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Does Prediabetes Lead to Diabetes?

With the right changes in lifestyle, it doesn't have to, says WebMD's diabetes expert.
In every issue of WebMD the Magazine, asks their experts to answer readers' questions about a wide range of topics. In our January-February 2011 issue,they asked WebMD's diabetes expert, Michael Dansinger, MD, to answer a question about the link between prediabetes and diabetes.
Q: At my last checkup, my doctor told me I have prediabetes. Does that mean I'll ultimately develop 

Don White, 68, a retired science teacher from upstate New York, first suspected he had type 2 diabetes when he was 45 years old and his school held a health fair for students and teachers. A simple prick of his finger to test for high blood sugar -- a sign of diabetes -- revealed some unexpected news. "My numbers were way above normal," says White. "In a matter of days, and a couple of doctor's appointments later, I found out I had type 2 diabetes." White and his family were surprised by...

A: Almost everyone who develops type 2 diabetes develops prediabetes first. But not everyone who has prediabetes -- defined as having levels of glucose (a type of sugar in the blood) that are higher than normal but not yet diabetic -- ends up with diabetes. In fact, changing your lifestyle can significantly delay or even prevent type 2 diabetes.

Those changes can include losing a moderate amount of weight (5% to 10% of your body weight -- about 8 to 16 pounds for a 160-pound woman), getting regular exercise (about 30 minutes daily), and eating healthy meals. There are lots of good eating plans for delaying or preventing diabetes -- most emphasize a variety of vegetables, fruits, fish, lean chicken, beans, low-fat dairy, egg whites, soy, and whole grains.
Quitting smoking, drinking alcohol only moderately (if you drink already), and reducing stress all help keep your blood glucose levels under control.  

You should also know that prediabetes puts you at risk for other conditions, such as heart disease and stroke. In fact, prediabetes is now considered one of America's most serious health problems (one in four adults has it). Knowing how to keep it in check can prevent diabetes from developing in the future.

Some Physiotherapy Asthma Management May Be Questionable

Physiotherapy Asthma management is a concern for about 15 million people in America. There are many different medications and other treatments used successfully for asthma management. However, some methods used are not quite proven to work.

Some physiotherapy clinics claim that massage can be used for asthma management. They state that it works to relieve the symptoms of wheezing and breathlessness. They use massage on patients young and old. However, there is no substantial proof that massage does any more good for asthma management than to relieve stress.

One alternative physiotherapy method that has been used for asthma management is acupuncture. There is some indication that this technique can actually have some benefit in relieving symptoms of asthma.

Acupuncture does seem to help the immune system fight off illnesses. This is important in helping asthma management. Illnesses such as colds or flu will exacerbate the asthma condition. If acupuncture can reduce this, it is a great help. Yet, acupuncture is still only recommended to be used along with other treatments. It is not to be used alone.

Some acupuncturists use other methods for asthma management. They might burn herbs over acupuncture points. They might give patients a certain kind of massage, or teach them breathing exercises. There is no known validity in these treatments.

Chiropractors rely on spinal manipulation for asthma management. The reviews of this theory are mixed. One study compared a sham, or fake, type of spinal manipulation that was done on one group of asthma patients. The other group got the real manipulations. There was little, if any, difference between the two groups. This would suggest that chiropractic adjustments are not effective for asthma management.

However, another study was done. Eighty-one children were followed through asthma management at a chiropractic clinic over a period of time. Overall, there were 45% fewer asthma attacks among these children after treatment. 30% were able to significantly reduce their asthma medications. Thus, the jury is still out on the effect of chiropractic medicine on asthma management.

There is a physiotherapy specialty certification for those who wish to work with asthma management. Physiotherapists may take a test to become certified as Certified Asthma Educators, and they help people to deal with their condition. What is more, Medicare and Medicaid pay for their services.

There is also some evidence that asthma management for those who have to be admitted to the hospital should involve physiotherapy. There was a study of respiratory patients who were given range of motion exercises while in the hospital. The average stay was three days less than those without the exercises.

One challenge of traditional physiotherapy for asthma management is that dehydration happens easily. Asthmatics get dehydrated more easily, and it affects them in a worse way. It can even bring on an asthma attack. Any exercise plan must take this into account.

There are ways for physiotherapy to be used for asthma management. Certainly, there are other methods, and research may prove these methods have value. In the meantime, some methods are better saved for alternative methods to be used in addition to medications and proven physiotherapy treatments.

Making a Career from Medical Education

You can have a career from medical education. This is because there is a demand for such individuals as more hospitals are being made and those who have been doing this for years are almost or have already reach retirement age. This means that there is a need for fresh faces to take their place.

