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Vamos and colleagues examined seven years of data on nearly 125,000 people in England with type 2 diabetes, which is associated with aging and obesity and accounts for most cases of the disease. Vamos said that flu vaccine may not only lower incidences of stroke and heart attack in high risk patients, but it may also reduce the risk of death during the flu season. Furthermore, flu infection has been found to increase the risk of heart attack or stroke in patients with cardiovascular disease. The scientists found that, compared to patients who had not been vaccinated, those who received the jab had a 30 per cent reduction in hospital admissions for stroke, 22 per cent reduction in heart failure admissions and 15 per cent reduction in admissions for pneumonia or influenza.
The research team says that there have been quite a few studies in the past that looks at the effectiveness of the flu vaccine in diabetes patients.
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Implement treatment strategies that reflect recent advances in insulin and incretin-based treatment strategies for the management of T2DM. Review recent advances in combination treatment strategies for patients with T2DM and identify patients who may benefit from such regimens.
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Science, Technology and Medicine open access publisher.Publish, read and share novel research. Behavioral Problems and Depressive Symptoms in Adolescents with Type 1 Diabetes Mellitus: Self and Parent ReportsNienke M.
Although the Body Mass Index (BMI), a calculation based on height and weight, helps measure a persona€™s a€?desirablea€? weight, it is not always accurate.
Accumulation of weight around and above the waist (apple-shaped) rather than the hips and buttocks (pear-shaped) increases a persona€™s risk for cardiovascular disease. Please register to participate in our discussions with 1.5 million other members - it's free and quick!
I don't know what the season might be for rambutan, but I see them for sale fresh at the farmers markets when I look for them during hot weather. Basically you cut around the spiny red skin and pop it open to free the translucent gelatinous fruit inside.
Rambutan also came to mind too, because we have it here in the Philippines like Hawaii does! We also have dragon fruit where the insides are white or red, but I don't care for the taste though, hard to described it.
The red that are sold mostly come from Costa Rica, I think, and if you eat a lot of the red ones they turn your pee and poo red! Here's a link to Plant it Hawaii which is a nursery above Hilo which is probably the best source for a lot of these different tropical fruits. I suppose it would be smarter to buy fruit at the farmers market and taste before planting trees. It is delicious tasting, like a delicate custard, and it's considered a superfood by some health experts and raw food gurus. Two new studies show that the percentage of obese adults, adolescents and children in the U.S. That was an improvement for NC compared to 2010 when it had the 10th highest obesity rates for adults.  However, the childhood obesity rank held at 11th. The NC State Center for Health Statistics produced this graphic on overweight and obesity based on BRFSS (Behavior Risk Factor Surveillance System of the CDC) data from 2009.  It provides and interesting geographical look at the percentages by county, the starkest difference being between the sides of the state. Since the vast majority of added sugars we eat come from processed foods and beverages, the first step in reducing sweeteners is to be able to identify them on the food label. Use our infographic, 46 Sneaky Names for Sugar,” to help you identify added sugars in the ingredient lists so you can keep better tabs on sources of added sugars in your diet.
The researchers also looked at records during the flu season and during summer, when the flue is less common.
It’s also possible that people who get vaccinated are healthier in other ways than people who skip their annual flu vaccine, the authors also point out. Many countries encourage vaccination against influenza, especially in older people and people with multiple health issues such as diabetes, although there is uncertainty about vaccine effectiveness in these groups.
Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. Athletic people with well-developed muscles often have a BMI higher than normal because muscle weighs more than fat.
I also hear that dragon fruit is good for the control of blood sugar for those with Diabetes type 2! I went to a wedding in Brooklyn once where one of of these folk brought a half dozen of these big fruits as a special treat, but if you wanted to taste some you had to go out to the far corner of the big commercial kitchen, where he was sequestered with his treats, under a big exhaust fan.


That’s 2-3 times as much added sugar as what health authorities recommend to keep tabs on obesity, type 2 diabetes, heart disease and many other chronic conditions that are linked to too much sweeteners. However, when combined with other measurements, such as waist size, the BMI is a helpful tool in determining whether a person should lose weight to reduce health risks. Data from the most recent National Health and Nutrition Examination Survey (NHANES) show more than one-third of U.S. Hood, 2010Depressive symptoms in adolescents with type 1 diabetes: associations with longitudinal outcomes. IntroductionChildren and adolescents with chronic diseases are at higher risk for mental health problems.
Drash, 1997Major depressive disorder in youth with IDDM: a controlled prospective study of course and outcome.
