Make a plan to help your child manage diabetes at school. Start by meeting with school staff and by making sure your child has the necessary supplies for routine care and blood sugar emergencies.

You may already have bought the basic school supplies for sending your child back to school. But if your child has diabetes, you need to make additional preparations.

A person with diabetes must manage this chronic illness all the time, including during the school day.  Staff such as nurses, teachers and coaches can work with you and your child on managing diabetes. This assistance may include helping your child take medications, check blood sugar levels, choose healthy foods in the cafeteria, and be physically active.

To help your child get ready for the first day of school and for the rest of the school year, here are a few key tips:

Meet with staff early in the school year to learn more about how the school helps students care for diabetes and handles any diabetes-related emergencies. Public schools and schools that receive federal funding are prohibited from discriminating against people with diabetes by the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.  You can work with your child's doctor and school staff to create a Diabetes Medical Management Plan. Having a plan helps your child and school workers with managing diabetes in school and during extracurricular activities. Be sure to include information on services the school will provide and how to recognize high and low blood sugar levels. Your child may need assistance with giving insulin and checking blood sugar levels, and also may need to eat snacks in the classroom. For more information, visit Helping the Student with Diabetes Succeed: A Guide for School Personnel.

Your child must have access to supplies needed to manage diabetes and to treat any episodes of high or low blood sugar. You and your child can work together to create a care package to bring in his or her backpack. Supplies should include:

blood glucose meter, testing strips, lancets, and extra batteries for the meterketone testing suppliesinsulin and syringes/pensantiseptic wipesglucose tablets or other fast-acting glucose snackwaterfor children who wear an insulin pump, backup insulin and syringes/pens in case of pump failure

Also, be sure school workers have a glucagon emergency kit and know how to use it if your child experiences a low blood sugar emergency.

If your child is going to monitor his or her blood sugar, ensure that he or she feels comfortable doing so. If a trained school employee will do the monitoring, be sure your child knows where and when to go for testing. Also, make sure your child knows who to go to for help with high or low blood sugar episodes. The actions to be taken should be in the Diabetes Medical Management Plan.

Prepare a healthy breakfast, which will help your child stay focused and active. If you send a lunch with your child, pack a healthy meal that contains whole grains and fresh fruits and vegetables. Replace high-fat foods with low-fat options, such as low-fat turkey, reduced-fat cheese, and skim milk. Include healthy snacks, such as fruit, nuts or seeds, which your child can eat later in the day to help avoid the vending machine and keep blood sugar under control. If your child buys meals at school, look at the cafeteria menus together to help him or her make choices that fit into a healthy meal plan. Many schools post their menus online, or you can request this information from school workers.

Having diabetes does not mean that your child cannot be physically active or participate in physical education classes.  In fact, being active can help your child improve his or her blood sugar control. Also, limit screen time – TV, videogames and the internet – to one to two hours a day. Being active at an early age establishes good habits for a lifetime and is a lot of fun. Encourage your child by being active together, doing such things as walking the dog, riding bicycles or playing basketball, and you will get the health benefits too.

Check to be sure your child has had all recommended vaccinations, including the flu shot. If children with diabetes get sick, they can take a longer time to recover than children without diabetes. Talk to your child's doctor to see if your child needs any vaccinations before starting the school year. Also, encourage your child to wash his or hands regularly, such as before eating and after using the bathroom.

Diabetes does not have to get in the way of your child's good experience at school. Remember, parents and schools have the same goal: to ensure that students with diabetes are safe and that they are able to learn in a supportive environment. Make sure school staff have the information and resources they need for your child's safety and health. Help prepare your child to manage diabetes when he or she goes back to school.

CDC works 24/7 saving lives, protecting people from health threats, and saving money to have a more secure nation. A US federal agency, CDC helps make the healthy choice the easy choice by putting science and prevention into action. CDC works to help people live longer, healthier and more productive lives.

After declining 2% between 2007 and 2008, birth rates for 15- to 19-year-olds decreased again between 2008 and 2009 for all races and for Hispanics. This indicates that the steady decline in teen birth rates from 1991 through 2005 has resumed, after briefly increasing between 2005 and 2007. In 2009, 409,840 live births occurred to mothers aged 15-19 years, a birth rate of 39.1 per 1,000 women in this age group (down from 434,758 births and a birth rate of 41.5 in 2008). The Hispanic, American Indian/Alaska Native, and non-Hispanic black teen pregnancy rates are more than twice as high as the non-Hispanic white teen birth rate.(1)

The teen birth rate for 15–19 year olds decreased 6% between 2008 and 2009. Rates decreased for all races, including 4% for non-Hispanic whites, 6% for non-Hispanic blacks, 5% for American Indian/Alaska Natives, 10% for Asian American/Pacific Islanders. The Hispanic teen birth rate decreased almost 10%.(1) During this time period, birth rates declined for all age groups except among women age 40 years and older.(1)