How do you make a career out of medical education?
For doctors, once they have finished their undergraduate studies, they can already enroll in medical school. One study shows that 96% of the students that have chosen to enroll in medical school obtained their M.D. degrees.

For the next four years, they will be able to interact with patients and then learn how to treat them. They will work together with experienced doctors who have been doing this for years and hopefully choose what they want to do later on be it that they want to pursue a career in family practice, gynecology, internal medicine, pediatrics, psychiatry, obstetrics or surgery.

Once they finish that, they may now apply for residency in a hospital until they soon become interns. Those who want to go farther can study for another two years or more to further specialize what they have learned.

With the training given, some of these professionals will open their own practice while others will work in hospitals. Their list of clients will grow if they do a good job with one patient who will then recommend them to friends and family.

For those who don’t end up becoming doctors like nurses and technicians, they too can make a career for themselves by working for a number of years in one position and then getting promoted later on. For instance, nurses who do a job will no longer be the ones doing the rounds in the hospital but instead handling a wing and having a group of nurses under them.

This begins by enrolling in a vocational school and then finding a hospital or a clinic who will accept them. Along the way, there are advance courses which they can take which gives them the opportunity to make them learn new things and keeps them updated with the latest trends in the medical field.

For pharmacists that have capital, they no longer need to work in a drug store when they can start one on their own. This is as such retail establishments can only be owned and run by licensed pharmacists so instead of getting a fixed wage, why not work and earn the profit?

The same goes for professionals who have been working in research laboratories for so long making drugs. Given their knowledge in chemistry, perhaps they can make something better than what the pharmaceutical company they are working for is making.

Individuals who have a knack for selling stuff can make a successful career selling either medicine or medical equipment. After all, companies need such individuals to help sell what they have so these can be used by hospitals and patients.

You make your career from medical education and not the other way around because how well you perform in the future is your decision. The school you came from merely gave you the tools you need to get started. The challenge is applying what you learn.

Six Poor Stomach Exercise Habits

As with all things, there is a right way to go about working for a flatter midsection, and several wrong ways. Working out the wrong way can lead to no physical improvement or worse, serious injury. When doing stomach exercises or any other exercise, be sure to consult a professional, warm up properly, and remember the following tips.

Keep Your Knees Up
When doing crunches, you want your knees to bent and your feet flat on the floor so that your knees are centered and pointed upward. Keep them centered and up, not to one side. If you drop your knees to one side, you are unnecessarily compressing your vertebrae, which can lead to a painful back injury.

Sit-Ups
Traditional sit-ups actually do very little for the abdominal muscles. Even when done properly, the strain is mostly on the hip muscles. There is also the tendency to pull the torso up with the arms, which of course is not the point of the exercise. Further, when sit-ups are done very quickly, as people have a tendency to do, it is momentum that mostly forces the torso up and down, rather than any muscle groups. The crunch is a good alternative to old school sit-ups.

Straight Leg Lift
Another traditional "stomach exercise," this move actually works the lower back more than any muscles in the midsection. This is also another way to put strain on your back, possibly leading to injury.

Too Many Reps
There is never a need to do more fifty reps of a stomach exercise. If fifty reps is not giving you results, doing more than that will not help wither. As you build strength, if you feel the need for a bigger challenge, try a more difficult exercise as an alternative to adding reps.

Sleeping
Believe it or not, how you sleep has an effect on your stomach exercise routine. If you sleep in a position that cause back pain, it will make it much more difficult to work on your midsection in the morning. Sleeping mostly on your stomach is one of the best ways to cause back pain, as it forces your back to arch, often resulting in annoying back pain. The best way to avoid this is to sleep on your back with a pillow under your knees. This will help keep your vertebrae in line, prevent back pain and allowing you work out pain free in the morning.

No Resistance
All stomach exercises need resistance to be effective, whether it comes from a resistance band, an exercise ball, or just gravity. Exercises that do not use any resistance, such as standing broomstick twists, will not be beneficial to your midsection. The good news is that this particular exercise will not do any harm and is actually a good warm up for your trunk. Just do not expect it to flatten out your stomach.

Proper exercise technique is important. These are just a few tips to help you avoid wasting time and potential injury. Be sure to research thoroughly before beginning a new exercise, and always consult your physician before beginning any physical fitness routine.

Choosing the Right Agency: Travel Nurses

When its time to choose the right agency to which you will become employed with what exactly do you look for? First look for an agency that has the values you want to instill in your nursing career. It's most important to make sure the agency you are working for treats there employees good and is there for their employees when there employees need guidance. Look for an agency that offers 24 hour support for any of your possible needs that may arise.

