Category Archives: Endocrine

Women’s health — Week 32: Menopause

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tacuin womenMenopause is a normal part of a woman’s life. It is the time of your last period, but symptoms can begin several years earlier, a time called perimenopause.

Some symptoms of menopause can last for months or years after you stop having periods. Continue reading

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Women’s Health – Week 18: Gestational Diabetes

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From the Office of Research on Women’s Health

Gestational diabetes (pregnancy)

Gestational diabetes is diabetes that occurs when a woman is pregnant. Changing hormone levels and weight gain are all part of a healthy pregnancy.

But both these changes can make it hard for your body to keep up with its need for a hormone called insulin. Your body may not get the energy it needs from the food you eat and, later in your pregnancy, you could develop gestational diabetes.

Gestational diabetes often goes away after the baby is born but having gestational diabetes can place you and your child at increased risk for developing diabetes later in life.

Taking care of yourself will help keep you and your baby healthy throughout your lives. Important action steps include:

  • Reaching and maintaining a healthy weight.
  • Being physically active for 30 minutes at least 5 days a week.
  • Following a healthy eating plan.

Your health care provider will decide when you need to be checked for diabetes depending on yourrisk factors. Risk factors include:

  • Age: 25 years of age or older.
  • Weight: Being overweight or obese.
  • Family history: Having a parent, brother, or sister with diabetes.
  • Baby’s birth weight: Delivering a baby weighing more than 9 pounds.
  • Health history: A previous diagnosis of gestational diabetes in an earlier pregnancy.
  • Blood glucose (blood sugar): Having pre-diabetes, a condition in which blood glucose levels are higher than normal.
  • Race/ethnicity: Being of African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander descent.
Risks of gestational diabetes
Having gestational diabetes may increase your risk of high blood pressure or your baby may grow very large. Both can make delivery difficult and dangerous for you both. It can also cause other problems for your baby including: 

  • Low blood glucose right after birth.
  • Breathing problems.
NIH and You
The NIH Office of Research of Women’s Health has partnered with the National Institute of Diabetes and Digestive and Kidney Disease’s National Diabetes Education Program on its Small Steps. Big Rewards – It’s Never Too Early…To Prevent Diabetes campaign to increase awareness about the future health risks for women with a history of gestational diabetes and their children. The campaign promotes screening for type 2 diabetes in women with a history of gestational diabetes, provides advice on future health risks, and promotes the importance of adopting and maintaining healthy behaviors.

for more information: www.niddk.nih.gov

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Women’s Health – Week 17: Complications of Diabetes

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From the Office of Research on Women’s Health

Complications of diabetes

If you have diabetes, you may be at greater risk for many serious health problems. But if you follow your treatment plan and make lifestyle changes, you may be able to prevent or delay serious health problems. Some common complications of diabetes are below.

Eye disease

Damage to the eyes can lead to severe vision loss or even blindness. Eye problems may include:

  • Retinopathy: damage to the blood vessels in the retina. Diabetic retinopathy gets worse with time. You may not notice vision changes at first. Timely treatment and follow-up care help prevent serious vision loss. Diabetic retinopathy usually affects both eyes and is a leading cause of blindness in adults.
  • Cataract: clouding of the eye’s lens. Cataracts develop at an earlier age in people with diabetes.
  • Glaucoma: increase in fluid pressure inside the eye, which leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.

Kidney failure

Diabetes is the most common cause of chronic kidney disease (CKD) and kidney failure, though most people with diabetes do not develop CKD that is severe enough to progress to kidney failure.

People with kidney failure undergo dialysis, an artificial blood-cleaning process, ortransplantation to receive a healthy kidney from a donor.

Researchers have found that high blood pressure and high levels of blood sugar increase the risk that a person with diabetes will develop kidney failure. Controlling your blood pressure and blood sugar may reduce your risk.

Nerve disease

Diabetes can cause serious nerve problems, or neuropathies. People with diabetes can develop nerve damage throughout their body. Some people with nerve damage have no symptoms. Others may experience pain, tingling, or numbness – loss of feeling – in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. People with diabetes can develop nerve problems at any time, but risk rises with age and the longer a person has diabetes. Neuropathies also appear to be more common in people who have problems controlling their blood sugar as well as those who are overweight or who have high blood pressure or high levels of blood fat.

Foot ulcers and amputations

People with diabetes need to take special care of their feet. The nerves to the feet, the longest in the body, are most often affected in diabetes. Loss of sensation in the feet means that sores or injuries may go unnoticed and may become ulcerated or infected.

Circulation problems also increase the risk of foot ulcers. More than half of all lower-limb amputations in the United States occur in people with diabetes – 86,000 amputations per year.

Health care providers estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.

Periodontal disease

People with diabetes are at higher risk for developing infections, including periodontal, or gum disease. For more information on dental health, please see Week 13.

For more information: www.ndep.nih.gov

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Women’s Health – Week 16: Diabetes: Type 1 and Type 2

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From the Office of Research on Women’s Health

Glucometer showing a blood sugar of 105Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Your blood always has some glucose in it because your body needs glucose for energy. Too much glucose, however, is not good for your health.

Insulin, a hormone produced by the pancreas, helps the glucose from food get into your cells. If your body does not make enough insulin, or if the insulin does not work the way it should, glucose cannot get into your cells for energy. It stays in your blood instead. Your blood glucose levels then get too high, causing diabetes.

With type 1 diabetes, the pancreas no longer makes insulin. People with type 1 diabetes need to take insulin every day. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. Children and young adults most often develop type 1 diabetes, but it can appear at any age.

With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. People with type 2 diabetes often need to take pills or insulin. Type 2 diabetes is the most common form of diabetes and can occur at any age, even childhood.

