الاثنين، 29 أغسطس 2016

Your Rights, One Voice: Carol’s Story

Legal_Advocacy_082916

It’s probably one of the worst fears there is for a parent of a child with diabetes: That their child could suddenly not have access to life-saving diabetes medications.

Legal_Advocacy_082916That is what happened to Carol. Her 31-year-old son Dan, who has had type 1 diabetes since age 18, was sentenced to 60 days at a Minnesota county jail for a misdemeanor offense. It may not seem like a very long time, but for someone with type 1 diabetes, 60 days of potentially receiving very poor diabetes care can be life-threatening.

Just 10 days after being incarcerated, Dan was already experiencing physical symptoms from constant high blood glucose levels. He was being denied access to appropriately timed insulin—and was being punished for demanding to see a nurse or requesting insulin. Dan was extremely anxious and felt helpless about his situation. He resorted to not eating in order to keep his blood glucose from going even higher. This resulted in jail officials deeming him a danger to himself and placing him in lock-up.

Dan was doing his best to advocate for himself from within the facility. On three different occasions, he filed grievances about the lack of diabetes care, and those grievances were refused. He requested to be taken to the emergency room because of how ill he was feeling (weakness, blurry vision, back and side pain that he associated with his kidneys, etc.) and that was also refused.

Carol used the facility’s online system to put money in a phone account for Dan, so he could call and inform her of what was going on. Dan was scared and begged for help. He told his mother this was the worst situation he’d ever been in. He had never felt as ill because of his diabetes as he did when he was in jail, and he feared for his life and well-being.

Carol, too, was trying to advocate for better care for her son from her home in Michigan, but to no avail. She had Dan’s personal doctor send his prescribed insulin regimen and medicine to the jail in an effort to educate the jail medical unit. Carol also spoke with jail officials and was told that they limit insulin in order to protect staff and themselves from liability. Carol also spoke with the Sheriff on two occasions, but those conversations were not productive.

Aside from the poor diabetes care he was receiving, Dan was also denied access to a work release program that the judge approved him for—a program that would have allowed him an earlier release from jail. Officials were denying him access because his blood glucose levels were too high, a condition that they were responsible for causing and that only they could correct.

All of this amounted to one thing: Dan was being discriminated against because of his diabetes. He went five weeks without proper diabetes care. It was a horrifying experience.

Then, Dan told Carol about a time that he fainted in front of other inmates and guards; rather than get him medical help, the guards removed him and put him in isolation. That’s when she called the American Diabetes Association® for help for her son.

Carol spoke to a Legal Advocate who gave her information about her son’s rights and guidance on how to move forward. The Legal Advocate also sent information directly to Dan and referred the case to Tim Phillips, a Minnesota attorney who is a member of the Association’s Advocacy Attorney Network.

Dan used the information and sample language provided by the Legal Advocate to write a fourth grievance, which was finally accepted by jail officials. At the same time, Phillips sent letters to the Sheriff’s office and to the jail’s medical unit demanding adequate care and access for Dan.

Immediately, Dan began receiving his insulin as prescribed, including corrective insulin, and blood glucose checks as needed. His health improved and he was allowed work release for the last few weeks of his sentence.

Phillips was very pleased that jail officials finally decided to do the right thing. He encourages other attorneys to take on these cases: “Prisons and jails aren’t safe for anyone. Attorneys should intervene on behalf of people whose rights are violated, whether by writing letters or filing lawsuits.”

Dan did not stop there. He shared the information he received from the Association with other detainees with type 1 who were not receiving adequate diabetes care. He talked to them about their options and used the materials to educate them about their rights.

“This is when he learned how important it is to have a family member or someone on the outside to assist with making contact with administrators, sheriff, prosecutor, among others,” Carol says of her son. “So many inmates do not have the benefit of a caring family member or friends.”

“Thank you [ADA] so much for all your help in getting him the help he needed during his time in [the] Minnesota jail system. We are both very appreciative of your efforts, calls, referrals and materials that gave Dan a voice in his diabetes care during incarceration.”


