Although doctors and researchers still are unsure what causes the disease, Bernstein insists, “bad eating habits such as too much refined sugars, empty carbohydrates, and fructose does not cause diabetes.”

So, he outlines some of the most prevalent myths surrounding diabetes.

Question: Diabetes Will Make You Go Blind?

Answer: According to Dr. Bernstein, while it is true that all people with diabetes are at risk of blindness, heart problems, and kidney disease, it is equally true that in this day and age, a smaller percentage actually experience the full brunt of such vision complications than 30 years ago. “The better the patient controls his or her blood sugar, the less likely the more serious complications associated with diabetes will progress. Anyone already experiencing the side effects of diabetes needs to achieve and maintain the most stringent possible control in order to minimize their further progression, he said.”

Question: Since I Don’t Have To Inject Insulin, My Diabetes Isn’t A Serious?

Answer: A surprising number of people still believe this falsehood. Non insulin-dependent diabetes mellitus (type 2 diabetes) can produce destructively high blood glucose levels if not kept under control. Type 2 diabetes often grows more severe with time, so a patient who starts with low numbers will probably need to progress to diet-and-exercise-based blood sugar control, then to oral diabetes medications. It is often better to start with insulin early rather than waiting to use it as a last resort. Many older patients are finding their soo-called oral meds have become ineffective with time, and may need to switch to insulin injections to maintain effective diabetes control. Type 2 diabetes, even pre- diabetes is serious even if your blood sugar isn’t that high,” Bernstein warns.

Question: I Can’t Eat What I Like Anymore?:

Answer: That’s a misconception considering that what is now coined the “diabetic diet” is actually a well- balanced, sensible food plan that would be healthy for anyone to adopt, with or without the disease. “Keep in mind, you can ‘have your cake and eat it too’ but if you want to eat something rich in carbs, you will need to balance it out by cutting an equivalent amount of carbs or sugar from somewhere else in your diet,” he advised.

Question: I Can Tell If My Blood Sugar Levels Are Too High Or Too Low?

Answer: “This myth is dangerous because you can wind up in the hospital if you ignore symptoms of hyperglycemia, which is hard to detect by the way you feel,” said Bernstein. “Making do without a regular blood glucose tests is like flying without a parachute or crossing the street with your eyes closed. You’re guessing. Learn your body’s signals when you get into trouble, but be certain to use your glucose monitor to be sure.”

Question? Diabetes Is The Beginning Of The End?:

 Answer: “I still get patients who believe their lives are over once complications set it,” said Bernstein. “The reality is that with the development of proper skills and mindset and the possession of monitoring equipment, patients with diabetes can continue to live full lives, even with severe complications. Many diabetics, even insulin-dependent, live well into old age.

“Pay attention to your body. Keep ahead of what your diabetes is doing — for baby boomers, this is no time for surprises! Consult with your doctor, or your diabetes educator.  Discuss exercise plans, and any adjustment in medications with your doctor.”

There’s no better way to honor dear old dad then by winning a competition for him.

Integris Men’s Health is having it’s first “What-A-Dad” contest. The rules are simple: In 200 words or less, tell why your dad deserves to win.

Prizes will keep dad healthy, happy and busy. The package includes a heart scan from Integris Heart Hospital, a one-hour massage from Pacer Fitness Center, a  grill, dinner gift certificates, movie tickets, Zoo Amphitheater concert tickets and sports tickets.

Dad will get to hear his name on the radio, too. The winner will be announced Friday morning on WWLS-AM and KISS-FM and that evening on Cox Channel 7 Sports Night. The winner will also be recognized during the Yard Dawgz halftime show June 21.

The deadline to enter is Wednesday at 5 p.m. Please include your name, address and phone number. To enter, visit http://www.integrismenshealth.com and find the contest link under “Men’s Health University.”

Surely dad is worth 200 words of your time.