Having a parent, brother, or sister with diabetes, or being overweight and inactive increases the chances of developing type 2 diabetes.

Pregnant women can also develop diabetes, called gestational diabetes (see Week 18 for more information). Gestational diabetes often goes away after the baby is born. But having gestational diabetes can place you and your child at increased risk for developing diabetes later in life.

Symptoms of diabetes may include fatigue, thirst, weight loss, blurred vision, and frequent urination. With type 2 diabetes, some people have no symptoms at all. A blood test can show if you have diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, heart, gums, teeth, and nerves. It can lead to blindness, kidney failure, and the loss of a foot or a leg. The most serious problem caused by diabetes is heart disease. If you have diabetes you are more than twice as likely as people without diabetes to have a heart attack or a stroke.

The good news is that if you have diabetes, you can take steps to manage the disease. Learn how to manage the ABCs of diabetes. A is for the HbA1C test, which shows you what your blood glucose has been over the past 3 months. B is for blood pressure and C is for cholesterol.

You can lower your chances of developing serious health problems by keeping your blood glucose, blood pressure, and cholesterol levels in the target range your health care provider gives you. You can manage your diabetes by being active every day and keeping your weight in a healthy range. Follow your meal plan, take your medications, and check your blood glucose as directed by your health care provider.

For more information: www.yourdiabetesinfo.org

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This National Diabetes Month: remember to keep an eye on your eyes

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From the National Institutes of Health

If you are one of more than 25 million Americans with diabetes, you may already know the importance of watching your diet and keeping track of your blood sugar. But did you know it’s also important to have regular eye exams?

In the United States, diabetic eye disease is the leading cause of vision loss among working-age adults. Diabetic retinopathy is the most common form of this disease, and affects about 28.5 percent of Americans with diabetes age 40 and older. That’s more than 7 million people, and the number is expected to reach more than 11 million by the year 2030.

The condition can creep up quietly. It gradually weakens small blood vessels in and around the retina, the light-sensing layer of tissue at the back of the eye. If the disease progresses, these vessels may rupture and leak blood into the eye; they can also spread and grow on the surface of the retina and cause scarring.

Typically, diabetic retinopathy has no symptoms until it reaches an advanced stage. But the disease can be detected early through a comprehensive dilated eye exam. In this procedure, an eye professional will put drops in your eye to dilate (widen) the pupil, which allows a closer look at the retina.

The good news is that with early detection, timely treatment, and appropriate follow-up, the risk of severe vision loss from diabetic retinopathy can be reduced by 95 percent.

There are several effective treatment options including laser surgery and injections of anti-VEGF drugs. These drugs block the actions of a protein that can cause abnormal blood vessels to grow and leak fluid.

 

A comprehensive dilated eye exam can catch diabetic eye disease early, before symptoms appear.

November is National Diabetes Month. If you have diabetes, it’s a good time to remember these health tips:

  • Get a comprehensive dilated eye exam at least once a year.
  • Control your blood sugar, blood pressure and cholesterol levels. By controlling your diabetes, you’ll reduce your risk of diabetic eye disease.
  • Talk to your eye care professional about diabetic retinopathy.
  • Learn more about diabetic eye disease from the National Eye Institute, part of the National Institutes of Health.

NEI’s Diabetic Retinopathy Clinical Research Network (DRCR.net) conducts large multi-center trials of new therapies for diabetic eye disease; it comprises nearly 1000 investigators at sites in 48 states.

Many of the sites are private practice eye clinics, enabling the network to quickly bring innovative treatments from research into community practice. An ongoing trial is comparing three anti-VEGF drugs for macular edema, a complication of diabetic retinopathy that causes central vision loss. For more information, please see trial NCT01627249 at http://www.clinicaltrials.gov.

The National Eye Institute, part of the National Institutes of Health, leads the federal government’s research on the visual system and eye diseases. NEI supports basic and clinical science programs that result in the development of sight-saving treatments. For more information, visit http://www.nei.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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Understanding obesity in children – AHRQ summary for parents

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Kids 1From the US Agency for Healthcare Research and Quality

How do I know if my child is at a healthy weight?

young boy on scaleYour child’s doctor will track your child’s height and weight over time and can tell you if your child is at a healthy weight. During wellness checkups, be sure to talk with your child’s doctor about your child’s weight.

Your child’s doctor may ask you about:

  • Your child’s eating habits
  • Whether you have places to get healthy food for your child
  • How much physical activity your child gets
  • Whether there are safe places for your child to run around and play
  • How much screen time your child has each day (time spent watching television, playing video games, or sitting in front of a computer, cell phone, or tablet such as an iPad)
  • Any health problems your child has
  • Your family’s medical history

What is BMI and what are BMI percentiles?

To find out if your child is in a healthy weight range, your child’s doctor may use something called BMI, or “body mass index.” BMI is a measurement based on your child’s height and weight. BMI helps the doctor estimate how much body fat your child has. The doctor can use BMI to see if your child is at a healthy weight for his or her height. A healthy BMI is different for girls and boys and changes by age.

Your doctor may compare your child’s BMI to the typical BMI range for children of the same sex and age. To do so, doctors may use what is called a “BMI percentile.” This can help the doctor figure out if a child is underweight, at a healthy weight, overweight, or obese.

According to the Centers for Disease Control and Prevention (CDC), children are considered:

  • At a healthy weight if their BMI is between the 5th and 85th percentile
  • Overweight if their BMI is between the 85th and 95th percentile
  • Obese if their BMI is in the 95th percentile or above

To calculate your child’s BMI and BMI percentile, go to http://apps.nccd.cdc.gov/dnpabmi/.

What health problems can being overweight or obese cause for a child?

