23.7 million Americans currently live with diabetes, and that number is expected to nearly double over the next 25 years.  A lot has changed since the early twentieth century, when diabetes was a clear death sentence. An extraordinary discovery in 1921 held out the first hope for treatment - insulin. Over the past ninety years, diabetes treatment has advanced by leaps and bounds as more effective types of insulin were developed and disposable syringes, glucose meters and pumps became available. Famous actors, musicians, political leaders and sports stars with diabetes clearly demonstrate that diabetes does not need to hold anyone back.

Still, living with diabetes isn’t always easy, even in 2010. If you are like many other Americans with diabetes, controlling your blood glucose levels might be a difficult challenge for you. Is it really that important? The famous Diabetes Control and Complications Trial, conducted between 1983 and 1993, proved that people who kept their blood glucose levels low had a much smaller chance of developing complications like eye, kidney and nerve disease. For pregnant women, controlling blood glucose levels is even more important. If the mother’s blood glucose levels are too high, especially in early pregnancy, her baby has a much higher chance of serious birth defects.

Standard blood glucose testing tells you how much sugar is in your blood when you take the test. But it doesn’t provide an overall indication of your blood glucose control. A1C testing is the gold standard for measuring long-term blood glucose levels. A1C levels indicate the average blood glucose levels over the past 2 to 3 months. Your physician may do this test for you periodically during office visits.

Now, you can take control. With Bayer's A1CNow SelfCheck you can test your A1C level in the privacy and comfort of your own home. The easy-to-use test provides fast results and is as accurate as the test your doctor uses. A1C testing should be used in addition to regular blood glucose monitoring and visits to your doctor.

Available for under $30, the A1CNow SelfCheck won’t put a big dent in your pocket. Compare that to the more invasive continuous glucose monitoring systems (CGMS) which go for at least $1000, not to mention the disposable sensors, which will cost you an additional $10 each day!

3 Great Reasons to Check Your A1C with A1CNow® SelfCheck:

1. Protect your health

Lowering your A1C by even one point translates into a big advantage – a 40% reduction in your risk for serious diabetes-related complications. Avoid potential problems such as blindness, kidney disease, nerve disease, and amputations.

1. Determine how well you are managing your diabetes

Even if you see your doctor regularly, checking your A1C in between doctor visits can let you know if changes in your diet, exercise, and medication are helping or hurting your efforts to maintain low blood glucose levels. An A1C level above 7 percent might indicate that you need to work with your doctor to adjust your diet or medication to better control your blood glucose levels.

1. Find out when it’s safe to get pregnant

If you are thinking about trying to have a baby, you can test your A1C every 2-4 weeks to see if your glucose control is improving, staying the same, or getting worse. Poorly controlled diabetes can cause serious birth defects in the first few weeks of pregnancy, before some women even know they are expecting. An A1C of 7 percent or below means you have no increased risk of having a baby with a birth defect. But the risk increases with higher A1C levels. An A1C of 11 percent or above means there is a 25%, or a 1 in 4 chance, of birth defects. Check your A1C, and talk to your doctor if you have any concerns before you get pregnant.

Your health is too precious to lose. Take the next step in managing your diabetes and preventing devastating complications by monitoring your A1C levels.

This time, we’ll compare the high-performance cardiology stethoscopes. Check back soon for a guide to the Littmann Classic II and Select models, as well as a look at the new electronic stethoscopes.

3M Littmann Cardiology III Stethoscope

The Cardiology III is probably the most popular Littmann stethoscope out there. General practitioners, pediatricians, medical students, EMTs and nurses will tell you they wouldn’t trade in their Card III for the world. Why does everyone love this stethoscope? The Cardiology III provides excellent acoustics, both in terms of loudness and clarity. What sets it apart from the other Littmann cardiology scopes, however, is its impressive versatility. It has a double head with a tunable diaphragm on each side – the large side for adults, the small side for children. The smaller diaphragm also works well for irregular surfaces, such as bony patients. The hallmark Littman tunable diaphragm allows you to hear low- and high-frequency sounds without turning the chestpiece over. Use light pressure on the chest piece to hear the low-frequency sounds (bell mode), and firm pressure to hear the high-frequency sound (diaphragm mode). The Cardiology III can also be converted to a traditional bell by replacing the pediatric diaphragm with a bell sleeve. The Cardiology III comes with a five year warranty.

Is this the right stethoscope for you? If you are ready to invest in a Littmann cardiology stethoscope, you will be rewarded by the superb acoustics of the Cardiology III. And if you are looking for a versatile stethoscope that is suited to examining any type of patient, this is your scope.

3M Littmann Cardiology STC Stethoscope

The Cardiology STC, or “Soft Touch Cardiology,” also delivers outstanding acoustics, as you would expect from any Littmann cardiology stethoscope.  In addition, the innovative chest piece is specially designed to be easy to hold in various hand positions. The unique shape of the Cardiology STC chest piece facilitates movement between auscultation sites. The single-sided, tunable diaphragm enables you to easily switch between the bell and diaphragm mode without the bulk of a double-sided scope, like the Cardiology III. EMTs and nurses appreciate that the sleek design of the Cardiology STC fits under blood pressure cuffs more easily than a dual-head stethoscope. The Cardiology STC comes with a six year warranty. If you are working primarily with adults, and looking for unparalleled acoustics and ease of use, the Cardiology STC was made for you.

