As vacation season arrives, here are travel tips for diabetics

It's vacation season. Traveling offers unique challenges for diabetics, but nothing that careful planning and a few precautions won't overcome, says the federal Centers for Disease Control and Prevention.

Image: diabeticlivingonline.com

The CDC offers these tips for diabetics to travel safely:

Before you leave

Discuss any concerns you may have about anticipated increased levels of activity, expected changes in diet and what to do if you have changes in your glucose readings with your physician. If you are traveling across time zones, let your doctor help you plan the timing of your injections. If you wear an insulin pump, make sure you know how to update the built in clock to reflect the change in time zone. The American Diabetes Association recommends making sure your blood sugars are well controlled before you leave.

Don't forget your supplies

Always keep your supplies close at hand and accessible, no matter how you travel. And don't forget to store them correctly; insulin stored in very hot or very cold temperatures may lose strength. Meters and supplies are also sensitive to extreme temperatures. There are cooling packs available made specifically for diabetes supplies.

To allow for any unexpected travel delays, it is recommended to pack twice the amount of diabetic supplies you expect to need. All supplies should be clearly labeled, with their original labels if possible, and don't forget to bring a copy your prescriptions with you.

It is also important to plan ahead for the possibility that your blood sugar might drop. Changes in what you eat, activity levels, and time zones can affect your blood glucose, so you need to monitor your blood glucose more often. If you use insulin, pack a glucagon emergency kit and all diabetics should pack glucose gel or glucose tablets, along with a few snacks.

Carry documentation and let others know

Carry a laminated 3-by-5 card in your wallet that says you have diabetes along with a list of any medications you use. Joslin Diabetes Center recommends that if you are traveling to a country where they speak a language other than your own, translate the note into this language. The ADA recommends that this card also say, "Sugar or orange juice please" in the language of the country you will be visiting.

In addition to wearing medical identification that says you have diabetes, tell the people you are traveling with that you have diabetes and tell them what to do in the case of an emergency. It is also a good idea to give them a copy of your medical card.

Keep your health insurance card and emergency phone numbers on hand at all times, including your doctor's name and phone number. First respondents are trained to look at cell phones for a contact labeled "emergency contact," so make sure you put one in there. All phone numbers should also include the country code if traveling abroad.

Once you arrive, find the closest medical care facility that could provide care if necessary. You can get a list of English-speaking foreign doctors from the International Association for Medical Assistance to Travelers at www.iamat.org or 716-754-4883, according to the ADA.

Nutrition

Do your homework before you go to determine the carbohydrate grams in the foods typically served where you are going. You might also want to pack a few bottles of water and some pre-measured dried fruit, nuts and seeds for snacks.

Air travel

If flying, put your diabetes supplies in a quart-size plastic bag separate from your toiletries. If you wear an insulin pump and don't want to walk through the metal detector with it on, tell the security officer about it and ask them to visually inspect the pump and do a security pat-down.

It is also important to call the airline ahead of time to assess whether your nutritional needs will be met while traveling. If a meal will be served, you can put in a request for a diabetic meal. If not, make sure to bring appropriate food with you.

Another thing to remember is that air on an airplane is probably pressurized, so when drawing up your dose of insulin, don't inject air into the bottle because the pressure differences can cause the plunger to "fight you," says the ADA. For more information about air travel and diabetes, click here.

To reduce your risk for blood clots, move around every hour or two.

Protect your feet

As always, diabetics need to protect their feet, being especially careful of hot pavement by pools and hot sand on beaches. Wear comfortable shoes and make sure to check your feet daily for blisters, cuts, redness, swelling and scratches.The general rule is to never go barefoot.

Annual health policy forum set Sept. 28 in Bowling Green

This year's annual Howard L. Bost Health Policy Forum "will offer new insights and opportunities from a range of civic sectors for a shared vision, policies, and actions for community health," says its lead sponsor, the Foundation for a Healthy Kentucky.

"Local, regional, and national speakers will share their knowledge and experiences in building healthy communities, with a focus on transportation and housing, education, food systems and policy, and employers and workplaces," the foundation says. "TED style" speakers will make presentations on each of the forum's four focus areas: education, food systems and policy, employer/workplace, and transportation/housing.

The forum will be held at the Sloan Convention Center in Bowling Green on Monday, Sept. 28. For the registration website, click here.

Free screenings of new Kentucky colon-cancer documentary, plus Q and A, are scheduled in Louisville, Lexington and Hazard

The Colon Cancer Prevention Project is premiering its new documentary, "Catching a Killer: Colon Cancer in the Bluegrass," in three select cities, before it starts airing on KET this summer.