Children who are overweight or obese are more likely to be overweight or obese as adults. They are also more likely to develop serious health problems such as:

  • High blood sugar or diabetes
  • High blood pressure
  • High cholesterol (a type of fat in the blood)
  • Sleep apnea (a condition in which you stop breathing for brief periods of time while you sleep)
  • Heart problems (such as heart attack or heart failure) or a stroke as an adult
  • Extra pressure on bones and joints, which could lead to bone and joint problems both as a child and as an adult
  • Nonalcoholic fatty liver disease (a disease caused by too much fat in the liver)
  • Low self-esteem or depression
  • Eating disorders such as binge eating and purging

What might lead to a child becoming overweight or obese?

Many things can lead to a child becoming overweight or obese, including:

  • Unhealthy eating habits. Children may eat too much, eat too many unhealthy foods, or drink too many sugary drinks.
  • Not getting enough sleep. Children who do not get enough sleep each night are more likely to become overweight.
  • Family history. Children from overweight families may be more likely to become overweight. This could be due to a child’s genes or learned family eating habits.
  • Not enough physical activity. Children may not get enough physical activity. Children should be active for at least 1 hour each day.
  • Too much screen time. Children may have too much screen time during the day. Some children may eat while watching television or playing on the computer.
  • Environment. Children may spend time in an environment (such as with relatives, with friends, in childcare, or at school) where healthy eating choices or opportunities for physical activity are not available.Keeping Your Child From Becoming Overweight or Obese

How can I keep my child from becoming overweight or obese?

To help keep your child from becoming overweight or obese, make sure your child eats healthy and is physically active. There are many things that can be done at home, in school, and in the community to help keep children at a healthy weight. Some examples of each are listed below.

At Home

There are many things you can do at home as a family. Some examples include:

Eat healthy
  • Cook healthy meals at home with foods from each food group.
    • The food groups include fruits, vegetables, grains, protein foods (such as meats, eggs, fish, tofu, and beans), and low-fat or nonfat dairy.
  • Be sure to eat a healthy breakfast every day.
  • Eat at the table as a family instead of in front of a screen (television, computer, cell phone, or tablet).
  • Limit or do not keep unhealthy foods and drinks at home.
    • Replace unhealthy snacks such as cookies, candy, or chips with healthy snacks such as fruits and vegetables.
    • Replace unhealthy sugary drinks such as sodas, sports drinks, or juices with healthy drinks such as water and low-fat or nonfat milk.
  • Eat most meals at home instead of at restaurants. At home, you are better able to limit the amount of fat, sugar, and salt in your meals.
  • Be sure to eat the right amount of food.
For more information about healthy foods, eating the right amount, and sample menus, go to http://choosemyplate.gov.
father swimming with his childrenBe physically active
  • Give your child a chance to run around and play – at least 1 hour a day.
  • Plan fun activities like bicycling, walking to the park, playing ball, or swimming.
  • Encourage everyone in the family to be active during the day.
    • For example, take the stairs instead of the elevator and walk or bike places instead of driving or taking the bus.
  • Limit the amount of screen time each day.
  • In addition to being physically active, make sure your child gets enough sleep each night.

Let’s Go! is a program to keep children from becoming obese. The program focuses on healthy eating and physical activity.

Let’s Go! recommends the “5-2-1-0” healthy habits for each day:

  • 5 fruits and vegetables
  • 2 hours or less of screen time for recreation
  • 1 hour or more of physical activity
  • 0 sugary drinks

Let’s Go! also recommends keeping television and computers out of your child’s bedroom and not allowing screen time for children younger than 2 years.

Let’s Go! is a State of Maine program that also supplies resources to communities outside of the State. These graphics and messages are adapted from Let’s Go! at www.letsgo.orgExit Disclaimer

In School

Girl in cafeteria line

In addition to eating healthy and being physically active at home, school programs can help keep children at a healthy weight. School programs could include things such as:

  • Lessons about the importance of healthy eating and physical activity
  • Information sessions for parents to learn ways to help keep their child at a healthy weight
  • Healthy breakfast and lunch options in the cafeteria with the right portion sizes
  • Healthy snacks and drinks in vending machines and at parties and events
  • Filtered water coolers to encourage drinking water instead of soft drinks or sports drinks
  • Adult-led walk-to-school or bike-to-school groups
  • A longer physical education (PE) period in which children are physically active
  • Gym equipment such as balls and jump ropes for use during recess

Let’s Go! also has resources for schools to help children eat healthy and be physically active. For more information and toolkits for your child’s school, go to www.letsgo.org/toolkits/Exit Disclaimer

To find out what your child’s school is doing to help keep children from becoming overweight or obese, talk with your child’s principal, school nurse, or school counselor. You can also ask how to become involved in the school’s Parent-Teacher Association (PTA) or Parent-Teacher Organization (PTO).

In the Community

In addition to home and school, things can also be done in the community to help keep children at a healthy weight. Communities and community centers can:

  • Improve community parks, sidewalks, and biking paths.
  • Take steps to make parks, sidewalks, and biking paths safe.
  • Advertise community events such as health fairs, 5K walks, sports events at local parks, community garden programs, and local farmers markets. This can be done on posters, in local newspapers, and on local television and radio stations.
  • Offer programs in which families can get advice on healthy eating and being physically active.

For other resources to help keep your child at a healthy weight, go to:

For more information about improving parks, sidewalks, and biking paths in your area, contact your local parks and recreation department.

For more information about events or programs in your community, contact your local community or recreation centers (such as the YMCA, Boys and Girls Club, or local religious community centers).

What have researchers found about doing things at home, in school, and in the community to help keep children from becoming overweight or obese?

Healthy eating and physical activity are very important in keeping children from becoming overweight or obese.