Jeff Raymond, Medical Writer

In the things-to-consider-for-the-sake-of-considering-them category, take a gander at this story from the May 27 edition of The Boston Globe: 

After healthcare reform was made law in Massachusetts in 2006, the number of newly insured patients in the state started to grow, and so did the demand for care. The demand, coupled with a longstanding shortage of primary-care physicians, is creating a real crunch for community clinics, say advocates of healthcare reform as well as area medical professionals.

About 80 percent of the new patients at a community health clinic who are covered under the state’s new health insurance program were formerly uninsured, a clinic supervisor told the newspaper. The result is a lengthy waiting list.

Clinics the newspaper contacted have had difficulty recruiting doctors.

‘What Chapter 58 has done is highlighted the crisis and the problem that we have with the primary-care workforce,’ said Dr. Bruce Auerbach, president of the Massachusetts Medical Society. According to a study conducted in 2006 by the society, 53 percent of patients who had an appointment with a primary-care physician were able to see a doctor within a week of initiating contact. Last year, only 42 percent were able to see a doctor within a week. …

Critics have said healthcare reform should not have been attempted without first addressing the workforce shortages, said John E. McDonough, executive director of Health Care for All, an advocacy group that helped craft the healthcare law. …

Healthcare advocates and providers say that the real problem is that the state underestimated the number of residents without health insurance. …

According to Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority, which administers the new health law, 340,000 people who had been mostly uninsured were covered through the state’s program as of Jan. 1. Of that number, about 110,000 have bought private insurance through Commonwealth Choice. But, he said, the remaining 230,000 people have MassHealth or Commonwealth Care, the state’s subsidized health insurance programs.

One thing that’s unclear is why the formerly uninsured choose the types of clinics mentioned in the story when it looks although they could go to any doctor. Maybe they can’t, or maybe the story didn’t address it.

Either way, the unintended consequences of insuring hundreds of thousands of people are worth considering.

Thoughts? Leave a comment on this blog.

Jeff Raymond, Medical Writer

Do you think it’s fair and/or accurate to see Oklahoma ranked at or near the bottom of, well, just about every study of health that comes our way? We can’t be worst in everything health-related, can we?

I say this after reading about Wednesday’s report from The Commonwealth Fund. The nonprofit ranked children’s health in states on 13 indicators that included access to and quality of care, outcomes, equity and cost.

Oklahoma pulled up the rear. Fifty-first. Behind the District of Columbia and Mississippi. Leading the rankings were Iowa, Vermont, Maine, Massachusetts and New Hampshire.

Now, I know the devil’s in the details, and I admit I haven’t looked at the methodology of this report. I usually do, however, which is why I ask about the fairness of all this. I imagine this report would pass muster if you agree what it measures accurately sums up the state of children’s health.

Ah, here’s where it gets tricky: Are the measures used fair? Are small differences in rates or percentages blown out of proportion? Is the information current, or as current as possible?

See the state’s “scorecard” for yourself here.

The interesting thing about these reports is they are all largely slicing and dicing the same data. Sometimes it gets hard to tell them apart.

Anyone who honestly assesses the state’s health will find huge problems. But last or near-last every time? Perhaps I’m becoming desensitized, but my reaction is getting to be “C’mon!?!”

What’s yours? Tell me what you think by posting a comment on this blog.

Jeff Raymond, Medical Writer

When I was asked whether I’d be interested in speaking to a Youth Leadership Exchange class last week, I was ambivalent.

I knew I’d agree to speak, because I consider it to be an important form of outreach that may get kids interested in current events and perhaps even pick up a newspaper now and then, but I’ve had some negative experiences.

Speaking to this group definitely was NOT one of them: Not one of them asked what kind of car I drive, how much money I make or which famous people I have met. I’ll typically answer these questions, but I always hope for better ones.

They didn’t disappoint.

Each member of the class, a part of Leadership Oklahoma City, applied to be there. When I asked what careers they were interested in, many said medicine. It was perhaps appropriate that I spoke on health care day. Speakers included a hospital executive and a scientist. Some of the class toured The Children’s Hospital at OU Medical Center.

(I was able to hold a human heart once while in high school. I never got to tour Children’s.)

