Happy Diabetes Awareness Month!


November is national diabetes awareness month, so now is a great time to ask why this matters and why screening is important.

So, why the awareness, and what exactly is diabetes?

In 2015, over 30 million American’s were living with diabetes, which was also the 7th leading cause of death in the United States [4,2]. The number of people diagnosed with diabetes is anticipated to continue growing, so providing awareness helps to shed light on the disease and the importance of screening.

Before we can understand the disease, let’s talk about blood sugar (also called blood glucose) and insulin. Every time you eat you are giving your body fuel so that it can perform all your favorite daily activities, just as filling your car with gas allows you to drive around to your favorite places. As your food gets broken down in your stomach, one of the important byproducts is blood sugar. Blood sugar is a vital component of energy for your body, but too much can cause major problems. This leads us to insulin. Insulin is a hormone made by the pancreas that helps to lower our blood sugar when it gets too high.

There are two types of diabetes, and we will talk briefly about each. In short, type 1 diabetes is caused because the pancreas can’t make any insulin, which results in high blood sugar. Type 2 diabetes, however, is caused because the body is not sensitive to the effects of insulin anymore, which results in high blood sugar. The overwhelming majority of American’s have type II diabetes.

What are some of the risk factors for diabetes?

The following are some of the things that may put you at risk for developing diabetes [3]

  • Having a family history of diabetes
  • Being overweight or obese
  • Being age 45 years or older
  • Being of African American, Native Alaskan, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
  • Having high blood pressure
  • Having high cholesterol
  • Having a history of gestational diabetes
  • Sedentary lifestyle
  • Having polycystic ovary syndrome

What kinds of problems can diabetes cause?

The following are some of the problems that uncontrolled diabetes can cause [1]:

  • Blindness
  • Limb Amputation
  • Kidney Failure
  • Vascular and Heart Disease
  • Nerve Problems
  • Delayed Wound Healing

So, diabetes can cause some major problems. Is it treatable? And what can I do to see if I am at risk?

The great news is YES! Diabetes can be treated and well controlled! The easiest and most important way to know if you are at risk for diabetes is to talk with your healthcare provider here at Cedar Park Pediatric and Family Medicine. As part of your annual wellness visit, we will look at your whole picture of health and screen you for diabetes by checking your fasting blood sugar. If you haven’t yet, take a moment today to advocate for your health by scheduling your annual wellness visit!

About the Author

Andrew Kester FNP Portrait Main web version


Andrew Kester, FNP-C, is a certified Nurse Practitioner on the Family Medicine team at Cedar Park Pediatric & Family Medicine.





Zika Prevention in Children

zika_mosquito-335x189Everywhere you turn these days, the spread of the Zika virus is talked about in the media.  Recently it has even been identified in Texas, primarily in the Rio Grande Valley region. With it encroaching so close to home, we thought it wise to review how it spreads, what the symptoms are and what can be done to prevent it.

As most of you probably know, Zika is contracted when humans are infected by mosquitoes. Humans can then spread it from person to person through blood transfusion, mother to baby in utero and sexual contact.

Symptoms associated with a Zika viral infection are relatively mild, and in fact, many experience no symptoms at all. For those that do show signs, the illness may entail a fever, rash, joint pain and red eyes which lasts approximately 3-7 days. The scare associated with Zika stems around an increase of newborn microcephaly believed to be associated with a Zika virus outbreak in Brazil starting in 2015.

To prevent the contraction of Zika virus, the CDC recommendations taking steps to prevent mosquito bites by following these recommendations:

  • Wear protective clothing including long sleeve shirts, pants, socks and hats to create a physical barrier from mosquitoes.
  • Use mosquito-repellent clothing treated with permethrin which lasts for 6 washes.
  • Avoid being outside during sunrise and sunset when the insects are most active.
  • The current AAP and CDC recommendation for children older than 2 months of age is to use 10% to 30% DEET. DEET should not be used on children younger than 2 months of age.
  • The effectiveness is similar for 10% DEET and 30% DEET but the duration of effect varies. Ten percent DEET provides protection for about 2 hours, and 30% protects for about 5 hours. Choose the lowest concentration that will provide the required length of coverage.
  • The concentration of DEET varies significantly from product to product, so read the label of any product you purchase.
  • As an alternative to DEET, Picaridin has become available in the U.S. in concentrations of 7% to 20%. Concentration of 7% Picardin provides protection for about 1-2 hours and 20% Picaridin provides 4-5 hours of protection. Picaridin is a synthetic compound developed from a plant extract from the genus Piper, the same genus that produces table pepper. Picaridin has been available since 1998 in Europe but was approved for sale in the U.S.A. only in 2005. AS with DEET, the EPA has concluded that the normal use of picaridin does not present a health concern. Picaridin is sometimes preferred over DEET because it is odorless, non-greasy, and does not dissolve plastics or other synthetics. Repellents that include picaridin include Cutter Advanced, Sawyer Premium and Repel Smart Spray.
  • With any type of insect repellent, remember not to apply to a child’s hands, eyes, mouth, or cut or irritated skin.
  • And finally, children should wash off repellents when they return indoors.

