World AIDS Day is held on December 1 each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died of AIDS. World AIDS Day was the first ever global health day. The first one was held in 1988.
Today, many scientific advances have been made in HIV treatment and laws have been passed that protect people living with HIV from discrimination and criminalization. However, HIV is one of the most destructive pandemics in history.
On World AIDS Day, Scott County Health Department encourages everyone to:
• Learn the facts about HIV.
• Use your knowledge about HIV and AIDS in order take care of your own health and the health of others.
• Know your HIV status; it is an important first step in the battle against HIV.
In recognition of Worlds AIDS Day, Scott County Health Department will be providing expanded clinic hours for HIV testing on December 1, from 8:30am to 3:30pm. Testing will be provided on a walk in basis. Please visit our web site for additional information and testing criteria. www.scottcountyiowa.com/health.

If your glucose levels get out of control, it can lead to serious diabetes problems. Knowing the signs of these diabetes conditions can help you take quick action to resolve them.

Diabetes complications can occur if you don't regulate your blood sugar (glucose) levels properly. Blood sugar is produced in your liver and muscles, and most of the food you eat is converted into blood sugar. This is your body's source of energy, but when your blood sugar gets too high, diabetes is the result.

Your pancreas produces the hormone insulin, which then carries blood sugar into your cells, where it's stored and used for energy. When you develop insulin resistance, high levels of sugar build up in your blood instead of your cells and you start to experience signs and symptoms of diabetes. You may notice fatigue, hunger, increased thirst, blurred vision, infections that are slow to heal, pain and numbness in your feet or hands, and increased urination. For awhile, your pancreas will work to keep up with your body's sugar demand by producing more insulin, but eventually it loses the ability to compensate and serious diabetes complications ? including blindness, kidney failure, loss of circulation in your lower extremities, and heart disease ? can develop.

For most people with diabetes, the target blood sugar level is 70 to 130 mg/dL, but your doctor will work with you to pinpoint your individual target range. Your doctor can also help you learn what to eat and how to keep your blood sugar within a healthy range.

Joel Zonszein, MD, director of clinical diabetes at Montefiore Medical Center in New York City, says it's very important to work with and see your doctor regularly and to consult a diabetes educator. If your diabetes is well-controlled and you're monitoring your blood sugar level at least once or twice a day, seeing your doctor four times a year should be sufficient to maintain good diabetes control.

Four Signs of Diabetes Complications

One of the main reasons monitoring your blood sugar level is so important is that it can change quickly and unpredictably. The sooner you detect any changes, the sooner you can catch early signs of diabetes complications. Be aware of these four specific diabetes problems:

Hyperglycemia. The most common cause of diabetes complications is hyperglycemia, or when your blood sugar level rises above 180. This kind of spike indicates that either there isn't enough insulin in your body or that insulin isn't being properly used. You can experience high blood sugar from overeating, medication deficiency, or as a reaction to new medication. Signs of hyperglycemia include being very thirsty, experiencing extreme fatigue, having blurry vision, needing to urinate a lot, and feeling sick to your stomach. Although regular exercise may help stabilize your blood sugar level, it's important to contact your doctor because your meal plan, your medication, or both may need to be adjusted. If left untreated, hyperglycemia can become a life-threatening condition.

Hypoglycemia. A quick drop in your blood sugar level is called hypoglycemia. Blood sugar levels below 70 are dangerously low and can be caused by missing or delaying a meal, exercising too much, or taking too much medication. Hypoglycemia may cause feelings of weakness, confusion, irritability, shakiness, hunger, and fatigue. You can prevent passing out or having a seizure from hypoglycemia by eating regular meals, taking your diabetes medication, and checking your blood sugar level often. When your blood sugar begin to drop, you should drink fruit juice or regular soda, take glucose tablets, eat a spoonful of sugar or honey, or eat five or six pieces of hard candy to stabilize your blood sugar. If you experience hypoglycemia, contact your doctor as soon as possible. Until your blood sugar level has stabilized, repeat the sugary drink or food every 15 minutes. Always carry food with you for this reason.

