December 1 is observed as World AIDS Day, which is dedicated to increasing awareness about AIDS and HIV. AIDS is a global pandemic that began in 1981 and has persisted as an international public health issue.

Since the pandemic began, an estimated 40 million people worldwide have died from AIDS. In addition, an estimated 37.7 million people are currently living with HIV. In the United States, an estimated 1.2 million people 13 and older are infected with HIV. About 13 percent — one out of seven— don’t know they’re infected and need to be tested.

HIV, or human immunodeficiency virus, is an infectious germ that attacks the body’s infection-fighting immune system. Specifically, it attacks and destroys a type of white blood cell called CD4 cells. These cells help coordinate the immune response to bacteria and viruses by stimulating other immune system cells to fight the germs.

When CD4 cells are compromised, the immune system doesn’t work properly. As a result, the person become susceptible to other illnesses called opportunistic infections. Without treatment, HIV gradually destroys the immune system and will progress to AIDS, acquired immunodeficiency syndrome.

HIV is spread through contact with certain body fluids of people infected with the virus. These body fluids include blood, semen, preseminal fluid, rectal fluids, vaginal fluids and breast milk. In most cases, HIV is spread by having unprotected anal or vaginal sex or by sharing drug equipment, such as syringes and needles, with an infected person.

The body can’t rid itself of HIV, and there’s cure for the infection. Once infected with HIV, a person has it for life.

Many people feel no symptoms during the first few months after infection and may not know that they’ve been infected. Others experience flu-like symptoms within two to four weeks after becoming infected with HIV. This time frame is considered Stage 1, or acute HIV infection.

Possible symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes and mouth sores. Some people experience no symptoms and do not feel sick during this stage. As the disease progresses, symptoms may expand to include weight loss, diarrhea and cough.

Even with symptoms, the only way to know for sure if someone been infected with HIV is to get tested. There are several types of tests available from a doctor’s office, hospital or community health center. There are even HIV tests you can take at home.

If you suspect that you’ve been exposed, get tested.

Stage 2 is chronic, or asymptomatic. During this stage, the virus is still active but not reproducing as quickly. A person often has no symptoms during this stage but can still spread HIV to others. Without treatment, this stage can last for 10 years or more before progress to Stage 3, which is AIDS.

A diagnosis of AIDS is made if the CD4 count drops to less than 200 cells per cubic millimeter of blood. (A normal count ranges from 500 to 1,500.) AIDs may also be diagnosed if certain opportunistic infections develop. These include pneumocystis pneumonia, a lung infection; Kaposi sarcoma, a skin cancer; cytomegalovirus, which typically affects the eyes; tuberculosis, which mainly infects the lungs; and candidiasis, a fungal infection.

HIV is treated with a combination of medications known as antiretroviral therapy (ART). In most cases, ART suppresses the HIV so that it is undetectable in the blood. The amount of the virus in the blood is called the viral load. People with HIV that take ART as prescribed and get and keep an undetectable viral load can live long, healthy lives and will not spread HIV to uninfected partners through sex.

In the US, most people with HIV don’t develop AIDS because ART stops the progression of the disease. Although an AIDS diagnosis indicates severe damage to the immune system, ART can still help. Without treatment, however, people with AIDS typically survive about three years.

To help prevent HIV and AIDS, use a latex condom during vaginal, anal or oral sex, and never share needles to inject drugs.

There are other ways to prevent HIV, including preexposure prophylaxis (PrEP), a medication taken daily if at risk for infection. Postexposure prophylaxis (PEP) is medication taken within 72 hours of possible exposure to prevent the virus from taking hold.

If you do become infected with HIV, take your ART and visit your doctor as recommended. Remember; ART enables people with HIV to live healthy, productive lives. It also serves to prevent further spread, reducing the risk of onward transmission by 96 percent.

Patti DiPanfilo

November is Pancreatic Cancer Awareness Month, so let’s take a few minutes to ponder this deadly disease. First, let’s learn a little bit about the pancreas and its important contributions to the body’s day-to-day functioning.

The pancreas is an oblong organ that sits across the back of the abdomen, between the stomach and the spine. It consists primarily of two types of cells. Exocrine cells make key enzymes for digestion, which they release into tiny tubes called ducts. Endocrine cells produce hormones such as insulin and glucagon, which help the body absorb glucose (sugar) for energy and control glucose levels in the blood. Endocrine cells release their hormones directly into the bloodstream.