Researchers found that:

  • Programs at schools to help children eat healthy and be physically active can keep children from becoming overweight or obese.
  • Along with school programs, additional steps at home and in the community can also help.
  • More research is needed to know which particular programs or steps work the best.
  • Talking With Your Child’s Doctor, School, and Community Centers

Examples of Questions To Ask Your Child’s Doctor

  • Is my child at a healthy weight?
  • What are the most important things for me to do at home to help keep my child at a healthy weight?
  • How can I get my child to eat healthy foods?
  • How much of each type of food should my child eat?
  • How much physical activity does my child need each day?
  • What are the best types of physical activity for my child?
  • How much screen time should I allow my child each day?
  • How much sleep should my child get each night?
  • Do you have any resources that can help me keep my child at a healthy weight?
  • Do you know of any community resources that can help?
  • If there are no grocery stores nearby or healthy food is too expensive for me, do you know of any resources that could help me?
  • If there is no safe place for my child to play outside, how can I help my child stay active?

Examples of Questions To Ask Your Child’s School Principal, Nurse, or Counselor

  • Does the school offer programs to help keep children from becoming overweight or obese? If not, how can we start some?
  • In the cafeteria and in vending machines, are healthy foods such as fruits and vegetables available instead of sugary drinks and salty or fatty foods?
  • How much time is my child given during PE, recess, and throughout the day to be physically active?
  • Does the school ever use PE or other physical activity as punishment?
  • Do you have adult-led walk-to-school or bike-to-school programs or other physical activity programs for children?
  • Are there information sessions that I can attend to learn more about helping my child stay at a healthy weight?
  • What can I do at home to help reinforce what my child is taught about healthy eating and physical activity at school?
  • Do you know of any community resources that can help?

Examples of Questions To Ask Your Local Community or Recreation Center

  • Do you have any resources or programs on healthy eating or physical activities for children?
  • Do you keep a calendar of community events such as health fairs, 5K walks, or sports events at local parks?
  • Do you have a list of local community gardens or farmer’s markets?
  • Do you know of any programs that can give me advice on how to help my family eat healthy and be physically active?Sources

The information in this summary comes from the report Childhood Obesity Prevention Programs: Comparative Effectiveness Review and Meta-Analysis, June 2013. The report was produced by the Johns Hopkins University Evidence-based Practice Center through funding by the Agency for Healthcare Research and Quality (AHRQ).

Additional information came from the MedlinePlus® Web site, a service of the National Library of Medicine and the National Institutes of Health. The site is available at www.nlm.nih.gov/medlineplus.

This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX. It was written by Amelia Williamson Smith, M.S., Jason A. Mendoza, M.D., M.P.H., and Michael Fordis, M.D. Parents of children between the ages of 2 and 18 reviewed this summary.

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Women’s Health – Week 6: Bone Health and Osteoporosis

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From the Office of Research on Women’s Health

Bones are living tissue. A healthy body with strong bones is essential to overall health and quality of life. Strong bones support us and protect the heart, lungs, brain, and other organs from injury. Weak bones break easily. They cause pain and interrupt everyday activities.

Osteoporosis, or porous bone, is a disease characterized by low bone mass. It makes bones weak and more likely to break – especially the bones of the hip, spine, and wrist.

The disease is a major public health threat for an estimated 44 million Americans, 68 percent of whom are women. Every year, 1.5 million Americans suffer a fracture because of weak bones, mostly in the wrists, spine, and hips.

Osteoporosis is called a silent disease because bone loss occurs without symptoms. People typically do not know that they have osteoporosis until their bones become so weak that a sudden strain, twist, or fall results in a fracture (broken bone). Many people are unaware of the link between a broken bone and osteoporosis.

While white women over the age of 50 are at highest risk for osteoporosis, women and men of every age and ethnicity should be concerned about bone health.

If you are older than 65, have broken a bone after age 50, have relatives with a broken bone, have certain medical conditions (for example, hyperthyroidism or arthritis), or take certain prescription medications (such as thyroid medicine or glucocorticoids), you may be at higher risk for osteoporosis. Talk to your health care provider and find out if you need a bone density test.

osteoporosis

Diagram showing a healthy spine versus a spine showing signs of osteoporosis. Click on the image to view larger.

Some steps you can take to help prevent osteoporosis and fractures:

  • Be physically active every day to keep your bones strong. Weight-bearing physical activity causes new bone tissue to form, which makes bones stronger.
  • Eat a healthy diet, including calcium and vitamin D, which are critical for good bone health.
  • Know that smoking and heavy alcohol use reduce your bone mass and increase your risk for broken bones.
  • Reduce your risk of falling with physical activity to make you stronger and to improve your balance and coordination (making you less likely to fall).
  • Make your home safe by removing things you can trip over (like small rugs and stepstools), using non-slip mats in the bathtub and shower, and installing bright light bulbs to make it easier to see.
  • Ask a health care provider to review your prescription and over-the-counter medicine because some medicines, or combinations of medicines, can make you less alert, slower to react, and can lead to a fall.
for more information: www.niams.nih.gov
NIH and You
Milk matters is a public health education campaign that promotes calcium consumption among tweens and teens, especially between the ages of 11 to 15, a time of critical bone growth. Bones grow fastest during the tween and teen years, and adequate calcium intake during these years helps prevent osteoporosis later in life. But, studies show that most tweens and teens are not getting enough of it in their diets. Fewer than one in ten girls and only one in four boys ages 9 to 13 are at or above their adequate intake of calcium. Although the consequences of low calcium consumption may not be visible in childhood, the Eunice Kennedy Shriver National Institute of Child Health and Human Development recognizes lack of calcium during the critical years of bone development can have a serious effect on the health of young people later in life.

 
for more information: www.nichd.nih.gov/milk

 

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Fake diabetes treatments flood marketplace – FDA warns

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health scams quackFrom the FDA

As the number of people diagnosed with diabetes continues to grow, illegally sold products promising to prevent, treat, and even cure diabetes are flooding the marketplace.

