{ CARE FOR CHILDREN WITH DIABETES }

By PHIL Riley, KERRITA McClaughlyn in Ailments

The discovery of insulin 87 years ago was hailed as a miracle. It was arguably the first example of a medicine that was both life-saving and life-sustaining. Overnight lives were transformed and a new era of optimism was hailed for all people living with diabetes. The impact of the discovery was electric and in less than two years the 1923 Nobel Prize in Medicine and Physiology was awarded to Researcher Frederick Banting and his supervisor Professor John MacLeod.

The legacy of the former continues to this day. World Diabetes Day is celebrated every year on 14 November to mark the birthday of Banting who, along with his research assistant Charles Best, is widely credited with the discovery of insulin.

Over the years, this miracle drug has saved countless lives. Today, the added benefits brought by modern types of insulin, delivery systems, glucose monitoring and diabetes education, mean that the prospects for children with Type-1 diabetes in the developed world have never been brighter. Regretfully for many, this is where the good news ends. The outlook for children with Type-1 diabetes in the developing world remains poor. Many die without being diagnosed or suffer severe complications leading to an early but avoidable death.

What is diabetes?

• Type-1 diabetes occurs when the body produces no or insufficient insulin. This form of diabetes cannot be prevented and daily insulin shots are required to survive. Worldwide over 500,000 children under age 15 live with Type-1 diabetes. India alone has over 92,000 of these children.
  
• Type-2 diabetes occurs when the body is unable to use the insulin it produces effectively. In many cases [not all], it is possible to prevent Type-2 diabetes through diet and exercise. Type-2 diabetes is increasing among children because of sedentary lifestyles.

The most common long-term complications of diabetes are:

• Diabetic nephropathy [kidney disease], which may result in total kidney failure and in the need for dialysis or kidney transplant.
• Diabetic eye disease [retinopathy and macular oedema], damage to the retina of the eye which can lead to vision loss.
• Diabetic neuropathy [nerve disease], which can ultimately lead to ulceration and amputation of the feet and lower limbs.
• Cardiovascular disease, which affects the heart and blood vessels and may cause fatal complications such as coronary heart disease [leading to a heart attack] and stroke.

Diabetes is the fourth leading cause of death by disease globally. Every year, more than three million people die from diabetes-related causes.

A time for change
Almost a century has passed since the discovery of insulin and almost 80 years have passed since Banting, serving as wartime liaison officer between the British and North American medical services, was killed in an air disaster. With so much time having passed, it seems unthinkable that such an essential medicine is unavailable or unaffordable for our most vulnerable citizens. It is not that solutions don't exist, they do. Answers are now available to address the issues of affordability and accessibility. The means exist to strengthen healthcare systems and provide the necessary diabetes education of both the healthcare professionals and the families of those affected by diabetes.

It is time for the organisations that can provide the interim humanitarian solutions to get on board and for key diabetes stakeholders to lay the groundwork for sustainable solutions that will benefit people with diabetes. The solutions, of course, will be more complex than simply ensuring accessibility to affordable diabetes medicines, syringes and monitoring. Country-specific solutions will be needed to address supply-chain systems, the coordination of corporate social responsibility programmes, the training of local healthcare professionals and the integration of diabetes support programmes into existing healthcare systems.

The International Diabetes Federation [IDF] is leading the way by highlighting the plight of children with diabetes in the developing world, driving awareness campaigns to educate public and bringing together those in a position to make a difference.

According to IDF figures, there are about 75,000 children worldwide living with Type-1 diabetes in desperate circumstances. The IDF supports a tiny number - 1000 children and young adults in 17 countries - through its "Life for a Child Program". The Federation is hoping to increase this number to 10,000 in a relatively short time frame.

Become an agent of change
Every parent, school teacher, school nurse, doctor and anyone involved in the care of children should be familiar with the warning signs and alert to the diabetes threat. Children who are not diagnosed or misdiagnosed can die from DKA [diabetic coma].

Access to medicine is particularly critical to children already living with diabetes in countries like India. You can help by supporting charities like the "Life for a Child Program" that support children with diabetes. While donations to charity are well needed, an even greater need is for governments to take responsibility in providing sustainable care for children with diabetes.

The United Nations Resolution on diabetes asks all governments to "develop national policies for the prevention, treatment and care of diabetes in line with the sustainable development of their health-care systems, taking into account the internationally agreed development goals, including the Millennium Development Goals."