Especially in adolescence, which involves a multitude of physical, cognitive and emotional developmental changes, a chronic disease such as diabetes mellitus type 1 (T1DM) that requires daily, careful attention, may influence social and emotional functioning. Offord, 1993The outcome of adolescent depression in the Ontario Child Health Study follow-up. Adolescents with T1DM must deal with disease-specific stressors, in addition to age-specific stressors (Reid, Dubow, Carey, & Dura, 1994). Cakan, 2004Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: a prospective study. Garralda, 2009Neuro-cognitive performance in children with type 1 diabetes--a meta-analysis. Stress, in itself, may dysregulate diabetes through psycho-physiological processes or associated changes in self-management behaviors (Snoek, 2000). Cicognani, 2008Quality of life, psychological adjustment and metabolic control in youth with type 1 diabetes : a study with self- and parent-report questionnaires. Dura, 1994Contribution of coping to medical adjustment and treatment responsibility among children and adolescents with diabetes. Therefore, diabetic treatment guidelines include metabolic goals, as well as facilitation of normal social and emotional development (Grey & Boland, 1996).
Problems in social-emotional functioning are reflected in the occurrence of internalizing or externalizing behavior problems.
Werther, 2005Psychiatric comorbidity and health outcome in type 1 diabetes; perspectives from a prospective longitudinal study. Hershey, 2008Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus. Snoek, 2007Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control.
The kind of mental health problems experienced by adolescents with T1DM needs to be clarified, in order to improve guidelines for treatment of diabetes.
To this end, researchers should rely upon both adolescent-reported measures that might be applied in regular care, as well as parent-reported measures. Young, 2004Relationship of depression and diabetes self-care, medication adherence, and preventive care.
Comparing answers of these youths to those from healthy peers can indicate the extent to which differences exist between these groups.We studied whether Dutch adolescents with T1DM had increased levels of behavior problems in comparison to peers without T1DM, both according to their self-reports and reports from their mothers and fathers. Additionally, we examined the extent to which metabolic control is related to depressive symptoms and specific behavior problems. Mc Keown, 2006Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth study. Sample Patients with T1DM between 12 and 18 years of age (n=302) and their parents were recruited for participation. Medical information (most recent HbA1c, duration of the disease, and treatment regimen) was recorded from the hospital charts. HbA1c was analyzed with similar assays, using gas chromatography, in the different hospitals. Schools were approached for cooperation in the same time period in order to recruit the comparison group.
Healthy adolescents without T1DM and their parents were invited to participate, matching school type, age, and gender to that of the adolescents with T1DM. The comparison group comprised 122 adolescents without T1DM; In formation was also collected from 114 of these mothers and 61 of the fathers. Exclusion criteria for both groups were no participation of a parent, and comorbid medical or psychiatric illness of the adolescent.
The children’s depression inventoryThe Children’s Depression Inventory (CDI) was developed to measure self-reported depressive symptoms in children and adolescents aged 7 to 17 years (Kovacs, 1992). The inventory assesses a variety of self-reported depressive symptoms, including disturbance in mood, self-evaluation, and interpersonal behaviors.
A cutoff score of 13 was used to indicate a serious level of depressive complaints, at risk for a clinical depression (Kovacs, 1992).
The child behavior checklist (CBCL) and youth self-report (YSR)The presence of behavior problems was studied using information from different sources, namely the adolescent themselves (YSR), and their mothers (CBCL) and fathers (CBCL).
The Child Behavior Checklist (CBCL) measures behavior problems and competencies of children and adolescents between the ages of 6 to 18, as reported by their parents (Achenbach & Rescorla, 2001). The Youth Self-Report (YSR) is a self-report derivative of the CBCL for adolescents between 11 and 18 years. The CBCL and YSR questionnaires have been shown to have adequate reliability and validity (Evers et al., 2000). ProcedureThe adolescents with T1DM answered the questionnaires when they visited the diabetes team, or at home. For the control group, the questionnaires were sent to the adolescents and their parents at home.
Data analysesPotential differences in group characteristics were analyzed using chi-square or t-tests.


Within the T1DM group, a regression analysis was conducted to study the relationship between HbA1c and the depressive symptoms and behavior syndrome scales.3.
Group characteristics A description of baseline group characteristics can be found in table 1.
