Prevalence of diagnosed diabetes has risen from 4.9% in 1990 to 7.3% in 2000.
There are approximately 12-14 million adults with known diabetes. Prevalence rises with increasing age.
An additional 6-7 million adults have diabetes but do not know it. When people with IGT are included, over 25% of the adult population in the U.S. has abnormal glucose metabolism.
Type 1 diabetes is present in less than 1 million people in the U.S. In 1997, expenditures attributable to diabetes were $98 billion.
Total medical expenditures by people with diabetes in 1997 were in excess of $10,000/year, about 4 times the expenditures for people without diabetes.
People with diabetes lose about 8.3 days from work each year, 5 times the days lost by those without diabetes.
A shift from hospital to outpatient-based care resulted in a decrease in direct costs for diabetes between 1992 and 1997, despite increased prevalence of the disease.
Major cardiovascular risk factors are usually present in excess before the diagnosis of type 2 diabetes as well as during the course of the disease.
Major advances in preventive measures directed at the complications of micro and macrovascular disease will lead to reduced costs of diabetes in the future, if translated into usual diabetes care.
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Posted: Friday, March 25th, 2011 at 5:39 am
Filed Under: Diabetes | No Comments »
Generally, xanthines do not cause serious long-term side effects. However, there can be acute side effects if the dosage is high. These side effects mainly involve the stomach and the nervous system. The effects on the stomach include nausea, vomiting, loss of appetite, stomach aches and cramps. The effects on the nervous system include irritability, dizziness, tremors, insomnia and headaches. Some children may become hyperactive, and in rare cases, develop learning problems. Parents should look out for these symptoms.
Sometimes the stomach or the intestines may become sensitive in which case theophylline or other xanthine drugs can be taken with milk, biscuits or other foods.
Precautions. These medicines should be taken exactly as prescribed, which is usually at equally spaced intervals spread over a 24-hour period. It is important to maintain their level in the blood stream within the therapeutic range at all times. The medicine should therefore be continued even when the child is well and shows no apparent signs of asthma. Any adverse or side effects should be reported to the doctor so that he can regulate the dosage to minimise or avoid undesirable side effects. The doctor should be informed if the child is taking any antibiotics. If so, the dose may need to be adjusted to keep the level of the drugs in the therapeutic range.
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Posted: Friday, March 18th, 2011 at 5:38 am
Filed Under: Asthma | No Comments »
The word allergy is fairly young but the signs and symptoms have been noted for centuries. Of course Hippocrates referred to it long before Christ. Four centuries ago a cardinal was said to have been forced to withdraw every year at the time the roses were in bloom. Thomas Willis is well known to us doctors for describing some little blood vessels at the base of the brain which occasionally force themselves on our attention by rupturing. About the time that Charles II was living his riotous life, and our austere ancestors were developing our eastern seaboard, Willis described asthma. Only in the last century has “hay fever” been recognized. The English in particular have continued to be hay-fever minded, while we in America are more disturbed by other plants.
The man who really told us something was Dr. Morrill Wyman, of Harvard Medical School, who eighty years or so ago wrote a book on Autumnal Catarrh. He was the one who put a finger on that wicked, wicked villain, ragweed. Somewhat before his time there was a pretty strong opinion that asthma was a nervous affliction. One man whom I cannot identify told of “an asthmatic little boy who would say to his father, ‘Don’t scold me or I will have the asthma,’ and so he did: his fears were as correct as they were convenient.” We all recognize now that both nervous and physical effects play a part.
There certainly is no routine way to dodge allergy, whether or not your equanimity and peace of mind are catered to. I have a fortunate friend who is fond of the mountains and at the proper time he takes his vacation in the White Mountains, where he is free from the pollen and happy. Such travel is worth while. It is a different story when home life is broken up to seek some distant location where bodily reactions will be no longer vile. There are pollens and molds practically everywhere. Often at first there is temporary improvement, but too often it is short lived. But always if a move is tried it should first be on a temporary basis. Do not burn your bridges behind you. Arrange it so that a return may be made to the scenes, friends, and associates of a lifetime if permanent relief is not found in the new place. Perhaps your psyche will come to your aid with your final return to your familiar and formerly loved surroundings.
The identification, regulation, and treatment of a case of allergy is a time-consuming, difficult job. Here is a rough outline of the manner in which it is usually done.
1. An exhaustive survey is made of clues and possible causes.
2. A general physical examination is made to appraise the patient as a whole.
3. Such tests as are called for to verify or disprove the clues obtained are now performed.
4. The non-essential items to which the patient is allergic or sensitive are eliminated. Common examples of these are pets, egg, lobster, feathers.
5. Injections are given to immunize against those things which cannot be eliminated from the environment. Examples: pollens, molds, and dust.
Successful management of allergic problems demands not only tests but the survey of the patient as a whole and the employment of previous experience of like cases. All possible approaches should be used. Patience on the part of the doctor and the patient is essential. Trial and error are often necessary and that takes time.
There is a tremendous amount of enthusiastic study of allergy going on at the present time. Several of my friends attend frequently what they call their Sneeze, Wheeze, and Itch Club. I should think that they would need a little of this jocosity to brighten up their work which to an onlooker would seem to be long and difficult, often baffling, and with many discouraging setbacks. Yet its rewards are great.
Few things not lethal that happen to the human body are more distressing than the manifestations of allergy. To restore to comfort a child covered with itching eczema, or an older person gasping and fighting day and night for barely enough air to keep alive, is indeed a rewarding experience. Diligent study by devoted physicians and the discovery of numerous new agents are bringing this about with increasing frequency.
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Posted: Friday, March 11th, 2011 at 5:38 am
Filed Under: Allergies | No Comments »