The 30-minute film, which features stories from Kentuckians who have been affected by colon cancer, will be shown June 18 at the Clifton Center in Louisville; June 23 at the Central Library in Lexington; and July 20 at the Perry County Library in Hazard. It includes stories from residents of Appalachia and Louisville, two areas where colon cancer rates are the highest.

All three events will run from 7 to 8 p.m. and include a question-and-answer session with expert panelists after the film is over. Free food, music and photos will be offered before the start of the film, from 5:45 to 6:45 p.m.

The Colon Cancer Prevention Project is Kentucky and Southern Indiana’s only nonprofit focused solely on work to end the second leading cancer killer among men and women. Colon cancer strikes 2,600 Kentuckians each year – making Kentucky one of the worst states in the country for colon cancer incidence – but it is highly preventable with screening.

"Catching a Killer" not only shares the heartfelt stories of our neighbors, but also shares information about screening options and resources in our state.

“Our goal is to make sure people get screened for this disease and avoid ever hearing the words: You have cancer,” Andrea Shepherd, the project's executive director, said in a news release. “We hope that after viewing this documentary, people get on the phone and start talking with their physicians and families about colon cancer screening.”

The events are free and open to the public. More information and an RSVP form is available on the project's website.

Louisville elementaries part of 'up to date' health curriculum study

Jefferson County Public Schools have partnered with researchers at the University of Virginia to study how integrating bi-weekly health and wellness instruction into its elementary curriculum will affect students over the years.

“Our aim is to test – using the best scientific methods – a health education curriculum that is up to date on skills children need for the coming world, and that can have important impact on school engagement and achievement, mental and physical health, and long-term well-being," Patrick Tolan, project leader and professor and director of Youth-Nex, U.Va.'s center to promote effective youth development, associated with the Curry School of Education, told WVIR-TV in Charlottesville.

The Compassionate Schools Project will offer "a 21st-century health curriculum," which includes "mindfulness for stress management and self-control; contemplative movements for physical awareness and agility, nutrition knowledge for healthy eating, and social and emotional skills for effective interpersonal relationships," for all K-5 students in 25 schools by fall 2016. It is being preceded by an introductory year in three schools.

Twenty-five other schools will participate in the research as control schools, where the existing “practical living” curriculum will remain in effect. The Virginia researchers will evaluate the impact of the curriculum for six years, which is expected to include more than 10,000 students.

According to the researchers, "the ability to implement this curriculum at such a large scale will provide sound evidence of how the curriculum works, for whom, and in what areas of academic, behavioral and emotional well-being over the course of several years."

The program was created by the U.Va. in partnership with the Sonima Foundation and with support from the Hemera Foudation, and is funded by private donors.

KentuckyOne Health teaches diabetics to manage the disease

KentuckyOne Health has launched a new program to help Kentuckians with diabetes learn how to self-manage their disease, according to a news release.

"Giving patients the tools and knowledge they need to manage their own health, including their diabetes, is an important way to empower them to take charge of their health," said Amanda Goldman, director of diabetes and nutrition care for KentuckyOne and quality and wellness director for food and nutrition services of Catholic Health Initiatives, a partner in KentuckyOne.

More than one in 10 Kentuckians have diabetes and the state ranks 17th in the nation in incidence of the disease, according to the 2014 "State of Obesity" report. The Kentucky Cabinet for Health and Family Services reports an estimated 233,000 adult Kentuckians have pre-diabetes.

The new program will teach classes to help its participants learn how to manage diabetes testing and medication as well as the basics of using diet and exercise to improve their health. It will also offer individualized counseling sessions for those who need outpatient medical nutrition therapy.

The program is accredited through the American Association of Diabetes Educators and will be offered at the Healthy Lifestyle Centers at Jewish Hospital Medical Center Northeast, Sts. Mary and Elizabeth Hospital, Saint Joseph Hospital in Lexington, Saint Joseph East in Lexington, Saint Joseph Berea, Saint Joseph London, and Saint Joseph Jessamine. It will also offer outpatient services in downtown Louisville.

"Maintaining a healthy weight and a diet that's filled with nutrient-rich fruits, vegetables and whole grains can help not only to manage diabetes, but other health concerns like high blood pressure, high cholesterol, heart disease, stroke and more," says the release. The release also recommends regular exercise, under the direction of a health care provider, to "curb the effects of diabetes and other health concerns,"

Anti-obesity program targets preschoolers, will expand to rural Kentucky next year

By Melissa Patrick
Kentucky Health News

The latest America's Health Rankings report ranks Kentucky as the 47th healthiest state, a fall from 45th last year. With the exception of one year, Kentucky has found itself ranked as one of the bottom 10 states since the rankings began in 1990.