The American Diabetes Association leads the effort to prevent and eliminate discrimination against people with diabetes at school, at work and in other parts of daily life. If you need help, call 1-800-DIABETES or visit http://ift.tt/1zCIiW2.

Learn about the rights of individuals in detention and strategies to obtain adequate medical care.

Give the gift of fairness — donate now to help people with diabetes facing discrimination, just like Dan.

donate now



Source Diabetes Stops Here http://ift.tt/2bwUE9q

الخميس، 25 أغسطس 2016

الأربعاء، 24 أغسطس 2016

insulin

Title: insulin
Category: Medications
Created: 3/26/1998 12:00:00 AM
Last Editorial Review: 8/24/2016 12:00:00 AM

Source MedicineNet Diabetes General http://ift.tt/1AHY8KN

Your Rights, One Voice: Jennifer and Allie’s Story

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Safe_At_School_082316b

Allie, left, with her brother at Tour de Cure.

It was surreal. Unimaginable. I still remember my daughter Allie’s type 1 diabetes diagnosis like it was yesterday.

My name is Jennifer Holdgreve, and that day in May 2011 changed my life forever.

Allie was only 6 years old, and she exhibited all the signs of diabetes: frequent urination, nonstop exhaustion, drinking tons of water and losing weight. When my husband and I eventually took her to the doctor, it took him all of one minute to hear the symptoms, smell her breath and realize what was wrong. We were whisked away from Centreville, Maryland, to a hospital in Baltimore via pediatric transport. We spent days in the intensive care unit getting her blood glucose under control and learning about this disease and our daughter’s new world.

We were sent home trying to comprehend that we were now responsible for literally keeping Allie alive, in addition to the regular demands of day-to-day parenting. We realized that we also needed to inform others about this new world, including Allie’s school—even when we still knew so little about diabetes ourselves. Since only one month of the school year remained, I spent my vacation time in the classroom with her. I did not know what else to do about her diabetes care at the time.

During the summer we were even more lost. We became increasingly concerned about the upcoming school year—we knew we could not spend each day in class with Allie. My husband and I felt as though we were drowning in a sea of uncertainty and confusion.

Then, one evening in August, we found our life raft. We attended a Safe at School meeting, having received a promotional flyer in the mail from the American Diabetes Association®. There, I met Crystal Jackson, Director of the Safe at School program, as well as staff from the local Association office.  All of a sudden, we were pulled back onto a boat, a big boat full of people who understood the challenges of diabetes—people who could help. We learned about 504 Plans, how to open up the lines of communication with school staff and ensure that school personnel were trained in managing Allie’s blood glucose.

From that moment, we developed a relationship with the American Diabetes Association office in Maryland and worked with them to raise awareness of type 1 diabetes. We recognized this need because we were that family who did not originally understand the causes and complexities of diabetes. Because we did not know the signs, we just as easily could have let Allie go to sleep the night of her diagnosis—and might not still have her with us today. We were that family who believed the misconceptions and did not realize there were multiple types of diabetes. We wanted to make sure others understood, so no one else would become that family. The American Diabetes Association gave us a voice to do this.

Safe_At_School_082316 We recently used that voice to pass Safe at School legislation in our state. Just last year, we testified before our Maryland State House committee, sent letters, made phone calls and watched the governor sign the Safe at School bill. We also used that voice to improve our relationship with school staff, which enabled Allie to become her own advocate at school and guaranteed she would receive appropriate diabetes care while she’s there. Her school now has designated a Diabetes Awareness Day to recognize her and the other students living with diabetes. It was amazing see our legislative process in action and how we as advocates can make a difference.

Much like that day five years ago when Allie was first diagnosed, the night of the Safe at School meeting changed my family’s life—but this time for the better. We were finally rescued from the sea of uncertainty and given a voice to improve our daughter’s life.


View Jennifer’s Safe at School Facebook LIVE chat with Crystal Jackson to learn more about her legislative experiences and the rights of students with diabetes.

The American Diabetes Association leads the effort to prevent and eliminate discrimination against people with diabetes at school, at work and in other parts of daily life. If you need help, call 1-800-DIABETES or visit http://ift.tt/1zCIiW2.

