April 1st, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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The larger the bureaucracy the more inefficient a system becomes. Several things can happen in the decision making process.
1. The decision making process can become opaque rather than transparent.
2. Decisions are made by a committee by consensus.
3. Consensus committee decisions might not sharply define the original goals.
4. Blame for errors gets dissipated.
5. Decisions are only as good as the information that is gathered.
6. Changing a wrong decision can be difficult and costly.
President Obama’s healthcare reform law is creating 256 new agencies to gather information and recommend decisions for other agencies to write regulations.
The following decision is being made by an agency in Washington state. It is not only the wrong decision, but is a decision that will set back the care of Type 2 Diabetes Mellitus 15 or 20 years. It is a decision being made using the wrong information. Read more »
*This blog post was originally published at Repairing the Healthcare System*
March 15th, 2011 by PJSkerrett in Health Tips, News
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One of the most abundant substances in the cloud of radioactive steam released by a failing nuclear power plant is iodine-131 — a radioactive form of the element iodine that is found throughout nature. Iodine-131 poses a special health risk because of its cancer-causing effect on the thyroid gland.
The small, butterfly-shaped thyroid sits just below the voice box. From this perch, it controls how fast every cell in the body changes food into energy. The gland’s main product, thyroid hormone, governs the function of the digestive tract, brain, heart, nerves, muscles, bones, skin, and more.
Iodine is a key ingredient that goes into making thyroid hormone. We get this element from ocean-caught or ocean-farmed fish and shellfish, milk, cheese, yogurt, eggs, and fruits and vegetables grown in iodine-rich soil.
The human body is surprisingly good at absorbing iodine and storing it in the thyroid gland. That’s a problem when iodine-131 is released into the atmosphere. The thyroid stores it as readily as natural, non-radioactive iodine. As iodine-131 builds up in the thyroid gland, it emits bursts of radiation that can damage DNA and other genetic material. Such damage can remove the normal limits to cell growth and division. Unchecked growth of thyroid tissue is thyroid cancer.
Iodine-131 gets into the body several ways. A person can breathe in radioactive steam released by a nuclear power plant. Fallout — radioactive particles that fall out of the atmosphere and settle onto plants, soil, and water — further adds to the burden when a person eats iodine-131 enriched fruits and vegetables or drinks water containing the isotope. Milk is another vehicle — cows that eat grass sprinkled with iodine-131 make milk that contains it. Read more »
*This blog post was originally published at Harvard Health Blog*
March 13th, 2011 by KerriSparling in Better Health Network, True Stories
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After a tough low this morning:
I want her to know that she was wanted so much, well before she arrived, and that her parents went to great lengths to make sure her arrival was as safe as they could manage.
I want her to know that those moments when she has to wait while I test, or while I bolus, or the times when I have to set her in her crib and gulp down grape juice while she stands there with her big, brown eyes staring at me while her mouth tugs into an impatient smile, that I love her and I just need to deal with diabetes for a few seconds so I can be the best mommy I can.
I want her to know that if my eyes don’t get better, it’s not her fault. It’s not my fault, either. The fault lies with diabetes.
I want her to know that the reason I’ll sometimes frown at a soggy diaper or a voracious pull from the bottle isn’t because she’s being “bad” or doing something wrong, but because I’m worrying.
I want her to know that just because I have it, and because some of her best buddies have it, doesn’t mean that she will have it. But I also want her to know that if a diagnosis of any kind ever touches her life, we’ll manage just fine and take the best care of one another that we can.
I want her to know that when she smiles at me, it’s like a thousand online communities inspiring me all at once. That the hope of her was once the biggest incentive to improve my health, only to be superseded by her arrival in my arms.
I want her to know that regardless of what she may hear about this “diabetes,” her mommy is going to be just fine. Just fine.
*This blog post was originally published at Six Until Me.*
March 8th, 2011 by KerriSparling in Humor, True Stories
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Life is trying to further mess with my diabetes control. (Or is diabetes trying to mess with life? Is a zebra white with black stripes, or a horse with black and white stripes?) I’m making efforts to get it together, but odd little things keep leaping in the way. Oh, efforts to thwart: Let me count the ways!
1. Recently, the jar of glucose tabs in my car was empty, so I was forced to stop at a random store and buy a regular Mountain Dew from the vending machine. But I had to open it and let it settle a little first before I could chug it, because draining a can of fizzy sugar would make me instantly ralph.
2. It snowed and/or was freezing on the days I went to the gym. But on the days I didn’t go? Sunshine and warm weather. Stupid weather wants me to be fat.
3. I lost my Dexcom receiver for about five hours, until I heard its muffled scream from between the couch cushions.
4. The sound of the clothes dryer finishing a load sounds like the happy tinkling of the chimes on an ice cream van, which spawns this borderline insatiable craving for ice cream.
5. During my meetings last week with PWoutD (people withOUT diabetes), my blood sugar cruised inexplicably into the stratosphere, forcing me to rage bolus in order to be able to eat more than the plate garnish during lunch. Read more »
*This blog post was originally published at Six Until Me.*
February 5th, 2011 by Felasfa Wodajo, M.D. in Opinion, Research
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The cost of managing chronic diseases is the largest portion of healthcare expenditures in developed countries. For example, the prevalence of adult acquired diabetes has been rising in the United States, in concert with increasing rates obesity. The CDC has termed it an “epidemic,” especially in light of the massive costs incurred by the healthcare system due to diabetes.
The deleterious health effects of many chronic conditions can be diminished by behavior modifications. While few would underestimate the difficulty of having patients lose weight or exercise more, good management of blood sugar in diabetes is both objectively measurable and strongly correlated with reduced end-organ damage.
This is among the reasons why Research2Guidance has recently nominated diabetes as the condition most likely to be most targeted by mobile medical software and devices (mHealth). This finding is part of their recently published Global Mobile Health Market Report 2010-2015. This is the same report that also predicted that, in the future, medical apps are likely to be distributed by physicians and healthcare institutions.
This time Research2Guidance is highlighting the portion of the survey where they looked into where mobile devices have the most potential to affect health outcomes. While other chronic conditions such as hypertension and obesity have larger populations, the market researchers felt diabetes had the largest market potential due to the huge cost saving potential, the demographic and geographic overlap between smartphone users and people with diabetes, and the real potential to improve blood sugar management using mobile devices. Read more »
*This blog post was originally published at iMedicalApps*