Underlying causes for the decreases are not yet known, and it is unclear whether they will continue. While birth rates for other age groups have also decreased during this time, teen birth rates bear concern due to the potential increase in the socioeconomic burden of teen pregnancy and childbearing. Teen birth rates in the U.S. remain up to nine times higher than in most other developed nations. In general, factors associated with teen pregnancy and childbearing include:

Being sexually active(2)Lack of access to or poor use of contraception(2)Living in poverty(3)Having parents with low levels of education(3)Poor performance in school(3)Growing up in a single-parent family(3)

As part of the President's Teen Pregnancy Prevention Initiative (TPPI), CDC is partnering with the federal Office of the Assistant Secretary for Health (ASH) to reduce teenage pregnancy and address racial, ethnic, and geographic disparities in teen pregnancy and birth rates. The ASH Office of Adolescent Health (OAH) is supporting public and private entities to fund medically accurate and age appropriate evidence-based or innovative program models to reduce teen pregnancy. For more information please visit Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies Through Communitywide Initiatives. 

Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary data for 2009. National vital statistics reports; vol 59 no 3. Hyattsville, MD: National Center for Health Statistics. 2010. Table 2.Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Estimated pregnancy rates by outcome for the United States, 1990-2004. National vital statistics reports; vol 56 no 15. Hyattsville, MD: National Center for Health Statistics. 2008.Singh S, Darroch JE. Adolescent pregnancy and childbearing: levels and trends in developed countries. Family Planning Perspectives 2000;32(1):14–23.CDC works 24/7 saving lives, protecting people from health threats, and saving money to have a more secure nation. A US federal agency, CDC helps make the healthy choice the easy choice by putting science and prevention into action. CDC works to help people live longer, healthier and more productive lives.

If your heart rhythms do not occur normally, then it can be a result of improper electrical signals being conducted to the heart because of defective cell or tissue pathways. Though the cause of this abnormality might not be clear at times, but conditions like atrial tachycardia, atrial flutter or supraventricular tachycardia can be treated with the help of a procedure called a cardiac ablation. If you are suffering from any cardiac dysfunction and looking for information on what is Cardiac Ablation, then read on.

When you go through the process of cardiac ablation, then the electrophysiologist carries out a cardiac catheterization that is responsible to send radio frequencies to the cells or tissues that are responsible for creating the abnormal heart rhythms. This radio frequency in turn destroys the cells or tissues that are creating problem, so that they are no longer able to transmit the improper signals that are causing arrhythmia.

In cases where the cardiac ablation is seen to be successful, it can also able to prevent the irregular heartbeats and bring back the proper functioning of the heart rhythm. However, the process of cardiac ablation does involve some risks. It is quite a possibility that radio frequency might cause damage to the normal cells and tissues and the same holds true for the catheter tip. It is seen in some cases that when people undergo this process of cardiac ablation, they end up needing a pacemaker. This however is seen in people who might not get any signals to their heart to help it beat normally.

The other considerable risks might include bruising or bleeding of the area where the catheter tip is inserted. Usually, the groin is used for insertion of the catheter and this can also lead to a possible infection; though the practitioner performing the test would take enough precautions to avoid and bruise or infection. Some of the rare complications that can develop as a result of the cardiac ablation include stroke, which can occur in case the catheter touches a blood clot which can find its way to the blood stream. This however is a rare risk seen as negligible in most cases.

The process of cardiac ablation usually only takes a couple of hours. However, the process can take up to six hours for the entire process. This process is conducted only if the physician feels that it would be effective for a particular patient. Usually, cardiac ablations are an outpatient process, but at times the doctor might want you to stay over night for observation in case any side effects occur and also for checking the improvement that the procedure has resulted in. You will have to visit the doctor frequently to have your cardiac rhythm analyzed so that the doctor can determine the progress.

The success rate of cardiac ablation has been recorded up to 90% in cases of defective atrial rhythm. The process seems to be less promising in case of abnormal ventricular rhythms, but still almost 70-80% of the cases resulting from ventricular tachycardia can be cured with the help of cardiac ablation. These days, cardiac ablation is being preferred as a good option before moving to surgical treatments.

Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of heart disease, stroke and diabetes. Conditions like increased blood pressure, elevated insulin levels, excess body fat around the waist or abnormal cholesterol levels are not diagnosed as metabolic syndrome, but they do contribute to the risk of a serious disease. If more than one of these conditions occur in combination, the risk is even greater.

