Patients struggle to get the tests from their local surgery, report shows

Caroline White

Thursday, 06 April 2017

One in four people had either experienced restrictions, or were refused test strips on the NHS compared to one in five people four years ago, finds a report* issued today by the charity Diabetes UK.

The report draws on a UK wide online survey about restrictions to prescribing of test strips and meters, which ran from March to May last year, and generated 1,248 responses.

It shows that more than half (52%) of people experiencing problems getting test strips had type 1 diabetes.

This is of particular concern as the National Institute for Health and Care Excellence (NICE) recommends all adults with type 1 should routinely self-monitor blood glucose levels, testing at least four times a day, says Diabetes UK.

These short-sighted cost savings cause people real anguish and potential financial distress. It also means people are struggling to manage their diabetes which can lead to serious consequences for their health, so we urge people to challenge restrictions and refusals, commented Diabetes UK Policy Manager Nikki Joule.

As well as being vital for people with type 1 diabetes, anyone with type 2 diabetes can benefit from testing so should be supported to do so if it is helping them to better manage their condition, she added.

She suggested that local policies should allow sufficient choice and flexibility for individual circumstances to be taken into account when prescribing test strips and meters for people with either type of diabetes.

The charity has updated its advocacy pack, on how patients can challenge GPs and nurses when faced with test strip restrictions or refusals.

Dr Stephen Lawrence, clinical lead for diabetes for the Royal College of GPs, insisted that as highly trained and skilled professionals GPs would always make the best decision for every patient.

But at the same time, 24 million of the scarce NHS budget is spent on diabetes care every day and it would be irresponsible not to make the most appropriate use of limited resources, he said.

The benefits of self-monitoring blood glucose levels in patients with type 2 diabetes were unclear, and the latest guidance from NICE specifies that most patients do not need to self-test, he pointed out.

Therefore it would be inappropriate to issue self-test strips as a one size fits all, especially when advances in medical treatment and technology are constantly emerging, particularly with newer forms of oral medications that do not cause hypoglycaemia, he said.

He cited a GP initiative in Tower Hamlets which dramatically cut inappropriate use of blood glucose self-monitoring kits among patients with type 2 diabetes without negatively affecting their health.

If thiswas applied nationally, it is estimated that we could safely and responsibly prevent unnecessary testing in 340,000 people, as well as saving 21.8 million of the NHS budget, he said.

Instead, GPs will perform HbA1c tests at set points throughout the year to measure their patients blood glucose level and once these levels have stabilised, the monitoring frequency will be reduced and GPs will then usually offer diet and lifestyle advice to help patients maintain this safe level.

He accepted that people with type 1 diabetes needed to self-monitor to ensure good control of blood glucose levels and help avoid hypoglycaemic episodes. But the frequency of such monitoring will depend on the patients individual circumstances and testing should never be done for the sake of it, he insisted.

* Testing times: restrictions accessing test strips and meters for people with diabetes. Diabetes UK, April 2017.

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GPs increasingly reluctant to give out diabetes test strips, says charity - OnMedica

The last few weeks, I have been noticing the bulge. My shirts dont fit well anymore and I have really been thinking about cutting back on the food and being more active.

The problem, I love food. Just like most people that have weight issues, I cannot say no to food. The last few weeks, I have told myself nearly every day that I need to start thinking about losing weight. Then, I remember that I have a raspberry cream cheese pie in the fridge.

This pie is pretty amazing. It has a graham cracker crust, a gooey cream cheese center and a raspberry gelatin top. To top it all off, it is covered with whipped cream. Steph doesnt like anything that tastes like raspberry, so this pie has been all mine. Ive been quickly devouring it every night before bed.

There are specific foods in my life that bring me over to the dark side. Simple things like desserts with raspberry, macaroni and cheese and Dr. Pepper. I am currently kicking the Dr. Pepper, but everything else has been fair game.

All of these temptations are what makes dieting suck. The worst part about it, it seems like everyone else is trying to foil your plans. When I was in college, I was holding pretty strong on my diet for about four months. One weekend when I came home, I actually had to argue with family so I didnt have to eat a piece of banana bread.

I have to admit, it was really hard to do.

I also hate all of the vegetables you have to eat, all of the workouts and all of the preparation it requires.

Behind all of these excuses is stress. I have a little birdy telling me that my life is already too stressful to add all of these new things on top of it. On top of that, I eat whenever I am stressed. In my mind, I think I deserve this piece of pie at the end of the day for what I have went through.

Ive begun to wonder if the stress in our lives is why diets dont work. Instead of dealing with what is stressing me out, I decide to pull out that pie, grab a blanket and watch one of my favorite TV shows.

When I look back on my life and I actually handled my stress, that is when I lost the weight. That is when I actually was able to focus on myself instead of focusing on what will numb my mind from everything going on in my life.

Now, lets face it, stress is a hard thing to get rid of. That is why I am encouraging you, and myself, to work slowly at this. Dont just think you are going to get rid of it all right away. We as Americans are naturally stressed out because that is who we are.

