Dr Arun Krishnan, a neurologist at the hospital and the study’s lead author, believes nerve excitability testing could be used to detect neuropathy in people before any outward signs of damage are exhibited.

He believes that treatments used only in more advanced cases of neuropathy could be effective in these early cases, although they are not used currently because the nerve damage is as yet undiagnosed.

”Some treatments we think that might not be beneficial because they’re used in later disease may actually be helpful in earlier stages of the illness,” he said. ”But if you are going to give these trials to people who have obvious neuropathy, you’ve sort of missed the boat.”

The trial uses electrodes taped over a nerve or muscle to record activity while electrical pulses are delivered. The nerve response is then mapped against that for age-matched healthy controls in the hope of predicting neuropathy – the first testing of its kind.

Sal Abela, an early participant in the trial, has had type 2 diabetes for 17 years. He has shown obvious signs of neuropathy for the past four years – unable to feel his feet, no longer able to play golf.

”It’s just got worse and worse and worse,” he said. ”It’s got to a stage now where I can’t feel my feet. I can’t wait to get up in the morning to get some circulation through my feet.”

About 30 patients have participated in the trail – half showing changes to nerve excitability against aged-matched controls, suggesting they may develop neuropathy. The hospital hopes to recruit more than 100 patients to be tested twice yearly for three years as part of the study.

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”As a father it was horrendous,” he says. ”You have this child that won’t settle and then you take off his top and he was beetroot red. I knew straight away it was an anaphylactic reaction.”

Convincing others to take his son’s nut allergy seriously was not as straightforward.

”When he started in kindergarten and primary school it became very difficult. A severe allergy is different to an intolerance; it is not just a bit of a rash or a bit of an itch, it is actually life-threatening.”

When it comes to food allergies, Australia could well be the world capital, with an estimated one in 10 children affected. However, despite the number of preschoolers with potentially life-threatening food allergies increasing fivefold since 1990, the medical profession is at a loss to explain why.

Looking for answers

Paediatric gastroenterologist and allergy specialist Professor Katie Allen and her colleagues at Melbourne’s Royal Children’s Hospital hope to find an answer.

After recruiting 5000 one-year-old children for a study of the problem three years ago, they found 10 per cent had an allergic reaction to a food challenge. The team is now testing the children at age four and will expose them to the foods again at age six.

”So far, all we know is that it has something to do with modern lifestyles,” Allen says.

Among the hypotheses are inadequate exposure to vitamin D, parasites, the age at which foods are introduced and the ”hygiene hypothesis”.

”Having lots of different diverse bugs in the intestine helps the system decide what we are eating is safe and what is dangerous,” Allen explains.

What can baby eat?

Advice on the age to introduce certain foods has also changed. For the past decade, parents were advised to delay potentially allergenic foods until after their child turned one or two. Recent studies, however, have indicated that delaying the introduction of troublesome foods might increase the risk of an allergy developing.

Last year, Allen and her team found children who were not introduced to eggs until after their first birthday were up to five times more likely to develop an egg allergy. Infants who were introduced to egg between four and six months of age were least likely to develop an egg allergy.

”We are thinking now that there is a window of opportunity and that the intestine is ready for foods at certain stages,” Allen says.

Who and what

The most common food allergens are peanuts, tree nuts (such as hazelnuts, cashews, pine nuts and macadamias), fish, shellfish, cow’s milk, soy, egg and wheat.

Most allergies develop in childhood, although in rare cases adults can develop an allergy. While more boys develop allergies in childhood than girls, women are more likely to develop allergies later in life, something doctors attribute to hormonal changes such as when a woman becomes pregnant.

While 80 per cent of children grow out of an allergy to eggs, wheat or dairy, it is the nut and seafood allergies that are of greater concern. They are the most likely to trigger anaphylaxis and are also the most likely to persist as the child gets older.

Agents of intolerance?

What is far more likely to develop in adulthood is an intolerance to a particular food. Nutritionist Emma Sutherland says it is important to differentiate between an allergic reaction and an intolerance.

”An allergy is a reaction that produces an immune-system response and it generally means you can never eat that food,” she says. ”With an intolerance, the symptoms are much more insidious, people could just feel tired and bloated or get a lot of headaches or colds, the kind of things you can put down to a host of other reasons.”

Sutherland advises those concerned about food intolerances take a blood test.

”If you only work on assumptions then you could be avoiding some foods that you think are causing the problem and still eating the ones that actually are.”

Those concerned about allergies also have a simple solution: a skin-prick test from an immunologist.

”Allergies are in response to a certain protein,” Allen says. ”Food allergies have a bad reputation and people are seen as fussy but if someone has a positive skin-prick test, it means they are at risk of a more severe reaction.”

Allergy checklist

Symptoms of an allergic response include swelling on the face, hives, vomiting, coughing, wheezing and breathing difficulties.