How does Kentucky even begin to dig itself out of this hole?

The long-term answer will likely be found in changing the health habits of our children, which is exactly what the Kentucky Department for Public Health is trying to do by participating in the National Early Care and Education Learning Collaborative Project, a childhood obesity-intervention program that targets child-care and education providers for preschool children.

Kentucky is one of a few states in the program, and will be expanding next year to locations in southeastern and western Kentucky.

“Sustained well-being is made possible when people learn the lessons of a healthy lifestyle early on,” Health Commissioner Stephanie Mayfield said in a press release. “By working with the early-care and education community, we are able to reach many of Kentucky’s young children and help them build the foundation for being healthy and active.”

Child obesity has been considered a national epidemic, with 17 percent of U.S. children considered obese and almost 32 percent considered overweight. Kentucky ranks eighth in child obesity, with 19.7 percent between the ages of 10 and 17 obese, according to the Trust for America’s Health and the Robert Wood Johnson Foundation’s annual "The State of Obesity" report.

The same report says nearly 16 percent of low-income children under the age of 5 in Kentucky who are enrolled in federally funded maternal and child health programs are characterized as obese. That is the target population for the project.

The project, which is part of a multi-state pilot funded by the federal Centers for Disease Control and Prevention and managed by Nemours Children’s Health System, aims to fight back against this epidemic by placing a focus on improving nutrition, increasing physical activity, reducing screen time, and providing breast-feeding support through a national curriculum and learning collaborative method with early care and education providers, according to a Nemours press release.

Kentucky received a $275,000 grant from Nemours to be a part of this project. Currently, nine states participate in the National ECELC Project.

The first phase of the Kentucky Early Care and Education Learning Collaborative includes 65 early care environments in Jefferson County, Fayette County and Northern Kentucky. The programs represent Head Start classrooms, non-profit and commercial child care, private preschool and public preschool settings and has reached 7,559 children.

Phase II of the project allows funding to launch four more collaboratives in 2015. The first two will launch in March: a second one in Jefferson County, and one in Laurel County, which will include an invitation to the early-care programs in the surrounding counties to participate. The second launch will happen in October, but these locations, which will be located west of Interstate 65, have not yet been determined.

Child-care centers in the program "participate in group learning and action planning and have access to technical assistance, tools, materials and resources to aid in their continuous improvement. Information is shared within and between teams," the state press release said.

The project is not designed to measure child outcomes, which would add tremendous cost in both time and money to this project, Rebekah Duchette, Kentucky's project coordinator, said in an e-mail. But they are seeing positive results from the program.

"We are seeing changes in environments, policies and practices around nutrition, physical activity, screen time, breastfeeding, family engagement and juice consumption," she said.

One of the missions of the project is to implement and influence policy around childhood obesity. Kentucky has taken this charge to heart both at the program level as well as the state level.

"We are working on some exciting policy changes and equally exciting clarifications for programs. At the program level we see programs implementing policies that go above what the state of Kentucky requires in child-care regulations: centers that are incorporating fresh fruits and vegetables, changing to seasonal menus that expose children to a larger variety of foods, eliminating pre-fried and fried foods from menus, adding more physical activity to the daily schedules and using physical activity time as learning time," Duchette said.

"As part of our sustainability planning we are working with early education stakeholders to develop a proposed list of child care regulations that support the best practices in healthy behaviors. Additionally, we are working with various branches of the state that regulate child care to clarify some existing regulations and send a consistent message to early care programs about how to implement best practices and stay in compliance with all state and local regulations."

“Reaching kids early is the key to combating childhood obesity,” Debbie I. Chang, vice president of policy and prevention at Nemours, said in the press release.

KET program to host authors of "Life Lessons from Cancer" to discuss inspirational messages of book

"One to One" with Bill Goodman will feature the authors of Life Lessons from Cancer, Keen Babbage and his sister-in-law Laura Babbage, on Sunday, Dec. 21 at 1 p.m. ET to discuss the book and its inspirational messages, especially the importance of family when facing life's challenges.

Keen Babbage, a teacher and native Lexingtonian, was diagnosed with cancer in his late 50s, despite a lifetime of healthy habits. He felt moved to share his experience in print.

With the help of his sister-in-law, a registered nurse and chaplain at the Chandler Medical Center at the University of Kentucky, they wrote Life Lessons from Cancer, published in September.