The Food and Drug Administration (FDA) is advising consumers not to use such products. They may contain harmful ingredients or may be otherwise unsafe, or may improperly be marketed as over-the-counter (OTC) products when they should be marketed as prescription products.

They carry an additional risk if they cause consumers to delay or discontinue effective treatments for diabetes. Without proper disease management, people with diabetes are at a greater risk for developing serious health complications.

“People with chronic or incurable diseases may feel desperate and become easy prey. Bogus products for diabetes are particularly troubling because there are effective options available to help manage this serious disease rather than exposing patients to unproven and risky products,” said Gary Coody, R.Ph., national health fraud coordinator for FDA.

“Failure to follow well-established treatment plans can lead to, among other things, amputations, kidney disease, blindness and death,” Coody said.

Warning Letters Issued

Recently, FDA launched an initiative to counter these illegally sold products aimed at consumers who have diabetes. In addition to evaluating numerous consumer complaints, FDA surveyed the marketplace for illegally sold products promising to treat diabetes and its complications.

In July 2013, FDA issued letters warning 15 companies about selling products for diabetes in violation of federal law. These products are sold as dietary supplements; alternative medicines, such as ayurvedics; prescription drugs and over-the-counter drugs, including homeopathic products.

Examples of claims observed on these illegally marketed products include:

  • “Lower your blood sugar naturally.”
  • “Lowers A1C levels significantly.”
  • “You’ll lower your chances of having eye disease, kidney disease, nerve damage and heart disease!”
  • “It can replace medicine in the treatment of diabetes.”
  • “For Relief of Diabetic Foot Pain.”

Some of the companies also promote unapproved products for other serious diseases, including cancer, sexually transmitted diseases, and macular degeneration.

FDA tested products marketed as “all natural” treatments for diabetes and discovered some of them contained one or more active ingredients found in prescription drugs to treat type 2 diabetes.

Undeclared ingredients can cause serious harm. If consumers and their health care professionals are unaware of the actual ingredients in the products they are taking, these products may interact in dangerous ways with other medications.

One possible complication: Patients may end up taking a larger combined dose of the diabetic drugs than they intended, and that may cause a significant unsafe drop in blood sugar levels, a condition known as hypoglycemia.

FDA also looked at sales of prescription drugs from fraudulent online pharmacies. Signs that indicate an online pharmacy is legitimate include: requiring that patients have a valid prescription; providing a physical address in the U.S.; being licensed by a state pharmacy board; and having a state-licensed pharmacist to answer questions.

Some fraudulent online pharmacies illegally sell drugs that are not approved in the United States, or sell prescription drug products without meeting necessary requirements.

One website that is subject to a warning letter shipped a prescription diabetes drug without requiring a prescription, and even included an unsolicited free sample of a prescription drug for erectile dysfunction.

Moreover, the prescription diabetes drug was dispensed without the medication guide and other precautions required by FDA to ensure the drug is used safely and appropriately.

Although some of these websites may offer for sale what appear to be FDA-approved prescription drugs, FDA cannot confirm that the manufacture or the handling of these drugs follows U.S. regulations or that the drugs are safe and effective for their intended uses. Also, there is a risk the drugs may be counterfeit, contaminated, expired or otherwise unsafe.

A Far-Reaching Problem

There are 26 million people in the U.S. who have diabetes, including about 7 million who are undiagnosed, according to the Centers for Disease Control and Prevention.

Millions more have pre-diabetes, meaning they have higher than normal blood sugar levels and can reduce their risks of developing diabetes through healthy lifestyle changes, including diet and exercise.

“Products that promise an easy fix might be alluring, but consumers are gambling with their health. In general, diabetes is a chronic disease, but it is manageable and people can lower their risk for developing complications by following treatments prescribed by health care professionals, carefully monitoring blood sugar levels, and sticking to an appropriate diet and exercise program,” said Coody.

Health care professionals and consumers are encouraged to report any adverse events related to products intented to treat or cure diabetes to FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

July 23, 2013

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Have diabetes? Travel tips from the CDC

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Safe travel tips from the US Centers for Disease Control and Prevention

Glucometer showing a blood sugar of 105Getting out of the routine is part of the fun of vacation and traveling. But your care routine should travel with you, especially if you have diabetes.

Meals away from home, changes in how much physical activity you get, and differences in time zones as you travel can affect how well you manage diabetes. Use this time to be refreshed, lose the stress, and be open to healthy habits. Before you hit the road, review these tips for taking care of yourself.

Don’t Forget Your Medication

  • Pack twice the amount of diabetes supplies you expect to need, in case of travel delays.
  • Keep snacks, glucose gel, or tablets with you in case your blood glucose drops.
  • Make sure you keep your health insurance card and emergency phone numbers handy, including your doctor’s name and phone number.
  • Carry medical identification that says you have diabetes.
  • Keep time zone changes in mind so you’ll know when to take medication.
  • If you use insulin, make sure you also pack a glucagon emergency kit.
  • Have all syringes and insulin delivery systems (including vials of insulin) clearly marked with the pharmaceutical preprinted label that identifies the medications. Keep it in the original pharmacy labeled packaging.
  • Find out where to get medical care if needed when away from home.
  • Take copies of prescriptions with you.

On the Road

  • Reduce your risk for blood clots by moving around every hour or two.
  • Pack a small cooler of foods that may be difficult to find while traveling, such as fresh fruit, sliced raw vegetables, and fat-free or low-fat yogurt.
  • Bring a few bottles of water instead of sugar-sweetened soda or juice.
  • Pack dried fruit, nuts, and seeds as snacks. Since these foods can be high in calories, measure out small portions (¼ cup) in advance.