The reaction is closely linked in time to a certain food, from within minutes up to an hour.

Sufferers should see their GP for a referral to an allergy specialist.

Symptoms of an intolerance can include bloating, headaches, stomach pains and even excessive tiredness.

Those who suspect an intolerance can try eliminating a single food for a week and then reintroducing it. This is not advised for suspected allergies.

THE rate of diabetes has increased by up to 40 per cent over five years in coastal retirement areas of NSW and has reached worryingly high levels in western Sydney – areas of the state least able to deal with the illness.

New analysis shows the incidence of diabetes in NSW has increased by an average of 27 per cent in that period.

”The actual numbers are huge and increasing. Looking at the figures, there’s no sign of it levelling off, which is pretty scary,” Alan Barclay, who prepared the data for the Australian Diabetes Council, said. 

”It certainly will require provision of specific health professionals and services.

”We do know that people with diabetes end up in hospital far more often than people without diabetes.”

The state electorate of Mount Druitt has the highest rate of diabetes in the state with 7.4 per cent of people – more than 11,000 people – suffering from the illness.

It is followed by Fairfield, the south coast, Wollongong, Smithfield, Toongabbie, Granville, Cabramatta and Liverpool.

”I don’t think it’s so much an age thing there,” Dr Barclay said. ”In south-west Sydney it’s like a Y-shaped band of people with diabetes. It follows age but also less affluent areas.”

Overwhelmingly, the research showed diabetes to be a disease of poverty: the unemployment rate in the top 10 electorates for diabetes is more than twice that for the bottom 10; median household income is almost half; the number of Aborigines is close to seven times what it is for the bottom 10.

But when the research analysed growth over the past decade, the disease swung dramatically to the coast.

In Port Macquarie, the disease rate had grown by 44 per cent since 2005.

In the northern coastal electorate of Oxley, the growth was 43 per cent.

The growth hovered around the mid to high 30s in Coffs Harbour, the south coast, Wyong, Myall Lakes, Wollondilly, Clarence, Tweed and Swansea.

”The main cause there is the ageing population moving to coastal areas,” Dr Barclay said. ”Diabetes basically happens when the body wears out. It’s reflected in these areas.”

Stig Pramming, a former head of the Oxford Health Alliance and adviser to the National Preventative Health Taskforce, said Australia performed reasonably well in diabetes care but the problem was complicated by distance between services.

”You have a vast geographical problem,” he said. ”A lot of doctors have profiled the disease as trivial, as a natural consequence of how you live your life.

”The reality is it is a beastly disease that cuts people into slices and could be likened to some cancers.”

The chief executive of the Australian Diabetes Council, Nicola Stokes, said the state Liberal government had shown positive signs of addressing the shifting needs of diabetics but structural problems remained in the disconnect between where diabetes rates are rising and where the services are in place.

”We know there are gaps in the services for regional and coastal areas, especially when people are trying to access specialist services,” she said.

”They have to come to Sydney, say, for an endocrinologist. And they may have to wait three months.”

The north shore had the lowest rate of diabetes, with just 2.7 per cent of residents of the electorate registered with the National Diabetes Services Scheme as sufferers. The other electorates by rate of diabetes making up the bottom five are Sydney, Vaucluse, Pittwater and Coogee.

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Food allergies don’t have to leave your child in the cold when it comes to summer camp. You can help them stay safe and healthy with a few simple tips. For parents, there are a few questions to ask.

Summer is about having fun and taking a break from school. For parents, it can mean finding a way to entertain their kids. One alternative is summer camp.

Whether your child chooses a day camp or an overnight camp, if they suffer from food allergies you have a valid concern about the safety of the camp. Here are a few questions to ask of the staff and administration of the camp before signing your child up.

How do you handle food allergies? – Many kids suffer from some sort of food allergy today. In an effort to accommodate, many eliminate the common allergens from their dietary list. Check to see what ingredients their food list contains.

How do you handle a food allergy emergency? – Even with changes to the food being served, there is always the chance that a child will come in contact with an allergen. What is the procedure for dealing with this emergency? How close is medical attention if it is needed? Know that your child will be in good hands should anything happen.

Can you handle children with multiple food allergies? – Some uncommon food allergies may be difficult for certain camps to monitor. If this is the case, pass on that camp in favor of one that can accommodate your child. This may mean a day camp where your child can eat their own lunch each day.

For your child, they also need tips to help them to navigate the waters of food allergies. If they have lived with these allergies all their lives, they can be prepared with a few suggestions to help them avoid potential danger.

Bring snacks from home – They are familiar with their own snack regimen at home. Bringing allergen-free snacks can reduce the chance of coming in contact with any trouble.