Pancreatic cancer develops when abnormal cells grow out of control and form a mass, or tumor. About 95 percent of pancreatic cancers start in the exocrine cells. These are called pancreatic adenocarcinomas. About 7 percent of pancreatic cancers begin in the endocrine cells. Those are called pancreatic neuroendocrine tumors, or PNETs.

According to the American Cancer Society, pancreatic cancer accounts for about 3 percent of all cancer diagnoses in the US and is responsible for 7 percent of cancer deaths. The society estimates that about 62,210 Americans will be diagnosed with pancreatic cancer in 2022 and about 49,830 people will die from it.

Pancreatic cancer is often called a “silent cancer” because it generally has no detectable symptoms in early stages. Consequently, it typically progresses and affects other organs and tissues before it is diagnosed.

When present, pancreatic cancer symptoms can include yellowing of the skin or eyes (jaundice), dark urine, pain in the abdomen or lower back, digestive upset (nausea, vomiting or indigestion), fatigue, depression, blood clots, decreased appetite, unexplained weight loss and sudden onset of diabetes.

The cause is unknown, but certain factors have been identified that increase the risk for developing this cancer. These include smoking cigarettes, being obese, not exercising regularly, eating a diet high in fat and processed meats, drinking heavily, being exposed to chemicals and pesticides, having Type 2 diabetes or a chronically inflamed pancreas, being African American, being male, being older than 55 and having a family history of pancreatic cancer.

To diagnose pancreatic cancer, a doctor will begin with a thorough review of the patient’s symptoms and medical history. The doctor will likely order a CT or MRI scan to get a detailed image of the pancreas. Other tests may include endoscopic ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).

These tests are performed through an endoscope – a thin, flexible tube with a tiny camera attached to its end that is passed down the throat and into the digestive system. During these endoscopic procedures, a doctor can obtain a sample of tissue to study under a microscope to look for cancer cells. This is called a biopsy.

Blood tests are also used to look for certain tumor markers that may indicate pancreatic cancer. Tumor markers are substances that are often found in high concentrations when cancer is present. Tumor marker CA 19-9 may be helpful in diagnosing pancreatic cancer. Carcinoembryonic antigen (CEA) is another tumor marker for pancreatic cancer, but it’s not used as often as CA 19-9.

Once a diagnosis of pancreatic cancer has been made, the doctor will assign a stage based on test results. The stage of a cancer indicates the size of the tumor and how far it has spread from where it originated. The stages of pancreatic cancer include:

• Stage 0 – Abnormal cells that could become cancerous are present in the pancreas.
• Stage 1 – Tumors are in the pancreas only.
• Stage 2 – Tumors have spread to nearby abdominal tissue or lymph nodes.
• Stage 3 – The cancer has spread to major blood vessels and lymph nodes.
• Stage 4 – The cancer has spread to other organs, such as the liver.

Treatment for pancreatic cancer depends on the stage. The goals of treatment are to kill the cancer cells, prevent the spread of the disease and relieve symptoms. Treatment may include surgery, chemotherapy, radiation therapy, targeted drug therapy and immunotherapy.

If the cancer is localized to the pancreas, it may be possible to eliminate the cancer cells by surgically removing all or part of the pancreas. A common procedure for pancreatic cancer is the Whipple procedure during which the surgeon removes the head of the pancreas and sometimes the entire pancreas, along with a portion of the stomach, the first part of the small intestine, the gallbladder, the bile duct and other tissue.

Chemotherapy uses drugs to kill cancer cells. Radiation therapy destroys cancer by focusing high-energy rays on the cancer cells. These treatments may be used before surgery to shrink tumors or after surgery to eliminate any remaining traces of the cancer.

Targeted drug therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide and spread. Immunotherapy works the immune system to recognize and destroy cancer cells.

Because pancreatic cancer is typically not diagnosed until it is in its advanced stages, it continues to be difficult to treat and cure. Fortunately, the outlook for people with this cancer is improving. Ongoing research and clinical trials, along with new treatments, are expanding the average five-year survival rate for people with pancreatic cancer.

Patti DiPanfilo

September marks National Muscular Dystrophy Awareness Month.