In the Air

  • If you’re flying and do not want to walk through the metal detector with your insulin pump, tell a security officer that you are wearing an insulin pump and ask them to visually inspect the pump and do a full-body pat-down.
  • Place all diabetes supplies in carry-on luggage. Keep medications and snacks at your seat for easy access. Don’t store them in overhead bins or checked luggage.
  • If a meal will be served during your flight, call ahead for a diabetic, low fat, or low cholesterol meal. Wait until your food is about to be served before you take your insulin.
  • If the airline doesn’t offer a meal, bring a nutritious meal yourself.
  • Make sure to pack snacks in case of flight delays.
  • When drawing up your dose of insulin, don’t inject air into the bottle (the air on your plane will probably be pressurized).
  • Reduce your risk for blood clots by moving around every hour or two.

Staying Healthy

  • Changes in what you eat, activity levels and time zones can affect your blood glucose. Check levels often. Talk with your doctor before increasing physical activity, such as going on a trip that will involve more walking.
  • Stick with your exercise routine. Make sure to get at least 150 minutes of physical activity each week.
  • Wash hands often with soap and water.
  • Protect your feet. Be especially careful of hot pavement by pools and hot sand on beaches. Never go barefoot.
  • Make sure you are up-to-date on immunizations.

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Accuracy of blood glucose meters draws scrutiny

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Glucometer showing a blood sugar of 105By Phil Galewitz

Blood glucose meters, which millions of diabetics rely upon to regulate their blood sugar, have become less costly and easier and less painful to use.

But they haven’t become more accurate, a top Food and Drug Administration official said Tuesday at a meeting of researchers analyzing studies that show wide variation in the performance of the machines used to measure blood glucose levels.

Katherine Serrano, diabetes branch chief in the FDA division of chemistry and toxicology devices, said the federal government was aware of problems with meters on the market. But she said the FDA is limited in its response because some manufacturers are in Asia, and the agency must rely on the manufacturers’ own studies related to accuracy.

Health experts say if a blood glucose meter provides a false reading, it puts a patient at risk of dosing with too much or too little insulin. If too much insulin is given, it can bring blood glucose levels down to dangerously low levels, putting the patient at risk of severe hypoglycemia and possible hospitalization.

Typically, a person with diabetes tests his or her blood sugar before eating or exercising to find out if he or she is within normal range. The patient then uses insulin or diet to restore blood glucose to a healthy level. About 24 million people have diabetes in the Unted States,  and nearly a third of that number rely on insulin to regulate their blood sugar.

Researchers at the Diabetes Technology Society meeting in Arlington, Va., presented several studies done in the United States and Germany showing it is common for many devices to fall short of the 95 percent accuracy standard required by the FDA.

Consumers often buy the devices based on which is cheapest, or which is covered by their insurance policy without realizing that not all meters offer same accuracy, they said.

Serrano said several factors can reduce a meter’s accuracy, such as storing it in a hot or cold area, or failing to wash your hands before using them. She said studies done by manufacturers seeking approval are done in labs by trained personnel.

“There have been a lot of advances in the technology of the meters but we have not seen great strides in accuracy,” Serrano said.

She noted manufacturers don’t have much incentive to improve accuracy because federal law requires  only that they prove they are “substantially equivalent” to another meter already on the market.

The FDA relies on the manufacturer’s own studies to analyze accuracy and does not require any independent testing, she said. Here are some tips to help improve accuracy.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Federal judge strikes down age limits on ‘morning-after’ pill

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planb-175By Scott Hensley, NPR News

This story comes from KHN partner ‘s Shots blog.

A federal judge in Brooklyn, N.Y., has ruled that the morning-after pill for emergency contraception must be made available over the counter to girls 16 and under.

The ruling could end a more than decade-long battle over how easy or difficult it should be for teenage girls to obtain emergency contraception.

The ruling would also make it easier for older women to obtain the drug because it wouldn’t have to be kept behind drugstore counters anymore.

The judge’s order effectively overturns a controversial 2011 decision by Secretary of Health and Human Services Kathleen Sebelius overruling the Food and Drug Administration. A

fter years of study and internal debate, the FDA had decided that Plan B One Step should be allowed for sale without a prescription — and without age restrictions.

In the ruling dated April 4, Senior Judge Edward R. Korman of the Eastern District of New York held that Sebelius’s decision on Plan B was “arbitrary, capricious, and unreasonable.”

On page 47 of the 59-page decision, Korman skewers Sebelius’s decision, calling it “politically motivated, scientifically unjustified, and contrary to agency precedent ….”

He also slammed the FDA’s rejection of a so-called Citizen’s Petition dating to 2005 that argued for the agency to approve unfettered over-the-counter sale of Plan B. That rejection, he said, was a direct consequence of Sebelius’s ruling.

In the decision, Korman sends the Plan B case back to FDA with orders to make the morning-after pill “available without a prescription and without point-of-sale or age restrictions within 30 days.” If the agency decides the instructions for the drugs need tweaks, that’s OK.

When Sebelius essentially vetoed the FDA’s decision in late 2011, women’s health groups erupted in protest. “As doctors and researchers have repeatedly stated, ample research shows Plan B to be safe for women of all ages and appropriate for over-the-counter access.

It is deeply disappointing that this administration would repeat the mistakes of the previous one,” said Susan Wood, an associate professor at George Washington University’s School of Public Health.

Wood was an assistant commissioner for women’s health at the FDA but quit in 2005 over its continued delay on over-the-counter approval for Plan B.

Advocates for Plan B kept up the pressure on the administration to reverse itself. They argued, in part, that the rules were just too complicated.

