Princess Health and A looming danger: About 1 in 3 U.S. adults are pre-diabetic, but only about 11% say they have received such a diagnosis.Princessiccia

Princess Health and A looming danger: About 1 in 3 U.S. adults are pre-diabetic, but only about 11% say they have received such a diagnosis.Princessiccia

diabetes heart disease prevention stroke

Gusty 18:07 Add Comment

Before Type 2 diabetes develops, most people experience what is called prediabetes, where the blood sugar levels are above normal, but below diabetic, Dr. Philip A. Kern, University of Kentucky professor and director of the Center for Clinical and Translational Science, writes in a UK news release.

In America, approximately one in three adults are pre-diabetic, but only around 11 percent are aware of that condition, according to the federal Centers for Disease Control and Prevention. In Kentucky, 289,000 adults, or almost 9 percent, reported that they had been diagnosed as pre-diabetic, according to the 2015 Kentucky Diabetes Report.

"Without intervention, there is a high likelihood that prediabetes will progress to diabetes within three to 10 years," Kern writes. "People with prediabetes are also at 50 percent higher risk for heart disease and stroke."

When a person is prediabetic, many of the diabetic disease processes, like nerve damage, eye problems and heart disease, begin in the body even though the person doesn't have diabetes.

And because prediabetes often has no symptoms and can affect people of all ages, Kern writes, it is important to know your blood sugar levels, especially if you have one of the following risk factors: overweight or obese, fat distributed around the abdomen, history of gestational diabetes, family history of diabetes, symptoms of diabetes (increased thirst, frequent urination, fatigue, and blurred vision), or history of elevated blood sugar levels.

Kern suggests the following lifestyle changes to help prevent the progression of prediabetes to diabetes; he notes that these changes will also help reduce your risk of heart disease, stroke, high cholesterol and high blood pressure:

• Weight loss: Losing just 10 to 20 pounds can reduce the liklihood of prediabetes progressing to diabetes.
• Healthy diet: Choose low fat, low calorie and high fiber foods, like fruits, vegetables and whole grains.
• Exercise: Incorporate 30 to 60 minutes of moderate physical activity most days of the week.
• Sleep: Research has found that getting at least six hours of sleep each night can help reduce insulin resistance. He also notes that sleep apnea can worsen prediabetes.
• Medications: Some diabetes medications are prescribed to prediabetics to prevent the condition from progressing.

If you're interested in learning about opportunities to participate in research about prediabetes at UK, visit ukclinicalresearch.com or call (859) 323-2737.

Princess Health andMost women are unaware of female-specific stroke symptoms and risks, according to a national survey by Ohio State.Princessiccia

Princess Health andMost women are unaware of female-specific stroke symptoms and risks, according to a national survey by Ohio State.Princessiccia

research stroke survey women's health

Gusty 14:23 Add Comment

Most women are unaware of the symptoms and risks of stroke for females, according to a national survey by the Ohio State University's Wexner Medical Center. The survey found that just 11 percent of the 1,000 respondents knew that pregnancy, lupus, migraine headaches and oral contraception or hormone replacement therapy are female-specific stroke risks.

Also, only 10 percent of those surveyed knew that hiccups and atypical chest pain with or followed by typical stroke symptoms are early warning signs. According to the National Stroke Association, stroke is the third leading cause of death for women, and Diana Greene-Chandos, a neurologist and director of the neuroscience critical care at Ohio State's Wexner Medical Center, said, "We have a ways to go when it comes to educating women about stroke and their unique risk factors."

Other symptoms unique to women include dizziness that is not class vertigo, headaches, atypical chest pain and/or numbness of the body, especially if one side is more numb than the other. Early recognition and treatment are key for strokes.

"Women do not think they are going to have a stroke," said Greene-Chandos. "They think of it as a man's disease." The reality is that 60 percent of stroke deaths occur in females and 40 percent for males. Every year, 137,000 Americans die from a stroke. Smoking, failing to exercise and having high blood pressure are risk factors for both men and women. To take an assessment created by Ohio State's stroke experts to determine risk of stroke, click here.

Princess Health andStudy shows that removing a clot that causes a stroke leaves victims with higher functional independence.Princessiccia

Princess Health andStudy shows that removing a clot that causes a stroke leaves victims with higher functional independence.Princessiccia

blood pressure research stroke

Gusty 16:11 Add Comment

In Kentucky, strokes cause about 5 percent of deaths, and the state had the 11th highest stroke mortality rate in 2009, according to data from the Kentucky Cabinet for Health and Family Services. Fewer than 40 percent of severe stroke victims regain functional independence if they get only the standard drug intervention, but a study has found that also removing the clot both helps restore blood flow to the brain and can lead to more favorable long term outcomes.

"The outcomes are the difference between patients being able to care for themselves after stroke and being dependent," said Demetrius Lopes, surgical director of the comprehensive stroke center at Rush University Medical Center.

