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Professional and Consumer Diabetic Guides Available Free on the Internet

Diabetes Health Magazine has compiled a helpful list of charts and resources for clinicians caring for persons with diabetes. Broken into two sections, Diabetes Health Charts covers charts on products such as AIC monitoring products, insulin, skin care, and syringe references. The Educational Resource Guides provide material that can be used in teaching patients and families and contact information for ordering patient teaching resources free from manufacturers. Subjects such as type 2 medications, insulin pumps and meters, and food and nutritional supplements represent some categories covered in this section. To access these helpful guides go to


Is Not Sleeping Enough Making You Fat?

A recent study (Vorona et al., 2005) found that individuals who are overweight or obese report that they get less sleep per week than do their normal-weight counterparts. The researchers interviewed 924 participants, aged 18 to 91 years, who completed questionnaires asking about demographics, medical problems, sleep habits, and sleep disorders and found three factors that affected total sleep time: being a night-shift worker, male gender, and obesity. The results were similar when the investigators excluded subjects with specific sleep disorders, such as obstructive sleep apnea and insomnia.


Although the researchers caution that this study and previous research do not establish a cause-and-effect relationship between restricted sleep and obesity, they do suggest that an extra 20 minutes of sleep per night seems to be associated with a lower body mass index, the measure of body fat based on height and weight that applies to both adult men and women.

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Vorona, R., Winn, M., Babineau, T., Eng, B., Feldman, H., & Catesby Ware, J. (2005). Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Archives of Internal Medicine, 165 (1), 25-30. [Context Link]


RESPeRATE to a Lower Blood Pressure

RESPeRATE, a noun (not a misspelled verb), is the only piece of equipment found effective in six clinical studies and approved by the Food and Drug Administration to lower blood pressure with no side effects. The RESPeRATE works by analyzing the user's breathing pattern and then automatically guides the user through a set of therapeutic breathing exercises that slow breathing to a therapeutic zone of less than 10 breaths per minute. The therapeutic reduction in breathing rate allows the muscles around the blood vessels to dilate, facilitating blood flow through a lower pressure system.


No prescription is necessary, there are no side effects, and it does not interfere with the patient's pharmacological therapy. Patients report that using the RESPeRATE three to four times a week for 15 minutes is pleasant and easy. Although not currently covered by insurance, the RESPeRATE can be ordered on-line at or by calling 201-720-7750.


New Evidence Report on End-of-Life Care Available

A new evidence review on end-of-life care and outcomes identified a large and diverse body of literature reflecting the tremendous growth and importance of end-of-life care during the past 20 years. In a new evidence report prepared by the Agency for Healthcare Research and Quality's Southern California Evidence-based Practice Center, the reviewers identified evidence to support the effectiveness of interventions to improve satisfaction, ameliorate cancer pain, relieve depression in patients with cancer, provide nonpharmacologic interventions for behavioral problems in dementia, and foster continuity in cancer and congestive heart failure care. More evidence is needed to support management of noncancer pain and symptoms, provide effective advance care planning, understand and address the needs of informal caregivers, and understand disparities by gender, race/ethnicity, and having a noncancer, life-limiting disease. A print copy of the summary and the full report are available by sending an e-mail to


Assessing for Elder Abuse and Neglect

Distinguishing between elder abuse and neglect and an elder's lifestyle choice often is difficult for clinicians in home care. Although many agencies have the policy and philosophy that even the slightest sign of suspected abuse or neglect be reported to the authorities, it is difficult to comprehensively document findings for the clinical record.


Medscape has published the Abuse and Neglect Assessment tool, which is easily adaptable for assessment of elders in the home setting. The tool assesses six general categories (general assessment; indicators of possible abuse, neglect, exploitation, or abandonment; and a summary category). The patient is assessed on a scale with indicators that range from no evidence to definite evidence. Although the tool does not include a scoring system, agencies can easily adopt one that reflects their state regulation and organizational policy. To view the article and the tool log on to:


An Apple a Day Keeps the Doctor Away, But Can an Orange Help?

Although the benefits of folic acid in the prevention of neural tube defects are well known, folic acid also may play an important role in decreasing a woman's risk for hypertension. As part of the analysis of the Nurses' Health Study II, participants who ingested 1,000 mg of folic acid on a daily basis were found to have a 46% lower risk of hypertension developing than were those who ingested only 200 [mu]g.

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Because only a few participants reported ingesting high quantities of dietary folate, the study determined that most benefits resulted from dietary supplements, rather than dietary intake. The report warns that these are preliminary findings, and no long-term studies have focused on this particular correlation. Total study results can be found at:, the Nurses' Health study Web site. Additional information about folic acid supplementation is available on the National Institute of Health Web site at