Diabetic ketoacidosis. When there isn't enough insulin or sugar for fuel, your body starts breaking down fats for energy instead. As a result, your body produces ketones, which are waste products found in the blood. Because your body can't tolerate high levels of ketones, your system will try to eliminate them through your urine. If ketones build up in the blood, a life-threatening condition called diabetic ketoacidosis can poison your body and lead to a coma or death. Early symptoms include thirst, dry mouth, shortness of breath, fruity smelling breath, frequent urination, fatigue, dry skin, nausea, vomiting, abdominal pain, confusion, high blood sugar, and high levels of ketones in your urine. You can check your ketone levels with a simple drugstore urine test. Diabetic ketoacidosis, which is relatively rare with type 2 diabetes, can be prevented by regularly checking for ketones, particularly when you're sick. Symptoms of diabetic ketoacidosis develop slowly, increase quickly, and can create an urgent medical situation. If you suspect you have diabetic ketoacidosis, call your doctor immediately and go directly to the emergency room.

Hyperosmolar hyperglycemic nonketonic syndrome (HHNS). HHNS occurs you're your blood sugar level is extremely high ? greater than 600 mg/dL. It's most common in older people with type 2 diabetes and develops over days or weeks, especially after an illness or infection. The high level of sugar in your blood makes it thick and syrupy, and your body will work to rid itself of excess sugar by passing it through your urine. If you don't drink enough liquid, you run the risk of dehydration, and HHNS can also lead to a seizure, a coma, or death. Warning signs of HHNS include a dry mouth, extreme thirst, a fever greater than 101° F, drowsiness, confusion, vision loss, hallucinations, weakness on one side of your body, and dark urine. The best way to prevent HHNS is to check your blood sugar level regularly, and more often when you're sick. If warning signs begin to appear, drink liquids at least every hour and call your doctor or 911.

Follow your doctor's recommendations about how often to check your blood sugar level. In general, Melissa Li-Ng, MD, an endocrinologist at the Cleveland Clinic in Ohio, advises people who take diabetes medication to check their blood sugar once a day, and if you're on insulin, check it three times a day before each meal. Monitoring your blood sugar closely can help you prevent serious diabetes complications from developing.

WASHINGTON, D.C. – Senator Tom Harkin (D-IA) today announced that the University of Iowa and Iowa Central Community College have been awarded a total of $790,350 to apply communication technologies for rural healthcare delivery. The funding comes from the U.S. Department of Agriculture's (USDA) Distance Learning and Telemedicine (DLT) Grant Program.  Harkin is a senior member of the Senate agriculture committee as well as the panel that funds rural development initiatives.

"Residents of all communities - both rural and urban - deserve access to quality medical care.  By using new technology, we are able to provide people in rural areas with the specialty medical care that many urban residents take for granted," said Harkin.  "I congratulate the University of Iowa and Iowa Central Community College for receiving this competitive funding."

The DLT Grant Program works to provide access to education, training and health care resources in rural areas.  Funding is provided to increase educational opportunities and expand health care.

Details of the funding are as follows:

• Iowa Central Community College: $291,377 to provide career & technical education, special education support services, media & technology services, a variety of instructional services and professional  and leadership development courses to 600 students, 266 teachers and 150 community members via an interactive distance learning videoconferencing system. Iowa counties that will benefit include : Buena Vista, Calhoun, Greene, Hamilton, Humboldt, Pocahontas, Sac, Webster, and Wright.

• University of Iowa: $498,973 to provide telemedicine videoconferencing services for Family Medicine at 40 rural sites, for Child Health Specialty Clinics at 9 rural sites and for Geriatric Outreach at 15 rural sites. Iowa counties that will benefit include : Allamakee, Appanoose, Benton, Bremer, Buchanan, Buena Vista, Cass, Carroll, Cerro Gordo, Cherokee, Clay, Clayton, Decatur, Delaware, Des Moines, Dickinson, Emmett, Fayette, Fremont, Hardin, Henry, Iowa, Jackson, Jefferson, Johnson, Keokuk, Kossuth, Linn, Louisa, Mahaska, Marion, Montgomery, Page, Plymouth, Polk, Poweshiek, Scott, Shelby, Union, Van Buren, Washington, Wayne, Winneshiek, and Wright.

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Affordable Care Act provides incentives to encourage doctors to serve in rural America, funds health rural centers, helps rural Americans get access to care

USDA awarding more than $10 million in grants to support telemedicine and rural health research

Washington, D.C., Nov. 20, 2014 - Today, on National Rural Health Day, Agriculture Secretary Tom Vilsack announced more than $10 million in grants through two U.S. Department of Agriculture (USDA) programs to improve access to health care for rural Americans across the nation. The Secretary also highlighted initiatives created by the Affordable Care Act that specifically address critical health needs in rural communities.