The traditional treatment for ischemic stroke�a stroke that involves clots in vessels bringing blood to the brain�is intravenous tissue plasminogen activator (tPA), a medication to dissolve the clot. However, doctors can also perform thrombectomy, a minimally invasive procedure to remove the clot that is allowed only in clinical trials.

In the study, patients with severe ischemic strokes were split into two groups. One group received only tPA, while the other group received tPA as well as thrombectomy. After 90 days, those who received both treatments had less disability and had a functional independence rate of 60 percent, compared to 35.5 percent of those who received only tPA. Also, patients who received thrombectomy had better blood flow rates in the brain.

"Ethically, we can't deny patients a treatment when we have such strong evidence it's better for them," Lopes said. Now thrombectomy is a standard treatment for severe strokes at Rush and some other locations. The study is published in the online edition of the New England Journal of Medicine.

Princess Health andNew health-related laws deal with heroin, dating violence, end-of-life care, prescriptions, colon-cancer and newborn screening.Princessiccia

Princess Health andNew health-related laws deal with heroin, dating violence, end-of-life care, prescriptions, colon-cancer and newborn screening.Princessiccia

colorectal cancer domestic violence drug treatment end-of-life care General Assembly health heroin legislation physician assistants prescription drugs research stroke

Gusty 10:39 Add Comment

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. � The Kentucky General Assembly passed several health-related bills this session, including high-profile measures on heroin and dating violence. It did not pass many others, including one that would have a great influence on the state's health: a statewide smoking ban, which passed the House for the first time ever, but never got out of an unfavorable committee in the Senate. Here's a roundup:

Heroin: Kentucky's heroin-overdose epidemic was caused partly by a 2012 legislative crackdown on prescription painkillers, which steered users to the illegal drug. Last year's bill died because of deadlock over sentences for traffickers and needle-exchange programs for addicts, and Gov. Steve Beshear and legislators gave this year's bill top priority. It was not finally negotiated until a few hours before passage, but Beshear signed Senate Bill 192 into law less than 12 hours after it passed so that its emergency clause could put it into effect immediately.

SB 192 includes both a needle-exchange program and harsher penalties against traffickers, the main points of contention between the House and Senate, but requires local governments to approve needle exchanges and allows judges to be lenient in sentencing addicts, to help them get treatment. It allocates money for drug-treatment programs, allows increased access to Naloxone, a drug that reverses the effects of an overdose, and allows jailers to provide medically assisted treatment for inmates with opiate addiction.

Dating violence: After 10 years of lobbying and debate, the dating violence bill will allow dating partners to get interpersonal protective orders from a judge if they have been the victim of dating violence, sexual abuse or stalking. This year's bill largely dissolved social conservatives' opposition by creating a new chapter in the law for dating violence, with the same protections as the domestic-violence law. Kentucky is the last state to offer protection to dating-violence victims. House Bill 8 was sponsored by Rep. John Tilley, D-Hopkinsville, who also sponsored the House heroin bill.

Beshear has signed these bills into law:

Prescription synchronization: SB 44, sponsored by Sen. Julie Raque Adams,R -Louisville, will allow patients with multiple prescriptions, in consultation with their health-care provider and their pharmacist, to synchronize prescriptions so that they may be picked up at the same time.

Medical order scope of treatment: SB 77, sponsored by Sen. Tom Buford, R-Nicholasville. will create a medical order scope of treatment (MOST) form that specifically directs the type of treatment a patient would like to have, and how much intervention he or she would like to have, during end-of-life care.

Colorectal cancer screening: SB 61, sponsored by Sen. Ralph Alvarado, R-Winchester, will require that a fecal test to screen for colon cancer, and any follow-up colonoscopy, be considered preventive measures that health insurance is required to cover without imposing additional deductible or co-insurance cost. The governor also signed a similar measure, HB 69, sponsored by Rep. Tom Burch, D-Louisville, which contains an amendment by Sen. Julian Carroll, D-Frankfort, for a Medicaid savings study.

Newborn screenings for fatal disease: SB 75, sponsored by Sen. Alice Forgy Kerr, R-Lexington, will require all newborns to be tested for Krabbe disease, a neurological disorder that destroys the protective coating of nerve and brain cells and is fatal once symptoms occur.

Spina bifida: SB 159, sponsored by Adams, will require medical providers to supply written, up-to-date, accurate information to parents when their unborn child is diagnosed with spina bifida so they can make informed decisions on treatment.

Emergency care for strokes: SB 10, sponsored by Sens. Stan Humphries, R-Cadiz, and David Givens, R-Greensburg, requires that local emergency services have access to a list of stroke-ready hospitals, comprehensive stroke centers and primary stroke centers in Kentucky. Emergency medical providers will set their own protocols for assessment, treatment and transport of stroke patients.