Avoid switching foods with other campers – New-found friends love to trade food in their stash. Your child can offer their snacks if they wish but warn them not to accept other snacks. The reasoning here is that they don’t know what ingredients are found in those other snacks. Foods such as peanuts can be listed under other names unrecognizable by your child. They may think it is safe to eat but it really is not.

Wear a medic alert bracelet – This can alert staff that your child has a medical condition they need to be aware of. In an emergency, there will be no doubt as to what has caused the reaction.

Summer camp can be fun and safe even for kids with food allergies. Be proactive and ask questions to ensure a positive, memorable experience.

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Researchers found that 1 in 12 children are affected by some form of food allergy; 40% of those suffering have a history of severe reactions, according to the journal Pediatrics. The study found that the most common food allergies were peanuts, milk and shellfish.

For parents of children with food allergies, just sending their child to school catapults a fury of anxiety: Will the teacher remember? What if they serve snacks? Do the other children understand? What if they get too close to something in the cafeteria lunches? There’s also the added sense of embarrassment for children and especially teenagers suffering food allergies.

“Teenagers find it ‘not cool’ to carry an auto-injector,” said Dr. Clifford Bassett, director of Allergy & Asthma Care of New York and member of the public education committee for the American College of Allergy, Asthma and Immunology, in a recent CNN article.

Medical ID bracelets can help calm some of those fears. By helping protect those afflicted by certain disease or allergies, medical identification bracelets can be engraved with your medical information right on there, so in the event of an emergency, people know how to react.

The trick is finding a company that doesn’t suit up with those clunky medical bands that look out of place. Hope Paige Designs mixes fashion with function as one of the foremost designers of stylish medical alert jewelry at an affordable price. Featuring necklaces, key chains, flash drives and silver, beaded, leather, mesh or rubber bracelets, Hope Paige can let parents rest a little easier and help children suffering with these food allergies feel comfortable around their peers.

Hope Paige Designs’ website and digital marketing campaign was created by 352 Media Group, an award-winning digital marketing and web design company.

SOURCE Hope Paige Designs

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The findings come amid calls for annual kidney screening tests to pick up the early signs of kidney disease helping those with type 2 or adult-onset diabetes.

Australian children to the age of 14 already have an unenviable rate of type 1 diabetes. In 2008, 138 children per 100,000 were counted as having the disease.

AIHW spokeswoman Anne-Marie Waters says the situation is going to get worse.

“We’ve also projected the prevalence to 2013 and predicted that it will rise by about 10 per cent by that time, so the rates we are predicting will actually rise from about 140 cases per 100,000 children to about 153 cases per 100,000 children,” she said.

Ms Waters says it is difficult to say why there has been a rise.

“I think the diabetes experts believe that especially with the increase in diabetes in recent decades that environmental changes are driving the increase in type 1 diabetes,” she said.

“So that is things like diet, early exposure to cows milk, viruses which could be linked to children being exposed to less infections at an early age now than they were years ago because we are all so hygiene focused, and also vitamin D deficiency is another thing.”

Type 1 diabetes only accounts for only 5 per cent of diabetes in Australia. The rest is adult-onset or type 2 diabetes and the numbers there are alarming as well.

Kidney Australia medical director Dr Tim Mathew says it is an escalating problem.

“Projections are for it to increase as a problem to about 145 per cent more in 10 years’ time,” he said.

“We already know the percentage of dialysis patients with diabetes has gone up from 5 per cent to 44 per cent across Australia in the last 25 years.”

Kidney Australia commissioned a report from Deloitte Access Economics to assess the cost effectiveness of an annual screening program for kidney disease.

Dr Mathew says the report calls for an annual screening program for type 2 diabetes.

“The cost effectiveness around that is remarkably positive and in number terms, it is about the same as or exceeds the cost effectiveness of breast cancer screening,” he said.

Dr Mathew says screening is vital to find signs of disease early.

He says Kidney Australia does not have a view as to how the screening program should be funded.

“All we know is that it is not expensive. In our report it suggests that the cost for Australia will be in the small millions rather than the multi-millions,” he said.

Dr Mathew says making the right lifestyle choices is the best way to prevent kidney disease.

“We see that as difficult but achievable but the longer-term solution, the short-term solution and for those impacted already caught up in the problem, they need to find out if they’ve got kidney disease and do something about it,” he said.

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When you are a health reporter, it is sometimes hard not to be a hypochondriac.

You get to learn a dangerous little about far too many illnesses and, in the middle of the night, it is easy to think any ache or pain is whatever it is you last wrote about.

Death, an urgent hospital trip, or, at the very least, months of debilitating treatment seem imminent. Disease of the week syndrome, I call it. Usually, it is complete nonsense, but in one instance my concern might have been worthwhile.

An article I wrote last year involving reference to a patient’s reaction to the commonly prescribed antibiotic Augmentin, prompted me to see how my own reaction to this had been recorded.