You will also want to make sure the agency you choose is well known and respected and those they have a viable databank of jobs available for you to choose your assignments from. You want to make sure the benefit packages that the agency offer are competitive to what other agencies are offering.

Does the agency offer medical malpractice insurance? Is it free? Do they offer you sign on bonuses, medical benefits, travel reimbursement? Travel reimbursement is one of the top things you will want to look for since this can be come costly to pick up and move when your assignment is over and move on to the next one.

First you need to ask yourself what exactly are you looking for the agency to offer you as an employee from there you can
make a list and then start to research into different agencies and find the one that best suits your needs and desires.
When contacting agencies never be afraid to ask them certain question you feel may be important. If an agency is not willing to respond to your questions or give you the time of day before you are hired that is a big indicator that you could have trouble down the line with this agency when you may truly need guidance and help. You may at that point want to keep looking into other agencies.

Choosing the right agency is essential as you plan for successful and fruitful career in becoming a traveling nurse. You can also ask an agency if they would be willing to put you into touch with other nurses who work with their agency to see if travel nursing is the way for you to go. Then you can talk to other nurses and see if they are comfortable working for the agency and ask them how any problems have been handled.

If an agency acts in a professional helpful manor the whole time this is a good indication the agency cares about their employees and will do what is necessary for you.

Other important information is to find out how long the agency has been in business, do they carry any awards or licenses?
How do the facilities that use them regard the agency? Ask to view a contract before you agree to any hiring process. You may also want to find out how your personal information is treated and will you be dealing with a team of people or will you have more interaction with say just a few people. Sometimes the more individual treatment is more important to some then to others.

When you feel fully comfortable that you have found the right agency for you then comes the time to sign up and begin your rewarding journey into becoming a traveling nurse.

Understanding Digestion in Children: Fiber-Rich Sack Lunches to Help Ease Constipation

Most kids don’t get enough fiber in their daily diet -- and that can lead to a host of digestive problems, the most obvious of which is constipation. Fiber doesn’t get digested by the human body, so it moves through your digestive tract and cleans up the pipes -- allowing a smoother, easier passage for waste products.
So one of the best ways to keep your child regular and promote his digestive health is to feed him plenty of fiber. Instead of sitting him down at the counter with a big bowl of bran flakes, try these dietitian-approved, kid-friendly snacks and lunch items that will go down easy in every way.

Homemade Trail Mix

Help kids make their own trail mix by putting out bowls of dried fruit, nuts, or seeds along with a higher-fiber cereal, and mixing them up into to-go containers or plastic bags, recommends Louise Goldberg, RD, LD, owner of An Apple A Day Nutrition Consulting in Houston, Texas, and formerly a dietitian at the Children's Memorial Hermann Hospital in the Houston Medical Center. (Just be sure to minimize the sugary “treat” ingredients, like chocolate chips or other candies.)

Flavorful Fruits and Veggies

Many fruits and vegetables are high in fiber --particularly with the skin on. If your child resists them, try making them fun by spearing fruit and veggie slices onto a kebab, or making a face with sliced-up fruits and veggies, suggests Beth Pinkos, MS, RD, LDN, a dietitian for the department of pediatric gastroenterology, hepatology, nutrition, and liver diseases at Hasbro Children’s Hospital in Rhode Island.
“You can use raisins for eyes, baby carrots for a nose, and celery for eyebrows, and an apple slice for a smile,” she says.
Remember not to give carrots to children younger than 3 or raisins to kids younger than 4 as they can be a choking hazard.

Creamy Dips

Kids who resist fiber-rich fruits and veggies may also be more adventurous if they can dip them in something first -- like yogurt, peanut butter, salad dressing, or hummus.

Mixed-Up Cereals

Having trouble getting your child to try that whole-wheat fiber cereal? Try mixing up a couple of high-fiber cereals with a small amount of one of the less good-for-you options that your child may be drawn to in the cereal aisle.
“Kids like to mix and match cereals like little chemists,” says Pinkos. “Look for a high-fiber cereal that has 3 to 5 grams of fiber per serving, and then let them mix it up with just a little bit of one of the junkier ones.”

Sandwich in Some Fiber

Just as with cereal, the whole-grain breads or wraps you’re using for your kids’ sandwiches should have at least three grams of fiber per serving.
“Check the package -- just because it’s called ‘whole grain,’ that doesn’t always translate to fiber,” says Goldberg. “And don’t be fooled by red- and green-colored wraps -- that doesn’t necessarily translate to fiber either.”