Alcohol and drug counselors: HB 92, sponsored by Rep. Leslie Combs, D-Pikeville, creates an enhanced licensing program to recognize three levels of certified alcohol and drug counselors, with different levels of education. The goal is to increase the number of counselors in the state.

UK cancer research center: HB 298, sponsored by Rep. Rick Rand, D-Bedford, revises the state budget to authorize $132.5 million, half of the cost, for a new medical research center at the University of Kentucky. The university says it will raise money to cover the other half.

These health bills awaited the governor's signature Monday morning:

Physician assistants: HB 258, sponsored by Rep. Denver Butler, D-Louisville, to allow physicians to supervise up to four physicians at the same time, rather than two.

In-home care: HB 144, sponsored by Burch, to establish a 60-day, hospital-to-home transition program through an approval waiver from the Department for Medicaid Services.

Pharmacist-practitioner collaboration: HB 377, sponsored by Rep. Dean Schamore, D-Hardinsburg, to allow collaboration between pharmacist and practitioners to manage patients' drug-related health needs.

Tax refund donations: SB 82, sponsored by Sen. Max Wise, R-Campbellsville, to put an income tax check-off box on tax forms to allow people the option of donating a portion of their tax refund to support pediatric cancer research, rape crisis centers or the Special Olympics.

Health related bills that were left hanging:

The smoking ban, HB 145, sponsored by Rep. Susan Westrom, D-Lexington, never got a hearing in the Senate Veterans, Military Affairs and Public Protection Committee, and neither did the Senate companion bill, SB 189, sponsored by Adams.

Three bills challenged Medicaid managed-care companies. SB 120, sponsored by Alvarado, would have created a process for health-care providers to appeal the companies' decisions to the state passed the Senate, but not the House.  And the following two bills that never got out of the Senate: SB 88, also sponsored by Alvarado, which challenged the $50 "triage fees" MCOs pay for emergency-room visits that they conclude were not emergencies, and would have required them to pay contracted fees instead and SB 31, sponsored by Buford, which would limited the amount of co-payments. Also not getting House action was Alvarado's SB 6 would have created review panels for lawsuits seeking damages from health-care providers.

Princess Health and First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk.Princessiccia

Princess Health and First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk.Princessiccia

diabetes diet heart disease soda stroke vegetables

Gusty 17:13 Add Comment

Genuine Kentucky fried platter:
Cornbread, fried catfish, fried green
tomatoes, fried apples and fried okra
(Photo from Ramsey's, Lexington)

By Molly Burchett
Kentucky Health News

People with a Southern diet, or one heavy on fried food and sugary drinks like sweet tea and soft drinks, are more likely to suffer a stroke, a new study finds.

It's the first big look at diet and strokes, and researchers say it might help explain people in the nation's "stroke belt" or southern states suffer more of them, reports Marilynn Marchione of The Associated Press.

These findings have important implications for Kentuckians because stroke accounts for 5.5 percent of Kentucky deaths each year and more than 81 percent of Kentucky adults eat fruit and vegetables fewer than 5 times a day, which is a indicator of risk for stroke:

Heart Disease and Stroke Risk Factors from federal Behavioral Risk Factor Surveillance System national survey	Ky.	U.S.
Eat fruits and vegetables less than 5 times/day	81.6	75.6
Overweight or obese	69.1	62.9
No moderate or vigorous physical activity	55.8	50.5
High total blood cholesterol	38.5	37.6
High blood pressure	30.0	27.8
Cigarette smoking	28.2	19.8
Diabetes	9.9	8.0

"We're talking about fried foods, french fries, hamburgers, processed meats, hot dogs," bacon, ham, liver, gizzards and sugary drinks, said the study's leader, Suzanne Judd of the University of Alabama in Birmingham.  For the study, a southern diet also included jerky, red meat, eggs, and whole milk.

???????????
???????????Fried foods tend to be eaten with lots of salt, which raises blood pressure and sweet drinks increases risk for diabetes- both are known stroke risk factors, Judd said.

People who ate about six meals a week featuring these sorts of "Southern" foods had a 41 percent higher stroke risk than people who ate that way about once a month, researchers found.

In contrast, people whose diets were high in fruits, vegetables, whole grains and fish had a 29 percent lower stroke risk, reports Marchione.

"It's a very big difference," Judd said. "The message for people in the middle is there's a graded risk" � the likelihood of suffering a stroke rises in proportion to each Southern meal in a week. 

These findings were reported last week at the American Stroke Association conference. The study was launched in 2002 to explore regional variations in stroke risks and reasons for them.

Stroke death rates in Kentucky vary widely among counties. Here's a county map of the rates, from KentuckyHealthFacts.org, which has a county-by county list:

The map shows stroke rates in ranges per 100,000 population from 2003 through 2007. Purple counties had rates above 69; blue counties ranged from 52 to 69; turquoise were 44 to 52; light blue were 31 to 44 (the number that is about the national average), and tan were 18 to 31.