“The unique dual-labeling of Plan B One Step has led to confusion among consumers and health care professionals alike, particularly regarding age restrictions and whether men and women can purchase non-prescription emergency contraception,” said a letter signed by more than three dozen women’s health, reproductive rights and individual providers of health care.

“A recent Boston University study of 943 pharmacies in five major cities revealed that, when called posed as 17 year olds seeking EC, one in five were told they could not purchase EC under any circumstances,” the letter said at the time. In fact, those 17 and older are eligible to purchase the product without a prescription; those 16 and younger may purchase it with a health provider’s written order.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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One in three US adults has prediabetes, yet few aware they have the condition

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Glucometer showing a blood sugar of 105It is estimated that one in three US adults aged 20 and older, or nearly 80 million Americans, has prediabetes, meaning they have blood sugars higher than normal but not high enough to be classified diabetic.

But only about one in ten of these men and women are aware they have the condition, according to a new study for the US Centers for Disease Control and Prevention (CDC).

People with prediabetes typically have no symptoms but are at high risk of developing type 2 diabetes, which greatly increases their risk of heart disease, stroke and other complications of this disease.

People who are at risk of having pre diabetes are people over age 45, who are overweight or obese, and who have a family history of diabetes.

Certain racial and ethnic groups are also at higher risk for prediabetes including:

  • African Americans
  • Hispanics/Latino
  • Native Americans
  • American Asians
  • Pacific Islanders

People with diabetes can prevent or at least delay the onset of type 2 diabetes by modest weight loss, improved nutrition and a more active lifestyle — though in some cases medications are prescribed to bring down blood sugar levels.

To learn more about prediabetes, read the prediabetes fact sheet prepared by the National Institute of Diabetes and Digestive and Kidney Diseases below:

Prediabetes: What You Need to Know

Did you know that if you are 45 years old or older, overweight, and inactive, you may have prediabetes?

What is prediabetes?

Prediabetes means the amount of glucose, also called sugar, in your blood is higher than normal but not high enough to be called diabetes. Glucose is a form of sugar your body uses for energy. Too much glucose in your blood can damage your body over time. If you have prediabetes, also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), you are more likely to develop type 2 diabetes, heart disease, and stroke.

How do I know if I have prediabetes?

Most people with prediabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal.

Who should be tested for prediabetes?

If you are 45 years old or older, your doctor may recommend that you be tested for prediabetes, especially if you are overweight. Being overweight is a key contributor, along with inactivity, to prediabetes. If your body mass index (BMI) is higher than 25, you are overweight. BMI is a measure of your weight relative to your height. If you’re not sure if you are overweight, ask your doctor.

Even if you are younger than 45, consider getting tested for prediabetes if you are overweight and

  • are physically inactive
  • have a parent, brother, or sister with diabetes
  • have high blood pressure or high cholesterol—blood fat
  • have abnormal levels of HDL, or good, cholesterol or triglycerides—another type of blood fat
  • had gestational diabetes—diabetes that develops only during pregnancy—or gave birth to a baby weighing more than 9 pounds
  • are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American
  • have polycystic ovary syndrome, also called PCOS
  • have a dark, velvety rash around your neck or armpits
  • have blood vessel problems affecting your heart, brain, or legs

If your test results are normal, you should be retested in 3 years. If you have prediabetes, ask your doctor if you should be tested again in 1 year.

What can I do about prediabetes?

Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse prediabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting the amount of calories and fat you consume and by being physically active at least 30 to 60 minutes every day. Physical activity also helps your body use the hormone insulin properly. Your body needs insulin to use glucose for energy.

Medicine can help control the amount of glucose in your blood. Ask your doctor if medicine to control glucose is right for you.

The National Diabetes Education Program’s Small Steps. Big Rewards. Prevent Type 2 Diabetes campaign has more information about preventing diabetes at www.ndep.nih.gov.

Where can I get more information about prediabetes?

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20814–9692
Phone: 1–888–693–NDEP (1–888–693–6337)
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndep@mail.nih.gov
Internet: www.ndep.nih.gov
www.yourdiabetesinfo.org

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services.

The NIDDK Awareness and Prevention Series is designed to make you ask yourself, “Could this be me or someone I care for?” So take a closer look. Additional information on this topic and other titles in the series is available through the National Diabetes Information Clearinghouse or at www.diabetes.niddk.nih.gov.

NIH Publication No. 12–6236

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Glucometer showing a blood sugar of 105

Managing diabetes – Tips from the CDC

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From the U.S. Centers for Disease Control and Prevention

Unless we make changes in how we live and eat, forty years from now we may have two or three times as many people with diabetes as we do now.

That means somewhere between one out of three and one out of five adults would have diabetes.

Right now, about one out of nine adults has diabetes.

Diabetes is a serious disease that affects almost every part of your body and can shorten your life. Some complications you can get because of diabetes are kidney disease, heart disease, stroke, eye disease, and having to have a leg or foot amputated.

If you already have diabetes, you can still do a lot to keep from getting complications from diabetes.

Here are some important steps you can take to control diabetes:

  • Talk to your doctor about how to manage your blood sugar level, your blood pressure, and your cholesterol levels.
  • Stop or don’t start smoking or using any kind of tobacco.
  • Do what you can to keep from getting sick. If you have diabetes, you are more likely to get sick and you may get sicker than a person without diabetes. Also, when you’re sick, it’s hard to keep your blood sugar under control. Here are some things you can do to improve your chances of staying well. Click here.
  • Get a flu shot. A person with diabetes is more likely to get really sick or even die from pneumonia or the flu (influenza) than a person who doesn’t have diabetes. If you or someone in your family has type 1 or type 2 diabetes, it is very important to get a flu shot. Make sure you ask for the flu shot—not the nose spray, which doesn’t help as much. CDC recommends that every person six months old and older get a flu shot. Also, ask your doctor if you should get a pneumonia shot. The shot is not appropriate for everyone.
  • Don’t ever use someone else’s insulin pen or any other device that draws blood. You can get a virus from the other person if you do. Click here to visit the One and Only Campaign website. It has more information on being safe and also has buttons and badges you can share with friends.
  • Stay at a weight that’s healthy for you.
  • Make sure you are physically active. Physical activity can help you control your weight, blood sugar, and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol.
  • Do something like walking quickly, gardening, dancing, jogging, or jumping rope at least 150 minutes a week to get yourself moving.
  • At least two days a week, also do other kinds of activity to make your muscles stronger.