For further questions/concerns regarding Zika and its prevention, please do not hesitate to consult your pediatrician.


What’s that rash? Have you had your shingles vaccine?

shingles vaccineHerpes zoster, or more commonly known as “Shingles” affects almost 1 in every 3 people in the United States in their lifetime.  Anyone who has ever recovered from the chickenpox may develop shingles, even children. However, the risk of shingles increases with age.  Almost half of cases are seen in individuals 60 years and older.  Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from VZV the virus stays inactive or dormant in the body and the virus can reactivate years later.

Symptoms of shingles include a very painful rash that develops on one side of the face or body. The rash forms blisters which may burst, and scab over in 7-10 days and clears up within 4 weeks. Before the rash develops you may have pain, itching, burning, or tingling to the area. This can happen anywhere between 1-5 days prior to the rash occurring. Most commonly, the rash occurs in a stripe pattern on one side of the body. It can also cause fever, headaches, chills, upset stomach, and fatigue.

Shingles cannot be passed on from one person to another. HOWEVER – the virus that causes shingles, VZV, can spread to another person with active shingles who has never had chickenpox. In this case, the person may develop chickenpox, but not shingles. The virus is spread through direct contact with fluid from the blisters. A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear and once the rash has developed crusts. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

  • Avoid touching or scratching the rash
  • Wash your hands often to prevent the spread of VZV
  • Until the rash has developed crusts, avoid contact with those who:
    • Are pregnant who have never had chickenpox or the vaccine,
    • Premature or low birth weight infants,
    • Have weakened immune systems (chemotherapy, immunosuppressant medications, HIV)

Treatment for shingles includes antiviral medications, which shorten the length and severity of the illness. Medication must be started as soon as possible after the rash appears. If you, or someone you know thinks they have shingles, contact our office for an evaluation appointment as soon as possible.

You can reduce your risk for developing shingles and long term pain from shingles by vaccination. The Center for Disease Control recommends that individuals age 60 and over get one dose of the shingles vaccination. If you, or someone you know is interested in the shingles vaccination contact our office at 512-336-2777 to schedule a wellness visit so we can discuss the vaccine, along with other vaccinations and screening measures for your age.  Here is more information on the vaccination. (http://www.cdc.gov/vaccines/hcp/adults/downloads/fs-shingles.pdf)

Center for Disease Control. Shingles (Herpes Zoster). http://www.cdc.gov/shingles/index.html (2016).

National Foundation for Infectious Diseases. Shingles (Herpes Zoster). http://www.nfid.org/idinfo/shingles.aspx. (2016)

About the Author: Ashley Hollister, FNP-C is a Nurse Practitioner on the Family Medicine team at Cedar Park Pediatric & Family Medicine. She is currently accepting new patients.


What you need to know about Zika virus:

Zika virus is spread to people primarily through mosquito bites. The most common symptoms of Zika virus disease are:zika

  • Fever
  • Rash
  • Joint pain
  • Conjunctivitis (red eyes)

The illness is usually mild with symptoms lasting from several days to a week and can generally be managed at home with symptomatic treatment alone, similar to the common cold.  Antibiotics do not treat Zika.  Severe disease requiring hospitalization is uncommon.  If you feel your symptoms are severe, we are available with same day appointments to see you and provide guidance.  For an appointment with one of our Family Medicine providers, call 512-336-2777, option 1.

Other online resources on Zika virus:

Author: Cameron T. King, MD


Can Electronic Cigarettes, “E-Cigs”, Really Help Me Quit Smoking?


Are you looking to quit smoking? That’s great news! Giving up smoking is an extremely tough decision to make (and keep), but one that has incomparable health benefits for the short and long term.

There are many ways you can quit smoking that range anywhere from quitting cold turkey, weaning yourself via nicotine patches and gum, to medications prescribed from your family provider. One speculated way of quitting that has gained popularity over the past few years is the use of electronic cigarettes or “e-cigs”. I would like to clear some misconceptions about the use of these products and hopefully provide good information that helps consumers make educated and accurate decisions about their quitting tools.

What are e-cigs?
E-cigs are battery operated, hand held devices that vaporize nicotine and other chemicals for inhalation. They were first introduced into the U.S. market in 2006 and have been gaining acceptance over the past few years. When exhaled, the vapor looks similar to smoke and has gained the nickname of “vaping”.

