SUNDAY, Jan. 20 (HealthDay News) -- When people with diabetes get a flu, cold or other illness, it can be a challenge to take care of their diabetes. But they need to do so or risk serious complications, says the American Diabetes Association.

"People with diabetes have special considerations when they are under the weather," Ann Albright, the ADA's president of health care and education, said in a prepared statement. "It is important to have a plan with your health-care team in place before you become sick to avoid getting worse. It is also critical to get a flu shot every year to potentially avoid getting influenza."

The ADA offers the following diabetes-management tips for diabetics who are ill:

• Check blood glucose levels every three to four hours. Also, if you've been instructed by your health-care team, check for ketones in your urine every few hours. Ketones, a waste product produced when the body begins to use stored fat for energy, can build up if a diabetic doesn't take insulin at regular intervals. High ketone levels can lead to ketoacidosis, which can lead to coma or death.
• Unless told otherwise by your doctor, don't stop taking insulin or other medications.
• Even if you've lost your appetite, try to eat. The ADA recommends at least 15 grams of carbohydrates about every hour.
• If you're vomiting or have diarrhea, or have a fever, try to drink a cup of fluid each hour to prevent dehydration. If your blood glucose level is too high, try sugar-free liquids such as water or broth. If your blood glucose level is low, try drinking liquids with about 15 grams of carbohydrates in them, such as a half a cup of apple juice or one cup of milk.
• Talk to your doctor before you take any over-the-counter cold or flu medicines, because some of them can increase blood glucose or blood pressure levels.
• Call your doctor if: there is a rise in ketones or if there are ketones in your urine for more than 12 hours; if you've been vomiting or had diarrhea for more than six hours; if you have a fever that keeps going up or one that lasts more than a day; if you have abdominal pain; or if you can't control your blood glucose levels.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes control.

TUESDAY, Jan. 8 (HealthDay News) -- Offering lower drug co-payments to people with diabetes, high blood pressure and other chronic diseases could increase use of preventive medicines, suggests a new study led by University of Michigan and Harvard University researchers.

Higher co-payments that took effect Jan. 1 are designed to help American employers cope with the rising costs of health insurance by making workers and retirees pay more out of their own pockets.

But this study, funded by GlaxoSmithKline and Pfizer Inc., suggests that some drug co-payments should be reduced for some people with chronic diseases. Reducing the amount of co-payments by a few dollars would increase the use of preventive drugs by these patients.

The researchers looked at a major private employer that made some medications free to employees and slashed co-pays for other drugs by 50 percent. This led to a significant increase in employees' use of preventive medicines.

The study authors also looked at another employer that kept co-payments at the same levels and found it didn't show the same increase in employee use of preventive medicines.

The findings were published in the January/February issue of Health Affairs.

"All research to this point has shown that individuals will not buy important medical services even if there's a small financial barrier: $5 or even $2," senior study author Dr. Mark Fendrick, of the University of Michigan Medical School and School of Public Health, said in a prepared statement. "This study showed that when you remove those barriers, people started using these high-value services significantly more. These results bolster the idea that health insurance benefits should be designed in ways that produce the most health per dollar spent."

More information

The American Academy of Family Physicians has more about health insurance  .

TUESDAY, Dec. 18 (HealthDay News) -- While cardiovascular disease (CVD) death rates in the United States are declining, the illness is still the leading cause of death in the nation, according to the American Heart Association.

Controlling heart disease risk factors remains a major challenge for many people, according to the American Heart Association's Heart Disease and Stroke Statistics -- 2008 Update, published online Dec. 17 in the journal Circulation.

CVD -- which includes heart disease, stroke, high blood pressure, heart failure and several other conditions -- has been the leading cause of death in the United States every year since 1900, with the exception of 1918, when there was a worldwide flu pandemic, the AHA noted.

In 2004, the most recent year for which final data was available, the age-adjusted CVD death rate in the United States was 288 people per 100,000, compared with 307.7 per 100,000 in 2003, the report said. In 2004, CVD was listed as the underlying cause of death in 869,724 deaths, compared to 911,163 deaths in 2003.

Cancer was the second leading cause of death, claiming 553,888 lives in 2004. When looked at separately from other cardiovascular diseases, stroke was the third leading cause of death, claiming 150,074 lives.

While CVD deaths appear to be decreasing, rates of many CVD risk factors are remaining the same or increasing, the report said. For example, rates of overweight and obesity in adults and in children have been rising for several decades. The report found that 66 percent of American adults are overweight, and 31.4 percent are obese. It also found that 17 percent of youngsters ages 12 to 19 are overweight, along with 17.5 percent of children ages 6 to 11, and 14 percent of children ages 2 to 5.

Poor dietary habits -- such as insufficient consumption of fruits and vegetables -- are contributing to overweight and obesity, the report warned. It cited U.S. Centers for Disease Control and Prevention data from 2005 that showed that only 21.4 percent of male high school students and 18.7 of female high school students reported eating at least five daily servings of fruits and vegetables.

Other 2005 data from the CDC revealed that fewer than one in three adults eat fruit two or three times a day, and only 27.2 percent eat vegetables two or more times per day.

Smoking, which increases the risk of coronary heart disease by two to three times, is another highly prevalent CVD risk factor. More than 46 million American adults are daily smokers, and about 4,000 people ages 12 to 17 begin smoking every day, the report said.

It also noted that the United States has increasing rates of diabetes, a major cardiovascular risk factor. It's estimated that the prevalence of diabetes in the United States will more than double between 2005 and 2050.

"Although we have made some substantial strides in understanding the causes of cardiovascular disease, the data in this publication show that we have a long way to go to capture people's attention and to implement the prevention and treatment programs we need," Dr. Donald Lloyd-Jones, one of the report authors and an associate professor in the department of preventive medicine at Northwestern University's Feinberg School of Medicine in Chicago, said in a prepared statement.

The report included good news about improvements in the quality of hospital care for CVD patients. A study of 159,168 heart failure patients treated at 285 U.S. hospitals during 2002-2004 found improvements in clinical outcomes and in the number of patients receiving counseling at discharge, smoking cessation counseling, prescription of beta blockers, and assessment of left ventricular function.

More information

The American Heart Association offers heart healthy lifestyle tips  .