For the first time in a while, I was nervous last week. Put me on camera, ask me questions, have me go up and get in a complete stranger’s business — these things have become second nature. Kinda have to be in my line of work. Speaking for a half-hour to smarty-pants sophomores and juniors from throughout Oklahoma County was enough to make my palms sweat.

Although I had a bullet-point presentation prepared, I realized it was too heavy on numbers and policy when my father suggested the kids likely would want to hear about some interesting things I’ve done.

By this point it was too late to change anything, and I’m not organized enough to be able to keep a group of high school students’ attention for 30 minutes without notes. Besides, going up for a flight with the Air Force, while exhilarating, has absolutely nothing to do with being a medical writer. Being cloned, well, I forgot to mention that one.

I told the group things would be a lot less painful for them and for me if we talked back and forth. I threw out some numbers — the uninsured, growth in certain classes of prescription drugs, elective procedures, etc. — and we then discussed what they mean and what to do about them.

Not only were the kids open to discussing these (admittedly) wonkish ideas, they had varying, reasoned opinions. I was impressed.

Should health insurance be mandatory, like car insurance? Is this possible? Is this enough? Is this too much? Should a liver go to a 30-year-old or a 70-year-old teetotaler?

By the time we finished this back and forth, I had gone over my allotted time; it seemed like no time at all.

The only question that caught me completely off guard was whether a girl in the class should attend the University of Tulsa, my alma mater.

It’s nice to be an expert in something. I told her yes.

 Jeff Raymond, Medical Writer

 You can be forgiven for thinking yesterday was anything more than a nice day to watch college hoops.

It was, but it also was National Doctor’s Day.

The American Medical Association uses the day to honor the more than 900,000 physicians in the United States.

“On this day of tribute, Americans can express appreciation for physicians’ continued commitment to providing exceptional medical care,” according to an AMA release.

The nation’s doctors, throughout almost 1 billion patient visits annually, are called to be healers, confidants and advocates, the AMA says.

The organization also says two-thirds of U.S. doctors provide some form of charity care and in 2006 were ranked the nation’s most trusted occupation.

Furthermore, the AMA says:

• Ninety percent of patients say they are very satisfied with their doctor.
• Americans’ life expectancy has increased by seven years since 1960.
• There has been a 77 percent decrease in the infant mortality rate since 1950.
• There has been a 63 percent decrease in the overall death rate for heart disease since 1950.
• There has been a 72 percent decrease in the overall death rate for stroke since 1950.
• There has been a 14 percent decrease in the overall death rates for cancer since 1990.

Do you consider the medical profession admirable and respectable? Do you respect your physician? Are you satisfied with him/her? Drop me a line at The Medicine Bag blog at http://blog.newsok.com/health.  

Now back to basketball!

Jeff Raymond, Medical Writer

USA Today had an interesting story yesterday about how the popularity of angioplasty, a commonly performed procedure in which doctors use a balloon to open blocked coronary arteries, may be eroding.

“The rise of angioplasty procedures has leveled off and appears to be on the decline,” Duke University’s Eric Peterson, who reviewed results of the analysis by the National Cardiovascular Data Registry, told the newspaper.

Three studies in the last two years that indicate that angioplasty may be no more beneficial than medication, and may be riskier. According to the newspaper, the research suggests angioplasty is used too often and its benefits don’t justify the procedure’s $10,000 to $12,000 cost.

The newspaper’s analyses found:

• The number of annual procedures performed each year has declined by 10% to 15% over the last two years.

• Angioplasty and stent use began dropping in June 2006, after two “landmark” studies cast doubt on them. Doctors often implant stents — both bare metal and drug-coated — after angioplasty to keep the artery open.

Angioplasty is used to treat the terrible chest pain, called angina, that comes from a heart without enough oxygen.  The slight decline is important because Centers for Medicare and Medicaid Services guidelines seek to have angioplasty available within 90 minutes of a patient’s arrival at the hospital. This is often called door-to-balloon time.

Many medical authorities tout the benefits of angioplasty.

Because hearts suffer from an inadequate blood supply, Bonnie Weiner, president of the Society for Coronary Angiography, told the newspaper, “(Angioplasty) is very effective at achieving more blood flow to the heart.” 