The term “muscular dystrophy” refers to a group of more than 30 genetic diseases characterized by progressive muscle weakness and the degeneration of the skeletal muscles that control movement. The focus of this blog, Duchenne Muscular Dystrophy ( DMD), is the most common and most severe form.

On Wednesday (September 7), people around the world will raise awareness through World Duchenne Awareness Day (WDAD).

For the past six years, Jett Foundation has hosted an annual event in recognition of this day.  This year, the foundation is hosting a virtual event to bring together patients and families, experts and industry partners to celebrate advances made in Duchenne research, acknowledge challenges still to come, and show they are Stronger Than Duchenne. You can participate to learn more about Duchenne throughout the day!

Duchenne affects approximately one out of every 5,000 live male births. About 20,000 children are diagnosed with Duchenne globally each year.

Parent Project Muscular Dystrophy

While DMD primarily affects males, females can also be affected, which is one of the reasons the World Duchenne Organization has deemed this year’s theme as Women in Duchenne.

Signs and symptoms of DMD may vary from person to person and can range from mild to severe. The average age of diagnosis is 4 years. Early signs may include delayed sitting, standing or walking, and trouble learning to talk.

DMD is a progressive disease, so symptoms generally worsen as a child ages.

Other signs and symptoms include weak legs, especially in the thighs and hips; difficulty running or jumping; waddling gait; walking on the toes or balls of the feet; trouble getting up from a sitting or lying position; enlarged calves; difficulty walking stairs; frequent falls; and weakness in the arms or neck.

As a child gets older, he or she may lose the ability to walk and require a wheelchair. The child may experience difficulty breathing and swallowing, and may develop a sideways curve of the spine (scoliosis). About one in three individuals with DMD also exhibit some cognitive impairment or learning disability.

As DMD progresses, it can weaken the heart and respiratory muscles as well. DMD is associated with a heart condition called cardiomyopathy and impaired lung function. People with DMD often die as a result of heart and breathing complications.

DMD is caused by a defect on the gene responsible for producing dystrophin, a protein that keeps muscles strong and protects them from injury as they contract and relax. Without dystrophin, muscle cells are fragile and easily damaged, resulting in a loss of muscle strength and function. The dystrophin gene is located on the X chromosome, one of two sex chromosomes in humans. The other is the Y chromosome.

Females rarely get DMD because they inherit two X chromosomes from their parents. If one has the gene with the defect, the other X chromosome can typically produce enough dystrophin to compensate. Females with a mutation on one X chromosome are considered carriers. Some female carriers are considered manifesting carriers and display a range of physical symptoms. If their X chromosome has the defective gene, they develop DMD. Females with the mutation are carriers and can pass the defect on to their children. However, in some cases, both X chromosomes have a defective dystrophin gene, where a female would be diagnosed with Duchenne.

A doctor may suspect DMD based on family history, symptoms or a thorough physical exam. The doctor will likely use certain tests to assist in making a diagnosis. One is a creatine kinase (CK) blood test. CK is an enzyme inside muscle cells. When these cells are damaged by DMD, they release high levels of CK into the blood.

Another test is a muscle biopsy, in which the doctor removes a tiny sample of muscle tissue and studies it under a microscope to check the level of dystrophin. Absent levels indicate DMD. Doctors can also use genetic tests to look for the defect on the gene that produces dystrophin.

There’s no cure for DMD, but there are treatments that can ease symptoms and improve quality of life. Treatment typically begins with anti-inflammatory medications called corticosteroids. These medications, which include prednisone and deflazacort (EMFLAZA®), have been found to slow the progression of DMD.

Since 2016, the FDA has approved five new treatments for DMD, including EMFLAZA. The other drugs are “exon-skippers,” which bypass the mutation on the dystrophin gene and allow for the continuation of the process for producing a functioning dystrophin protein. 

Medications that improve heart and respiratory function may also be prescribed, and many of these are being researched in clinical trials.

Physical therapy helps the child maintain motion in the joints and prevent joint deformity and scoliosis. Occupational therapy can help the child manage activities of day-to-day life, such as dressing or using a computer.

In the past, people with DMD often did not live beyond their teens. However, improvements in diagnosis and treatment have increased life expectancy. Today, many people with DMD reach their 30s, and some live into their 40s and 50s. Ongoing research on new treatments is making that possible.