I had been prescribed the drug on discharge from Dunedin Hospital in late 2006 when I had to be surgically repaired after stupidly falling off my bike in Portobello Rd and smashing a previously fractured elbow.

My reaction to this medication after a day included itchy welts over much of my body and a tongue-swelling incident (cruelly welcomed by some around me who thought talking would be curtailed).

My breathing was not affected.

As this occurred on New Year’s Eve and I thought emergency department staff would be busier with more important things, I stopped taking the medication. The tongue swelling had resolved spontaneously before I visited the ED the next day.

There, I was prescribed a different antibiotic which I took without further incident.

When I viewed my hospital records, I discovered the symptoms I had reported were accurately recorded, but when I asked some further questions, I discovered the reaction was flagged neither on my electronic record nor on the front of my paper records folder. That has now been rectified.

As far as I can ascertain, without getting a copy of what is recorded against my national health index number, the allergy information has not entered the medical warnings system (MWS).

This is the system that should alert hospital doctors about the reaction should I turn up to be treated at any hospital in the country in future.

Doctors with whom I have discussed this agreed that if they were contemplating treating me with antibiotics they would want to know about this incident before making a decision.

If I want to ensure my reaction is recorded on the MWS, I have been advised to discuss the issue with either my GP or the relevant hospital specialist, who could ensure the information got to the MWS.

While I could have reported the information myself through the Centre for Adverse Reactions Monitoring, the involvement of medical professionals is recommended because it is important events are recorded accurately and there is a distinction made between what might be an annoying side effect of a medication, and a true allergic reaction.

It also makes sense to have those involved with your ongoing medical care up to date with your concerns.

A suggestion was buying a Medic Alert bracelet. My advice: discuss it with your GP and take it from there.

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Researchers said introducing solids early on could ‘kick-start’ the immune system, making children with a family history of allergies about five times less likely to develop sensitivity.

In contrast, experts generally recommend mothers breastfeed infants for the first six months because it is the best form of nutrition.

The study, published in the Journal of Allergy and Clinical Immunology last month, was conducted on 594 children, whose mothers were interviewed about feeding practices when they were one, six, and 12 months old.

Reuters Health reports blood samples were taken from children ages two and three years old and tested for antibodies against peanut, egg and milk.

‘Eleven per cent of those tested were found to be at an increased risk of developing an allergy to peanut.

‘The risk of sensitivity was lower among children whose parents had allergies or asthma, if they had been started on solid food or cow’s milk before the age of four month,’ according to reports.

Just under six per cent of those tested had peanut sensitivity, compared to 16 per cent of those whose mothers introduced solid foods or cow’s milk later.

The findings were not consistent among children who did not have a family history of allergy.

Lead researcher Christine Joseph, an epidemiologist at the Henry Ford Health System in Detroit, said the study did not, however, prove early introduction of solid foods prevents peanut allergies.

Ms Joseph told Reuters Health: ‘Intuitively, it does seem like the opposite of what you’d expect.’

She explained early exposure to solids and cows milk could ‘kick start’ the immune system and make children more tolerant of peanuts.

Controversy over what infant feeding methods might cut risk of food allergies has long been subject to debate.

Until recently, the American Academy of Pediatrics recommended parents not feed children cow’s milk until age one.

That decision was reversed in 2008, after studies showed no evidence it lowered allergy risks.

It’s estimated that just over one percent of U.S. children are allergic to peanuts.

The wristbands carry the words “fall risk” in large black letters and will let all health-care providers know that fall prevention cautions should be taken, said Barbara Johnson of SouthWest Health.

For more than a year now, each patient admitted to Digby General Hospital and Yarmouth Regional Hospital, as well as Roseway Hospital in Shelburne, has been assessed to help identify any fall risk.

Records show that 401 hospital patient falls were reported in 2009-10 by the three hospitals.

“The most common cause of falls is falling in liquids and it’s usually urine,” said Johnson.

She said she is unaware of any civil action pending against SouthWest Health as a result of an in-hospital fall.

All inpatients, including those admitted to mental health, addictions or rehabilitation units, will be assessed for fall risks, she said Monday.

Staff will look beyond the senior or frail segment of hospital patients, she said.

Normally, healthy people who have had surgery or have new medications could also be susceptible to falls.

Patients will be reassessed throughout their hospital stay to see if anything has changed, and when they no longer present a risk they will have their wristband removed, said Johnson. The wristbands will be left on when a patient is discharged if a high risk for falling remains.

“And there will be an offer to follow up with rehab services,” said Johnson. Someone may come to a patient’s home to see how they are progressing.

A fall injury in hospital delays recovery and results in an average 40 per cent longer hospital stay, she said. After a fall many seniors lose their independence and require a long-term care bed

“We also have a mobility team that works with hospital patients . . . to get people up out of bed and get them moving,” said Johnson.

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