Through our nationwide Safe at School program, the Association is dedicated to making sure that all children with diabetes are medically safe at school and have the same educational opportunities as their peers. Visit our Safe at School website for information and resources.

Give the gift of fairness — donate now to help people with diabetes facing discrimination, just like Allie.

donate now



Source Diabetes Stops Here http://ift.tt/2bNfYZs

الثلاثاء، 23 أغسطس 2016

Mouse Study Suggests Antibiotics in Kids Might Help Spur Type 1 Diabetes

Title: Mouse Study Suggests Antibiotics in Kids Might Help Spur Type 1 Diabetes
Category: Health News
Created: 8/22/2016 12:00:00 AM
Last Editorial Review: 8/23/2016 12:00:00 AM

Source MedicineNet Diabetes General http://ift.tt/2blujNj

Identification of Novel Changes in Human Skeletal Muscle Proteome After Roux-en-Y Gastric Bypass Surgery

The mechanisms of metabolic improvements after Roux-en-Y gastric bypass (RYGB) surgery are not entirely clear. Therefore, the aim of our study was to investigate the role of obesity and RYGB on the human skeletal muscle proteome. Basal muscle biopsies were obtained from seven obese (BMI >40 kg/m2) female subjects (45.1 ± 3.6 years) pre- and 3 months post-RYGB, and euglycemic-hyperinsulinemic clamps were used to assess insulin sensitivity. Four age-matched (48.5 ± 4.7 years) lean (BMI <25 kg/m2) females served as control subjects. We performed quantitative mass spectrometry and microarray analyses on protein and RNA isolated from the muscle biopsies. Significant improvements in fasting plasma glucose (104.2 ± 7.8 vs. 86.7 ± 3.1 mg/dL) and BMI (42.1 ± 2.2 vs. 35.3 ± 1.8 kg/m2) were demonstrated in the pre- versus post-RYGB, both P < 0.05. Proteomic analysis identified 2,877 quantifiable proteins. Of these, 395 proteins were significantly altered in obesity before surgery, and 280 proteins differed significantly post-RYGB. Post-RYGB, 49 proteins were returned to normal levels after surgery. KEGG pathway analysis revealed a decreased abundance in ribosomal and oxidative phosphorylation proteins in obesity, and a normalization of ribosomal proteins post-RYGB. The transcriptomic data confirmed the normalization of the ribosomal proteins. Our results provide evidence that obesity and RYGB have a dynamic effect on the skeletal muscle proteome.



Source Diabetes Pathophysiology http://ift.tt/2bE0WrE

Hypothalamic Vitamin D Improves Glucose Homeostasis and Reduces Weight

Despite clear associations between vitamin D deficiency and obesity and/or type 2 diabetes, a causal relationship is not established. Vitamin D receptors (VDRs) are found within multiple tissues, including the brain. Given the importance of the brain in controlling both glucose levels and body weight, we hypothesized that activation of central VDR links vitamin D to the regulation of glucose and energy homeostasis. Indeed, we found that small doses of active vitamin D, 1α,25-dihydroxyvitamin D3 (1,25D3) (calcitriol), into the third ventricle of the brain improved glucose tolerance and markedly increased hepatic insulin sensitivity, an effect that is dependent upon VDR within the paraventricular nucleus of the hypothalamus. In addition, chronic central administration of 1,25D3 dramatically decreased body weight by lowering food intake in obese rodents. Our data indicate that 1,25D3-mediated changes in food intake occur through action within the arcuate nucleus. We found that VDR colocalized with and activated key appetite-regulating neurons in the arcuate, namely proopiomelanocortin neurons. Together, these findings define a novel pathway for vitamin D regulation of metabolism with unique and divergent roles for central nervous system VDR signaling. Specifically, our data suggest that vitamin D regulates glucose homeostasis via the paraventricular nuclei and energy homeostasis via the arcuate nuclei.



Source Diabetes Pathophysiology http://ift.tt/2bLXqJF