We need to make sure that governments take action. You can lobby your government by writing letters and contacting politicians and government officials to find out how they are implementing the Resolution and developing programmes to care for people with diabetes. You can participate in activities to raise awareness of diabetes-issues and become an agent of change. With the help of committed organisations and individuals worldwide, the IDF wants to make access to appropriate medication and care the right of every child with diabetes and a privilege resulting from the geographic accident of birth.

History owes a debt to the pioneers of diabetes research. Surely it is time for the results of their ground-breaking research, carried out so long ago, to benefit every child with diabetes.

Warning signs

Know the diabetes warning signs*:

• Frequent urination
• Excessive thirst
• Increased hunger
• Weight loss
• Tiredness
• Lack of interest and concentration
• Blurred vision
• Vomiting and stomach pain [often mistaken as flu]
  *In Type-2 diabetes these symptoms may be mild or absent.

{ CAT ALLERGIES }

Life with cat allergies -- whether they're yours or a family member's -- can raise a lot of questions. Could a cat allergy explain your son's never-ending cold symptoms? Will you regret giving in to your daughter's demands for a kitten, despite your allergies? Will a so-called hypoallergenic cat allow you to have the pet you've always wanted without making you a sneezing, sniffling mess?

Here are some answers -- what you need to know about cat allergies, from causes to treatments.
What causes cat allergies?
About 10% of the U.S. population has pet allergies, and cats are among the most common culprits. Cat allergies are twice as common as dog allergies. But contrary to what you might think, it's not the fur or hair that's the real problem. People with cat allergies are really allergic to proteins in the cat's saliva, urine, and dander (dried flakes of skin).

How do these tiny proteins cause such a big allergic reaction in your body? People with allergies have oversensitive immune systems. Their bodies mistake harmless things -- like cat dander -- for dangerous invaders, and attack them as they would bacteria or viruses. The symptoms of the allergy are the side effects of your body's assault on the allergen, or trigger.

Keep in mind that even if you don't have an actual cat allergy, your cat can still indirectly cause your allergies to flare up. Outside cats can bring in pollen, mold, and other allergens on their fur.

And what about so-called "hypoallergenic" cats? While some breeds -- like the "hairless" sphinx -- are said to be less likely to trigger symptoms of cat allergies than others, any cat has the potential to cause problems. This is true regardless of its breed, hair length, or how much it sheds. So if you know that you or another family member is allergic to cats, getting one -- no matter what the breed -- is not a good idea.

What are the symptoms of cat allergies?
Symptoms of cat allergies can include:

coughing and wheezing
hives or a rash on the chest and face
red, itchy eyes
redness of the skin where a cat has scratched, bitten, or licked you
runny, itchy, stuffy nose
sneezing
Symptoms of a cat allergy might develop in just a few minutes or take hours to appear. About 20% to 30% of people with allergic asthma have severe flare-ups after coming in contact with a cat.

How would I know if I have a cat allergy?
Although the symptoms of a cat allergy may seem fairly obvious, it's not always the cat that causes them. So it's a good idea to get confirmation from your doctor. After all, you wouldn't want to blame Mr. Whiskers unjustly.

Your doctor can do a skin or blood test to see if you're allergic. However, allergy tests aren't always correct. So the doctor may also want you to try living without a cat for a few months to see how it affects your allergy symptoms

How are cat allergies treated?
Cat allergies can usually be controlled with standard allergy drugs. Your doctor might recommend:

Antihistamines, which are available over-the-counter -- like Claritin or Benadryl -- or by prescription -- like Allegra or Zyrtec. Some antihistamines come as nasal sprays -- for instance, Astelin.
Decongestants, like over-the-counter Sudafed or prescription Allegra-D.
Other medicines, which affect allergy or asthma symptoms in various ways. Prescription steroids -- like Flonase or Nasonex sprays -- are a common treatment for allergies.

Allergy shots are another option. Allergy shots are not always effective, and completing treatment can take years. They're also not safe for children under 5. But they can be a huge help to some people. Ask your doctor if they make sense for you.

Unfortunately, there's no way to prevent an allergy. Some studies have shown that exposure to pets as a young child seems to reduce the risk of developing pet allergies later. On the other hand, a child who already has allergic tendencies may get worse with exposure to a pet.

Reducing your exposure to cats
While medical treatment can help control cat allergies, the best approach to is simple: avoid cats and their dander. Here are some tips.

*Don't touch, hug, or kiss cats. It should be obvious, but some people think a little cat contact is OK. It isn't.
*Beware of visitors who own cats. Even if your house guests leave their cats at home, they can bring the dander with them on their clothing and luggage. This indirect exposure can cause serious cat allergy symptoms in some people.
*Plan. If you have to stay in a house with cats, ask that the cat be kept out of the room in which you will sleep for a few weeks before you arrive. Also, start taking your medicine a few weeks beforehand. Once an allergic reaction gets started, it can be tough to control. But taking medicine can prevent it from happening in the first place.