Keen told an audience at the first promotional event in October that he hoped the lessons in the book would be an inspiration and offer guidance for other patients with cancer as well as a resource for health-care providers.

The show will also air on Tuesday, Dec. 23 at 7:30 p.m. ET on KET2.

Conference focuses attention on importance of patient- and family-centered care, health education, communication

Health education, communicating with physicians, and patient- and family-centered care that empowers patients to be their own best health advocates, were some of the topics discussed at the Health Watch USA conference in Lexington this month.

Joycelyn Elders

“Patient empowerment is the right of the patient to take an active role in decisions about his or her own care,” said former U.S. surgeon general Joycelyn Elders, professor emeritus of pediatric endocrinology at the University of Arkansas. “But you can't make a good decision if you have not been educated. You can't keep an ignorant population healthy.”

Waiting until a person is old and set in their ways and then trying to teach them better health strategies doesn't work, Elders said. For patients to really be involved in their health, health education must start early.

“We must push for comprehensive health education in our school systems from kindergarten through 12th grade,” she said. “It is just as important as teaching reading, writing, and arithmetic. . . . We need to have science-based answers rather than ubiquitous myths. We need to protect people by arming them with correct information.”

Elders offered some practical suggestions to help patients become more empowered during their doctor's visits:

• Take a trusted person with you.
• Ask questions if you don't understand.
• Bring all of your medications with you.
• Write down questions and concerns before you go.
• Ask your doctor to write down information and instructions discussed.
• Make sure to tell your doctor if you have vision or hearing problems.

Elders said health education for physicians could also be improved, by putting more emphasis on preventive care and the treatment of chronic diseases, which are 75 percent of diseases in the United States, rather than acute diseases.

“We spend only 3 percent of our health-care dollars on keeping people well,” Elders said. “We have to do a better job. We haven’t educated our doctors.”

Karen D. Meyers

Karen D. Meyers, a lawyer who works with catastrophic-injury victims and health-care providers, said medical schools must start teaching doctors how to become better collaborators, not only between specialties, but with their patients as we move toward a model of patient and family centered care.

“They must learn to treat patients with dignity and respect, listen and share information with their patients, and allow patients to participate in their care,” said Meyers, who became an advocate for patient- and family-centered care after becoming a health advocate for her mother, who was in a coma for 40 days.

Elders said patient empowerment requires the patient to take some responsibility for his or her care, which requires respectful communication and shared decision-making between the doctor and the patient. The current physician-patient model of care does not support this concept, Elders said: “This has to change.”

Meyers concurred, saying physicians, hospitals and patients must change the attitude of “my patient, my treatment plan, my procedure, my case” to a model that recognizes that “everything about a patient's health belongs to the patient and their family.” She added, “Patients have to understand, because they are responsible for their care.”

Health Watch USA, based in Somerset, was founded by Dr. Kevin Kavanagh to promote health care transparency and patient advocacy, according to its website. For its report on the conference, in PDF format, click here.

Fear of Ebola is causing people all over the country to act on unfounded fears, and Kentucky is no exception

By Melissa Patrick
Kentucky Health News

Fearing the Ebola virus, administrators at St. Margaret Mary Catholic School in Louisville put Susan Sherman, a registered nurse and an elementary school teacher, on "precautionary leave" after she returned from a medical mission trip from Kenya, an African nation that is 3,000 miles from Ebola-stricken areas and has no known Ebola cases, Allison Ross reports for the The Courier-Journal. Sherman has since resigned from her job.

Last week, Paul Sherman, Susan's husband and a retired orthopedic surgeon, sent a letter to Louisville Archbishop Joseph Kurtz, complaining that "unfounded fears" of some parents and parish staff "are triumphing over truth and reason, " Ross reports in a separate article.

Kurtz said in retrospect that the school's decision to ask Sherman to take a leave of absence was "not the right judgement" and that he was "very open" to having her come back to work at the school again, Ross reports.

The school has also sent a letter to parents saying that it asked Sherman to take a leave because "attempts to communicate facts and reduce fear were unsuccessful," and apologizing for poor communication to her, Ross reports.

Sherman's husband responded with a letter and said his wife was not "asked" to take a leave and called the school's apology "'half-hearted' and disputed parts of the school's account," Ross reports.

