Close Concerns Weblog

White House Vegetable Garden

If you can’t tell, we absolutely love Michelle Obama and how she’s actively promoting and being a positive role model in a healthy lifestyle. We also love that she’s digging up a patch of the South Lawn of the White House to plant a vegetable garden to help educate children about healthful and locally grown fruit and vegetables. The entire family - including President Obama - will help out in the garden "whether they like it or not," she says, in addition to local students and White House staff members. Mrs. Obama is a strong supporter of the bottom-up strategy, like us – teach children, and they’ll teach their families and will spread to educating entire communities.  

She is quick to emphasize that she doesn’t want people feel guilty if they don’t have the time or the space for a garden, but that there are still changes people can make. Note that Mrs. Obama first began making changes after she herself, a working mom, saw the negative effects of eating out or grabbing pizza regularly to feed her family. “You can begin in your own cupboard,” she said, “by eliminating processed food, trying to cook a meal a little more often, trying to incorporate more fruits and vegetables.” 

Mobile diabetes communication – soon on the iPhone!

We’re excited to hear about Lifescan’s new iPhone application that lets users upload glucose readings to their iPhone. Unlike past diabetes applications that require manual typing of each number, the app should use Bluetooth or a dock connector to pull in your numbers from your blood glucose monitor. Users can send readings and include a message to others. People with diabetes can build meal plans and create an injection schedule for insulin with “easy tagging” of pre- or post-meal. It sounds like there is a food database built in, enhancing the basic bolus calculator-device of providing an estimate of insulin needed for each meal.

Readings can then be shown on a chart and we bet this will help people (like us!) who usually need a nudge to get logging! Lifescan reps have cited the ability to send data to caregivers, but we think this will be most useful for parent-children teams in managing diabetes. Of course, having an iPhone or iTouch is a huge barrier, but it’s a start to moving diabetes to an all-in-one device, and we can’t wait to try it out!

Diabetes Alert Day ... Questions to ask!

It’s a Numbers Game – Fight Back, Sound the Alert

How many of your family members over the age of 45 know their LDL or HDL cholesterol numbers? 

How many of you know what your last blood pressure was? 

How many of you have had it checked in the last 3 months? 

How many of you know that there is a 10mm microfilament that you can use to check for foot neuropathy in 2 seconds (and it's probably less than $20)? 

How many of you know that ethnic populations including African Americans, Latinos, and Native Americans have an increased risk of type 2 diabetes? 

How many of you know that one in five Americans are at risk for developing type 2 diabetes right now?

Why don’t you tell somebody that! It’s American Diabetes Alert day – get your numbers together and find out your risk at www.diabetes.org/risk.

Study Highlights Teen Obesity Risks

Happy St. Patrick’s Day!

The New York Times recently reported on a study highlighting the increasing risks for overweight teens – they’re as likely to die by age 60 as those who smoke lightly. Obese teens, like heavy smokers, have a double risk of an early death. This is a different set of results compared to other recent studies suggesting that those who are overweight were not at a higher risk of premature death.

Originally published in the British Medical Journal, the study tracked the death rates of 45,290 Swedish men over 38 years. The study only included men enrolling in the Swedish Army in 1969 and 1970, but compared the risk to normal-weight recruits who smoked a half a pack of cigarettes or more a day (aka “heavy” smokers).

Critics are pointing out that because health behaviors are established earlier in life, those overweight at age 18 may have become obese and thus the deaths may reflect the risk of obesity, rather than being a result of being overweight as teens.

Here’s the link to the article and a link to the study and here’s hoping this has some impact on persuading us all not to pick up that second doughnut … or first!

Healthy Role Model – Hallelujah!

There’s hope sweeping across America – not only to save the economy but to save everyday Americans from the rising epidemics of obesity, diabetes, and more. Healthy role model Michelle Obama, our First Lady, is taking charge and adding promoting a healthy lifestyle to her hefty personal agenda.

In addition to taking on support of working and military families, Mrs. Obama has been urging Americans to increase the inclusion of fresh, unprocessed, and locally grown foods to their families and to share throughout the community. While visiting a drop-in center serving the homeless last week, she pointed out that the kitchen was only serving fresh food – nothing canned or processed. Mrs. Obama suggests communities come together to build community gardens and share with those in need.

We’re impressed with Mrs. Obama’s practical take – she acknowledges that everyone has a “hankering” from fast food from time to time, but that it’s all about moderation. This is something she says that everyone, including ordinary families, can take on. Excellent…. Thank you Mrs. Obama!

Diabetes Education Accreditation Program Will Increase Community-Based Programs

AADE recently unveiled their participation in the Diabetes Education Accreditation Program to increase the number of community and clinic-based programs that can get accredited and expand access to diabetes education. Many diabetes educators think the program is promising to help those who cannot or do not seek care in a large settings, such as a hospital, access care. We think the expansion for diabetes education programs is terrific, especially as those in many small towns and rural areas often do not have education programs. The Centers for Medicare and Medicaid Services (CMS) also approved the American Diabetes Association and the Indian Health Service to accredit organizations for self-management training.

CCEO of AADE, Lana Vukovljak, MS, MA, described trends of diabetes education moving into the community and that AADE wants to go where the patients are seeking care. HURRAH! The accreditation process is important because educators don’t bill Medicare directly like many health care providers. Instead, Medicare and other third-party insurers only accept billing from an accredited diabetes program. AADE suggests that the new accreditation program will encourage patients to follow the AADE “7” framework, a structure of “achieving behavior change”. We’re so glad for patients that these three organizations have the opportunity to expand education programs outside of major centers and facilities and that they are bringing more access to care into the community. Kudos – and thank you so much.

Healthy food for healthy schools

Alice Waters recently described the problem of the National School Lunch Program as “No Lunch Left Behind.” We think it’s fantastic to raise the issue of the need for healthy food in the school system. It’s important to note that she doesn’t think increased financing is the only solution to this – instead, the Department of Education can also take initiative here. Nutrition education can only aid in increasing health and increasing opportunities for healthy lifestyles.

“…the Department of Education should take some initiative, too. After all, eating well requires education. We can teach students to choose good food and to understand how their choices affect their health and the environment. The new school lunch program should be partly financed by the Department of Education […] Every public school child in America deserves a healthful and delicious lunch that is prepared with fresh ingredients. Cash-strapped parents should be able to rely on the government to contribute to their children’s physical well-being, not to the continued spread of youth obesity, Type 2 diabetes and other diet-related problems. Let’s prove that there is such a thing as a good, free lunch. “

You can read the full article here.

CMS to cover bariatric surgery for morbidly obese with type 2

The Centers for Medicare & Medicaid Services (CMS) recently announced it will cover bariatric surgery for Medicare beneficiaries who are morbidly obese and have type 2 diabetes. Morbidly obese individuals are those with a BMI of 35 or greater. In 2006, CMS expanded coverage of four types of bariatric surgery to those with a BMI of 35 or higher, and at least one co-morbidity related to obesity. The recent bulleting specified type 2 diabetes as a co-morbidity.

The CMS said beneficiaries with BMIs lower than 35 will not have the surgery covered because “current evidence has not proven that bariatric surgery will lead to improved health outcomes in these people.” Those beneficiaries covered will be required to receive the surgery at facilities certified by the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery. We applaud the direction that CMS is headed – although the costs for surgeries are high ($20,000-plus), the cost of serious diabetes complications dwarf the price of surgery, especially because diabetes is a progressive disease and costs every year will go one direction only without intervention – up, up, up.