The total group of adolescents with T1DM did not differ from the comparison group in age, gender, or education level, as expected in light of the matching procedure. In the group with T1DM, 18 adolescents (12.4% of a total 145 with complete data) were identified as being at risk for a clinical depression, as were18 adolescents in the control group (14,8% of in total 122 with complete data). Behavior problems Means and standard deviations for the YSR (as assessed by the adolescents) are presented in table 2, as are CBCL behavioral syndromes (as assessed by mothers and fathers). This table also indicates significant differences found with univariate analyses of variance. Mean factor scores (internalizing, externalizing, and total behavior problems,) and mean scores for the behavioral syndrome scales for adolescents with and without T1Dm, are presented in figures 2 and 3. One behavioral syndrome scale differed significantly between the groups, reflecting Thought problems, (F(1,247)=11,63, p=0.001), see table 2. Glycemic control and social emotional functioningA regression analysis, using the enter procedure, was conducted in order to study the relationship between glycemic control and social-emotional functioning of adolescents with T1DM, as represented by their CDI score and the scores on the eight behavioral syndromes of the YSR (see table 3).
DiscussionOur study on the types and extent of social-emotional problems among adolescents with T1DM revealed that emotional and behavior problems are related to glycemic control. Blood glucose regulation was found to be related specifically to depressive symptoms and rule breaking behavior among the adolescents with T1DM.
The adolescents with poor blood glucose regulation experienced difficulties, in general, as well as problems followng rules; This likely also extends to difficulties in following the rules of their treatment for diabetes. The problems adolescents with T1DM experienced in social emotional functioning could be specifically related to diabetes and diabetes management tasks. The questionnaires used in this study were not diabetes-specific, however, so we cannot indicate diabetes-specific burdens yet.We also found a remarkable difference, in that the adolescents with DM1 reported more thought problems than the comparison group. The results of our comparison group were in the same range as those of the original norm group of the YSR (Achenbach & Rescorla, 2001). The reports of both mothers and fathers did not show an overall significant difference, but looking univariately at the dimension, a difference in thought problems also appeared in mothers’ and fathers’ reports of youths’ functioning, with parents of adolescents with T1DM reporting more thought problems than the parents of healthy adolescents. The fact that mothers and fathers of youths with T1DM agreed with their children regarding the higher prevalence of Thought problems may underline the importance of these kinds of behavioral difficulties. Thought problems refer to a variety of problems in learning behavior and information processing.
These adolescents more often ruminate on certain thoughts, and have twitches, strange thoughts, or sleeping problems. An explanation for such group differences may be found in subtle neuropsychological effects of diabetes. Both hypo- and hyperglycemia affect cognitive functioning, but in different ways (Periantie et al., 2006). In a recent meta-analysis, Naguib and colleagues (Naguib, Kulinskaya, Lomax & Garralda, 2009) found mild cognitive impairments in adolescents with T1DM, especially poorer visuospatial ability, motor speed, writing, and sustained attention. The relationship between thought problems and blood glucose regulation was only marginally significant in our study. It is conceivable, however, that the fluctuating blood glucose levels that all patients with diabetes experience, and the high blood glucose regulation in our group (mean 8.3%), may influence thinking and perception. Our findings are also in line with Nardi (Nardi et al., 2008), who found more thought problems among adolescents in the age of 14 to 18 with T1DM, relative to a comparison group. Our findings indicate that one in eight youths with T1DM met the clinical cut off for depression.
This level of depressive symptoms is comparable with the results of Hood (Hood et al., 2006), who reported that one in seven adolescents with T1DM met the same criteria for depression as used in our study. Clinical implications In view of the elevated thought problems, and the important associations that blood glucose regulation held with both depressive symptoms and rule breaking behaviors, routine screening for behavioral problems in adolescents with T1DM is recommended. Increased attention should be devoted to the large group of adolescents who have poor metabolic control.
Although strict diabetic treatment management is necessary to maintain adequate levels of HbA1c, this may indicate greater interference with daily life. Adolescents need to be stimulated by their parents and health care professionals to find intrinsic motivation for their own disease management, and to maintain their mental health.
Thought problems may need special consideration, and it seems useful to investigate whether and how these problems interfere with diabetes management and daily living. To optimize glycemic levels, specific attention should be paid to adolescents reporting depressive symptoms or rule breaking behavior, in general, because they may experience the most adaptation problems when it comes to treatment rules. Strengths, limitations, and future directions A strength of our study is that we examined a relatively large group of 151 adolescents with T1DM. The self-selection evolving from voluntary participation may have led to an underestimation of the number of adolescents with depressive symptoms in the group with T1DM.
Nevertheless, the group differences found in a behavioral syndrome like thought problems need further study, as it may be important to consider for treatment improvements.
The adolescents with T1DM did not differ from healthy peers in their number of depressive complaints.
However, the combination of depressive symptoms and rule breaking behavior was related to metabolic control. Further, elevated thought problems were found among adolescents with T1DM, in comparison to healthy peers.




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