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.

McConnell, Mass. Democrats find common ground on opioid-overdose epidemic; Kentucky ranks 3rd in overdose deaths

Republican U.S. Sen. Mitch McConnell and two Massachusetts Democrats have found common ground in efforts to fight the opioid-overdose crisis and are working across the aisle to push for legislation and information to address it, Asma Khalid reports for WBUR, a Boston NPR affiliate.

Sens. Ed Markey, D-Mass., and Mitch McConnell, R-Ky.,
agree on fighting the opoid overdose epidemic. (AP photos)

“McConnell and I are requesting that there be a surgeon general report on the opioid overdose epidemic in the United States,” Sen. Ed Markey told Khalid. Markey is also co-sponsoring a bill with Sen. Rand Paul, R-Ky., to expand the use of medication-assisted treatment, like Suboxone.

Kentucky has the third highest overdose death rate in the nation, with more than 1,000 people dying each year, according to the state attorney general's website. Massachusetts has the 32nd highest overdose death rate in the nation, according to Trust for America's Health. Most of these opioid deaths in both states are from prescription drugs.

“The reason I can do that with two senators from Kentucky, who are Republicans, is that there really is no difference between Lexington, Massachusetts, and Lexington, Kentucky,” Markey said. “We have an epidemic in both states, and we have to ensure that we put together a national plan.”

McConnell has also partnered with Rep. Katerine Clark, D-Mass,, on a bill that focuses on infants and neonatal abstinence syndrome. “Mitch McConnell and I may disagree on 98 percent of topics, but we agree on this,” Clark told Khalid.

Drug-dependent newborns in Kentucky increased by 48 percent last year, to 1,409 from 955 in 2013, which was up from only 28 in 2000, Laura Ungar reported for The Courier-Journal last week. "Research in the Journal of Perinatology shows opioid addiction in babies grew nearly five-fold between 2000 and 2012," Khalid notes.

The McConnell-Clark proposal "tries to pull the best practices from around the country to improve treatment and prevention for sick babies. The bill has 80 cosponsors so far, and they’re from both sides of the aisle," Khalid reports, with no opposition voiced at the House Committee Energy and Commerce last week.

Another Massachusetts Democrat on the committee said he supports the effort, but the key is money -- something McConnell has been stingy with, supporting automatic cuts to reduce the federal budget deficit.

“The big push that I’ve been trying to focus on in our hearings is this comes back to the lack of resources — lack of doctors, lack of treatment facilities, lack of beds, lack of continuum of care,” said Rep. Joe Kennedy III, D-Mass., “because our federal government has systematically underfunded resources for prevention and treatment.”

Eating trans fat weakens memory in younger men, study says

Trans fats, the use of which the U.S. Food and Drug Administration limited last month, are associated with reduced memory function in men 45 and younger, says a University of California San Diego School of Medicine study published in the online journal PLOS ONE.

Researchers asked 1,018 men and women to fill out a dietary survey and take a word-recall memory test. Men 45 and younger remembered an average of 86 words, but for each additional gram of trans fats eaten daily, memory dropped by 0.76 words. Compared to the men who didn't consume trans fats, those in the study who consumed the most recalled 12 fewer words.

"Trans fats were mostly strongly linked to worse memory in men during their high-productivity years," said Beatrice A. Golomb, lead author and professor of medicine at UCSD. "Trans fat consumption has previously shown adverse associations to behavior and mood—other pillars of brain function. However, to our knowledge a relation to memory or cognition had not been shown."

Other research has shown that trans fatty acid consumption is linked to negative effects on lipid profile, metabolic function, insulin resistance, inflammation and cardiac and general health. "As I tell patients: While trans fats increase the shelf life of foods, they reduce the shelf life of people," Golomb said.

Obese children's parents say kids are 'about the right weight,' likely comparing them to other kids instead of growth standards

Most parents of overweight children consider them to be "about the right weight," which poses a real concern because parents aren't likely to help their children change their behaviors toward weight reduction if they don't recognize there is a problem, according to a study from the NYU Langone Medical Center.

Photo: nydailynews.com

"Parental recognition of their child's overweight status is paramount in childhood obesity prevention efforts," says the report. "Previous research has shown that parents with accurate perceptions have a greater readiness to make weight-related changes in health-related behaviors and are more effective in doing so.

Kentucky ranks sixth among the states for obesity among preschoolers, with 15.5 percent of 2-to 4-year-olds from low-income families considered obese, according to the "States of Obesity" report. This percentage has remained consistent for several years, but it's worth noting that in 1989, only 9.4 percent of of this population was considered obese. "Children who are overweight or obese as preschoolers are five times as likely as normal-weight children to be overweight or obese as adults," says the federal Centers for Disease Control and Prevention.

The study, published in the journal Childhood Obesity, analyzed data from two groups of children over two time periods from the National Health and Nutrition Examination Survey, one between 1988 and 1994 and the other between 2007 and 2012, both samples had over 3,000 children. The survey asked parents whether they considered their child, ages 2–5-years-old, to be overweight, underweight, or just about the right weight.

Nearly 97 percent of parents of overweight boys in the earlier group identified their sons as "just about the right weight," compared to 95 percent in the second group; 88 percent of parents of overweight girls thought they were "just about the right weight" in the first group, compared to 93 percent in the later group. Experts have dubbed this misperception "The Goldilocks syndrome."

Notably, the researchers said that "the children in the second study group were significantly more overweight than the children in the first study group, yet the parents’ perception of their children remained relatively unchanged." In fact, "the misperception became more prevalent in the recent survey given that an estimated 30 percent reduction in correct perception was observed, compared to the earlier survey," says the report.

"It shows that essentially we're more obese as a society and we're not recognizing our obesity as a society, in this case in children," Dustin Duncan, lead author of the study and assistant professor in the Department of Population Health at NYU Langone, told Lisa Flam on NBC's "Today" show. "Obesity is a well-known medical condition associated with immediate and long-term health risks for children. This is an alarming finding."

The study also found that these misperceptions were more pronounced among the African-American families. "This was especially concerning because African-American and low-income children in the U.S. have the highest rates of obesity," Duncan said in the release.

One reason given for these misperceptions is that parents often compare their own child to other kids in deciding if their child is overweight instead of using science-backed growth charts. The authors also noted that poor communication between parents and their pediatricians could also contribute to these misperceptions.

“We need effective strategies to encourage clinician discussions with parents about appropriate weight for their child. This will be critical for childhood weight management and obesity prevention," Jian Zhang, senior author of the study, said in the release.

Louisville dental school ranked second in U.S. by website that surveys students and recent graduates

The University of Louisville School of Dentistry is ranked second among dental schools in the U.S. by GraduatePrograms.com, a peer-written rating and review site for graduate schools. Last year the school ranked fourth. The No. 1-ranked program on the site was Western University of Health Sciences in Pomona, Calif.

Students and recent graduates, contacted via scholarship entries and social media, rate schools on 15 areas, including academic competitiveness, workload and faculty accessibility, a university news release said.

 “It is gratifying to know that students at the UofL School of Dentistry value their experience in the program, even if it is from a limited sampling,” Dean John Sauk said in the release. “In any case, we will persevere to continually seek to improve the quality of our educational programs and develop the empathy and skills of the professionals we educate.”