You need to make a goal right now that will de-stress your life. One of the things that stresses me out is paperwork and filing things. I hate when it sits out, but I also hate when I have to file it. So, this week I am going to make a plan and get rid of the paperwork, while also making filing easier.

I dont know what I will do next, but whatever it is will be a baby step towards less stress.

I dont know about you, but I am tired of dieting. What I really want to do is work on de-stressing my life, because that is what is going to get my mind ready to devote time to making real changes in my eating habits. Maybe then I will have the will power to go out for a walk or eat on-the-go less.

I can tell you one thing, right now I am just too stressed to even think about it.

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Simonson: Dieting sucks - La Crosse Tribune

B ecause 70 percent of our bone destiny is due to heredity, youre at greater risk for osteoporosis if you have a family history of the disease but that doesnt mean you cant help shape the health of your bones.

We actively build bone until our mid-20s, then we start to slowly lose bone mass. One in 2 women, and 1 in 4 men, age 50 or older will break a bone due to osteoporosis.

Until they break that wrist, hip or vertebrae in the spine, odds are they will have no idea they have osteoporosis. In women, that risk of bone loss temporarily speeds up for about 5 years post-menopause.

While its best to develop bone-healthy habits in childhood, you can take action at any age to improve both bone and muscle health, even if your genes may be working against you.

Why is muscle important? Maintaining muscle as you age makes it more likely that you can stop a fall and prevent a fracture if you lose your balance.

Dont fear calcium

You know that calcium is important for strong bones but you may also be concerned that calcium supplements increase the risk of cardiovascular disease. Andrea Singer, M.D., F.A.C.P., C.C.D., National Osteoporosis Foundation (NOF) trustee and clinical director, says that calcium intake from food and supplements that doesnt exceed 2000-2500 milligrams (mg) per day should be considered safe from a cardiovascular standpoint, based on a recent rigorous review of the evidence by the NOF and the American Society of Preventative Cardiology.

Supplement calcium smartly

The NOF recommends that women under age 50 get 1,000 mg of calcium per day and women 50 and older get 1,200 mg. Men age 70 and younger need 1,000 mg per day, those 71 and older need 1,200 mg. Obtaining calcium from food sources is preferred, Singer says. Supplemental calcium can be safely used to make up any shortfalls in your diet.

Look beyond the obvious

Calcium-rich foods beyond dairy products include canned sardines and salmon that still have their bones, tofu made with calcium, tempeh, calcium-fortified soymilk, and some dark leafy vegetables. Collard greens, broccoli rabe, turnip greens and kale are the best of the bunch.

Dont block calcium

Spinach and beet greens contain oxalic acid, which makes their calcium unavailable to us. Cooking greatly reduces oxalic acid, and eating a food with oxalic acid does not affect absorption of calcium from other foods you eat during the same meal. One food that will block calcium absorption is wheat bran if you eat wheat bran cereal with milk, you will only absorb some of the milks calcium.

Load up on produce

A diet rich in fruits and vegetables creates an environment in the body that prevents bone and muscle breakdown. Antioxidants and other nutrients, like potassium, in produce help prevent calcium loss. Produce and plant foods include still more nutrients that Singer says are good for bone health, including magnesium and vitamins K and C.

Stock up on vitamin D

Vitamin D is essential for absorbing calcium, but it also helps build muscle. When exposed to the sun, your skin produces vitamin D.

However, most of us protect our skin from the sun.

Food sources include fatty fish, and fortified foods such as milk and most soymilks. Mushrooms contain variable amounts. Taking 800-1,000 IUs of supplemental vitamin D with food is recommended for osteoporosis prevention if you dont get enough through diet, especially if you live in northern states where vitamin D production from sunshine exposure may be limited.

Power up with protein

Adequate but not excessive protein is good for both muscle and bone. Divide your weight in pounds in half to estimate your protein goal in grams. So, if you weigh 150 pounds, aim for about 75 grams of protein per day.

Calm Inflammation

Omega-3 fatty acids, both EPA and DHA from fatty fish and ALA from walnuts and flax seed, can help reduce inflammation in the bodyimportant, because inflammation can accelerate bone loss.

Get and stay active

Weight-bearing exercise walking, running, strength training stimulates bone-building activity and builds and maintains muscles. Exercises that help improve balance can also help avoid falls.

Avoid bad to the bone behaviors

These include smoking, and excessive intake of alcohol, caffeine and sodium, all of which can increase calcium loss. Yo-yo dieting has also been shown to reduce bone density.

By Carrie Dennett, M.P.H., R.D.N.

More:
Nutritionist shares 10 tips to help prevent osteoporoses - Union Democrat

Mediterranean diet: A heart-healthy eating plan

The heart-healthy Mediterranean diet is a healthy eating plan based on typical foods and recipes of Mediterranean-style cooking. Here's how to adopt the Mediterranean diet.

If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you.

The Mediterranean diet incorporates the basics of healthy eating plus a splash of flavorful olive oil and perhaps a glass of red wine among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.

Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet are tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.

Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. The diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol the "bad" cholesterol that's more likely to build up deposits in your arteries.

In fact, a meta-analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of cardiovascular mortality as well as overall mortality.