3M Littmann Master Cardiology Stethoscope

The Master Cardiology is Littmann’s top-performing acoustic stethoscope. With superior acoustics and a 10 out of 10 Littman performance rating, this stethoscope is ideal for users who want the greatest diagnostic precision. Similar to the Cardiology STC, the Master Cardiology offers the convenience of a tunable diaphragm in a single-sided chest piece. The classy, hand crafted stainless steel   definitely makes a statement and is also easier to hold than a dual-head. A special procedures adaptor is ideal for difficult sites or pediatric use. The Master Cardiology comes with a seven year warranty - the longest Littman warranty available. The Master Cardiology may be what you’re looking for if you need the best acoustic stethoscope available for high-performance auscultation.

The difference in price between these three models is slight, so base your decision on the design and features that are most important to you. Whether you select the versatility of the Cardiology III, the ergonomic design of the Cardiology STC, or the top-of-the-line acoustics of the Master Cardiology, you can be confident that your new Littman cardiology stethoscope will serve you well for many years.

Not sure these are the right scopes for you? Check back soon for the 3M Littmann Acoustic Stethoscope Buyer’s Guide: Part 2 to learn about the Littmann Classic II and Select models.

Share your stethoscope advice below by leaving a comment. Which model do you find works best for your field?

Everyone’s looking for ways to cut costs these days, but the FDNY has taken it a bit too far. According to the NY Daily News, Assistant Chief of EMS John McFarland recently cancelled all tune-ups on the department’s LifePak 12 defibrillators and cardiac monitors and ordered that all expired units are to be kept in service. This policy change seems to be a misguided attempt to save a little money while the FDNY looks for a new defibrillator contract. The FDNY claims that this policy does not pose a risk to anyone, but EMTs in the department are worried that relying on out of date equipment could cost a victim’s life in an emergency.

The FDNY deserves a lot of credit for all the lives they save with their rescue work. Their firefighters, EMTs and other rescue professionals are putting their lives on the line every day to protect the residents of NYC. The FDNY website has an impressive list of recent rescues (many of which involve treating victims of sudden cardiac arrest with defibrillation). The FDNY is all about saving lives. That’s why it’s so absurd for them to cancel tune-ups on this life-saving equipment. They are welcome to set up a new contract for a different brand of defibrillator/monitor, but why do they need to cancel tune-ups on the ones they are using now?

No one trusts milk that’s past its expiration date. So how does the FDNY expect us to trust their “expired” defibrillators?

As one of the leading causes of death in the United States, SCA (Sudden Cardiac Arrest) claims more than 310,000 lives every year . The tragedy is that most of these deaths are preventable. Many victims of SCA would survive if they received CPR and defibrillation within minutes of the event. AEDs are devices that can measure the victim’s heart rhythm and recognize when a shock needs to be administered. Easy-to-use AEDs guide the rescuer through the steps needed to save the victim’s life. The public has begun to recognize the vital importance of AEDs, leading to AED placement in some public areas.

Sure, you’re thinking, I’m all for AEDs in airports. But it’s not enough to have AEDs in convention centers and malls. In order to prevent as many SCA-related deaths as possible, AEDs need to be available in all places where there is an increased risk of a person suffering an SCA, and that includes your office.

Patients with underlying medical conditions face a greater risk of SCA, and some of those patients may be coming to see you for acute or routine medical treatment.  Without an AED available in the office, the paramedics might not arrive in time to save the victim’s life. With an AED right in your office, you will be prepared for an emergency rescue if disaster strikes.

But placing AEDs in doctors’ offices is more than just a smart idea. It’s also becoming standard of care. With the American Heart Association now supporting AED placement in all doctor’s offices, you could be vulnerable to litigation charging you with negligence for failure to have an AED available. Lawsuits have already been filed against airlines, theme parks, and health clubs for failing to have AEDs on hand.

The Zoll AED Plus Professional Package is the answer if you are looking for the ideal AED for your practice. The Zoll AED not only delivers shocks, it also coaches the rescuer, step-by-step, on how to use the AED and perform proper CPR using voice prompts, text, and pictures.  The Zoll AED actually monitors the rate and depth of the compressions you administer to the victim in real time and responds by announcing “good compressions” or “push harder!” as needed. The electrode pad and the inexpensive lithium batteries all last for five years in stand-by mode, so you won’t have to worry about frequent maintenance to keep your AED ready for emergencies.

Display your AED in the waiting room and your patients will understand that you are truly committed to their health and safety. With AED prices at an all time low, now is the perfect time to buy a life-saving AED for your practice.

As you know, health care is one of the hottest subjects in our nation right now. This chart shows that the number of searches people have done on Google relating to health care has risen sharply since July.

A recent report from the U.S. Census Bureau projected that the number of people without health coverage in the United States increased to 46.3 million in 2008, compared with 45.7 million in 2007.

Here are some more projections:

• The number of citizens covered by private health insurance fell from 202 million to 201 million
• Those with employment-based health insurance fell from 177.4 million to 176.3 million.
• The uninsured rate for native- and foreign-born people stayed about the same, at 12.9 percent and 33.5 percent, respectively, and the number of uninsured non-citizens remained at approximately the same level, 44.7 percent uninsured.
• The number covered by government health insurance jumped from 83 million to 87.4 million.

No matter what your political views, it looks like the Obama administration is spot on when it comes to the number of people going without health insurance. With rising unemployment the numbers for 2009 will likely be even higher.

Please share your views on this important issue. Post your comments below.