The “normal” glucose level in the blood (after a 10- to 12-hour fast) has long been regarded as 50 to 100 mg%. Above that, doctors say, there is a risk of pre-diabetes or actual diabetes, with its higher risk of developing cardiovascular disease. But now a research team headed by the Sheba Medical Center’s Dr. Shai Kviti have followed up some 11,000 healthy men and women over 40 for more than a decade. Between 2000 and 2010, 1,000 of them developed heart disease or had a stroke.

The team, based at the Tel Hashomer hospital, compared the level of fasting blood glucose and found that the risk of getting cardiovascular disease when the level was 95 to 100 mg% was significantly higher when compared to those of “healthy people” with a level under 95 mg%. The study was controlled for age sex; blood pressure, cholesterol and triglyceride levels; whether they smoke; and family history, leaving only glucose level as the determining factor.

The scientists concluded that healthy people not suspected of having diabetes because of having a fasting glucose level of 95 to 100 mg% or even 100 to 126 mg% are at higher risk of developing cardiovascular disease and should be urged to adopt a more healthful lifestyle. If overweight, they should lose kilos and ensure that their blood cholesterol and triglyceride levels are lower.

THE RIGHT TO APPEAL

All Israeli residents have the right to appeal their health funds’ decision that certain medical treatments are not included in the basket of health services, according to Yoel Lipschitz, a Health Ministry lawyer and deputy director-general in charge of supervising the public health funds.

Lipschitz has issued a document (on the ministry’s Hebrew-language Web site www.health.gov.il under hozrim) based on rulings by the labor courts, which are responsible for cases involving health insurance eligibility. Every health fund member must be allowed to apply to an appeals committee, and must be informed by his insurer of his right to do so, Lipschitz wrote. This right is valid not only in cases of medical treatments that extend or save lives but also those for which his medical problem significantly influences his  function, he said. The document sets down patients’ rights to a hearing by the health fund, and of receiving all information on the appeals committees’ decisions, including the explanation in writing for refusals to provide treatments at health fund expense.

SUN, VITAMIN D AND MS

It has been known from epidemiological studies that multiple sclerosis (MS) – the potentially debilitating autoimmune neurological disease that usually hits before age 40 – is more common in countries farthest from the equator. Now Scientists from the Royal Children’s Hospital in Melbourne say they have evidence that women not exposed to enough sunlight during the first 12 weeks of pregnancy are more likely than others to have babies that develop MS decades later.

The researchers suggest that inadequate vitamin D (produced in the skin by the sun’s rays) in pregnant women can raise the risk for their babies developing MS, as the central nervous system is formed during this period. In MS, the nerves become demyelinated, with the immune system attacking their myelin coating. The researchers studied over 1,500 MS patients and found in retrospective studies that those born in November and December during the Australian summer were conceived in the winter and were 32 percent more likely to develop MS. If there is a connection, sunbathing during pregnancy is not the answer; it is another reason to test one’s blood for vitamin D levels and take a supplement in drop or pill form.

The research has been published in the British Medical Journal.

HELPING THE MENTALLY ILL BELIEVE IN THEMSELVES

A new intervention – the result of a collaboration among researchers from the University of Haifa, City University of New York and Indiana University – has been found to reduce “self stigma” and improve self-esteem among people with serious psychiatric illness. Self-stigma is one of the central factors hindering social integration of people with mental illness. “Improving ease of access for people with disabilities has received much attention over the past years, but accessibility for persons with mental illness has not gained adequate attention,” says Prof. David Roe, chairman of the community mental health department of the University of Haifa’s Faculty of Social Welfare and Health Sciences, who led the study.

“Just like wheelchairs and Braille have increased social integration for people with physical handicaps, there is a need to identify and remove the barriers to inclusion for people with serious mental illness,” says Roe. Much attention has been given to providing accessibility to all facilities intended for the public, in striving to gain equality for people with physical disabilities. But while the obstacles facing the physically challenged can be relatively easily identified, pinpointing the obstacles for persons with a mental illness is much harder.

Previous studies have shown that one of the central obstacles is the negative stigma society at large attaches to mental illness; it is much more powerful than the labels attached to people with other disabilities. This stigma may lead to social exclusion. Another obstacle that may result is the patient regarding himself  as being less worthy or capable than other people. This often causes them to avoid taking an active role in seeking work, adequate housing and a social life, Roe explains. 

In an attempt to address this problem, Prof. Philip Yanos of CUNY Prof. David Roe and Prof. Paul Lysaker of Indiana University School of Medicine (with the help of a research grant from the National Institute of Mental Health) developed what they term Narrative Enhancement Cognitive Behavioral Therapy (NECT), which is aimed at giving people with a mental illness the necessary tools to cope with the self stigma.

They ran a pilot course with 20 sessions at three separate locations in New York, Indiana and Israel. Following the pilot run,  Roe headed a study here in which 21 people with a mental illness (with at least a 40% mental handicap) completed the intervention. They were compared with a control group who had not participated. Those who attended the course were found to have reduced self-stigma and, in parallel, an increase in quality of life and self-esteem.

Roe hopes to “train more professionals in this intervention, and root the method in rehabilitation centers and community health centers to encourage community inclusion of a larger and more significant population of people with a mental illness.”

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