Patti DiPanfilo and Alexa Tinsley

December is a month of multiple religious and cultural celebrations. A tradition common to these celebrations is the giving of gifts to our loved ones, particularly our children. We all want to make our kids happy this holiday season. But before you give them that toy they’ve been asking for, make sure it’s safe. That’s the message of National Safe Toys and Gifts Month.

The US Consumer Products Safety Commission (CPSC) has established strict toy safety guidelines that include rigorous testing by independent, third-party laboratories, enforcing rigid lead and phthalate limits for toys, and imposing stringent standards to stop dangerous toys from reaching the marketplace and getting into children’s hands.

In spite of these efforts, thousands of children are injured every year as a result of playing with unsafe toys. A report released by the CPSC revealed that in 2020, there were nine deaths and nearly 150,000 emergency room visits for toy-related injuries in children ages 14 and younger.

Actually, those figures represent an ongoing decline in toy-related incidents compared to the past two years. In 2019, there were 14 toy-related deaths and 224,200 injuries. In 2018, there were 17 deaths and 226,100 injuries treated in US emergency rooms. Fortunately, more than 90 percent of the injured children were treated and released.

The most common toy-related injuries treated in emergency rooms included lacerations, contusions and abrasions, strains and sprains, fractures, internal injuries, ingestion of toys or toy parts, concussions, dislocations and puncture injuries. Nonmotorized scooters were associated with several of the reported deaths each year.

The best way to avoid a toy-related injury is to be proactive when selecting toys and gifts for your children. Before you buy, consult a watchdog website, such as toysafety.org, the website of World Against Toys Causing Harm (W.A.T.C.H.), for a list of recent toy recalls. But not all unsafe toys are recalled, so follow these tips before you purchase a toy:

• Read all instructions and warnings listed on the packaging.
• Ask yourself if the toy is appropriate for your child’s age and developmental abilities.
• Avoid buying toys with sharp edges, rigid points or spikes.
• Buy toys that can withstand impact and will not break into pieces that can be a choking hazard or cause other injuries,
• Look for the letters “ASTM” on the toy or packaging. That means the toy has met the safety standards set by the American Society for Testing and Materials (ASTM).
• Avoid toys that shoot, such as BB guns, or include parts that fly off.

Here are some additional tips to keep in mind this National Safe Toys and Gifts Month:

• Be sure the gifts you give are age appropriate. Playing with toys above a child’s age and level of maturity can lead to misuse and potential injury. Toy manufacturers list the age the toy is appropriate for on the packaging.
• Learn how to properly use the toy first, then teach your children how to use it.
• Buy quality toys. They might be more expensive, but high-quality materials are less likely to break into pieces and lead to injury.
• Inspect your children’s gifts as they open them to be sure they are safe before allowing them to play with the toys.
• If you give your children sports equipment, give them the appropriate protective gear for the sport as well, such as helmets for riding toys. Make sure the gear is sized to fit your child.
• A gift that includes art supplies should be labeled “non-toxic.”
• Keep small toys, “button” batteries and other potential choking hazards away from children under 3 years old.
• Keep deflated balloons away from children under 8. Immediately throw away balloons that won’t inflate or have popped.
• Discard plastic wrapping and other toy packaging right away before they become dangerous playthings for young children.

According to WATCH., online shoppers are at a disadvantage because they cannot physically inspect the toys before purchasing them. Unfortunately, there are some disreputable online retailers that may omit warnings and cautions and provide incomplete or misleading information regarding a toy’s safety. Further, unsafe and recalled toys can resurface on online websites.

If you shop for toys online, be sure to carefully inspect the toy and its packaging for obvious hazards before giving it to your child. “Don’t let your child unwrap a potential safety hazard this holiday season,” states Joan Lawrence of The Toy Association, a site for toy safety information. “By shopping smart, you can ensure safe play.”

We all know that bacteria and viruses, including the coronavirus that causes COVID-19, trigger infections that can be serious and even life-threatening. These germs are easily spread when you touch contaminated objects or surfaces and then touch your nose, mouth or eyes, where the malicious microbes can enter your body and make you ill.

Consider all the objects you touch in a typical day. These may include doorknobs, elevator buttons, door handles, ATM keys, touchscreens and your cellphone, to name a few. When you touch these objects, any germs on their surfaces are transferred to your hands. Then your touch your face.

Think you don’t? The Association for Professionals in Infection Control and Epidemiology estimates that people touch their face at least 23 times an hour!

