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HEALTH&HABITAT

December 2011/January 2012 www.esb.ie/em

DIABETES - THE FACTS

HEALTH SERVICES UPDATE

Diabetes

Some 180,000 Irish people have diabetes, with as many as 50,000 diabetics remaining undiagnosed. The majority of people with diabetes are only diagnosed as such as the result of an acute medical event due to complications of long term untreated high blood sugar.

What is diabetes?

Diabetes Mellitus, or just diabetes as it is more commonly known, occurs when the sugar (glucose) level in the blood is too high. This happens when the body is not burning up carbohydrates properly due to a defect in the pancreas, the gland that produces insulin. Insulin is the hormone which keeps blood sugar levels within the normal healthy range. Diabetes may be present either when no insulin is made or when insulin is made but not working properly.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested:

• A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
• An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood glucose. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

• Type 1 diabetes - (Insulin dependent diabetes) is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are required to sustain life. Without proper daily management, medical emergencies can arise.
• Type 2 diabetes - (Non insulin dependent diabetes) is far more common than type 1. It usually occurs in adulthood although we are increasingly seeing young adults and teenagers with the condition. Here, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to increasing obesity levels, and widespread failure to exercise.
• Gestational diabetes - is high blood glucose that develops at any time during pregnancy in a person who does not have diabetes.

There are many risk factors for diabetes, including:

• Family history of diabetes (parent or sibling)
• Obesity
• Age greater than 45 years
• History of gestational diabetes
• Not being active

Symptoms

High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, unexplained weight loss or gain and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Treatment & Medication
There is no cure for diabetes. The immediate goals of treatment are to stabilize the blood sugar and eliminate the symptoms of high blood sugar. Medications to treat diabetes include insulin and glucose-lowering pills, called oral hypoglycemic agents. The long-term goals of treatment are to prolong life, improve quality of life, relieve symptoms, and prevent longterm complications such as heart disease and kidney failure.

Weight management, exercise and a well-balanced diet are important to achieving control of diabetes. Some people with type 2 diabetes can discontinue medications after intentional weight loss, although the diabetes is still present.

If you are worried:

Speak to your GP and tell him/her why you think you may have diabetes. A simple diabetes test will ease any worries you may have.

If you are diagnosed with diabetes, don’t worry. Your doctor will take steps to treat and control your condition. Early detection, effective treatment and good control will help you avoid the more serious health related problems of diabetes and allow you to maintain your quality of life.

As part of ESB Health Services threeyearly Cardiovascular Health Screening programme, your glucose level is checked – so don’t miss this opportunity.

World Diabetes Day took place on Monday November 14th and the Diabetes Federation of Ireland has called on people with diabetes to learn how to prevent or deal with hypoglycaemia, which occurs when blood sugar crashes to a dangerously low level.

Learn more about diabetes by visiting: www.diabetes.ie. www.diabetesaction.ie

Medical Provident Fund Annual Outpatient claim

EAP NOTICEBOARD

The end of the year is fast approaching and now is the time to start checking to see if you have any medical costs that can be recouped. In the next edition of EM we will look at tax relief on medical expenses incurred during the year. This month we are looking at the Medical Provident Fund (MPF) annual claim.

The MPF annual outpatient claim covers the following medical costs which you may have incurred during the year from January to December 2011.

• GP Fees
• Prescribed Pharmacy costs
• Hospital A&E / Emergency room charges
• Some Alternative Medical treatments, ie Acupuncture, Osteopathy, and Chiropractic and Physical Therapy
• Psychologist’s and certain other Practitioners’ Fees

How much can be claimed:
Family: 70% of allowable costs in excess of £360 to a maximum payment of £695 per fund year. Sole Member: 70% of allowable costs in excess of £280 to a maximum payment of £450 per fund year.