What is the controversy behind e-cigs?
You may have heard the many arguments behind whether e-cigs can truly help people quit smoking, or whether that is simply a marketing ploy. The producers of e-cigs and those that provide accessories to the product hold fast to the claims that they are “healthier” than traditional cigarettes because “[they] deliver nicotine without the thousands of known and unknown toxicants in tobacco smoke” (Cahn & Siegel, para. 3, 2011). However, a 2014 study revealed higher voltage e-cigs have higher levels of formaldehyde and other toxic carcinogens (American Lung Association (ALA), 2015).

E-cigs are currently not regulated by the Food and Drug Administration (FDA), which means it is unknown how much nicotine or other harmful chemicals are being ingested during use (FDA, 2014). This means e-cig vapor contents can vary across manufacturers, who are not required to disclose what exactly is in the vapor being sold. These chemicals are the same as those found in traditional cigarettes and have been known to be the cause of cancer related to tobacco smoking.

What are my other options then?

Thankfully, there are many other FDA regulated and medically approved options available for smoking cessation. First, talk with your family provider about your intentions. They will be able to discuss with you various alternatives that range from over the counter tools to prescribed medications. Smokefree.gov is an excellent website full of information from reputable sources that includes tips on how to adjust to life without smoking and how to manage withdrawal symptoms.

The first step is making the commitment and the second is making an informed plan of action!

Meredith Long is a Board Certified Family Medicine Nurse Practitioner at Cedar Park Pediatric & Family Medicine. She is currently accepting new patients.

At Cedar Park Pediatric & Family Medicine one of our goals is to provide relevant and accurate medical information for our patients and their families.
Cahn, Z. & Siegel, M. (2011). Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? Journal of Public Health Policy, 32, 16-31. doi: 10.1057/jphp.2010.41.Food and Drug Administration. (2014). Electronic cigarettes. Retrieved from http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm .

Food and Drug Administration. (n.d.) Ecigarettes. Retrieved from http://smokefree.gov/e-cigarettes

American Lung Association. (2015). American Lung Association Statement on E-Cigarettes. Retrieved from http://www.lung.org/stop-smoking/tobacco-control-advocacy/federal/e-cigarettes.html.

Turkey and ham and pie – OH MY!

TurkeyTrotThe average American gains one to two pounds (or more…) during the holiday season. While this may not seem like much, this weight does accumulate over time.

Here are a few tips to help you have a fun holiday season and stay healthy:

  • Don’t skip meals. Sometimes we skip meals to prepare for a large meal later in the day, however skipping meals can actually lead to over eating later in the day. Instead, have a healthy high fiber breakfast, including whole grains, fruits and vegetables.
  • Use a smaller plate. This can help with portion control. When serving buffet or family style, always start with salad or vegetables first. This can help one eat less calories overall.
  • Eat slowly, savor the meal. Wait at least 10 minutes before serving yourself more food. This will assure that you are still hungry prior to eating more.
  • Get Active! Make plans to participate in a community Turkey Trot before your big meal. It’s a great way to get the family active and earn those extra calories!  Check out the Cedar Park Turkey Day 5K or the Turkey Trot in Austin.

 Wishing everyone a Happy & Healthy holiday!


What you Need to Know about Screening for Cervical Cancer

iStock_000001840964XSmallOne of the primary ways to prevent cervical cancer is by having regular screenings to improve the chances of early detection. But how often do you need to be screened and at what age?

Our clinic follows The American Cancer Society, U.S. Preventative Task Force, and American College of Obstetricians and Gynecologists which recommends a cervical cancer screening (or pap smear) at the age of 21, regardless of sexual activity.

  • Women ages 21-29: Pap smear should be done every 3 years. This exam screens for abnormal cervical cells.
  • Women ages 30-65: Pap smear should be completed every 3 years but co-testing with HPV (human papilloma virus) should be completed once every 5 years.
  • Women over the age of 65: Screenings may stop with an adequate screening history, which includes 3 normal pap smears without a history of hysterectomy due to abnormal pap smear.

You can read more on cervical cancer screening guidelines on the Center for Disease Control website.

HPV Screening:

HPV (human papilloma virus) is very common in women under the age of 30. It is not useful to test women under the age of 30 for HPV because most HPV that is found will never cause long term health risks and your body will fight off the HPV within a few years.

Not all types of HPV can lead to cervical cancer. There are two different types of HPV, one type that places you at a higher risk for developing abnormal cervical cells and a low risk type which can cause other symptoms such as genital warts.

  • Women under the age of 30: HPV co-testing should not be completed.
  • Women ages 30-65: HPV is less common in women over the age of 30 who are at an increased risk for cervical cancer. HPV is also more likely to signal a health problem for these women, who may have had the virus for many years.

You can read more on HPV screening guidelines on the Center for Disease Control website at http://www.cdc.gov/vaccines/vpd-vac/hpv/

*Please keep in mind, guidelines are generalized to a large population and may be applied differently to an individual based on a variety of factors. Talk to your provider about what screening methods and recommendations apply to you.