Having metabolic syndrome means one has several disorders related to the metabolism at the same time, including:

ObesityHigh blood pressureHigh triglycerides and low level of high-density lipoprotein (HDL) cholesterol (also called the good cholesterol)Resistance to insulin, a hormone that helps to regulate the amount of sugar in your body

Risk Factors:

The following factors increase the chances of developing the metabolic syndrome:

1. Age – the prevalence of metabolic syndrome increases with age.
2. Race – hispanics and Asians seem to be at a greater risk of metabolic syndrome than other races.
3. Obesity – a body mass index greater than 25 increases the risk of metabolic syndrome. So does abdominal obesity; having an apple shape rather than a pear shape.
4. History of diabetes, one is more likely to have metabolic syndrome if there is a family history of type 2 diabetes or a history of diabetes during pregnancy.
5. Other diseases – a diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome also increases the risk of metabolic syndrome.

Aggressive lifestyle changes and, in some cases, medication can improve all of the metabolic syndrome components. Getting more physical activity, losing weight and quitting smoking helps reduce blood pressure and improves cholesterol and blood sugar levels. These changes are key to reducing the risk.

Exercise: 30 to 60 minutes of moderate intensity exercise, such as brisk walking, every day.
Lose weight: losing as little as 5 percent to 10 percent of body weight can reduce insulin levels and blood pressure and decrease your risk of diabetes.
Eat healthy: a diet that limits unhealthy fats and emphasises fruits, vegetables, fish and whole grains is ideal.
Stop smoking: smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome.

It is important to monitor weight and blood glucose, cholesterol and blood pressure levels to ensure that lifestyle modifications are working. If you are not able to achieve your goals with lifestyle changes, medications may be prescribed to lower blood pressure, control cholesterol or help you lose weight.

Prevention:

Whether one has one, two or none of the components of metabolic syndrome, the following lifestyle changes will help reduce the risk of heart disease, diabetes and stroke:

1. A healthy diet – eat plenty of fruits and vegetables. Avoid processed or deep-fried foods. Eliminate table salt and experiment with other herbs and spices.
2. Get moving – get plenty of regular, moderately strenuous physical activity.
3. Schedule regular checkups – Check your blood pressure, cholesterol and blood sugar levels on a regular basis.

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There has been a lot of talk recently about informed consent regarding surgical procedures. Most of this talk has been centered around the spate of cases involving unnecessary stent placement. While informed consent is a wonderful thing especially when the patient has time to digest what information they have been given, it can work against the patient as well when time is of the essence. Unfortunately when the patient is in an emergency situation such as having a heart attack, informed consent falls by the wayside.

When I had my heart attack back in 2009 everything seemed to happen so fast as soon as I entered the emergency room. As soon as I told the admitting nurse what was going on with me, IE chest discomfort and a shooting pain in my jaw, I was immediately taken to a room where my shirt was taken off and an EKG started. No less than 2 doctors were present and while one was administering the EKG another was taking blood. The EKG showed a minor anomaly but before they could re-administer the test the other doctor returned with the news that there were enzymes in my blood, I had had a heart attack.

The doctor informed me that an ambulance was waiting and I would be taken to the hospital down the street because they had a cardiac catheterization lab ( cath lab ) where I would receive the care that I needed. I was confused and very scared at this point and all the previous actions happened in the span of just 15 minutes.

When I reached the new hospital I was taken from the ambulance and rolled no more than 50 feet into the hospitals cath lab, which was already full of people waiting for me. As soon as I was in the lab IV’s were started and the operating doctor was standing over me. He quickly explained the catheterization process. An incision would be made on my inner thigh and a catheter with a small camera would be threaded through my femoral artery up to my heart, where they would begin the process of searching for the blockage.

While all the doctors in my case were very good at informing me of what was going on and what they were doing to help me there wasn’t time for them to explain every nuance of the procedures or give me an extensive history of the drug eluting stents they placed in my artery , not to mention the fact that I had never heard of a stent before and would have gone with the doctors decision anyway as he knows best, right?

Here’s the real problem when it comes to informed consent in an emergency, I was alone, scared and my mind was racing a million miles hour, even if there was time for the doctors to explain the pro’s and con’s of stenting and drug eluting stents I wouldn’t have digested that information in a rational way…I was having a heart attack! I knew nothing about the catheterization procedure or the stents used and as far as anyone knew time was ticking and I could have another heart attack at any second.

In cases such as this informed consent is almost meaningless but the after care is of paramount importance. After the emergency is over the doctor needs to sit with you and explain in detail what took place, what procedures were used, what devices were used or implanted and the significance of this is on your health and life.All your questions need to be answered in a setting where you are ready to digest all the information.

Because the recent problems concerning what some believe as unnecessary stenting in several states there is now a call for better informed consent before beginning these procedures. While I agree that informed consent is a good thing in most cases, in an emergency such as a heart attack there just isn’t time and the patient would unlikely understand what was being said even if they knew beforehand about stents and catheterizations.

I believe the majority of medical professionals have your best interest at heart and they also have the knowledge that we as laypeople don’t. If you are having a kidney stone removed then by all means informed consent is a blessing, when you are having a heart attack informed consent could kill you.