Frequent handwashing is a powerful tool for avoiding getting sick and spreading germs to others. December 1-7 is National Handwashing Awareness Week. It’s an excellent opportunity for us to take our mothers’ admonitions to heart and revisit the healthy habit of washing our hands.

Handwashing can protect you from COVID-19, respiratory infections such as pneumonia and gastric infections that cause diarrhea. These conditions can be deadly to some people, including older individuals, those with weakened immune systems, infants and children. In fact, about 1.8 million children under age 5 die each year from diarrheal diseases and pneumonia, which are the top two killers of children worldwide.

Educating people about proper handwashing has been shown to reduce the number of people who get sick with diarrhea by 23 to 40 percent. It can also reduce respiratory illnesses, including colds, by 16 to 23 percent. Further, it cuts down absenteeism due to gastrointestinal illness in schoolchildren by 29 to 57 percent.

It’s important to wash your hands thoroughly after using the toilet and changing a baby’s diaper because feces can get on your hands. Studies show that a single gram of human feces, which is about the weight of a paper clip, can contain one trillion germs! Other times you should wash your hands include:

• When your hands are visible dirty
• Before, during and after preparing food
• Before eating
• Before and after caring for a sick person
• Before and after treating a burn or wound
• Before changing contact lenses
• After blowing your nose, coughing or sneezing
• After touching or feeding your pet, walking your dog and handling animal waste
• After touching garbage
• After handling money

Washing your hands with soap and water has been found to eliminate more germs that washing with water alone. The steps for washing hands effectively include:

1. Rinse your hands under clean running water at a comfortable temperature. Warm water isn’t more effective at killing germs than cold water.
2. Apply the soap of your choice. It doesn’t matter if you use bar soap, liquid or foam. Antibacterial soap is not necessary to use every day outside of health care facilities.
3. Lather up for 20 seconds, Be sure to get in between your fingers, on the back of your hands and wrists, and under your nails, where germs collect
4. Rinse and dry thoroughly with a clean towel.
5. If you are using a public restroom, use a paper towel to turn off the faucet and turn the door handle when leaving.

When running water and soap aren’t available, you can clean your hands on the go using a hand sanitizer. Be sure to choose one that contains at least 60 percent alcohol. Ethanol alcohol and isopropyl alcohol ate both acceptable types.

When using a hand sanitizer, place the amount recommended by the manufacturer on your hands and vigorously rub it into both hands. Make sure to cover all areas, including your wrists and under your nails. Continue rubbing until your hands air dry.

If frequent handwashing dries your skin, consider using a moisturizing soap, such as glycerin, or a hand cream or lotion after washing to keep your skin smooth and moist.

Washing your hands only takes 20 seconds. It may be the best time you devote to your health, and the health of others.

Alzheimer’s disease is a progressive form of dementia, a group of disorders characterized by brain changes that lead to a decrease in memory, language, problem-solving and thinking abilities, as well as behavior changes that can impair your daily functioning. Alzheimer’s disease is the most common cause of dementia, accounting for 60 to 80 percent of all dementia cases.

Alzheimer’s disease is more common in older adults. It is estimated that 6.2 million Americans age 65 and older are living with Alzheimer’s disease today. And unless a cure or a way to prevent the disease is discovered, the number of American affected by it could balloon to nearly 14 million by 2060.

According to the National Institute on Aging, Alzheimer’s disease is the sixth leading cause of death in the US. But, other recent data suggest it may be the third leading cause of death, just behind heart disease and cancer.

Alzheimer’s disease most often affects people 65 and older, but it can also affect people in their 30s, 40s and 50s. This is called early-onset Alzheimer’s disease or younger-onset Alzheimer’s disease. This type affects about 5 percent of all people with the disease or around 200,000 US adults under age 65.

The exact cause of Alzheimer’s disease is unknown, but certain factors increase your risk for developing the condition. Risk factors for Alzheimer’s disease include: Age, family history, genetics (certain genes have been linked to both late-onset and early-onset forms of the disease), high blood pressure, high cholesterol, diabetes, smoking and obesity.

Among the complex brain changes that occur with Alzheimer’s disease, the development of the condition is associated with an abnormal build-up of proteins in the brain called beta-amyloid and tau. It is believed that amyloid protein builds up and forms masses called plaques and twisted fibers of tau form into tangles. These plaques and tangles interfere with communication between brain cells, which prevents normal brain function and leads to symptoms.

