BY DR. AVANTIKA WARING
DIABETES IS A chronic
by blood glucose (blood
sugar) levels that rise
beyond healthy ranges
due to the body’s inability to make enough insulin (Type ; diabetes) or
inability to use insulin (Type ; diabetes).
The impact of diabetes can be serious,
increasing the risk of heart disease, kidney
failure, stroke and other health issues. It is
the seventh leading cause of death in the
United States, according to the Centers for
Disease Control and Prevention.
Managing diabetes is a full-time,
round-the-clock job. New technologies are
allowing diabetics and their families to
reclaim more of their lives and improve
the e;ciency of care, allowing them to live
a healthy life with fewer of the stresses of
managing a disease.
Continuous glucose monitoring
People with diabetes have to closely
track their blood glucose levels. Historically, this has involved ;nger pricks from a
needle to get a drop of blood for testing glucose levels. Although these tests provide
accurate data, frequent ;nger pricks can
be painful. Also, individual glucose checks
lack continuity of data.
Some of these issues are addressed by
using continuous glucose monitors that
track blood glucose levels day and night
with a small, wearable device that requires
;nger pricks only two or three times a day
for device calibration. The device sends
timely alerts for blood sugar anomalies to
the wearer, and many of these devices can
send alerts to family members and care-givers as well.
Currently under development is the
hybrid closed-loop insulin pump, a device
that continuously monitors blood glucose
levels and automatically delivers a cali-
brated amount of insulin to keep levels in a
healthy range. These devices combine a
continuous glucose monitor, an insulin
pump and a computer program that calcu-
lates proper doses of insulin. These pumps
can lower the amount of blood glucose test-
ing required by the wearer and make auto-
matic, real-time adjustments to insulin
dosing with less input from the user.
There has been an explosion in mobile
applications for managing diabetes, including tools for tracking diet and exercise and
monitoring glucose levels. Many of these
tools are designed to make self-care for diabetes easier and more engaging by incorporating games and education and creating
communities for people with diabetes.
These features can be especially helpful for
younger people managing the disease.
Telehealth technology allows users to
communicate with physicians and other
providers promptly and from a remote
location. These communication tools are
also creating new pathways for families to
support someone managing diabetes.
Devices come with the capability to upload
and share data so providers and family
members can help people analyze health
data in near real time.
Diabetes a;ects millions of people and
their families and takes a heavy toll on the
economy and the health care system. The
latest technology is giving people with diabetes powerful new tools to lessen the burden of managing the disease and more
hope than ever before of living full and
healthy lives. C
Dr. Avantika Waring is the medical director
of the diabetes program at Kaiser Perman-ente in Seattle.
AN ESTIMATED 30 million people in the
U.S. suffer from chronic obstructive pulmonary disease (COPD), but more than
half them have the symptoms without
realizing it’s COPD. Early diagnosis can
prevent major loss of lung function.
COPD is an umbrella term used to
describe progressive lung diseases,
including emphysema and chronic bronchitis. The disease can develop for years
without causing noticeable shortness of
breath. It is important to talk to a health
care professional as soon as symptoms
occur, and to ask about taking a spirometry test to assess lung function.
Signs and symptoms
• Increased breathlessness during
• Inability to take a deep breath.
• Frequent coughing.
• Excess sputum production.
• Tightness in the chest.
• Most cases of COPD are caused by
inhaling pollutants (smoking cigarettes,
cigars, pipes) and secondhand smoke.
• Fumes, chemicals and dust found
in many work environments are contributing factors.
• Genetics can also play a role, even
if the person has never smoked.
COPD treatment focuses on relief
• Smokers must quit to slow down
damage to lungs.
• Avoid known air pollutants.
• Inhalers and steroids may be used
to open the airway and/or relieve airway inflammation.
• Antibiotics may be used to treat
• Vaccinations for flu and pneumonia are essential for COPD patients
with weakened lungs.
• Supplemental oxygen may be necessary with low blood oxygen levels.
Search these websites for additional information about COPD:
• National Heart, Lung, and Blood
• American Lung Association, lung.org
• Centers for Disease Control and
• COPD Fdn., copdfoundation.org
FOR YOUR HEALTH
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