Fear of Ebola was also used as part of an election strategy during the recent U.S. Senate race, reports Kentucky's U.S. Senate Race, an independent blog run by students and their instructor, Al Cross, at the University of Kentucky:

"A stealthy coterie of difficult-to-trace outside groups is slipping tens of millions of dollars of attack ads and negative automated telephone calls into the final days of the midterm campaign, helping fuel an unprecedented surge of last-minute spending on Senate races," report Nicholas Confessore and Derek Willis of The New York Times. "Much of the advertising is being timed to ensure that no voter will know who is paying for it until after the election on Tuesday." The story doesn't mention Kentucky, but a friend of ours in West Kentucky, a white man in his early 60s, said he got about 10 phone calls Sunday, most favoring Republicans, including one with a woman's voice "threatening 'African danger' from Ebola and to vote against Obama," he wrote in an email.

CBS News reports other cases of unfounded Ebola fears affecting people who had no apparent risk of exposure to the disease, including a third-grade girl in Milford, Conn., who after returning from a relative's wedding in Nigeria, which was recently declared Ebola-free, was told to not come to school for 21 days "due to concern from certain parents and teachers that she could transmit Ebola to other children," according to the lawsuit. They also report that two middle school boys in the Bronx, originally from Senegal, also with no known cases of Ebola, have been harrassed with Ebola taunts at school.

Ross cites more stories of fear from across the nation, including a certified nursing assistant in Dallas who claimed she was sent home because her daughter had visited Kenya, and a bridal shop in Akron that closed temporarily after learning that a nurse who was later diagnosed with Ebola had shopped there.

A recent press release about Ebola from Kentucky's Cabinet for Health and Family Services says,"There is no significant risk to Kentuckians at this time."

“The only individuals potentially at risk for Ebola in the United States right now are those who have traveled to affected areas of West Africa or who have been directly involved in treating cases of Ebola or close contacts to a symptomatic patient with Ebola," Health Commissioner Stephanie Mayfield said in the release.

The release reminds us: "Ebola is not spread by air, water, casual contact or food in the United States. You can only get Ebola from contact with bodily fluids of a person who is sick with or has died from Ebola, or from exposure to contaminated objects, such as needles."

The only actual Ebola case known in the U.S. right now is that of a New York physician who was infected while treating patients in Guinea. He is listed in stable condition at a Manhattan hospital, CBS reports.

Kentucky schools teach nutrition with hands-on-learning

Visiting dairy cows, growing food in the air and being the first school in the state to grow its own garden on school grounds are just some of the efforts Kentucky schools are making to help their students learn more about nutrition.

Shelby County's Heritage Elementary School joined schools in 40 countries in the 15th annual World School Milk Day on Sept. 24, where they learned about the nutritional importance of milk, Ashley Wilkins reports for The Sentinel-News of Shelbyville.

The students learned from the Southeast United Dairy Industry Association in the cafeteria, which was decorated in a cow-related theme while the cafeteria employees wore cow costumes and provided milk to the students. The students also enjoyed stick-on milk mustaches and were able to pet and view calves outside on the playground.

“Lots of kids don’t have a lot of opportunities to see dairy cows up close,” SUIDA's Kathy Belcher told Wilkins.

Students in the Eastern Elementary School Wellness Club in Barren County are learning about nutrition not only in this club, but with its hydroponic tower garden, adding a second one this week, Bobbie Hayse reports for the Glasgow Daily Times.

The Wellness Club meeting was led by fourth-grade teacher Cathy Bishop, who asked the students if they had talked to their parents about what they had been learning about health. They also talked about who had met their goal of not drinking any sodas that week, and also about the importance of making healthy choices such as getting plenty of sleep, drinking plenty of water, making good food choices, exercising and limiting screen time.

“We need to try to make healthy choices, and try to take care of our bodies the best we can because this is the only body we get,” Bishop said. “The habits we start today are going to make a difference for the way our body feels a long time down the road from now."

Nutritional learning in the club is reinforced with growing plants in the tower gardens, which are vertical systems that grows food hydroponically with aeroponics, a process for growing food in an air and water environment, Hayse reports.

Jennifer Turner, a dietitian who helped the students plant seeds and build the tower garden, told Hayse, "Research shows that if kids have a hand in growing and making food, they are more likely to try it."

Beaver Dam Elementary School in Ohio County is the first school in the state to have a garden on school grounds, through donations from businesses and individuals, Lisa Autry reports for WKU Public Radio.

Kindergarten teacher Becky Gaither, who helped start the garden project, told Autry that "students learn the value of hard work by maintaining the garden and they get to enjoy the harvest." She said that the students had already made pizzas in the classroom with cherry tomatoes and herbs harvested from the garden.

Kentucky Agriculture Commissioner James Comer visited the school on Thursday to recognize the school as having the state’s first certified “Ready, Set, Grow” garden and said he hoped the "concept will expand statewide," Autry reports.