of medication changes and talk with your doctor about symptoms.

2. More than 75 percent of people suffering with dizziness/vertigo have an inner ear (vestibular) disorder which can be corrected without medication.

3. Have your eyes checked by an eye doctor. You may be wearing the wrong glasses or have a condition such as glaucoma or cataracts that limits your vision. Poor vision can increase your chances of falling.

seniorcoupleexercisesmall4. Exercise is one of the most important ways to reduce your chances of falling. It makes you stronger and helps you feel better. While all exercise is not equal where balance is concerned, exercise makes you stronger and helps you feel better. Challenge your balance by walking around the house or yard barefooted, or even learn Tai-Chi.

5. To make your home safer, remove obstacles that may cause falls (cords, non-anchored rugs, etc.), use grab bars in the bathroom, improve lighting, and wear shoes with good support and non-slip soles.

“I’m often called into a home to conduct a falls assessment so I can eliminate barriers that may contribute to a fall. I also work with seniors and family caregivers to teach them proper techniques for improving balance and preventing falls,” adds Chizek.

– For more information on making informed decisions about dementia care, visit Mardy Chizek and Charism Elder Care Services on-line at www.charism.net.