Things to Do to Help Keep Yourself from Getting Type 2 Diabetes

If you have prediabetes, there’s good chance you will have type 2 diabetes within three to six years. A person with prediabetes has a blood sugar level that is higher than normal, but not high enough to be diagnosed as diabetes.

CDC estimates that 79 million people in the United States—one out of three adults—has prediabetes.

There is hope, though. If you have prediabetes, research shows that you can slow down or keep from getting type 2 diabetes by losing weight and becoming active. For example, a person who weighs 200 pounds needs to lose about 10 to 14 pounds. (If you weigh more than that, you need to lose more weight. If you weigh less, you need to lose less weight.)

You also need to become physically active for at least 150 minutes per week. Just doing these things can slow down or keep you from getting type 2 diabetes by nearly 60%.

You don’t have to make these changes on your own, you can get help (free written and electronic resources) through the National Diabetes Education Program, which is led by CDC and the National Institutes of Health. Also, CDC leads the National Diabetes Prevention Program.

To find a class in your area click here.

Free! Tools to Educate and Help Yourself

More Information

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Step Out: Walk to Stop Diabetes event Seattle – Oct. 13

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2012 Step Out: Walk to Stop Diabetes event this Saturday

A walking event in Seattle to support the American Diabetes Association’s efforts to STOP DIABETES!

Saturday, October 13, 2012 – SEATTLE: Magnuson Park

For more information:

Volunteers needed to help the event run smoothly. For information, go to: Step Out Volunteer Resources

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King County health officials say consumption of sugary drinks contributing to obesity among the young

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Photo: Alessandro Paiva

Close to a third of high school students, or 26,000 youth, drink soda daily in King County, and 8,000 students drink two or more sodas per day, according to a new “Youth consumption of sugary drinks in King County” report.

Sugary drinks are the largest single source of calories in the U.S. diet and account for almost half of all added sugars that Americans consume.

With 1 in 5 youth in King County is either overweight or obese “reducing the amount of sugary drinks our children consume is a key strategy for improving health,” said Dr. David Fleming, Director & Health Office for Public Health – Seattle & King County.

A person who drinks two 20-ounce regular colas per day consumes 4.7 cups of sugar per week — or 243 cups of sugar per year — from soda alone. The consumption of sugary drinks has been linked to risks for obesity, diabetes, heart disease, stroke, and hypertension.

According to the new “Youth consumption of sugary drinks in King County” Data Watch Report:

  • Two out of three King County middle and high school students report drinking sugary drinks, including sodas, sports drinks or other flavored sweetened drinks, at school.
  • Of those youth who drink sugary drinks at school, 43% bring them from home, 9% get them from friends, 29% buy them at school, and 20% obtain them in other ways
  • Among high school students, daily consumption of at least one soda is highest among American Indian/Alaskan Native youth (40%), Hispanic/Latino youth (39%), Native Hawaiian/ Pacific Islander youth (38%) and African American youth (37%) versus 30% for white, non-Hispanic youth.

Sugary drinks are beverages with added sugars, such as regular sodas (or “pop”), energy drinks, sports drinks, sweetened fruit drinks, and sweetened coffees and teas.

On average, a 20-ounce bottle of regular soda has more than 16 teaspoons of sugar and 240 calories. This is double the total amount of added sugar allowed for an entire day based on a 2,000 calorie diet.

During the last two years as part of Communities Putting Prevention to Work (CPPW), a one-time federal stimulus-fund initiative, King County organizations have been taking steps to decrease access to sugary drinks and offer healthier options, such as water or low-fat milk.

As part of CPPW, the Childhood Obesity Prevention Coalition launched Soda Free Sundays, a community level campaign to take a break from sodas one day a week.  Over 1,000 individuals and 55 organizations took the pledge to go soda free on Sundays.

“This report demonstrates that sugary drink overconsumption continues to be a real problem in King County,” said Victor Colman, Director of the Childhood Obesity Prevention Coalition. “We know that with action at the individual, organizational, and community-wide levels we can see real progress and make healthier beverage choices within reach for everyone.”

Steps families and organizations can take to cut down on sugary drinks:

  • Purchase, serve and enjoy low-sugar options like water, low-fat milk, unsweetened tea and coffee drinks, and small portions (4 ounces or less) of 100% fruit juice.
  • If you do have a sugary drink as an occasional treat, cut calories and save money by ordering a small size and saying “no thanks!” to refills.
  • Ensure easy access to cool, fresh water at work, in organizations that serve kids and in public spaces.
  • Use the King County Board of Health’s Healthy Vending Guidelines to make sure that your vending machines offer the healthiest beverage options
  • .Limit the availability of sugary drinks at your workplace or organization by using the King County Vending Guidelines to identify the types of healthy drinks to make available.

To learn more about sugary drinks and what you can do, visit:

  • Public Health’s sugary drinks webpages, includes new  “10 things parents should know about sugary drinks” and “10 things families and organizations can do to cut down on sugary drinks” fact sheets
  • Soda Free Sundays, a community-wide challenge to take a break from soda and other sugary drinks for just one day out of the week.

Story photo and thumbnail photo courtesy of Alessandro Pavla.

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