The symptoms of Alzheimer’s disease generally present gradually, and the effects on the brain are degenerative. This results in a slow, progressive decline in your condition. Symptoms of Alzheimer’s disease include:

• Memory loss that impacts daily life
• Inability to learn new things
• Trouble with familiar tasks
• Difficulty with problem-solving
• Trouble with speech or writing
• Disorientation with time or places
• Impaired judgement or reasoning
• Difficulty recognizing family or friends
• Changes in mood and personality
• Difficulty sleeping
• Impulsive behavior
• Withdrawal from friends, family and community
• Hallucinations, delusions or paranoia

Alzheimer’s disease can be definitively diagnosed only after death, when the doctor can actually visualize the plaques and tangles in your brain tissue. Your doctor can make a presumptive diagnosis of Alzheimer’s disease while you are alive.

There is no single test for diagnosing Alzheimer’s disease. Your doctor will begin by asking you about your experiences, symptoms and medical history. The doctor will perform a physical and neurological exam to rule out other medical causes for your symptoms such as infection or stroke.

Your doctor may order imaging tests to get a clearer picture of your brain. These tests may include CT, which can show abnormal characteristic in your brain; MRI, which can reveal inflammation and bleeding, as well as structural issues; and PET, which can help your doctor detect abnormal activity in your brain.

Blood tests may also be recommended to look for specific genes that are linked to the development of Alzheimer’s disease.

Currently, there’s no cure for Alzheimer’s disease, but there are medications that can help ease the symptoms and temporarily delay disease progression. Donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) work to maintain high levels of the neurotransmitter acetylcholine in the brain. Acetylcholine helps nerve cells communicate so the brain functions better. These medications are often used in early to moderate Alzheimer’s disease.

If you have moderate to severe Alzheimer’s disease, your doctor may prescribe memantine (Namenda), which helps block the effects of glutamine. Glutamine is a brain chemical that is released in high amounts in people with Alzheimer’s disease. Glutamine damages brain cells; blocking it keeps brain cells healthier.

Many people with Alzheimer’s disease experience behavior-related symptoms as well, such as depression, anxiety, restlessness, aggression, agitation, paranoia and hallucinations. Your doctor may prescribe antidepressant, antianxiety, anticonvulsant or antipsychotic medications to treat these symptoms.

Unfortunately, there’s no sure-fire way to prevent Alzheimer’s disease, but practicing healthy lifestyle habits may help you avoid cognitive decline. The following measures have been suggested: quit smoking, exercise regularly, maintain a healthy weight, eat a plant-based diet, consume more antioxidants, try cognitive training exercises and maintain an active social life.

The prognosis for people with Alzheimer’s disease varies from person to person. On average, people with Alzheimer’s disease live four to eight years after diagnosis, but some can live as long as 20 years after diagnosis.

November is American Diabetes Month. Let’s get up to speed on this common disorder.

Diabetes is a chronic metabolic condition that affects how your body uses food for energy. When you eat, your body breaks down the food into a simple sugar called glucose, which enters your body’s cells with the help of insulin, a hormone produced by special beta cells in your pancreas. When the amount of glucose in your blood increases, it signals the pancreas to release insulin.

With diabetes, either your pancreas doesn’t make enough insulin or your body stops responding to the insulin made, a condition called insulin resistance. When this occurs, too much glucose accumulates in your blood, called hyperglycemia. Untreated hyperglycemia can lead to serious health problems, such as heart disease, kidney disease, nerve damage and vision loss.

According to the Centers for Disease Control and Prevention, 34.2 million US adults have diabetes, and one in five don’t know they have it. Diabetes is the seventh leading cause of death in the US and the number one cause of kidney failure, lower limb amputations and adult blindness. The number of adults diagnosed with diabetes has more than doubled in the last 20 years.

There are three main types of diabetes: Type 1, Type 2 and gestational. Type 1 diabetes is an autoimmune disease. It occurs when your immune system mistakenly attacks and destroys the beta cells in your pancreas, so no insulin gets produced. The reason for the attack is not known, but genetics may play a role. It’s also possible that a virus sets off the immune system’s attack.

Type 1 diabetes is most often diagnosed in children and teens but can occur at any age. People with this type of diabetes must take insulin every day to stay alive.