Allowable costs:

• GP visits: £32 per visit – Ordinary Scheme
  £37 per visit – Extra Benefits (subject to the overall limits)
• Prescribed Drugs:
  £60 per month (subject to the overall limits above)
• A&E/Emergency Room outpatient Hospital Charge: £50 per visit – Ordinary Scheme £65 per visit - Extra Benefits (subject to the overall limits above)
• Alternative Medicine (Acupuncture, Osteopathy and Chiropractic and Physical Therapy): £15 per visit for Ordinary Scheme and £20 per visit for Extra Benefits (subject to the overall limits above and subject to a maximum of 18 visits covered under the overall heading of alternative treatments). Only alternative practitioners registered as full members of the Irish Organisations listed below are covered for benefit by MPF:

Acupuncture

• Acupuncture and Chinese Medicine Organisation
• The Acupuncture Foundation

Chiropractic

• Chiropractic Association of Ireland

Osteopathy

• Irish Osteopathic Association

Physical Therapy

• Irish Association of Physical Therapists
• Clinical Psychologists (Registered): £35 per visit for Ordinary Scheme and £40 per visit for Extra Benefits. Cover is subject to G.P. referral. Psychologist’s report with prognosis is required in all cases after twelve visits for consideration of cover for any further visits. Psychological assessments/tests for educational purposes are excluded.
• Other Practitioners: Outpatient Dietician Fees where consultant referral applies, Audiology Tests and Orthopist Fees. £20 per visit for Ordinary Scheme and £25 per visit for Extra Benefits.

When and how to claim

Claims should be made as soon as possible after 31st December each year using the MPF Annual Outpatient GP Fees/Pharmacy Claim Form (purple form). Forms are available from the MPF office, your local EAP or downloadable from the Intranet: go to “My life@ esb” then “a-z content” then MPF and MPF Forms.

You can also download forms from www.esbretiredstaff.ie

The Employee Assistance Programme (EAP) is a confidential service provided to ESB Staff and Pensioners. For further information on this or any related matter contact your local EAP Officer.

Christmas dinner – A healthy option?

MIRIAM MCDONALD

NATURAL HEALTH

The Festive Season is here and with it the temptation to overeat and to drink too much. But it can also be a time when many of us actually eat better than we usually do.

Turkey, the centerpiece of the traditional Christmas dinner, is very nutritious – high in protein and low in fat. Its high protein content has been shown to regulate insulin production and keep blood sugar levels in a healthy range. Turkey also contains the tryptophan amino acid. Tryptophan is essential for body function. It helps improve mood and is used by the body to produce the hormone, melatonin, essential for sound sleep.

Supplementation with tryptophan (with doses larger than normal dietary intake) has improved mild cases of depression and aggressive behaviour. Those with eating problems, such as anorexia have been found to be low in tryptophan. L-tryptophan has assisted in easing tremors associated with Parkinson’s disease. The research is continuing and it includes seeing if tryptophan has a role in prolonging exercise and in combating aging.

So whether the tradition of turkey at Christmas is by accident or design, it is very sound nutritionally, particularly in winter.

Christmas vegetables such as broccoli, brussels sprouts, cabbage and cauliflower belong to the cruciferous, or Brassicaceae, family. Cruciferous vegetables have been associated with a reduced risk of colon, breast and prostate cancer and are powerful anti-inflammatories. They contain compounds called indoles that assist the body in getting rid of excess oestregens, which is important in preventing breast cancer. For maximum effect they need to be eaten on a regular basis.

Cruciferous vegetables are also high in vitamin A, vitamin C and folic acid, all essential nutrients for the winter and for general health. As an extra benefit, their fibre content helps our digestive system, which can be sluggish during winter months.

Other positive ingredients in the Christmas dinner include: cranberries, important for the urinary tract, and red wine, which contains resvesterol, important in cancer prevention. Finally, chocolate, provided it is more than 75% cocoa and taken in matchbox size amounts, can lift the mood.

So enjoy your Christmas dinner, eat well and get plenty of rest after a long year. Have a happy healthy Christmas, but don’t forget the exercise programme from 1st January!

Miriam McDonald is a Nutritional Consultant & Practitioner (CANNP). She can be contacted at miriam. mcdonald@freshperceptions.com