“I personally wasn’t surprised by the results,” says Michael Rich, a cardiologist at Washington University School of Medicine in St. Louis who will debate the study at the heart meeting.

Michael Rich, a cardiologist at Washington University School of Medicine in St. Louis, said angioplasty won’t prolong a person’s life or decrease the risk of a heart attack but will decrease the symptoms of one.

“The analyses conducted for the newspaper also reflect what may be the beginning of a broader change in medicine: a move toward ‘evidence-based’ care drawing on reams of data from medical research and patient treatment,” USA Today reported.

Jeff Raymond, Medical Writer

An article that appeared in a supplement to last month’s issue of Diabetes Care argues that the bowel is the site of mechanisms that lead to diabetes.

The study’s author, Dr. Francesco Rubino of New York-Presbyterian Hospital/Weill Cornell Medical Center, presents evidence on the mechanisms of diabetes control after surgery.

“Clinical studies have shown that procedures that simply restrict the stomach’s size (i.e., gastric banding) improve diabetes only by inducing massive weight loss. By studying diabetes in animals, Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese,” according to a press release.

Rubino’s previously has shown that the main way gastrointestinal bypass controls diabetes is by skirting the upper small intestine — the duodenum and jejunum.

“It has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the regulation of sugar metabolism,” according to the release.

Rubino’s findings suggest bypassing the upper intestine may work by reversing abnormalities of blood glucose regulation.

He guesses the upper intestine of diabetic patients may be the site where an “abnormal signal” is produced that causes or predisposes one to diabetes.

Gastrointestinal surgery offers the possibility of complete disease remission. This is a major shift in the way we consider treatment goals for diabetes. It is unprecedented in the history of the disease,” he said.

What do you think of using surgery to treat diabetes? Have you had an experience with it? Leave me a comment at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

 Is retirement going to be a luxury for thirty- and forty- something workers? I increasingly think it will be, and a new estimate from investment giant Fidelity does nothing to dispel that.

A 65-year-old-couple retiring this year will need approximately $225K to cover medical costs in retirement, Fidelity estimates. Let’s not lose sight of the fact that this is in addition to the coverage available under Medicare, which may itself not be available when I and others retire.

The hypothetical retirees will still have to have enough money to live, either independently or in long-term care.

Perhaps what’s even more sobering than the estimate is its growth since 2002 — 41 percent.

The roughly 6 percent annual growth in the Fidelity projection about matches the growth of my 401K fund during a slow year. I know that doesn’t take into account contribution matching and interest compounding, but I think it raises a worthwhile point nonetheless.

And health care costs show no signs of flattening or decreasing.

Does paying for retirement terrify you as much as it terrifies me? Leave me a comment at http://blog.newsok.com/health.

Fidelity recommends:

- Creating an individual retirement plan

- Starting early and maximizing opportunities to save

- Assessing health status and becoming a smarter consumer of health care

- Determining details of any employer-sponsored coverage

- Understanding the financial impact of health care costs on Social Security income

Jeff Raymond, Medical Writer

If you’re interested in keeping tabs on your doctor, HealthGrades now offers a notification service.

The Web site, www.healthgrades.com, is best known for its hospital ratings. But given the information it compiles, a physician notification service is a natural addition.

The “Watchdog” e-mail alert service costs $4.95 a month.  

Notification items include board certification, disciplinary actions, malpractice suits and patient safety reviews.

Would you monitor your doctor? Would you pay to have someone notify you of lawsuits and other information of interest? Leave a comment at The Medicine Bag blog at http://blog.newsok.com/health. I’d like to hear what you think.

HealthGrades maintains quality profiles on almost every practicing physician in the country. The profile includes information on the doctor’s medical training, patient ratings, state and federal sanctions, malpractice judgments (in 15 states), procedure costs and hospital affiliations.

Subscribers to the service receive e-mail alerts when a physician’s information changes. Comprehensive physician profiles cost $29.95.

Jeff Raymond, Medical Writer