"Delivering these programs to rural communities that often do not have access to quality, affordable medical and educational services has tremendous economic and social benefits," Vilsack said. "They also mean that people who live and work in rural areas will not have to travel long distances for specialized health care services. These investments mean that students in rural high schools will have educational opportunities often not available outside urban areas."

Through the Distance Learning and Telemedicine (DLT) program, USDA has helped hundreds of rural communities deliver care in remote areas since it began two decades ago. Today, USDA's Rural Development is awarding $20.4 million in grants that will provide rural Americans access to medical services, improve educational opportunities, and support Native American communities. Fiscal Year 2014 Distance Learning and Telemedicine Grant recipients

Rural residents are more likely to report a fair to poor health status and have higher rates of health complications, morbidity and mortality due to challenges associated with low levels of employment and education, geographic barriers and isolation, lack of quality nutrition and health education, and lack of access to health care.

USDA's National Institute of Food and Agriculture (NIFA) is awarding 12 grants totaling more than $1.4 million to universities aimed at enhancing the quality of life in rural areas through improved health and safety education efforts. NIFA funded the grants through the Rural Health and Safety Education program which addresses these challenges by developing programs that provide the necessary health information to rural residents. The program has three main focus areas: 1) individual and family nutrition and health education; 2) farm safety education; and 3) rural health leadership development education.

Projects funded in fiscal year 2014 focus on a diversity of rural health and safety issues, from diabetes education, obesity prevention, and physical activity and healthy nutrition education, to eco-healthy child care promotion, and rural expansion of 4-H Healthy Living program. Fiscal Year 2014 Rural Health and Safety Education Grant recipients

In addition to today's announcements, Secretary Vilsack encouraged rural Americans to take advantage of the Health Insurance Marketplace created by the Affordable Care Act and discussed the health care reform law's specific benefits for rural communities.

"Rural residents have higher rates of chronic conditions.  This can be exacerbated by a lack of doctors or clinics in rural communities," Secretary Vilsack continued. "The Affordable Care Act is improving the health of rural communities and giving all families the security they deserve. No one should go without healthcare because of where they live, or be forced to leave the communities they love to get the coverage they need."

Rural Americans suffer from higher rates of chronic conditions like diabetes, heart disease and high blood pressure.  The Affordable Care Act has taken steps to address the unique challenges rural communities face when it comes to getting the health care they need.

One in five uninsured Americans lives in a rural area, and yet on average only 10 percent of the nation's physicians practice in these communities. The Affordable Care Act has significantly increased the size of the National Health Service Corps, which offers scholarships and loan repayment to health practitioners in return for practicing in rural communities and other underserved areas. More than 3,500 Corps members now serve in rural areas, and an average of 86 percent of them will remain in their communities even after completing their service.

The Affordable Care Act also invests significantly in expanding services at community health centers, where 7.5 million rural Americans get access to primary and preventive care. That comes on top of the more than $3 billion USDA has invested since 2009 to strengthen health infrastructure in rural areas, building rural hospitals and health clinics and expanding access to health care in remote rural areas through telemedicine.

Not only can a lack of health insurance coverage help lead to high rates of chronic conditions, it threatens rural families economic health as well.  Before the Affordable Care Act passed, the average rural family paid nearly 50% of all health costs out of pocket. One in five farmers is in debt because of medical bills. Uninsured individuals living in rural areas are able to use the Marketplaces to compare qualified health plan insurance options based on price, benefits, quality, and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the qualified health insurance plan that best fits their needs.

Open Enrollment for the Health Insurance Marketplace began Nov. 15, 2014, and runs through Feb. 15, 2015. Those who have plans can continue them without re-enrolling. However, consumers are encouraged to visit HealthCare.gov to review and compare health plan options and find out if they are eligible for financial assistance, which can help pay monthly premiums and reduce out-of-pocket costs when receiving services. In order to have coverage effective on Jan. 1, 2015, consumers must enroll or update their coverage by December 15.

Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Translation services are available. The call is free.

To preview plans in your area, visit: www.healthcare.gov/see-plans/

For more information about Health Insurance Marketplaces, visit: www.healthcare.gov/marketplace