New Hampshire Adults with Disabilities Need Better Diabetes Prevention Care

Source: New Hampshire Disability & Public Health Project (DPH) Data Briefs & Reports

In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.2  Promising diabetes prevention care for adults with disabilities includes accessible and inclusive health promotion.

Several factors contribute to a higher risk of diabetes, including:

• Unhealthy eating habits that result, in part, from uninformed and limited food choices;

• Lack of physical activity due to social, environmental, and behavioral barriers; and

• Lack of knowledge and support to address risk factors for diabetes.

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Above-normal blood sugar linked to dementia – Harvard Health Blog – Harvard Health Publications

There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans. A study published in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia.

Source: Above-normal blood sugar linked to dementia – Harvard Health Blog – Harvard Health Publications

There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans.

A study published in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia. This finding goes beyond previously seen links between diabetes and dementia. “It establishes for the first time, convincingly, that there is a link between dementia and elevated blood sugars in the non-diabetic range,” says study author Dr. David Nathan, a Harvard Medical School professor and the director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital.

Dr. Nathan teamed up with researchers across the country to look at blood sugar levels in more than 2,000 older adults—the average age was 76—taking part in the Adult Changes in Thought study. The vast majority of the study participants did not have diabetes. What the researchers found is that any incremental increase in blood sugar was associated with an increased risk of dementia—the higher the blood sugar, the higher the risk.

Why? There are only theories. “The speculation is that elevated blood sugar levels are causing more vascular disease, but it may be other metabolic issues. For example, people with elevated blood sugar often have insulin resistance which may be the link that affects our brain cells,” says Dr. Nathan.

The study does not prove that high blood sugar causes dementia, only that there is an association between the two. For that reason, don’t start trying to lower your blood sugar simply to preserve your thinking skills, cautions Dr. Nathan. There’s no evidence that strategy will work, although he says it should be studied.

But it is worth keeping an eye on your blood sugar to try to avoid developing type 2 diabetes. This disease is at epidemic proportions. Almost 26 million Americans—one in 12—have diabetes. High blood sugar is hallmark of this disease. Normal blood sugar is under 100 milligrams per deciliter of blood mg/dL after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher after a fast. People with a blood sugar reading of above 100 but below 126 have what’s called prediabetes. Nearly 80 million Americans are in that camp.

Excess blood sugar is a problem because it can lead to a variety of health problems including heart, eye, kidney, and nerve disease.

Taming blood sugar

What if your blood sugar is above normal? There’s good news in that department: You can lower your blood sugar by exercising and, if needed, losing weight. Shifting to a healthier diet with more vegetables, fruits, and whole grains and cutting back on highly refined grains can also help.

Try to get 150 minutes per week of moderate intensity activity, such as brisk walking. If that’s daunting, know that even a little activity can make a big difference in lowering blood sugar levels. Short but frequent walking breaks—as brief as a minute and forty seconds every half hour—can lower blood sugar. So can taking a walk after a meal.

And it doesn’t always have to be official “exercise.” Try taking the stairs more often, parking farther away from the store, and getting up and moving if you’ve been sitting too long. “It’s common sense,” says Dr. Nathan. “The more active you are and the less sedentary, the more likely it is that your muscles can uptake glucose, and the insulin you make will be more effective.”

Also helpful is cutting back your intake of highly refined carbohydrates, especially foods with added sugars such as sucrose, high fructose corn syrup, and also molasses, cane sugar, corn sweetener, raw sugar, syrup, honey or fruit juice concentrates. The American Heart Association recommends no more than 100 calories from sugar or six teaspoons of sugar per day for women, and 150 calories or nine teaspoons of sugar per day for men. If you’re in the prediabetic or diabetic range, you’ll want to work with a dietitian to determine your exact needs.

Making these changes is an investment, to be sure. But the payoff—better physical and mental health—is definitely worth it.

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Adults with Disabilities Need Better Diabetes Prevention Care

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.Several factors contribute to a higher risk of diabetes, including:

  • Unhealthy eating habits that result, in part, from uninformed and limited food choices;

  • Lack of physical activity due to social, environmental, and behavioral barriers; and

  • Lack of knowledge and support to address risk factors for diabetes.2

Download Diabetes Prevention

Improving diabetes care for people with ID: a qualitative study exploring the perceptions and experiences of professionals in diabetes and ID services

Source: Brown – 2017 – Journal of Intellectual Disability Research – Wiley Online Library

Abstract

Background

Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners.

Methods

A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area. In total, 29 qualitative interviews were conducted: 10 with diabetes practitioners from primary and secondary care, 14 from ID services and 5 from community care services regarding diabetes service provision for this population. Thematic content analysis was undertaken to identify the themes and subthemes.

Results

Three main themes were identified: (1) enabling access to services to meet diabetes-related care needs of people with ID; (2) communication and service improvements between staff, patients and across services; and (3) providing person-centred diabetes care and developing adapted resources to increase patient self-care.

Conclusions

The findings of this study have important international implications in how diabetes practitioners plan and deliver services for people with ID and other vulnerable groups with limited cognitive ability and communication skills and difficulties in self-management. The findings highlight that access to diabetes education and adapted resources is needed, and if ‘reasonable adjustments’ are made to service provision and practice, people with ID can benefit from improved healthcare. Developing joint clinics to share knowledge and resources between diabetes and ID practitioners may improve service delivery and continuity of care, and thereby diminish the costs of not providing quality care.