But what if you already own a cat? Here's the most sensible advice: if you or a family member has cat allergies, you shouldn't have a cat in your home.

Of course, such harsh advice may not be easy to follow. What if your kids have already fallen in love with a kitten? What if your fiancee will never, ever part with her cat? If the cat has to stay, there are other things you can try.

Keep your distance. Limit your exposure to the cat. Certainly, another family member should take responsibility for the cat's care and do things like cleaning the litter box.
Restrict the cat to certain sections of the house. Don't allow your cat to roam free. Keep the cat out of your bedroom at all times.

Keep the cat outdoors as much as possible. That's how some people get around their cat allergies.

Clean rigorously and often. Cat dander gets everywhere. So you need to sweep and mop the floors, vacuum the rugs, and clean furniture regularly. Make sure to get a vacuum with a HEPA filter, because regular filters may not be fine enough to catch allergens. Get rid of carpets and drapes that can trap dander.

Clear the air. A central air cleaner -- as well as filters on the vents themselves -- can help prevent cat dander from circulating through the house.
Consider bathing your cat on a regular basis. Experts aren't certain if bathing really helps reduce the amount of allergen. But if it doesn't traumatize the cat too badly, you could try it and see if it reduces yours or someone else's symptoms.

While these techniques might help, they may not be enough. As hard as it might be, if keeping your cat is putting your health -- or a family member's health -- at risk, you have to consider giving it up.

Whatever you do, don't assume that you can just wait it out, that cat allergies will naturally get better over time. They might very well get worse. Out-of-control allergies can do more than make life miserable -- they can increase the risk of asthma, which is a serious disease.

So don't ignore the signs of cat allergies. Instead, see a doctor. Together, you can figure out the best way to tackle the problem.

{ CAN YOU BOOST YOUR CHILD'S IQ? }

from http://children.webmd.com/

What makes kids smart may surprise you

Aside from genetics, what influences your child's IQ? Clearly, good nutrition, protection from toxins, and plenty of playtime and exercise can nurture a child's intelligence. But can you really boost your child's IQ?

Many child development experts now focus less on measuring a child's IQ than on helping children reach their full intellectual potential - and without adding too much pressure.

WebMD talked with the experts about how a child's intelligence develops. None of them is touting the flashiest toys, computer programs, or latest Baby Mozart video - and you may find that their insights help your child's IQ far more than any fad.

A Child's IQ: How does a child's brain develop?

From before birth to age 4, an infant's brain grows explosively. In fact, your child's brain has reached 90% of its adult size before kindergarten. This period of great growth provides an ideal window of opportunity for learning.

But the brain doesn't stop developing at age 4. It continues to organize and restructure throughout childhood - even into early adult life - as it becomes more complex. Unfortunately, knowing about the brain's early growth has prompted many parents to panic about their child's IQ or push their kids into "primo preschools."

"It's a classic American concern - how to accelerate learning," says Ross A. Thompson, PhD, professor of psychology at the University of California, Davis. "Many parents believe that if their children learn fast early, they will remain accelerated. But children learn best at a natural rate. Those who show early advances settle out by the time they reach grade school. Others catch up."

The early years do matter, says Thompson. "But lower circuits in the brain must be built before higher circuits, and advanced skills must be based on basic skills," he says.

Your Child's IQ: Emotion drives learning

One of these basic skills involves creating a template for close relationships - usually through early attachment to parents and caregivers. Critical to your child's emotional and social development, attachment also helps build your child's intelligence.

Being attuned to your child's inner mental life helps your child's developing brain become integrated, according to Daniel J. Siegel, MD, director of the Center for Human Development at the UCLA School of Medicine. Writing in Infant Mental Health Journal, Siegel, who studies how relationships affect learning, says being attuned also provides a "safety net" for your child's brain.

"Close, affectionate relationships throughout childhood are important, but especially when a child is little," says Pat Wolfe, EdD. Wolfe is an educational consultant and co-author of Building the Reading Brain, PreK-3. One way to attune to your child is to listen closely and make eye contact. "If you only pretend to listen because you're distracted, kids pick up on that really fast," Wolfe says. Other ways to connect? With your facial expressions, tone of voice, gestures, and other nonverbal signals. Wolfe tells WebMD that when your child is older, one of the best things you can do is to talk about the day.