Type 2 diabetes occurs when your body develops insulin resistance and glucose builds up in your blood. It’s the most common type of diabetes, accounting for 90 to 95 percent of diabetes cases. You can develop Type 2 diabetes at any age but it’s most often diagnosed in people ages 45 and older. A combination of genetics and lifestyle factors are believed to cause this type of diabetes.

You are at a greater risk for developing Type 2 diabetes if you are overweight; have a family history of diabetes; have a family history of high blood pressure; have had gestational diabetes or gave birth to a baby weighing more than 9 pounds; are African-American, Native-American, Latin-American or Asian-Pacific Islander or live a sedentary lifestyle.

In many cases, Type 2 diabetes can be managed by controlling your weight, exercising regularly and eating a healthy diet high in whole grains, fruits, vegetables and lean proteins. Sometimes, people with Type 2 diabetes must take medication or inject insulin to control their blood glucose levels.

Gestational diabetes occurs in women who are pregnant and usually resolves after they give birth. It develops when the placenta produces hormones that make your cells less sensitive to the effects of insulin. If you have gestational diabetes, your baby is at a higher risk for health problems, such as excessive birth weight, early (preterm) birth, breathing problems, low blood glucose (hypoglycemia) and even stillbirth.

Further, you and your baby are at a greater risk for developing Type 2 diabetes later in life.

Treatment for gestational diabetes typically includes special meal plans and scheduled physical activity. You may have to inject insulin if you cannot manage your glucose level with diet and exercise alone.

If you have any type of diabetes, it’s important that you check your blood glucose level frequently throughout the day.

Prediabetes is a condition in which your blood glucose level is elevated but not high enough to warrant a diagnosis of Type 2 diabetes. In the US, 88 million adults, more than one in three, have prediabetes, and 84 percent of them don’t know they have it. Having prediabetes raises your risk for developing Type 2 diabetes, heart disease and stroke.

Each type of diabetes has its own symptoms, but there are some general symptoms. These include increased hunger, increased thirst, weight loss, frequent urination, blurry vision, extreme fatigue and sores that don’t heal.

There are certain blood tests your doctor will use to make a diagnosis of prediabetes and diabetes. The fasting plasma glucose test measures your blood glucose after you’ve not eaten anything for eight hours. The A1c test provides a view of your blood glucose levels over the previous three months.

The glucose challenge test checks your blood glucose level an hour after you drink a sugary liquid, and the glucose tolerance test checks your glucose level after you fast overnight and then drink a sugary liquid.

Women who are pregnant are typically tested for gestational diabetes between the 24th and 28th weeks of their pregnancy.

If you eat a healthy diet, control your weight, exercise regularly and follow your doctor’s instructions for taking any medications, if required, you can successfully manage your diabetes and live a full and active life.

October is Sudden Infant Death Syndrome (SIDS) Awareness Month. Want to learn more about SIDS? Read on.

First of all, SIDS is the name given to the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African-American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens suddenly and unexpectantly to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase your baby’s risk of dying from SIDS. The most important risk factor is laying your baby down to sleep on his or her stomach or side rather than their back. Other factors that increase your baby’s risk include:

• Having a family history of SIDS
• Being overheated with blankets or a high room temperature
• Co-sleeping (sharing a bed with a parent or caretaker)
• Having a mattress that’s too soft and having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight
• Having a mother younger than 20 years old
• Having a mother who received inadequate or no prenatal care
• Having a mother who smoked, drank alcohol or took drugs during pregnancy
• Being exposed to secondhand smoke

The cause of SIDS is unknown but researchers are studying certain theories. Many researchers believe that SIDS is related to your baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the baby’s bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in your baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in your baby’s development, essentially the first six months of his or her life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening to your baby. But there are some tips for reducing your baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved mattress for your baby’s crib and place a fitted sheet over it.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of your baby’s crib when he or she is sleeping.
• Don’t smoke, drink or take drugs while you are pregnant and if you are breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of your baby’s siblings.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of young babies during Sudden Infant Death Syndrome Awareness Month and all year long.

It’s October, and we all know that October is National Breast Cancer Awareness Month. Look around. See all the pink ribbons? The color pink is a reminder to learn the basics of breast cancer and then get screened. And men, don’t think this doesn’t apply to you. Though it’s much more common in women, breast cancer affects men, too.