What Spinal Cord Injury Patients Can Accomplish with Physiotherapy

Di you know that Sports injuries and car accidents, among other injuries, can cause spinal cord injury. The range of spinal cord injury is very wide. Some of these injuries are fairly minor and will heal well with a limited amount of physiotherapy, while others need physiotherapy for the rest of their lives.
Evaluation: As always with physiotherapy, the first step is evaluation. A plan is formulated that will include therapies specific to the kind of spinal cord injury the patient has. Neck injuries can cause quadriplegia, which requires special treatments.

Level of the damage: An important issue in spinal cord injury is the level of the damage. If a physiotherapy program is not followed faithfully, the spine will begin to atrophy below the level of the spinal cord injury. The spine will shrink and the whole body below that point will become weaker as time goes by.

It is important that spinal cord injury patients get exercise of some form. They are prone to osteoporosis and heart problems, among other conditions. If there is a total lack of exercise, these risk factors become even more pronounced.

Physiotherapy for spinal cord injury involves exercising and stimulating the nerves and muscles below the level of the damage. This will allow patients with spinal cord injury to stay in good physical condition where they can. That way, if a cure becomes available, they will not be too weakened to benefit from it.

Every exercise the physiotherapy personnel go through with the spinal cord injury patient should be video-taped. This allows work to go on at home with an example of each exercise. Range-of-motion exercises are done by a caregiver, who moves the limbs so that they will not become set in one position.

For spinal cord injury patients who are not quadriplegics, there is physiotherapy using mats. These mats are raised off the floor, and can be operated by a hand crank or a power system. The physiotherapist will give exercises where the patient lies on the side, back, or stomach and works out or sits up and works out.

There are many restorative therapies in physiotherapy for spinal cord injury patients. These include electrical stimulation, biofeedback, vibrational therapy, laser therapy and other stimulation activities. Aqua therapy is also a physiotherapy method that is conducive to progress in spinal cord injury patients.

With all these therapies, spinal cord injury patients can sometimes restore themselves to earlier functioning. Other times, they can simply keep their bodies from deteriorating as they wait for a cure.

Spinal cord injury research is being conducted constantly. Physiotherapy is one of the fields that are being explored. One study is putting spinal cord injury patients in harnesses over treadmills stimulating walking. They are trying to find a way to help people walk again who had given up hope of doing so.

Physiotherapy gives hope for spinal cord injury patients. It allows them to have the most normal functioning that they are currently able to have. Perhaps when a cure comes outcomes will be even better. However, physiotherapy will probably always be needed for spinal cord injury patients.

Geting Along With a Home Nurse

 Whenever you are dealing with an elderly parent who's health is failing, you are going to be stressed. This is one of those times when you are not going to be at your best. You are already worried about whether you are doing the right thing for your parent by keeping them at home and hiring a home nurse to take care of them as opposed to moving them into a nursing home. You have to deal with the rest of your family. You are watching your parent, who was once the person who took care of you, grow weaker and more ill with each passing day.

The good news is that when a home nurse is employed to take care of your aging parent they don't expect to see you, or your family at their best. They understand that you are not going to be at your best. Hopefully they have been properly trained and know how to handle the stressed family as well as they know how to take care of their cranky, confused patient.

The first thing you can do to make sure that the home nurse who is going to be taking care of your elderly parent's medical needs is to make sure that nurse has a personality that compliments you and your family. The way you get a nurse that suits your family's personality is being sure that you are completely honest with the agency you are using to locate the home nurse. Make sure your description of your family, their routine, and your parent's medical needs is completely true. The more honest you are about your needs and requirements the easier it will be for the agency to match you with a home nurse. If your parent needs to be physically lifted an moved make sure that you request a nurse with enough strength to get the job done.

When you are told that a nurse has been found for your parent, make sure you meet the nurse before they start taking care of your parent. Make sure this is a person whom you are comfortable welcoming into your home. If the nurse is, for whatever reason, not someone you are comfortable with, politely request a new nurse.

Make sure that both you and home nurse are both perfectly clear on what the nurse will be doing while she is in the home. When the nurse is just coming to the home for a few hours a day it is easy to know and understand that they are a professional that is doing a job. The line between health care and house keeper can become a little more blurred. Before the nurse ever moves into the spare bedroom, make a list of what they will and wont be doing. Make sure the whole family understands. Having a clear understanding of the nurses responsibilities will make everyone's life's easier and will make the whole experience as pleasant as possible.

Remember that the home nurse is a professional. They are in your home to take care of a family member, but they are not an actual member of your family. Make sure that your maintain a polite, friendly, but professional relationship with the home nurse