Connecting with you helps a child's brain develop, says Thompson, because neurons get connected through social connection and language. Learning is also often motivated by close relationships. "Kids become interested in learning because learning is valuable to the people who matter," he says.

By contrast, when children don't feel safe and secure, their ability to learn is affected.

The amygdala is a structure in the brain that regulates emotion. When children feel threatened, the amygdala creates a fight-or-flight response - a chain reaction that allows emotion to overrule rational thought by "shutting down" the thinking parts of the brain. Early or long-term stress in a child's life can lead to changes in this part of the brain, making that child more susceptible to stress - and less susceptible to learning. But close, loving relationships can protect against this.

Your Child's IQ: Experience sculpts the brain

"The brain is the only organ in the body that sculpts itself through experience," says Wolfe. We now know, she tells WebMD, that experiences actually change and reorganize the brain's structure and physiology.

Instead of seeing a child's intelligence as a dynamic process, parents too often think of the brain as a vessel that can be simply filled up with knowledge, says Thompson. But that's not the way it works, especially for young children.

"The best learning occurs through active engagement," he says. "A child is thrilled to be counting peas in the context of gardening, measuring ingredients in the context of working with a recipe, or sorting nails in the context of building a birdhouse."

Wolfe agrees: a variety of learning experiences in the real world are good for a child's intelligence. Even at the grocery store, children can learn a lot by weighing foods, reading labels, and counting change.

Although eliminating TV and video games may not be entirely realistic, Wolfe says that too much time with media like these puts children in a receptive mode. And that keeps them from a rich, natural interaction with the real world - so important for a child's brain development.

Your Child's IQ: Do you need fancy toys?

At the UC Davis Center for Mind and Brain, Lisa Oakes, PhD, a professor of psychology and specialist in infant cognition, studies another aspect of childhood intelligence. She examines how infants categorize and make sense of the visual world - research that makes her question the push by parents to boost a child's IQ with fancy toys.

"We know that stimulation is good for the development of the brain," says Oakes. You probably know that infants need different colors and textures and experiences. "But it doesn't all need to come in one toy," she says.

From her research, she has learned that infants are more interested in the action of a toy than the outcome it produces - so babies do not need expensive gadgets with lots of "bells and whistles" to learn. But if a certain toy is fun for a parent, it may still have a benefit, she says. That's because babies learn through their parents' reactions, too.

Your Child's IQ: Effort and mindset

Carol Dweck, PhD, professor of psychology at Stanford University and author of Mindset: The New Psychology of Success, has studied yet another key to building a child's intelligence. Through 20 years of research, she has found that differences in children's mindsets affect their motivation to learn - and ultimately their performance in school.

Dweck learned that middle school students who believed intelligence was fixed tried to preserve their self-image by only doing what they already knew how to do well. "They didn't want to risk their precious label - being smart," says Dweck. Their fixed mindset, ultimately, could limit the growth of their intelligence.

By contrast, kids with a "growth mindset" were attracted to challenges - even if they failed at first. These kids thought about what they would do differently next time, such as how they would study harder to score higher on a test. When asked what they would do differently, kids with a "fixed mindset" said they would study less - or even consider cheating.

"After all, if you think intelligence is fixed and you do poorly, what are your choices?" says Dweck.

So she took her work further. She began to teach kids that the brain is like a muscle. It gets stronger with use, it makes new connections - and this can make you smarter over time. When she re-tested these students who had learned to have a "growth mindset," their grades and study habits improved considerably after only two months.

A Child's IQ: Praise the effort

Dweck began her research after seeing parents put too much emphasis on praising "intelligence" and pushing their kids. She learned early on that certain kinds of praise actually backfire.

Praising only a child's IQ or intelligence can send the message that intelligence is a natural gift - and thus out of a child's control, she says. Better, instead, to give kids the idea that hard work is always needed for achievement.

If you want to praise, she says, praise your child's process, commitment, the strategies that work - focus on the learning, not just the grades. Do you tell your child, "Easy A, wow, you're smart!" Or, do you ask, "What did you learn in that class?"

Children praised lavishly for their past high performance may be harmed even more than kids who have typically done less well, says Dweck. "The high performers think it's beneath them to try hard - that it's just for dummies. There's a false promise here: You're so smart, it will just come to you." And when academic success doesn't just happen, some kids may worry that they are no longer the whiz kids they once thought they were - and lose their motivation to study.

Of course, we all come with certain natural abilities, says Dweck. "But just because some have a more natural ability doesn't mean others can't learn the skill, too."

"Parents need to value learning, progress, effort, resilience," she says. "Their children will take that with them and enjoy it for a lifetime."