Consider these facts. About one in eight American women will develop breast cancer over the course of her lifetime. Breast cancer is the second most common cancer in women after skin cancer and the second leading cause of cancer death in women. Only lung cancer kills more women each year.

The American Cancer Society estimates that 281,550 new cases of invasive breast cancer will be diagnosed in American women in 2021. In addition, 49,290 new cases of non-invasive breast cancer (ductal carcinoma in situ) will be diagnosed. Sadly, about 43,600 women are expected to die from breast cancer this year.

Further, the American Cancer Society estimates that about 2,650 new cases of invasive breast cancer will be diagnosed in American men in 2021, and about 530 men will die as a result. A man’s lifetime risk for developing breast cancer is about one in 833.

Breast cancer occurs when cells in the breast start growing uncontrollably. Most of the time, but not always, these extra cells collect and form tumors. These are the lumps that can often be detected in the breast on your self-exams or mammograms.

A new lump in your breast or armpit is one symptom of breast cancer, but there are others as well. You might notice thickening or swelling of an area of your breast, or irritation or dimpling of your breast skin. Look for red or flaky skin near the nipple, as well as secretions from the nipple other than breast milk. Changes in the size and shape of your breast, and pain in any area of the breast are other breast cancer symptoms.

If you have any of these symptoms, visit your doctor for a proper diagnosis.

Breast cancer is the result of a mutation, or abnormal change, in the genes that regulate the growth and reproduction of breast cells. About 5 percent to 10 percent of breast cancers are inherited, or caused by mutations passed on from your parents. The rest are caused by abnormal changes that occur as the result of aging and life in general.

That makes getting older a risk factor for breast cancer, one you can’t do anything about. Other risk factors for breast cancer you cannot control include getting your period before age 12 and menopause after 55, having dense breasts, having a personal or family history of breast cancer and having been treated with radiation therapy.

There are also risk factors for breast cancer you can control, things like being physically inactive, being overweight, drinking a lot of alcohol and taking hormones. In addition, having your first baby after age 30, not breastfeeding and never having a full-term pregnancy can also increase your risk for breast cancer.

You can’t change your age or your genes, but there are steps you can take to reduce your risk for breast cancer. A few of these suggestions are no-brainers. We already know that we should maintain a healthy weight, exercise regularly and limit our alcohol consumption to one drink a day.

These suggestions you may not have heard. For one, think hard and have a heart-to-heart discussion with your doctor about the risks of taking the Pill or hormone replacement therapy (HRT). They may not be right for you. If you have a baby, consider breastfeeding, if you’re able. If you have a family history or a genetic mutation, talk to your doctor about ways you can lessen your breast cancer risk.

With breast cancer, as with most cancers, early detection is critical to treatment success. It’s best to find it before the cancer cells have had a chance to invade the nearby lymph nodes and spread to other areas of the body. Maintaining a routine screening schedule can assist with early detection.

The first part of the screening process is regular breast self-exams. You know the look and feel of your breasts, so you’re likely to notice changes such as lumps, pain, or differences in size or shape. You should also get routine clinical breast exams by a doctor or nurse, who use their hands to feel for lumps in your breasts.

The next step is to get a mammogram. The American Cancer Society’s Breast Cancer Screening Guidelines recommend that women begin yearly mammograms by age 45. They can switch to having mammograms every other year at age 55. If lumps are detected, your doctor may perform a biopsy to determine if their cells are cancerous.

If cancer is detected, there are many approaches to treating it. Doctors often use more than one approach on each patient.

Chemotherapy is a common approach. It uses drugs to kill cancer cells and shrink tumors. Surgery, called mastectomy, is often used to remove the breasts and the tumors. Radiation therapy uses high-energy rays directed at the spot of the cancer to kill cancer cells. Unfortunately, chemotherapy and radiation therapy have uncomfortable side effects.

Doctors use additional treatment approaches including hormonal therapy, which doesn’t allow the cancer cells to get the hormones they need to survive. Another approach is biological therapy, which works with the immune system, your body’s natural defense against disease. Biological therapy helps the immune system fight the cancer. It also helps control the side effects of other cancer treatments.

Breast cancer is the subject of much research, and if you’re interested, you can participate in a clinical trial to test the safety and effectiveness of new drugs and treatments. To find a clinical trial near you, ask your doctor or go to clinicaltrials.gov.

Now, you know the basics of breast cancer. Put on something pink and share what you’ve learned!