The Mediterranean diet is also associated with a reduced incidence of cancer, and Parkinson's and Alzheimer's diseases. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.

For these reasons, most if not all major scientific organizations encourage healthy adults to adapt a style of eating like that of the Mediterranean diet for prevention of major chronic diseases.

The Mediterranean diet emphasizes:

Adapted from Oldways Preservation and Exchange Trust, 2016

The Mediterranean diet traditionally includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables.

Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil not eaten with butter or margarines, which contain saturated or trans fats.

Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat (approximately 80 percent of their calories come from fat), but most of the fat is not saturated. Because nuts are high in calories, they should not be eaten in large amounts generally no more than a handful a day. Avoid candied or honey-roasted and heavily salted nuts.

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The rest is here:
Mediterranean diet for heart health - Mayo Clinic

Mama June Shannon may have dropped a shocking 300 lbs., but the reality star who famously chowed down on sketti (a.k.a. noodles slathered in butter and ketchup) still hasnt completely overhauled her diet.

Nobody taught me how to cook, so its a learning experience all the time as we look up new recipes, Shannon saysin the latest issue of PEOPLE. The Mama June: From Not to Hot star underwent an extensive series of surgeries that include the insertion of a gastric sleeve, breast augmentation and skin removal on her turkey neck, bat wings, and stomach an area where doctors removed 9 lbs. of loose skin.

Since then, Shannon has switched to a low-carb, low-sugar diet, though she still indulges in her favorite cheat meal items: Mexican, barbecue and Little Debbie jelly-filled pies, she reveals. They are heaven in a box.

One lesson Shannon learned the hard way? Eating way too much in one sitting.

I have thrown up, because you cant over eat with the gastric sleeve, she says. When you do it that one time, you dont do it again.

For the most part Shannon tries to stick to a simple diet.

Breakfast I dont kind of eat breakfast. If Im lucky enough, I get my ass up before 12, 1 oclock most days, so breakfast is nonexistent.

Lunch I usually have a protein pack with slices of meat, cheese and almonds.

Snack Grapes and cheese are my go-to, says Shannon. I walk by the refrigerator, get three or four grapes and then walk away.

Dinner We eat chicken and beans plus whatever sides the girls want, says Shannon, who keeps portions small.

FROM COINAGE:Try This Healthy, Cheap Late-Night Snack

While shes still figuring out her diet, Shannon says her self-confidence is through the roof.I thought of myself as being sexy before, she declares. Now, Im the s.

The finale of Mama June: From Not to Hot airs Friday at 9 p.m. ET on WE tv.

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Mama June Shannon's Post-Surgery Diet: Protein Packs, Little Debbie Pies and Mexican Food - PEOPLE.com

While we all know eating carrots wont magically give us 20-20 vision, can what we eat affect our eyesight?

It turns out, eye health is crucially linked to diet consuming certain essential nutrients can stave off eye disease and age-related degeneration. Fox News spoke to Dr. Andrea Thau, president of the American Optometric Association, and Lauren Blake, a dietitian at The Ohio State University Wexner Medical Center, to get their tips on the best foods to eat for optimum eye health:

1. Leafy greens The carotenoids lutein and zeaxanthin found in eggs and leafy greens like spinach and kale are essential for eye health, Thau and Blake said. Studies have shown that lutein and zeaxanthin reduce the risk of chronic eye disease, including age-related macular degeneration, Thau explained. (Age-related macular degeneration is a common cause of vision loss in people over 50.)

6 WAYS TO LOSE MORE WEIGHT AS YOU AGE

2. Salmon Essential omega-3 fatty acids, found in fish like salmon and tuna, can help reduce inflammation, enhance production of tears, and support the outer layer of the eye, Thau said.

3. Sweet potatoes Vitamin E is a powerful antioxidant that helps protect our eyes from free radicals, which break down healthy tissues, Thau said. She noted that sweet potatoes and fortified cereals are both great sources of vitamin E.

4. Chickpeas Zinc is a trace mineral and helper molecule that plays an essential role in bringing Vitamin A from the liver to the retina, Thau said. Good sources of zinc include chicken, chickpeas and pumpkin seeds.

AVOID THESE 'HEALTHY' FOODS THAT ARE ACTUALLY SUGAR BOMBS

5. Bell peppers Vitamin C, found in foods like bell peppers, broccoli, and Brussels sprouts, can help protect against UV light damage to our eyes, Blake said. It can also lower the risk of developing cataracts and even, in combination with other nutrients, slow down the rate of age-related macular degeneration, Thau said.

6. Almonds Vitamin E is another essential nutrient that can help prevent cataracts and age-related degeneration, Blake said, noting that good sources include wheat germ, peanut butter and almonds.

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7. Vitamin and mineral supplements An overall healthy diet is the best aid for eye health, Blake said. But what happens if you struggle to get the nutrients you need through diet alone? In that case, discuss your concerns with your doctor during your annual eye examination: Thau noted that your physician can work with you to determine whether you need certain supplements to make sure youre getting all the nutrients you need.

The rest is here:
7 foods and supplements that can help improve your eyesight - Fox News